Maternal depression, changing public assistance, food security, and child health status

Abstract

. Casey, P., Goolsby, S., Berkowitz, S., Frank, D., Cook, J., Cutts, D., Black, M.M., Zaldivar, N., Levenson, S., Heeren, T. & Meyers, A. ( 2004 ) 113 , 298 – 304 . Objective To examine the association of positive report on a maternal depression screen (PDS) with loss or reduction of welfare support and foods stamps, household food insecurity, and child health measures among children aged 36 months at six urban hospitals and clinics.Methods A convenience sample of 5306 mothers, whose children < 36 months old were being seen in hospital general clinics or emergency departments (EDs) at medical centres in five states and Washington, DC, were interviewed from 1 January 2000 until 31 December 2001. Questions included items on sociodemographic characteristics, federal programme participation and changes in federal benefits, child health status rating, child's history of hospitalizations since birth, household food security status and a three‐question PDS. For a subsample interviewed in the ED, whether the child was admitted to the hospital that day was recorded.Results Positive maternal depression screen status was associated with loss or reduction of welfare support and food stamps, household food insecurity, fair/poor child health rating and history of child hospitalization since birth but not low child growth status measures or admission to the hospital at the time of ED visit. After controlling for study site, maternal race, education and insurance type as well as child low birthweight status, mothers with PDS were more likely to report fair/poor child health [adjusted odds ratio (AOR) 1.58, 95% confidence interval (CI) 1.33–1.88] and hospitalizations during the child's lifetime (AOR 1.20, 95% CI 1.03–1.39), compared with mothers without PDS. Controlling for the same variables, mothers with PDS were more likely to report decreased welfare support (AOR 1.52, 95% CI 1.03–2.25), to have lost food stamps (AOR 1.56, 95% CI 1.06–2.30), and reported more household food inseurity (AOR 2.69, 95% CI 2.33–3.11) than mothers without PDS.Conclusion Positive maternal depression screen status noted in paediatric clinical samples of infants and toddlers is associated with poorer reported child health status, household food insecurity, and loss of federal financial support and food stamps. Although the direction of effects cannot be determined in this cross‐sectional survey, child health providers and policy makers should be aware of the potential impact of maternal depression on child health in the context of welfare reform.