Material Hardship and Child Socioemotional Behaviors: Differences by Types of Hardship, Timing, and Duration

"Growing up under pressure": The family stress model and its role in psychological aggression and physical assault across early and late childhood

BACKGROUND

As economic pressures on families intensify, the pathways through which material hardship shapes parental behavior and child outcomes become increasingly critical to understand.

OBJECTIVE

Building upon the Family Stress Model (FSM), we examined the combined influence of material hardship, parental aggravation, and neighborhood efficacy on child maltreatment risks. We hypothesized that these pathways would differ in strength between early and late childhood.

METHODS

We conducted multiple linear regression analysis with RStudio using waves 3 and 6 of the Future of Families and Child Wellbeing Study (n = 3830) data.

RESULTS

Material hardship significantly predicted both psychological aggression (β = 0.20, p < .001) and physical assault (β = 0.22, p < .001) in early childhood, while its influence diminished in late childhood, remaining significant only for psychological aggression (β = 0.22, p < .001). Parental aggravation showed similar patterns, with stronger effects in early childhood for both outcomes (β = 0.18 and β = 0.15, respectively, p < .001) but maintaining significance only for psychological aggression in late childhood (β = 0.15, p < .001).

CONCLUSIONS

These findings extend the FSM by demonstrating that the transmission of family stress varies substantially across developmental stages, with early childhood emerging as a period of heightened vulnerability. The enduring impact of psychological aggression through adolescence, coupled with declining physical assault, exposes how different forms of maltreatment follow unique age-related patterns - a finding that challenges traditional 'one-size-fits-all' interventions approaches. Hence, we suggest developmentally tailored interventions that address both immediate material needs and parental stress management, particularly during early childhood when the impact of these stressors are strongest.

The double jeopardy of low family income and negative emotionality: The family stress model revisited

The family stress model has, for decades, guided empirical work linking poverty with increased risk of child social-emotional dysfunction. The present study extends this line of work by examining whether child negative emotionality moderates associations between family income, family stress (maternal distress, parental locus of control, and relationship dissatisfaction), and later externalizing and internalizing behavior problems. In a longitudinal population-based sample (n ~ 80,000) of Norwegian children followed from birth through age five (The Norwegian Mother, Father, and Child Cohort Study; MoBa), we examined whether high (vs. moderate or low) negative emotionality families would display: (a) compounding stress (i.e., particularly strong associations between low family income and family stress), (b) diathesis-stress (i.e., particularly strong associations between family stress and behavior problems), or (c) double jeopardy (i.e., both compounding stress and diathesis-stress moderating effects). Negative emotionality significantly moderated the association between family income and behavior problems in a manner most consistent with double jeopardy. As a result, compared with children with moderate/low negative emotionality, the family income-behavior problems association was two to three times larger for those with higher negative emotionality. These findings underscore the active role children may play in family processes that link low family income with behavior problems.

Economic hardship and adolescent behavioral outcomes: Within- and between-family associations

Understanding how youth perceive household economic hardship and how it relates to their behavior is vital given associations between hardship and behavioral development. Yet, most studies ignore youth's own perceptions of economic hardship, instead relying solely on caregiver reports. Moreover, the literature has tended to treat economic hardship as a stable force over time, rather than a volatile one that varies month-to-month. This study addressed extant limitations by collecting monthly measures of economic hardship, specifically caregiver- and youth-reported material deprivation and youth-reported financial stress, and youth internalizing and externalizing problems from 104 youth-caregiver dyads (youth: 14-16 years, 55% female, 37% Black, 43% White) over nine months. We examined month-to-month variability of these constructs and how youth-reports of material deprivation and financial stress predicted their behavior problems, controlling for caregiver-reports of material deprivation. We found that hardship measures varied month-to-month (ICCs = 0.69-0.73), and youth-reported material deprivation positively predicted internalizing when examining both within- and between-individual variability (β = .19-.47). Youth-reported financial stress positively predicted within-individual variation in externalizing (β = .18), while youth reports of material deprivation predicted externalizing when looking between families (β = .41). Caregiver-reported material deprivation was unrelated to youth behavior when accounting for youth perceptions of economic hardship.

The Association Between Early Family Social Stressors and Emotional Well-Being Among Infants and Toddlers

OBJECTIVE

Early childhood behavioral and emotional disorders are linked to diagnosable mental health problems both later in childhood and into adulthood. However, little work has examined the association between family social stressors and emotional well-being among children under two years of age, including whether differences exist between infancy and toddlerhood.

METHODS

Data come from the nationally representative 2019-2022 National Health Interview Survey, an annual, cross-sectional survey conducted by the National Center for Health Statistics. Separate multivariate logistic regression models estimated associations between family social stressors (stressful life events, family food insecurity, family difficulty paying medical bills) and having a Baby Pediatric Symptom Checklist (BPSC) subscale score of 3 or more ("above the BPSC cutoff") for poorer emotional well-being among children 2-23 months. Models were additionally stratified by age group (infants, 2-11 months; toddlers, 12-23 months), and adjusted for child and family sociodemographic and geographical characteristics.

RESULTS

Children who had experienced a stressful life event (AOR=3.83, 95% CI: 2.48-5.92), family food insecurity (AOR=1.69, 95% CI: 1.13-2.51), or family difficulty paying medical bills (AOR=2.10, 95% CI: 1.54-2.87) had higher odds of being above the BPSC cutoff, adjusted for all relevant covariates. Toddlers who experienced a stressful life event (66.5% vs 41.0%) or family difficulty paying medical bills (53.1% vs 29.8%) had higher odds of being above the BPSC cutoff compared with infants.

CONCLUSIONS

Family social stressors were linked to poorer emotional well-being among young children. Future research may benefit from the exploration of additional predictors of emotional well-being among this age group.

Evaluating the long-term effects of income assistance for material hardship among families with children

Background

As a key aspect of poverty, material hardship describes day-to-day struggles in affording necessities. In explorations of policy initiatives that mitigate material hardship, evidence suggests direct income support can be effective in alleviating hardship. However, research investigating the long-term effects of income supports is limited, and it remains uncertain as to how benefit receipt may mitigate material hardship for families with children across time.

Methods

To explore the associations between income assistance and material hardship longitudinally, we utilised data from four waves of the Growing Up in New Zealand birth-cohort study (n = 5964), where family experiences were tracked between birth and adolescence. The variables of interest included mother-reported receipt of income benefits and material hardship from when the children were aged 9-months, 54-months, 8-years, and 12-years. Multilevel logistic regression analysis was employed to examine the associations between benefit receipt and material hardship in the short- and long-term. Interaction terms between benefit receipt and time were incorporated in the modelling to determine whether receiving benefits corresponded with significant changes in the likelihood of experiencing material hardship at specific time points.

Results

The key results suggest that benefit receipt in early childhood reduced the likelihood of experiencing material hardship at subsequent time points at least until adolescence, when controlling for key sociodemographic characteristics.

Conclusion

These findings provide insight into the associations between early childhood income supports and reductions in the likelihood of experiencing material hardship in the long-term, to emphasise the potential for such interventions to have longstanding effects. By elucidating the associations between benefit receipt and subsequent material hardship, this research gives direction for policy interventions and timely support for families.

Food insecurity and quality of life in patients with sickle cell disease

Little is known about the relationship between quality of life (QOL) and food insecurity (FI) among patients with sickle cell disease (SCD). We hypothesized FI is associated with lower QOL in children and young adults with SCD. Overall (N = 99), 22% screened positive for FI. Supplemental Nutrition Assistance Program (SNAP) enrollment was 50 and 71% among people from food secure and FI households, respectively. A higher FI score was correlated with lower overall QOL (r = -0.22, p = .03), specifically lower QOL in worry and communication domains. Interventions for FI beyond SNAP may be important for QOL among people living with SCD.

Latent classes and longitudinal patterns of material hardship as predictors of child well-being

This study examined the associations of multifaceted material hardship measured cross-sectionally and longitudinally with children's wellbeing in the United States. Results from linear regression and child fixed effects models indicated that more intense material hardship had consistent, detrimental associations with child health status and internalizing and externalizing behaviors. More intense longitudinal patterns of material hardship were consistently associated with behaviors only. These findings examine new, multifaceted measures of material hardship and suggest associations between child wellbeing, particularly behavior challenges, and exposure both to multiple forms of material hardship and to more intense long-term patterns of hardship.

Making a way out of no way: The importance of improving financial instability among African American kinship care families

Close attention should be given to the increased reliance on kinship care to provide out-of-home care for vulnerable children and youth because although these families have various strengths, they also frequently face financial instability and experience material hardship. Living in poverty and experiencing material hardship are linked to an array of negative outcomes, including physical and mental health problems, elevated parental stress, and children's academic difficulties and social and behavioral problems. This study examined African American families who are providing informal kinship care with the aim of developing a nuanced understanding of the financial characteristics, challenges, and coping strategies of these families. Data for this study were obtained from two sources: (1) an exploratory sequential mixed-method pilot study and (2) the National Financial Capability Study. It was found that most caregivers in the pilot reported their family resources were only seldom or sometimes adequate to cover their household's basic needs. Some caregivers reported being unaware of public benefits and community resources available for kinship care families, and they had difficulties navigating the system. Additionally, family members' love and support for each other helped them to cope with financial instability. Using a nationally representative dataset, predicted probabilities for three types of financial instability were higher among households with demographic characteristics of kinship care families including difficulty covering expenses, having income that exceeds expenses, and having emergency savings. Implications for practice, policy, and future research are discussed.

The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes

Introduction

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes.

Methods

This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level.

Results

Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress.

Discussion

These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

The mediating role of neighborhood social cohesion and trust in the relationship between childhood material hardship and adolescent depression

OBJECTIVE

The purpose of this study is to examine the association between childhood material hardship and adolescent depression and how the relationship is mediated by neighborhood social cohesion and trust. Previous studies on childhood material hardship and adolescent depression have consistently pointed to the importance of social and environmental contexts in explaining health inequalities among children in socially disadvantaged families. However, little is known about the extent to which neighborhood social context contributes to increasing or decreasing the strength of the association between childhood material hardship and adolescent depression.

METHOD

Using data from the Future of Families and Child Wellbeing Study (FFCWS) waves 3 and 6, this study conducted Structural Equation Modeling (SEM) analysis to examine whether levels of neighborhood social cohesion and trust mediates the association between childhood material hardship and adolescent depression. The study sample consisted of 2,096 children at age 3 and 15.

RESULTS

Findings from the SEM analysis suggest that childhood material hardship is linked with higher levels of adolescent depression and this pathway is partially mediated by neighborhood social cohesion and trust.

DISCUSSION

Results suggest that neighborhood conditions played a role in mediating the association between childhood material hardship and adolescent depression. The implications of the findings are discussed in relation to policy and practice.

Antenatal and early childhood exposures associated with non-fatal infant injury: evidence from a longitudinal birth cohort in New Zealand

OBJECTIVE

To identify antenatal and early childhood exposures of unintentional injury among infants in New Zealand (NZ).

METHOD

The theoretical life-course framework of child injury prevention domains was utilised to analyse data from a prospective longitudinal NZ birth cohort (Growing Up in NZ). Risk and protective factors for injury were identified using Robust Poisson regression models.

RESULT

Among children included for the analysis(n=6304), 52% were male, 55% were born to European mothers, and 37% lived in a household with high levels of deprivation. Mothers reported that 6% of infants (n=406) had sustained at least one injury by 9 months. Multivariate analysis showed injury risk among single mothers with antenatal depression were more than twice that (IRR=2.20) of children of mothers with partners and without depression.

CONCLUSION

Understanding antenatal risk and protective factors for infant injury will assist in implementing injury prevention programmes or modifying the existing policies that affect these vulnerable age groups.

Children's ethnic-racial identity and mothers' cultural socialization as protective in relations between sociocultural risk factors and children's internalizing behaviors

OBJECTIVES

The present study examined whether sociocultural risk factors (i.e., mothers' risky behaviors, mothers' and grandmothers' ethnic discrimination, and family economic hardship) predicted children's internalizing behaviors. We also tested whether sociocultural protective factors, including children's positive ethnic-racial identity (ERI) attitudes and mothers' cultural socialization, moderated relations.

METHOD

Participants were 182 5-year-old Mexican-origin children, their mothers, and grandmothers.

RESULTS

Findings indicated that children's positive ERI attitudes were protective, such that grandmothers' discrimination predicted children's greater internalizing at low levels of children's positive ERI attitudes, but this relation was not significant at high levels of children's positive ERI attitudes. Mothers' cultural socialization was also protective, such that mothers' risky behaviors predicted children's greater internalizing at low levels of mothers' cultural socialization, but this relation was not significant at high levels of mothers' cultural socialization. Economic hardship predicted children's greater internalizing and no variables moderated this relation.

CONCLUSIONS

Findings highlight that mothers' engagement in risky behaviors, grandmothers' ethnic discrimination experiences, and family economic hardship contribute to children's greater internalizing behaviors. However, in some of these relations, children's positive ERI attitudes and mothers' cultural socialization are protective. In future research and programming, a consideration of the role of individual, family, and cultural factors will be important for addressing and reducing children's internalizing behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Early life stress, prenatal secondhand smoke exposure, and the development of internalizing symptoms across childhood

BACKGROUND

Prior findings relating secondhand tobacco smoke (SHS) exposure and internalizing problems, characterized by heightened anxiety and depression symptoms, have been equivocal; effects of SHS on neurodevelopment may depend on the presence of other neurotoxicants. Early life stress (ELS) is a known risk factor for internalizing symptoms and is also often concurrent with SHS exposure. To date the interactive effects of ELS and SHS on children's internalizing symptoms are unknown. We hypothesize that children with higher exposure to both prenatal SHS and ELS will have the most internalizing symptoms during the preschool period and the slowest reductions in symptoms over time.

METHODS

The present study leveraged a prospective, longitudinal birth cohort of 564 Black and Latinx mothers and their children, recruited between 1998 and 2006. Cotinine extracted from cord and maternal blood at birth served as a biomarker of prenatal SHS exposure. Parent-reported Child Behavior Checklist (CBCL) scores were examined at four timepoints between preschool and eleven years-old. ELS exposure was measured as a composite of six domains of maternal stress reported at child age five. Latent growth models examined associations between SHS, ELS, and their interaction term with trajectories of children's internalizing symptoms. In follow-up analyses, weighted quintile sum regression examined contributions of components of the ELS mixture to children's internalizing symptoms at each time point.

RESULTS

ELS interacted with SHS exposure such that higher levels of ELS and SHS exposure were associated with more internalizing symptoms during the preschool period (β = 0.14, p = 0.03). The interaction between ELS and SHS was also associated with a less negative rate of change in internalizing symptoms over time (β=-0.02, p = 0.01). Weighted quintile sum regression revealed significant contributions of maternal demoralization and other components of the stress mixture to children's internalizing problems at each age point (e.g., age 11 WQS β = 0.26, p < 0.01).

CONCLUSIONS

Our results suggest that prior inconsistencies in studies of SHS on behavior may derive from unmeasured factors that also influence behavior and co-occur with exposure, specifically maternal stress during children's early life. Findings point to modifiable targets for personalized prevention.

Examining mechanisms linking economic insecurity to interparental conflict among couples with low income

Objective

The current study used the family stress model to test the mechanisms by which economic insecurity contributes to mothers' and fathers' mental health and couples' relationship functioning.

Background

Although low household income has been a focus of poverty research, material hardship-defined as everyday challenges related to making ends meet including difficulties paying for housing, utilities, food, or medical care-is common among American families.

Methods

Participants were from the Building Strong Families project. Couples were racially diverse (43.52% Black; 28.88% Latinx; 17.29% White; 10.31% Other) and living with low income (N = 2,794). Economic insecurity included income poverty and material hardship. Bayesian mediation analysis was employed, taking advantage of the prior evidence base of the family stress model.

Results

Material hardship, but not income poverty, predicted higher levels of both maternal and paternal depressive symptoms. Only paternal depressive symptoms were linked with higher levels of destructive interparental conflict (i.e., moderate verbal aggression couples use that could be harmful to the partner relationship). Mediation analysis confirmed that material hardship operated primarily through paternal depressive symptoms in its association with destructive interparental conflict.

Conclusion

The economic stress of meeting the daily material needs of the family sets the stage for parental mental health problems that carry over to destructive interparental conflict, especially through paternal depressive symptoms.

Implications

Family-strengthening programs may want to consider interventions to address material hardship (e.g., comprehensive needs assessments, connections to community-based resources, parents' employment training) as part of their efforts to address parental mental health and couples' destructive conflict behaviors.

The effects of housing insecurity on children's health: a scoping review

There is a well-established connection between housing conditions and children's health. However, little is known on how housing insecurity indicators including, multiple moves, being behind on rent/mortgage, doubling up and crowding, affect child health. The purpose of this paper is to identify how pathways of association between housing insecurity and health may become established during childhood, using evidence from the literature. Using the Joanna Briggs Institute framework for scoping reviews, a search was conducted using key terms associated with housing insecurity and health among children. Twenty-seven articles were included in the review. Forty-six outcomes related to child health were identified throughout the articles. Physical health was the most commonly examined outcome in these articles. Multiple moves was the most common housing insecurity indicator associated with health. This review identified multiple studies showing negative associations between housing insecurity and poorer health-related indicators among children. Results from this review provide important information on the implication of certain housing insecurity indicators for children's health. Although housing is increasingly recognized as a social determinant of health, it may be particularly important to go beyond physical housing conditions to consider and measure housing insecurity in future work, as a key social determinant shaping health in pediatric populations.

Prevalence and factors associated with multidimensional child deprivation: Findings from the Future of Families and Child Well-Being Study

Despite the growing importance of the multidimensional methods of assessing child poverty, few studies in the U.S. have applied a rights-based approach to examining child deprivation. This study examines multidimensional child deprivation using eight dimensions and twelve indicators based on the Convention on the Rights of the Child (CRC). Using a sample of children at age nine from the fifth wave of the Future of Families and Child Well-being Study, this study applied the multiple overlapping deprivation analysis (MODA), a comprehensive analytic method to assess the multidimensionality of child deprivation and to provide a detailed picture of material and social forms of deprivation among the U.S. children. This study found that the overall child deprivation rate was 8.89%; environmental safety (20.36%), information (15.94%), and housing security (14.23%) dimensions contributed the highest to the overall child deprivation; the overlap between deprivation and income poverty was 12.83%. Results suggest that understanding multifaceted and interrelated contexts of child deprivation is crucial to promote child rights.

Needs of Caregivers of Youth Enrolled in a Statewide System of Care: A Latent Class Analysis

Objective

Systems of care (SOC) provide a coordinated array of services to youth with serious emotional and behavioral problems and their families. Little is known about what caregiver-specific needs at presentation to care may contribute to use of and engagement with care coordination and subsequent youth and family outcomes. This study aimed to determine latent classes of youth enrolled in wraparound care coordination within a statewide SOC based on caregiver needs impacting youth functioning and identify the relationship between class membership and characteristics of participation in Child and Family Team meetings (CFTs) and mental health outcomes at six-month follow-up.

Method

Participants were 703 youth (Mage = 11.21, SD = 3.67) and their caregivers that had information about caregiver needs and received a six-month follow-up assessment. Latent class analysis determined latent classes of families based on caregiver service needs at presentation to care, and differences in participation in care coordination and youth outcomes at 6-month follow up based on class membership was examined.

Results

Results indicated four classes of caregivers: Physical Health Needs, No Needs, Basic Needs, and Mental Health/Trauma Needs. Class membership was associated with size of the CFT, number of CFTs attended by the youth, percentage of CFTs with a natural support present, and percentage of CFTs that occurred in the family's home. Class membership was associated with caregiver ratings of objective strain at 6-month follow-up.

Conclusion

Assessing caregiver needs at presentation to care can provide direction for care coordinators to more directly target areas of family need through wraparound and individualize services.

Childhood food insecurity, mental distress in young adulthood and the supplemental nutrition assistance program

Food insecurity affects 14% of US homes with children and has been associated with increased mental health problems. Few studies have examined long-term consequences for mental health and the role of social policies. This study examined the association between childhood household food insecurity (HHFI) and young adult psychological distress, and the moderating role of caregiver psychological distress and the Supplemental Nutrition Assistance Program (SNAP) using data from the Panel Study of Income Dynamics (1995-2015). The sample comprised 2782 children ages 0-12 years in 1997. Past-year HHFI was measured using the USDA 18-item questionnaire in 1997, 1999, 2001 and 2003. Young adults' non-specific psychological distress was measured with the Kessler (K6) scale in 2005, 2007, 2009, 2011, 2013 and 2015. Three trajectories of food insecurity were identified: 1) Persistent food security (70.5%); 2) Intermediate/fluctuating food insecurity (24.6%), and; 3) Persistent food insecurity (4.9%). Compared to persistent food security, fluctuating and persistent food insecurity were associated with significantly higher levels of psychological distress. This association was robust to adjusting for socio-demographic factors, caregiver psychological distress, and family access to governmental supports: [Adj. ORs (95% CI's = 1.72 (1.59-1.85) and 2.06 (1.81-2.33)]. Having a caregiver who suffered from psychological distress (1997 and/or 2002) and growing up with persistent food insecurity placed children at greater risk for mental health problems. Access to SNAP attenuated this risk. Early HHFI is associated with psychological distress in young adulthood. Interventions to increase access to SNAP and address caregivers mental health may prevent mental health problems associated with childhood HHFI.

Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers

Latinx families may be particularly vulnerable to emotional dysfunction, due to higher rates of economic hardship and complex social influences in this population. Little is known about the impact of environmental stressors such as unmet social needs and maternal stress on the emotional health of Latinx children from low-income families. We conducted secondary analyses using survey and biomarker data from 432 Latinx children and mothers collected in a separate study. We used binomial and multinomial logistic regression to test if household social needs, or maternal perceived stress or hair cortisol concentration (HCC), predicted child measures of emotional functioning or child HCC, independent of relevant sociodemographic factors. Approximately 40% of children in the sample had symptoms consistent with emotional dysfunction, and over 37% of households reported five or more social needs. High perceived maternal stress predicted higher odds of child emotional dysfunction (OR = 2.15; 95% CI [1.14, 4.04]; p = 0.01), and high maternal HCC was positively associated with high child HCC (OR = 10.60; 95% CI [4.20, 26.74]; p < 0.01). Most individual household social needs, as well as the level of household social need, were not independently associated with child emotional dysfunction or child HCC. Our findings begin to define a framework for understanding emotional health, stress, and resilience when caring for Latinx children and mothers living with high levels of social need, and the need for integrated mental health and social needs screening and interventions in settings that serve this population.

Hardship in the Heartland: Associations Between Rurality, Income, and Material Hardship

One in three U.S. households has experienced material hardship. The inadequate provision of basic needs, including food, healthcare, and transportation, is more typical in households with children or persons of color, yet little is known about material hardship in rural spaces. The aim of this study is to describe the prevalence of material hardships in Iowa and examine the relationship between rurality, income, and material hardship. Using data from the 2016 State Innovation Model Statewide Consumer Survey, we use logistic regression to examine the association between rurality, income, and four forms of material hardship. Rural respondents incurred lower odds than non-rural respondents for all four hardship models. All four models indicated that lower income respondents incurred greater odds for having material hardship. Material hardship was reported across all groups, with rurality, income, race, and age as strong predictors of material hardship among our sample.

Informal caregiving and the risk of material hardship in the United States

Millions of people in the United States provide unpaid care to family and friends with long-term illnesses and disabilities. Research shows that informal caregiving can be beneficial for recipients of care, but taxing for those providing care. Studies have not explored associations between informal caregiving and the risk of experiencing different forms of material hardship. In this study, we use data from the Survey of Income and Program Participation (N = 31,633) to address this gap in the literature. The sample was drawn from a multistage-stratified sample of the civilian, non-institutionalised population of the United States. We analyse data that were collected in 2011 and find that providing informal care to others is associated with an increased risk of experiencing healthcare hardship, bill-paying hardship and food insecurity. Moreover, we find that household financial resources mediate the association between caregiving and material hardship. As a result, while caregiving households face a higher risk of experiencing material hardships at all income levels, the disparity is largest at low incomes and smallest at high incomes. The findings highlight the need for a stronger safety net for informal caregivers.

Longitudinal Patterns of Material Hardship among US Families

Material hardship has emerged as a direct measure of deprivation in the United States and an important complement to income poverty, providing different evidence about the ways in which deprivation may affect wellbeing. This study addresses gaps in our knowledge about deprivation as the first to examine patterns of material hardship over time. Using data from the Fragile Families and Child Well-Being Study, this study examined five material hardship types (food, housing, medical, utility, and bill-paying) experienced at five timepoints over 15 years. Employing latent class analysis and latent transition analysis, this study identified six longitudinal patterns of material hardship experience, characterized by trajectories of stability or movement and relative severity of material hardship experience over time. These findings improve our conceptual understanding of deprivation and move us towards understanding the impacts of material hardship on wellbeing and identifying policy approaches to prevent deprivation or mitigate negative consequences.

Material hardship level and unpredictability in relation to U.S. households' family interactions and emotional well-being: Insights from the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has been recognized to provide rare insight to advance the scientific understanding of early life adversity, such as material hardship. During the COVID-19 pandemic, material hardship (i.e., difficulty paying for basic needs) in families of young children has had detrimental effects on caregivers' and children's well-being. In addition to the degree of material hardship, the week-to-week and month-to-month unpredictability of hardship status may add to families' stress and worsen well-being. This study examined the magnitude of and mechanisms underlying the effects of material hardship level and unpredictability on the well-being of U.S. households with young children during the pandemic.

METHODS

Data were drawn from the RAPID project, a large ongoing national study that used weekly/biweekly online surveys to investigate the pandemic impact on U.S. households with young children. The current study leveraged data from 4621 families who provided at least three responses between April 2020 and October 2021.

RESULTS

Findings indicated that racial/ethnic minorities and lower-income households experienced higher levels of material hardship and unpredictability during the pandemic, compared to their White or higher-income counterparts. Levels of pandemic-related material hardship and hardship unpredictability were both significantly associated with worsened well-being among caregivers and children. Finally, the effects of hardship level and unpredictability on well-being outcomes were partially mediated through disrupted family routines.

CONCLUSIONS

The findings from this study highlight that ensuring equal and adequate access to financial resources, as well as promoting financial stability for households with young children are both critical for maintaining functional family dynamics and promoting caregivers' and children's optimal well-being.

Poverty, Material Hardship, and Children's Outcomes: A Nuanced Understanding of Material Hardship in Childhood

There are four distinct, related types of material hardship-basic expense hardship, food insecurity, housing hardship, and medical hardship. Extant research has not sufficiently accounted for the complex relationships between these different types of material hardship. Using 1997 and 2002 data from the Panel Study of Income Dynamics Child Development Study on a national sample of 3- to 17-year-old children (N = 3563), this study describes the prevalence of each type of material hardship, their relative correlations, and their associations with children's behavior problems, and reading and math scores. Material hardship is more prevalent than income poverty and the four types of material hardship were only moderately correlated with each other. Only basic expense hardship, food security, and one type of medical hardship were associated with increased behavior problems. Only housing hardship was associated with lower math and reading scores. These findings highlight the need to more carefully investigate the distinctions between material hardship types in childhood and the importance of a diversified set of policy responses to protect children from the possible effects of distinct, but interrelated experiences of material hardship.

What kind of "poverty" predicts CPS contact: Income, material hardship, and differences among racialized groups

•Differences in income explain some racial inequities in child welfare contact. •Differences in hardship do not explain racial inequities in child welfare contact. •Material hardship predicts child welfare contact across racialized groups.

Background and Purpose

Child protective services (CPS) contact is consistently linked with poverty in the US, and empirical evidence is mounting to indicate that disparate exposure to income poverty explains a substantial portion of racial inequities in CPS involvement. Evidence about the different distributions of income poverty and material hardship also suggests that income poverty may not sufficiently capture economic wellbeing among families. This paper assessed whether differences in exposure to income poverty and/or material hardship explain racial inequities in CPS contact and further examined whether income poverty and material hardship predict CPS contact differently within racialized groups.

Methods

We used data from the Fragile Families and Child Wellbeing Study (FFCWS), an urban cohort representative of births in large US cities in 1998–2000. The FFCWS data are ideal for this study in capturing each of the key constructs: racialized group membership, income, material hardship, and CPS contact. We measured income poverty and material hardship when children were age 1 and measured any CPS contact by age five. Our final sample included 3,517 families, including 1,848 Black, 614 white, and 1,055 Latinx families. We employed logistic regression to assess the associations between income poverty and material hardship, independently and jointly, and CPS contact. We conducted analyses in our full analytic sample and among subsamples of the Black, white, and Latinx families.

Results

We found that differences in income-to-poverty ratio account for differences in CPS contact between Black and white families. Differences in CPS contact between Black and Latinx families were not explained by economic wellbeing measures alone but were ameliorated when differences in income poverty, material hardship, and a full set of family characteristics were considered. Additionally, we found that material hardship was a consistent predictor of CPS contact in the full sample and within each of the Black, white, and Latinx subsamples, even accounting for differences in income and other family characteristics.

Conclusions

The clear role of income poverty in explaining inequities in CPS contact between Black and white families and the consistent importance of material hardship in predicting CPS contact across all families underscore the critical importance of reducing income poverty and hardship and of distinguishing material need from maltreatment in the context of CPS. Our findings offer clear implications for policy intervention to reduce income poverty and material hardship. Such interventions might include extending the temporarily expanded Child Tax Credit and expanded food and housing assistance benefits, toward the ends of supporting child and family wellbeing and reducing economic and racial inequities in CPS contact.

Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight

Although immigrant mothers from some Latinx subgroups initially achieve healthy birth outcomes despite lower socioeconomic status, this advantage deteriorates across generations in the United States. Interpersonal discrimination and acculturative stress may interact with economic hardship to predict an intergenerational cascade of emotional and biological vulnerabilities, particularly perinatal depression. Network analyses may elucidate not only how and which psychosocial experiences relate to depressive symptoms, but which symptom-to-symptom relationships emerge. This study aims to understand (1) how economic, acculturative, and discrimination stressors relate to prenatal depression and low birth weight and (2) how Latinas may respond to and cope with stressors by exploring symptom-symptom and symptom-experience relationships. A sample of 151 pregnant Latinas (predominantly foreign-born and Mexican and Central American descent) completed the EPDS and psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) during pregnancy (24-32 weeks). Birth weights were recorded from postpartum medical records. We created network models using the Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator to estimate the relationship between variables. Discrimination exposure connected psychosocial stressors to depressive symptoms, particularly worry, crying, sadness, and self-blame. Discrimination also revealed a connection between acculturation and low birth weight. Furthermore, younger age of migration and greater acculturation levels were correlated to greater discrimination stress and low birth weights. Perinatal research in Latinas must account not only for measures of cultural adaptation but recognize how developmental exposures across the life span, including discrimination, may be associated with adverse health trajectories for a mother and her child.

Differential Developmental Associations of Material Hardship Exposure and Adolescent Amygdala-Prefrontal Cortex White Matter Connectivity

Accumulating literature has linked poverty to brain structure and function, particularly in affective neural regions; however, few studies have examined associations with structural connections or the importance of developmental timing of exposure. Moreover, prior neuroimaging studies have not used a proximal measure of poverty (i.e., material hardship, which assesses food, housing, and medical insecurity) to capture the lived experience of growing up in harsh economic conditions. The present investigation addressed these gaps collectively by examining the associations between material hardship (ages 1, 3, 5, 9, and 15 years) and white matter connectivity of frontolimbic structures (age of 15 years) in a low-income sample. We applied probabilistic tractography to diffusion imaging data collected from 194 adolescents. Results showed that material hardship related to amygdala-prefrontal, but not hippocampus-prefrontal or hippocampus-amygdala, white matter connectivity. Specifically, hardship during middle childhood (ages 5 and 9 years) was associated with greater connectivity between the amygdala and dorsomedial pFC, whereas hardship during adolescence (age of 15 years) was related to reduced amygdala-orbitofrontal (OFC) and greater amygdala-subgenual ACC connectivity. Growth curve analyses showed that greater increases of hardship across time were associated with both greater (amygdala-subgenual ACC) and reduced (amygdala-OFC) white matter connectivity. Furthermore, these effects remained above and beyond other types of adversity, and greater hardship and decreased amygdala-OFC connectivity were related to increased anxiety and depressive symptoms. Results demonstrate that the associations between material hardship and white matter connections differ across key prefrontal regions and developmental periods, providing support for potential windows of plasticity for structural circuits that support emotion processing.

Differential Effects of Multiple Dimensions of Poverty on Child Behavioral Problems: Results from the A-CHILD Study

The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data from first-grade students who participated in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2015, 2017, and 2019 (N = 12,367) in Japan. Material deprivation was divided into life-related deprivation (i.e., lack of items for a living) and child-related deprivation (i.e., lack of children’s books, etc.), and low income was assessed via annual household income. We assessed child behavioral problems and prosocial behavior using the Strengths and Difficulties Questionnaire. One in ten children belonged to low-income families, 15.4% of children experienced life-related deprivation, and 5.4% of children experienced child-related deprivation. While life- and child-related deprivation had significant adverse effects on behavioral problems, they had no association with prosocial behavior. The effects of low income were mediated by parental psychological distress (45.0% of the total effect) and the number of consulting sources (20.8%) on behavioral problems. The effects of life-related and child-related deprivation were mediated by parental psychological distress (29.2–35.0%) and the number of consulting sources (6.4–6.9%) on behavioral problems. Life-related and child-related deprivation, but not low income, are important for child mental health.

Timing-specific associations between income-to-needs ratio and hippocampal and amygdala volumes in middle childhood: A preliminary study

It is well known that financial disadvantage is associated with alterations in brain development in regions critical to socioemotional well-being such as the hippocampus and the amygdala. Yet little is known about whether family income at different points in development is differentially associated with these structures. Furthermore, little is known about which environmental factors statistically mediate associations between income and subcortical structure. Using a longitudinal birth cohort and linear mixed-effects models, we identified associations between income-to-needs ratio (INR) at 6 timepoints throughout childhood and hippocampal and amygdala volumes at age 7-9 years (n = 41; 236 INR measurements; 41 brain measurements). Mediation analysis identified environmental sequelae of income that statistically accounted for INR-brain associations. Lower INR prior to age 4 was associated with smaller hippocampal volumes, whereas lower INR prior to age 2 was associated with smaller right amygdala volume. These associations were mediated by unmet basic needs (e.g., food, housing). These findings delineate the temporal specificity of associations between income and hippocampal and amygdala structures.

Material hardship and suicidal behavior: Associations among parents and non-parents

INTRODUCTION

Material hardship is unique facet of economic distress and may be a risk factor for suicidal behavior. Parents are more likely to experience both material hardship and suicidal behavior than non-parents. The aims of this study were to (a) examine the association of material hardship with suicidal behavior and (b) assess whether associations differed for parents and non-parents.

METHODS

We used data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health (N = 10,685). We conducted logistic regression to examine the association of one and two or more material hardships at Wave IV with suicidal behavior at Wave V.

RESULTS

Overall, 38.8% of participants reported material hardship at Wave IV and 7.5% reported suicidal ideation or attempts at Wave V. In the total sample, one material hardship (OR = 1.57, 95% CI 1.20, 2.06) and two or more material hardships (OR = 1.52, 95% CI 1.04, 2.21) were associated with an increased likelihood of suicidal behavior. Among parents, two or more material hardships (OR = 1.86, 95% CI 1.17, 2.94) were associated with an increased likelihood of suicidal behavior. Among non-parents, one material hardship (OR = 1.81, 95% CI 1.26, 2.59) was associated with an increased likelihood of suicidal behavior.

CONCLUSIONS

Programs and policies aimed at addressing material hardship, particularly accumulating material hardships among parents, may be an effective suicide prevention strategy.

The mediating effect of parenting stress and couple relationship quality on the association between material hardship trajectories and maternal mental health status

BACKGROUND

Household material hardships could have a negative impact on maternal mental health. Understanding mechanisms by which material hardship trajectories affect maternal depression and anxiety could aid health care professionals and researchers to design better interventions to improve mental health outcomes among mothers.

METHODS

The study identified family-level mechanisms by which material hardship trajectories affect maternal depression and anxiety using Fragile Families and Child Wellbeing Study data (n = 1,645). Latent growth mixture modelling was used to identify latent classes of material hardship trajectories at Years-1, -3, and -5. Parenting stress and couple relationship quality was measured at Year-9. The outcome measures included maternal depression and generalized anxiety disorder (GAD) at Year-15 based on the Composite International Diagnostic Interview - Short Form.

RESULTS

Parenting stress mediated the association between low-increasing hardship (b = 0.020, 95% confidence interval (CI):0.003, 0.043) and maternal depression. Parenting stress also mediated the association between high-increasing hardship (b = 0.043, 95% CI:0.004, 0.092), high decreasing hardship (b = 0.034, 95% CI=0.001, 0.072), and low-increasing (b = 0.034, 95% CI:0.007, 0.066) and maternal GAD. In all models, current material hardship was directly related to maternal depression (b = 0.188, 95% CI:0.134, 0.242) and GAD (b = 0.174, 95% CI:0.091, 0.239).

LIMITATIONS

Study results need to be interpreted with caution as the FFCWS oversampled non-marital births as part of the original study design.

CONCLUSIONS

While current material hardship appears to be more related to maternal mental health, prior material hardship experiences contribute to greater parenting stress which places mothers at risk for experiencing depression and GAD later on.

Biopsychosocial correlates of psychological distress in Latina mothers

BACKGROUND

Few studies have explored the relationship between psychological, psychosocial and biological factors among Latinas. An integrated understanding of how these factors associate with psychological distress is necessary for the development of culturally relevant screening tools and interventions. The study aim was to examine the relationships among (a) psychological distress symptoms, (b) psychosocial factors (discrimination, acculturation, acculturative stress, economic hardship), and (c) biological (DNA methylation of stress-related genes) factors among Latinas during pregnancy and postpartum period.

METHODS

A sample of 150 pregnant Latinas completed the Inventory of Depression and Anxiety Symptoms II (IDAS-II), psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) before (24-32 weeks) and after gestation (4-6 weeks postpartum). Blood samples were collected between 24-32 weeks gestation. Correlations were determined between psychosocial and biological measures and psychological distress measures. Multivariable linear regression models were conducted to assess the relationships between IDAS and stressors.

RESULTS

Several correlations among psychosocial measures,DNA methylation factors and IDAS-II variables were identified. Among the psychosocial measures, everyday discrimination was the most strongly and consistently associated with IDAS-II. DNA methylation of NR3C1 affects the associations between psychological and psychosocial distress.

LIMITATIONS

We only assessed DNA methylation during pregnancy and focused on four HPA-related genes. Longitudinal assessment of DNA methylation and genome-wide analysis can provide a better picture of the role of methylation in psychological distress.

CONCLUSIONS

This work may assist clinicians and policy makers in effectively recognizing and preventing maternal mental health disparities based on discrimination and other psychosocial stressors in at-risk groups.

Socioeconomic status and child psychopathology in the United States: A meta-analysis of population-based studies

Children raised in families with low socioeconomic status (SES) are more likely to exhibit symptoms of psychopathology. However, the strength of this association, the specific indices of SES most strongly associated with childhood psychopathology, and factors moderating the association are strikingly inconsistent across studies. We conducted a meta-analysis of 120 estimates of the association between family SES and child psychopathology in 13 population-representative cohorts of children studied in the US since 1980. Among 26,715 participants aged 3-19 years, we observed small to moderate associations of low family income (g = 0.19), low Hollingshead index (g = 0.21), low subjective SES (g = 0.24), low parental education (g = 0.25), poverty status (g = 0.25), and receipt of public assistance (g = 0.32) with higher levels of childhood psychopathology. Moderator testing revealed that receipt of public assistance showed an especially strong association with psychopathology and that SES was more strongly related to externalizing than internalizing psychopathology. Dispersion in our final, random effects, model suggested that the relation between SES and child psychopathology is likely to vary in different populations of children and in different communities. These findings highlight the need for additional research on the mechanisms of SES-related psychopathology risk in children in order to identify targets for potential intervention.

Material Hardship and Contraceptive Use During the Transition to Adulthood

Decades of research have attempted to understand the paradox of stubbornly high unintended pregnancy rates despite widespread use of contraception. Much of this research has focused on socioeconomic disparities in rates of unintended pregnancy, finding that economically disadvantaged women tend to use less effective contraceptive methods and use them less consistently. Building on this research, this study examines how material hardship is associated with less consistent contraceptive use among women who do not desire to become pregnant. Using the Relationship Dynamics and Social Life (RDSL) Study, a weekly longitudinal survey, I find lower levels of contraceptive use and less consistent use of contraception among women experiencing material hardship, relative to those without hardship experiences. I also investigate the extent to which this association is explained by access barriers and lower contraceptive efficacy among women experiencing hardship. Using structural equation modeling, I find that these mediators significantly explain the relationship between hardship and risky contraceptive behaviors, suggesting that hardship creates mental and resource constraints that impede successful implementation of contraception. However, net of these mediators, material hardship remains associated with riskier contraceptive behaviors among young women, calling for further research on how hardship exposes women to greater risk of unintended pregnancies.

Is Housing Hardship Associated with Increased Adolescent Delinquent Behaviors?

Housing-related hardships, ranging from an inability to pay full housing costs to being evicted, are common experiences for families in the U.S. Despite the frequency of these hardships, little is known about their relationships with adolescent behaviors. The current paper uses longitudinal data on births in large U.S. cities from all six waves of the Fragile Families and Child Well-being Study to explore the association between childhood experiences of housing hardships and delinquent behaviors in adolescence. About 60% of the sample experiences housing hardship at one or more waves. Inabilities to meet housing costs are common among the sample: over 40% are unable to pay their full rent or mortgage payment. Results from multivariate regression and residualized change models indicate that children who experience any housing hardship are more likely to engage in delinquent behaviors than children who do not experience hardship. Exposure to higher average levels of hardship and more waves of hardship are both associated with increased delinquency. Childhood poverty does not moderate the relationship between housing hardship and delinquency suggesting that housing hardship is associated with delinquent behaviors for poor and non-poor children alike. This research builds on existing literature highlighting the importance of examining hardship as a measure of family wellbeing. It also suggests that preventing common housing-related hardships can be beneficial for youth behavioral outcomes.

Material hardship, prefrontal cortex-amygdala structure, and internalizing symptoms in children

Material hardship, or difficulty affording basic resources such as food, housing, utilities, and health care, increases children's risk for internalizing problems. The uncinate fasciculus (UNC) and two of the gray matter regions it connects-the orbitofrontal cortex (OFC) and amygdala-may play important roles in the neural mechanisms underlying these associations. We investigated associations among material hardship, UNC microstructure, OFC and amygdala structure, and internalizing symptoms in children. Participants were 5-9-year-old children (N = 94, 61% female) from socioeconomically diverse families. Parents completed questionnaires assessing material hardship and children's internalizing symptoms. High-resolution, T1-weighted magnetic resonance imaging (n = 51), and diffusion tensor imaging (n = 58) data were acquired. UNC fractional anisotropy (FA), medial OFC surface area, and amygdala gray matter volume were extracted. Greater material hardship was significantly associated with lower UNC FA, smaller amygdala volume, and higher internalizing symptoms in children, after controlling for age, sex, and family income-to-needs ratio. Lower UNC FA significantly mediated the association between material hardship and internalizing symptoms in girls but not boys. These findings are consistent with the notion that material hardship may lead to altered white matter microstructure and gray matter structure in neural networks critical to emotion processing and regulation.

Economic hardship and child intake of foods high in saturated fats and added sugars: the mediating role of parenting stress among high-risk families

OBJECTIVE

Economic hardship (EH) may link to poorer child diet, however whether this association is due to resource limitations or effects on family functioning is unknown. This study examines whether parenting stress mediates the association between EH and child consumption of foods high in saturated fats and added sugars (SFAS).

DESIGN

Data were collected from the Fragile Families and Child Wellbeing study. EH was assessed using eight items collected when children were between 1-9 years old. Mothers reported parenting stress and frequency of child consumption of high SFAS foods when children were 9 years old. Latent growth curve modelling (LGCM) and structural equation modelling tested direct associations between the starting level/rate of change in EH and high SFAS food consumption, and parenting stress as a mediator of the association.

SETTING

Twenty US cities.

PARTICIPANTS

Mothers/children (n 3846) followed birth through age 9 years, oversampled 'high-risk', unmarried mothers.

RESULTS

LGCM indicated a curvilinear trend in EH from ages 1-9, with steeper increases from ages 3-9 years. EH did not directly predict the frequency of high SFAS foods. Average EH at 3 and 5 years and change in EH from ages 1-9 predicted higher parenting stress, which in turn predicted more frequent consumption of high SFAS foods.

CONCLUSIONS

Findings suggest it may be important to consider parenting stress in early prevention efforts given potential lasting effects of early life EH on child consumption of high SFAS foods. Future research should explore how supports and resources may buffer effects of EH-related stress on parents and children.

Many Kinds of Poverty: Three Dimensions of Economic Hardship, Their Combinations, and Children's Behavior Problems

Income poverty, material deprivation, and subjective financial stress are three distinct dimensions of economic hardship. The majority of the theoretical and empirical literature on the effects of economic hardship on children has treated material deprivation and subjective financial stress as only mediators of the effects of income poverty, not considering the independent effects of each dimension or the effects of their combinations. Using nationally representative, longitudinal data from the Millennium Cohort Study on more than 18,000 families in the United Kingdom, we propose seven distinct experiences of economic hardship, based on the possible combinations of income poverty, material deprivation, and subjective financial stress. We use mixed- and fixed-effects linear regression models to identify whether these different economic hardship combinations are differentially associated with children's behavior problems between ages 3 and 7. We find that all economic hardship combinations, including those without income poverty, are associated with higher levels of children's behavior problems. The combination of material deprivation and subjective financial stress and the combination of all three dimensions of economic hardship are associated with the highest levels of behavior problems. Based on these findings, we argue that income poverty is an important but insufficient measure of economic hardship for children and that theory and research on the effects of economic hardship on children should consider the multidimensional nature of economic stressors for families.

Food Insecurity and Housing Instability Partially Mediate the Association Between Maternal Depression and Child Problem Behavior

Maternal depression is a risk factor for the development of problem behavior in children. Although food insecurity and housing instability are associated with adult depression and child behavior, how these economic factors mediate or moderate the relationship between maternal depression and child problem behavior is not understood. The purpose of this study was to determine whether food insecurity and housing instability are mediators and/or moderators of the relationship between maternal depression when children are age 3 and children's problem behaviors at age 9 and to determine whether these mechanisms differ by race/ethnicity. We used data from the Fragile Families and Child Wellbeing Study. Food insecurity and housing instability at age 5 were tested as potential mediators and moderators of the relationship between maternal depression status at age 3 and problem behavior at age 9. A path analysis confirmed our hypothesis that food insecurity and housing instability partially mediate the relationship between maternal depression when children are age 3 and problem behavior at age 9. However, housing instability was only a mediator for externalizing problem behavior and not internalizing problem behavior or overall problem behavior. Results of the moderation analysis suggest that neither food insecurity nor housing instability were moderators. None of the mechanisms explored differed by race/ethnicity. While our findings stress the continued need for interventions that address child food insecurity, they emphasize the importance of interventions that address maternal mental health throughout a child's life. Given the central role of maternal health in child development, additional efforts should be made to target maternal depression.

Stability and Change in Early Life Economic Hardship Trajectories and the Role of Sex in Predicting Adolescent Overweight/Obesity

There is evidence that poverty is related to adverse child health outcomes. Yet, evidence is lacking on how economic hardship experiences during early childhood are related to adolescent obesity, how the relationship may differ by child sex, in addition to the potential child and maternal behavioral factors that link economic hardship and adolescent obesity. The purpose of the current study was to address this gap by using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 1814). The analytic sample included 50.5% girls, 20% experiencing overweight status, and 19% experiencing obesity. Majority of the adolescents were born to non-Hispanic black (49%), U.S. born (86%), married/cohabitating mothers (61%) with high school or greater level of education (75%). The economic hardship trajectory classes were determined using the latent growth mixture modeling approach and supported a 4-class trajectory model, with 5% of the adolescents in the high-increasing economic hardship trajectory class. The children in the high-increasing economic hardship class had increased odds of developing overweight/obesity in adolescence compared to those in low-stable class. This association was significantly moderated by child sex (i.e., relationship was significant for adolescent boys). Parenting stress and child snacking behaviors did not significantly mediate the association between economic hardship classes and overweight/obesity. Economic hardships that increase through early childhood need to be recognized as an obesity risk factor particularly for adolescent boys.

Examining income dynamics and externalizing and internalizing trajectories through a developmental psychopathology lens: A nationally representative study

Prior research has documented elevations in levels of internalizing and externalizing behaviors among children in lower income families in comparison to more advantaged peers. However, most studies focus on behavior problems at a single point in time or within a short developmental period. Associations between income dynamics and developmental trajectories of behavior problems over time are less understood. To address this, the current study uses data from the National Longitudinal Study of Youth (N = 7,476; 50.8% male) to examine how income dynamics (annual income and income volatility) across three distinct developmental periods from early childhood to early adolescence relate to trajectories of externalizing and internalizing problems. Group-based mixture modeling revealed a five-group trajectory model for externalizing behavior and a four-group trajectory model for internalizing behavior. Higher cumulative annual income predicted greater likelihood of belonging to the low-stable group compared to the other, more problematic groups for both externalizing and internalizing trajectories. In addition, income losses predicted higher risk of membership in any group other than the low-stable group for internalizing and externalizing behavior. Developmental period-specific income dynamics, though not as consistent as cumulative dynamics, also predicted trajectory group membership.

Food Insecurity and Child Health

OBJECTIVES

Food insecurity is an important public health problem facing children in the United States. Although a number of previous studies suggest that food insecurity has negative impacts on health, these studies have not dealt thoroughly with issues of selection bias. We use propensity scoring techniques to approximate the causal effects of food insecurity on children's health and health care use outcomes.

METHODS

We use nationally representative data from the 2013-2016 waves of the National Health Interview Study (N = 29 341). Using inverse probability of treatment weighting, a propensity scoring method, we examine a broad range of child health outcomes and account for a comprehensive set of controls, focusing on a sample of children 2 to 17 years old.

RESULTS

Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure household had rates of lifetime asthma diagnosis and depressive symptoms that were 19.1% and 27.9% higher, rates of foregone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. No significant differences emerged for most communicable diseases, such as ear infections or chicken pox, or conditions that may develop more gradually, including anemia and diabetes.

CONCLUSIONS

Policies used to reduce household food insecurity among children may also reduce children's chronic and acute health problems and health care needs.

A Prospective Test of the Family Stress Model with Mexican-origin Adolescent Mothers

The current six-wave longitudinal study tested the Family Stress Model among 204 Mexican-origin families in which an adolescent pregnancy had occurred. Wave 1 (W1) occurred when adolescents (M age = 16.80 years; SD = 1.00) were pregnant, and the last wave (W6) occurred when children were 5 years of age. In the current study, the Family Stress Model was expanded to include parenting relations among adolescent mothers and fathers, and among adolescent mothers and grandmothers. In support of the Family Stress Model, findings indicated that W1 family income was negatively associated with W6 child internalizing and externalizing problem behaviors via increased W2 economic pressure, increased W3 maternal depressive symptoms, increased W4 mother-grandmother coparenting conflict, and increased W5 maternal parenting hassles. Additionally, W4 mother-father coparenting conflict was positively associated with W6 child internalizing and externalizing problem behaviors via W5 maternal parenting hassles. Findings are discussed with attention to the processes by which family income informs child problem behaviors over time. El presente estudio longitudinal de seis años analizó el Family Stress Model con una muestra de 204 familias de origen mexicano en las cuales había ocurrido un embarazo durante la adolescencia. La primera fase (W1) del estudio se llevó a cabo cuando las adolescentes (M edad= 16.80 años; DE= 1.00) estaban embarazadas, y la última fase (W6) ocurrió cuando sus niños tenían cinco años. En el presente estudio, el Family Stress Model se amplió para incluir variables sobre la co-paternidad entre las madres adolescentes y los padres, y entre las madres adolescentes y las abuelas. Los resultados apoyaron las ideas del Family Stress Model; ingreso familiar en W1 mostró un efecto negativo con problemas de comportamiento y problemas de internalización de los niños en W6 a través del aumento de la presión económica en W2, el aumento de síntomas de depresión maternos en W3, el aumento del conflicto de la co-paternidad entre madre y abuela en W4, y el aumento de problemas de crianza maternas en W5. Adicionalmente, conflicto de la co-paternidad entre la madre y el padre mostró un efecto positivo con problemas de comportamiento y problemas de internalización de los niños en W6 a través de problemas de crianza maternas en W5. Varias ideas se presentan en la Discusión sobre como el ingreso familiar informa el comportamiento problemático en niños a largo plazo.

Jailed Parents and Their Young Children: Residential Instability, Homelessness, and Behavior Problems

This study examined family disruption in the form of jailed parents' housing instability in the year leading up to their most recent incarceration, including periods of homelessness with and without their children, and links between parental housing instability and children's behavior problems. Using the Family Stress Proximal Process Model to understand the links between stressors related to family disruption and child outcomes, the study analyzed data from interviews and surveys with 165 jailed fathers and mothers with young children (age 2-6 years) regarding jailed parents' reports of housing instability during the 12 months prior to their incarceration and child behavior problems. Analyses showed that housing instability, homelessness, and recidivism in jailed parents were relatively common, with a significant proportion of the disruptions occurring with young children, although many disruptions involved parental absence from children. Results indicated that the more months that parents lived with their children prior to incarceration in jail during the past year, the less housing instability the parents experienced. Additionally, multiple regression analyses revealed that more housing instability experienced by parents in the year leading up to their incarceration in jail were associated with elevations in children's internalizing and externalizing behavior problems. These results have implications for future research that explores family disruption as a mechanism in understanding recidivism and homelessness among adults and risk for child behavior problems in families affected by parental incarceration.

Associations Between Perceived Material Deprivation, Parents' Discipline Practices, and Children's Behavior Problems: An International Perspective

This study investigated the association between perceived material deprivation, children's behavior problems, and parents' disciplinary practices. The sample included 1,418 8- to 12-year-old children and their parents in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Multilevel mixed- and fixed-effects regression models found that, even when income remained stable, perceived material deprivation was associated with children's externalizing behavior problems and parents' psychological aggression. Parents' disciplinary practices mediated a small share of the association between perceived material deprivation and children's behavior problems. There were no differences in these associations between mothers and fathers or between high- and low- and middle-income countries. These results suggest that material deprivation likely influences children's outcomes at any income level.

The Unequal Impact of Food Insecurity on Cognitive and Behavioral Outcomes Among 5-Year-Old Urban Children

OBJECTIVE

To examine the associations of food insecurity with children's cognitive and behavioral outcomes using quantile regression.

DESIGN

Secondary analysis of the Fragile Families and Child Wellbeing Study dataset.

PARTICIPANTS

A total of 2,046 children aged 5 years.

MAIN OUTCOME MEASURES

Child behavioral outcomes were measured using externalizing (aggressive) and internalizing (emotional) behavior problems. Child cognitive outcomes were measured using the Peabody Vocabulary test and the Woodcock-Johnson letter-word identification test. Food insecurity was measured using the US Department of Agriculture's Food Security Module.

ANALYSIS

Unconditional quantile regressions were employed. Statistical significance was set at P ≤ .05.

RESULTS

Negative associations between food insecurity and child behavior problems (externalizing and internalizing) were largest for children with the most behavior problems. For Peabody Vocabulary scores, the negative association with food insecurity was statistically significant only for children in the top half of the distribution (≥50th percentile). The analysis found mixed evidence of an association between food insecurity and the Woodcock-Johnson letter-word identification test. These associations were similar for boys and girls.

CONCLUSIONS AND IMPLICATIONS

Because children's cognitive skills and behavioral problems have long-lasting implications and effects later in life, reducing the risk of food insecurity might particularly benefit children with greater externalizing and internalizing behavior problems.

Individual and contextual factors for the child abuse potential of Croatian mothers: The role of social support in times of economic hardship

The study assessed mothers' risk for abusing their children in middle adolescence in relation to individual and contextual factors during the economic crisis in Croatia. Socioeconomic status of mothers, family economic pressure, and mothers' exposure to stress were measured. Special attention was given to the perceived availability of social support as one of protective factors potentially buffering the negative impact of risks of child abuse. The community sample included 746 mothers (Mage = 42.85; SDage = 5.319). The results showed that the risk of child abuse is higher for mothers with lower education, those who perceive themselves as suffering greater family economic hardship, those who have experienced a higher number of stressful events, and those with lower social support. When the mothers perceive a lower availability of social support, the effects of exposure to cumulative risk, namely the combination of socioeconomic status, economic pressure, and exposure to stress, are stronger. Since social support proved to be one of the key protective factors in the relationship between adverse life circumstances and parenting, the development of effective and non-stigmatized interventions aiming to increase social support, positive social relationships, and adequate parenting practices for parents facing economic hardship is an important direction for future family policy measures.

Dual Food and Energy Hardship and Associated Child Behavior Problems

OBJECTIVE

To examine dual food and energy hardship and internalizing and externalizing behavior problems in 9-year-old children.

METHODS

We conducted a cross-sectional analysis of the Fragile Families and Child Wellbeing Study, a prospective national urban birth cohort, when the children were 9 years old. Maternal-reported "food hardship" (ever hungry and/or ever received free food) and "energy hardship" (ever unable to pay utility bill and/or utility shutoff) within the past year, and child behavior using the Child Behavior Checklist for Ages 6-18 were assessed. Multiple logistic regression analyses estimated associations between individual and dual food and energy hardship and child behavior problems, adjusting for a priori covariates (ie, child sex, health insurance, maternal sociodemographic characteristics, poverty, reported health, attention deficit hyperactivity disorder, depressive symptoms, smoking, and substance and alcohol abuse).

RESULTS

Approximately 10% of households reported dual food and energy hardship. Children experiencing dual food and energy hardship had 3 times greater odds of withdrawn/depressed behaviors (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.4-5.5), threefold greater odds of somatic complaints (AOR, 3.2; 95% CI, 1.5-6.9), and 4 times greater odds of rule-breaking behavior (AOR, 3.7; 95% CI, 1.5-9.2) in the borderline/clinical range than children with no hardship, and had fourfold greater odds of borderline/clinical range somatic complaints (AOR, 4.2; 95% CI, 1.7-10.3) than children with only energy hardship.

CONCLUSIONS

Children experiencing dual food and energy hardship have greater odds of coexisting internalizing and externalizing behaviors after controlling for possible confounders. Providers can consider screening and resource referrals for these addressable hardships alongside behavior assessments in the clinical setting.

Food insecurity and emotional health in the USA: a systematic narrative review of longitudinal research

OBJECTIVE

To examine the causal directionality in the relationship between food insecurity and emotional well-being among US-based populations.

DESIGN

Systematic literature review from January 2006 to July 2016 using MEDLINE (PubMed), PsychInfo, Web of Science and CINHAL. Inclusion criteria were: written in English; examined a longitudinal association between food insecurity and emotional well-being.

SETTING

The USA.

SUBJECTS

Children and adults.

RESULTS

Twelve out of 4161 peer-reviewed articles met inclusion criteria. Three articles examined the effect of emotional well-being on food insecurity, five studies examined the effect of food insecurity on emotional well-being, and four studies examined a bidirectional relationship. Most studies (83 %) reported a positive relationship between negative emotional well-being and food insecurity over time.

CONCLUSIONS

Findings suggest a bidirectional association whereby food insecurity increases the risk of poor emotional health, and poor emotional health increases the risk of food insecurity. Better-constructed studies are needed to follow cohorts at risk for both food insecurity and poor emotional health to further understand the mediators and moderators of the relationships. Intervention studies designed to mitigate or reverse risks are also needed to determine best evidence for practice and policy.