Abstract
Objective: We aimed to explore the association between food insecurity and depression among early care and education (ECE) workers, a vulnerable population often working in precarious conditions. Design: We utilized cross-sectional data from a study exploring the effects of wage on ECE centers. Participants were enrolled between August 2017 and December 2018. Food insecurity was measured using the validated six-item U.S. Household Food Security Survey Module and participants were categorized as food secure (score = 0–1), low food security (score = 2–4), and very low food security (score = 5–6). Depression (defined as a score ≥ 16) was measured using the 20-item Center for Epidemiologic Studies Depression Scale-Revised. We employed a logistic regression model to examine the relationship between food insecurity and depression. All models controlled for marital status, nativity, race/ethnicity, number of children in the household, job title, weekly hours of work, education, income, and study site. Setting: Participants were from Seattle (40%) and South King County (26%), Washington, and Austin, Texas (34%). Participants: Participants included 313 ECE workers from 49 ECE centers. Results: A majority of participants were female, non-Hispanic White, born in the U.S., and did not have children. Compared to being food secure, very low and low food insecurities were associated with a 4.95 (95% confidence interval (CI): 2.29, 10.67) and 2.69 (95% CI: 1.29, 5.63) higher odds of depression, respectively. Conclusions: Policies and center-level interventions that address both food insecurity and depression may be warranted, in order to protect and improve the health of this valuable, yet vulnerable, segment of the U.S. workforce.
Highlights
The association between food insecurity and depression noted in our early care and education (ECE) sample is consistent with that of several previous studies that look at this association within vulnerable populations and predominantly female samples [4,5,18,35]
72 sample participants received benefits from any food assistance program, and only 12% of sample participants or household members (n = 34) were enrolled in Supplemental Nutrition Assistance Program (SNAP), which was much smaller than that of previous studies [2,3]. This may have been attributable to differences in SNAP eligibility requirements, as our study focused on ECE workers in only two states, rather than a nationally representative sample; our sample mostly consisted of working, able-bodied adults without dependents (ABAWD), who must abide by specific work requirements in order to receive SNAP benefits and are only eligible for SNAP benefits for three months in a three-year period [38,39]
This study found that food insecurity is associated with depression among a sample of ECE workers
Summary
In 2019, 10.5% of U.S households (13.7 million households) experienced low or very low food security, defined as households that lack stable access to sufficient food [1]. Prior studies find high prevalence rates of both food insecurity and depression among the early care and education (ECE) workforce [7,8,9], a vulnerable population who typically earns low wages, works long hours, and lacks fringe benefits [7,8]. Compared to national averages or women of similar demographics, this workforce has been found to have unhealthier diets, lower rates of physical activity, fewer hours of sleep, and higher rates of depression and diabetes [7,8] This population has a high prevalence of both food insecurity and depression [7,8,9]. A better understanding of this relationship is needed to inform interventions and policies that are designed to improve the health and well-being of the ECE workforce, which may benefit the workers themselves, as well as the children whom they care for [25,26]
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