Food Insecurity Is Associated with Depression Among a Vulnerable Workforce: Early Care and Education Workers

Abstract

Abstract Objectives The primary objective of this analysis was to explore the association between food insecurity and depression among early care and education (ECE) workers. Methods We conducted a cross-sectional analysis of baseline data collected from a study exploring the effects of wage on ECE centers and workers in Seattle and South King County, WA, and Austin, TX. We employed a logistic regression model to investigate the relationship between food insecurity (i.e., six-item U.S. Household Food Security Survey Module) and depression (i.e., Center for Epidemiologic Studies Depression Scale-Revised). Models controlled for age, marital status, birth country, race/ethnicity, number of children in the household, job title, average paid hours of work per week, highest level of education, total household income, and study site. In two separate models, an interaction term was used to assess whether food assistance participation and wage modified the association between food insecurity and depression. Results Our primary model included 313 ECE workers from 49 ECE centers in Seattle (40%), South King County (26%), and Austin (34%). Majority of participants were female, non-Hispanic White, born in the US, and did not have children. In our primary model, low and very low food insecurity, compared to normal food security, was associated with a 2.69 (95% Confidence Interval [CI]: 1.29, 5.63) and 4.95 (95% CI: 2.29, 10.67) higher odds of depression, respectively. The association between food insecurity and depression did not vary by participation in food assistance program(s) or median site wage. Conclusions Results suggest a dose-response relation between food insecurity and depression among a sample of predominantly female, non-Hispanic white, and low-wage ECE workers. Policies and center-level interventions that address both food insecurity and depression warrant consideration in order to improve the health vulnerable workforce, which ultimately is vital to delivering quality childcare. Funding Sources This research study was supported by a Robert Wood Johnson Foundation Evidence for Action grant, as well as a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant awarded to the Center for Studies in Demography and Ecology at the University of Washington.