The Great Recession, Public Transfers, and Material Hardship

Prenatal family income, but not parental education, is associated with resting brain activity in 1-month-old infants

Childhood socioeconomic disadvantage is associated with disparities in development and health, possibly through adaptations in children's brain function. However, it is not clear how early in development such neural adaptations might emerge. This study examined whether prenatal family socioeconomic status, operationalized as family income and average years of parental education, prospectively predicts individual differences in infant resting electroencephalography (EEG; theta, alpha, beta, and gamma power) at approximately 1 month of age (N = 160). Infants of mothers reporting lower family income showed more lower-frequency (theta) and less higher-frequency (beta and gamma) power. These associations held when adjusting for other prenatal and postnatal experiences, as well as infant demographic and health-related factors. In contrast, parental education was not significantly associated with infant EEG power in any frequency band. These data suggest that lower prenatal family income is associated with developmental differences in brain function that are detectable within the first month of life.

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.

Constructing Residential Histories in a General Population-Based Representative Sample

Research on neighborhoods and health typically measures neighborhood context at a single point in time. However, neighborhood exposures accumulate over the life course, influenced by both residential mobility and neighborhood change, with potential implications for estimating the impact of neighborhoods on health. Commercial databases offer fine-grained longitudinal residential address data that can enrich life-course spatial epidemiology research, and validated methods for reconstructing residential histories from these databases are needed. Our study draws on unique data from a geographically diverse, population-based representative sample of adult Wisconsin residents and the LexisNexis (New York, New York) Accurint, a commercial personal profile database, to develop a systematic and reliable methodology for constructing individual residential histories. Our analysis demonstrated that creating residential histories across diverse geographical contexts is feasible, and it highlights differences in the information obtained from available residential histories by age, education, race/ethnicity, and rural/urban/suburban residency. Researchers should consider potential address data availability and information biases favoring socioeconomically advantaged individuals and their implications for studying health inequalities. Despite these limitations, LexisNexis data can generate varied residential exposure metrics and be linked to contextual data to enrich research into the contextual determinants of health at varied geographic scales.

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.

How Does Consistency of Food and Nutrition Support Effect Daily Food Consumption among Children Living in Poverty? Recession-Era Implications

Underutilization of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance (SNAP) food safety net programs may compromise child nutritional benefits for families with limited incomes. Using a sample of children surveyed before (2003−2006) and after the Great Recession (2007−2009), we examine whether consistent access to WIC and SNAP during times of increased economic stress moderated the association between poverty level (i.e., income-needs ratio [INR]) and fruits and vegetables (FV) or foods high in saturated fats and added sugars (SFAS). Fragile Families and Child Wellbeing Study income-eligible mothers/children (≤185% of poverty) with available FV and SFAS data at the 5- (2003−2006) and 9-year (2007−2010) waves (n = 733) were included. Main effects of INR and interaction effects of consistency of WIC, SNAP, and dual WIC and SNAP support from birth through age 5 were examined. INR was associated with decreased FV consumption frequency from age 5 to 9, conditional upon consistency of dual WIC/SNAP enrollment. FV declined when there was low consistency (<1 year) of dual support. FV consumption was stable across INR when combined WIC/SNAP support lasted at least 2 years. Results can inform strategies for optimizing the nutritional impact of WIC and SNAP by focusing on those most at risk for underutilization of multiple benefits.

How do low-income single-mothers get by when unemployment strikes: Patterns of multiple program participation after transition from employment to unemployment

Little is known about longitudinal patterns of welfare program participation among single mothers after they transition from employment to unemployment. To better understand how utilization patterns of these welfare programs may change during the 12 months after a job loss, we used the 2008 Survey of Income and Program Participation to examine the patterns of participation in Medicaid, the Supplemental Nutrition Assistance Program, Temporary Assistance for Needy Families, and unemployment insurance among 342 single mothers who transitioned from employment to unemployment during the Great Recession. Using sequence analysis and cluster analysis, this paper identified four distinct patterns of program participation: (a) constantly receiving in-kind benefits; (b) primarily but not solely receiving food stamps; (c) inconsistent unemployment insurance or Medicaid-based benefits; and (d) limited or no benefits. Almost two-fifths of our sample of single mothers received inconsistent, limited, or no benefits. Results of the multinomial regression revealed that race, work disability, poverty, homeownership, and region of residence were significant factors that influenced whether study subjects participated in or had access to social safety net programs. Our findings illustrate the heterogeneity in patterns of multiple program participation among single mothers transitioning from employment to unemployment. Better understanding these varied patterns may inform decisions that increase the accessibility of US social safety net programs for single mothers during periods of personal economic hardship.

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.

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.

The Prevalence of Hardship by Race and Ethnicity in the USA, 1992-2019

Racial and ethnic inequality continues to be the subject of considerable public interest. We shed light on this issue by examining racial disparities in the prevalence of several types of hardship, such as trouble paying bills and housing problems, in the USA over the 1992-2019 period. Using data from several panels of the Survey of Income and Program Participation, we find that hardships were considerably higher-sometimes double, depending on the measure-among blacks and Hispanics than whites and Asians. Nevertheless, these disparities generally narrowed over time. We find that the decline in these disparities-as indicated by a summary hardship index-exceeded that of the official income poverty ratio. We also find that while Asians were more likely to be poor than whites, they were not more likely to experience hardship. Notably, we also see variation in the experiences of different types of hardship. Specifically, there was little decline in the racial disparity of two of the hardships that tend to be responsive to short-term fluctuations in income-bill-paying and health hardship, as well as fear of crime-but substantial declines in disparities with most other measures. Overall, our findings indicate significant racial differences in the experience of hardship, though with a narrowing of many gaps over time.

The Earned Income Tax Credit and Intimate Partner Violence

Intimate partner violence (IPV) is a serious public health problem in the United States with adverse consequences for affected individuals and families. Recent reviews of the literature suggest that economic policies should be further investigated as part of comprehensive strategies to address IPV. The Earned Income Tax Credit (EITC) is the nation's largest anti-poverty program for working parents, and especially benefits low-income women with children, who experience an elevated risk of IPV. The EITC may prevent IPV by offering financial resources; such resources may help individuals experiencing IPV leave abusive relationships or address IPV risk factors, thereby preventing entry into abusive relationships. However, the association between EITC generosity and IPV has not been previously examined. We used state-level and individual-level datasets to examine the association between EITC generosity and IPV. Our state-level data source was the nationally representative National Crime Victimization Survey (NCVS; N = ~ 95,000 households per year). For NCVS, we used a difference-in-difference approach to investigate the relationship between state EITC generosity and IPV rates. We also used individual-level longitudinal data from the Fragile Families and Child Well-being Study (n = 13,422 person-waves). Using this cohort of US families at higher risk for IPV, we evaluated associations between estimated EITC benefits based on the mother's state of residence and number of children and self-reported IPV. In both state- and individual-level analyses, no significant association between state EITC benefits and IPV was found. Factors that may account for these null findings include program ineligibility for individuals who separate from abusive spouses. Future research efforts should more closely examine EITC policy implementation processes and the lived experience of participating in anti-poverty programs for people experiencing IPV.

Maternal depression and economic well-being: A quasi-experimental approach

Maternal depression is associated with adverse impacts on the health of women and their children. However, further evidence is needed on the extent to which maternal depression influences women's economic well-being and how unmeasured confounders affect estimates of this relationship. In this study, we aimed to measure the association between maternal depression and economic outcomes (income, employment, and material hardship) over a 15-year time horizon. We conducted longitudinal analyses using the Fragile Families and Child Wellbeing Study, an urban birth cohort study in the United States. We assessed the potential contribution of time-invariant unmeasured confounders using a quasi-experimental approach and also investigated the role of persistent versus transient depressive symptoms on economic outcomes up to 15 years after childbirth. In models that adjusted for time-invariant unmeasured confounders, maternal depression was associated with not being employed (an adjusted risk difference of 3 percentage points (95% CI 0.01 to 0.05)) and experiencing any material hardship (an adjusted risk difference of 14 percentage points (95% CI 0.12 to 0.16)), as well as with reductions in the ratio of household income to poverty by 0.10 units (95% CI -0.16 to -0.04) and annual household income by $2114 (95% CI -$3379 to -$850). Impacts at year 15 were strongest for those who experienced persistent depression. Results of our study strengthen the case for viewing mental health support services as interventions that may also foster economic well-being, and highlight the importance of including economic impacts in assessments of the cost-effectiveness of mental health interventions.

Examining the Early Impact of COVID-19 on Single-Parent TANF Caseloads: a Brief Analysis of New Jersey

Hard economic times often force a greater number of families to turn to public benefits and programs for financial help. These larger safety net caseloads are more diverse than those of strong economic times, including families who are brand-new to the safety net as well as families who, under different economic circumstances, may have needed only short-term assistance. These families may differ from traditional recipients in terms of characteristics and circumstances. To understand how the New Jersey single-parent Temporary Assistance for Needy Families (TANF) caseload changed in response to COVID-19 between April of 2019 and April of 2020, we conducted a two-step cluster analysis that identified six different types of families. Compared to the April 2019 (pre-pandemic) caseload, we found that the number of the TANF participants increased in April 2020 (during the COVID-19 pandemic). Interestingly, we also found that the largest proportional increases in the caseload were driven by single jobless adults who are older, have at least a high school education, do not have a disability, and have fewer and older children, while the largest declines were driven by single adults with a job. Taken together, it seems that single adults with relatively better demographic circumstances are having a harder time finding jobs, and so turned to or remained on TANF in April 2020. In response to the pandemic, some, but not all, states have relaxed or temporarily suspended TANF work requirements and time limits. Our findings suggest that such changes in TANF requirements reflect empirical changes in the caseload and merit further attention, particularly in terms of federal and state budget strain.

Depression in the Postpartum Year and Life Course Economic Trajectories

INTRODUCTION

Perinatal depression affects 13% of childbearing individuals in the U.S. and has been linked to an increased risk of household economic insecurity in the short term. This study aims to assess the relationship between perinatal depression and long-term economic outcomes.

METHODS

This was a longitudinal analysis of a cohort of mothers from the Fragile Families and Child Wellbeing Study starting at delivery in 1998-2000 and followed until 2014-2017. Analysis was conducted in 2021. Maternal depression was assessed using the Composite International Diagnostic Interview-Short Form 1 year after childbirth, and the outcomes included measures of material hardship, household poverty, and employment. Associations between maternal depression and outcomes were analyzed using logistic regression and group-based trajectory modeling.

RESULTS

In total, 12.2% of the sample met the criteria for a major depressive episode 1 year after delivery. Maternal depression had a strong and sustained positive association with material hardship and not working for pay in Years 3, 5, 9, and 15 after delivery. Maternal depression also had a significant positive association with household poverty across Years 3-9 and with unemployment in Year 3. Trajectory modeling established that maternal depression was associated with an increased probability of being in a persistently high-risk trajectory for material hardship, a high-risk trajectory for household poverty, and a high-declining risk trajectory for unemployment.

CONCLUSIONS

Supporting perinatal mental health is crucial for strengthening the economic well-being of childbearing individuals and reducing the impact of maternal depression on intergenerational transmission of adversity.

Diaper Need During the COVID-19 Pandemic Associated with Poverty, Food Insecurity, and Chronic Illness: An Analysis of a Representative State Sample of Caretakers with Young Children

Objectives: Diaper need is an important form of material hardship for families with young children. This study quantified diaper need during the COVID-19 pandemic and examined factors associated with diaper need.

Methods: Using a representative statewide sample of adults in Massachusetts, diaper need was assessed during the COVID-19 pandemic among respondents with at least one child 0–4 years of age in diapers (n=353). Bivariate tests examined associations between diaper need and individual and household factors. Multivariable regression was used to examine associations between diaper need and demographic factors, job loss, and mental health during the pandemic.

Results: More than one in three respondents reported diaper need (36.0%). Demographic factors associated with diaper need were age <25 years, Latino ethnicity, having less than a high school degree, unemployment before the pandemic, household income <$50,000, household food insecurity, or having a household member with a chronic disease. Diaper need was higher among respondents who utilized a nutrition assistance program or a food pantry during the pandemic. In multivariable analyses considering job loss and mental health during the pandemic, diaper need was associated with household income <$50,000 (odds ratio [OR] 3.61; confidence interval [95% CI] 1.40–9.26) and a chronic disease diagnosis within the household (OR 4.26; 95% CI 1.77–10.29).

Conclusions: This study indicates a level of diaper need similar to what was documented before the COVID-19 pandemic despite federal stimulus payments and increased distributions by local diaper banks. The findings identify groups at increased risk and suggest opportunities to reach those at risk through food assistance programs.

Household Spending Patterns and Hardships during COVID-19: A Comparative Study of the U.S. and Israel

The combined supply and demand shocks of the COVID-19 pandemic have created the largest consumer behavior shift in recent history, while exposing millions of households to material hardships like food insecurity and housing instability. In this study, we draw on national surveys conducted early in the pandemic to investigate the pandemic's effects on self-reported consumer spending behaviors and experiences of hardship for households in the US and Israel; two countries that are similar in terms of their development but have had divergent experiences with and responses to the pandemic. We also examine the extent to which racial/ethnic/religious minority status and pre-pandemic employment characteristics predict these outcomes. Using descriptive and logistic regression approaches, we find that housing expenditures were fairly stable in the U.S. and Israel, while food and credit card payment expenditures were relatively volatile. We also find that skipped utility bill payments were much higher in the US than Israel, while rates of skipping housing payments and food insecurity were similar between the two countries. Generally speaking, racial/ethnic/religious minorities in both countries were more likely to experience spending volatility, while Black and Hispanic (in the US) and Arab (in Israel) households were more likely to experience hardships. Employment and financial characteristics also appeared much more predictive of hardship in the US than in Israel.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10834-021-09814-z.

Contributions of the Fragile Families and Child Wellbeing Study to Child Development

We describe the promise of the Fragile Families and Child Wellbeing Study (FFCWS) for developmental researchers. FFCWS is a birth cohort study of 4,898 children born in 1998-2000 in large US cities. This prospective national study collected data on children and parents at birth and during infancy (age 1), toddlerhood (age 3), early childhood (age 5), middle childhood (age 9), adolescence (age 15), and, in progress, young adulthood (age 22). Though FFCWS was created to understand the lives of unmarried parent families, its comprehensive data on parents, children, and contexts can be used to explore many other developmental questions. We identify six opportunities for developmentalists: (a) analyzing developmental trajectories, identifying the importance of the timing of exposures for later development, (c) documenting bidirectional influences on development, (d) understanding development in context, (e) identifying biological moderators and mechanisms, and ( f ) using an urban-born cohort that is large, diverse, and prospective.

Socioeconomic factors, stress, hair cortisol, and white matter microstructure in children

Socioeconomic disadvantage has been linked to increased stress exposure in children and adults. Exposure to stress in childhood has been associated with deleterious effects on cognitive development and well-being throughout the lifespan. Further, exposure to stress has been associated with differences in brain development in children, both in cortical and subcortical gray matter. However, less is known about the associations among socioeconomic disadvantage, stress, and children's white matter development. In this study, we investigated whether socioeconomic disparities would be associated with differences in white matter microstructure in the cingulum bundle, as has been previously reported. We additionally investigated whether any such differences could be explained by differences in stress exposure and/or physiological stress levels. White matter tracts were measured via diffusion tensor imaging in 58 children aged 5-9 years. Results indicated that greater exposure to stressful life events was associated with higher child hair cortisol concentrations. Further, physiological stress, as indexed by hair cortisol concentrations, were associated with higher fractional anisotropy in the cingulum bundle. These results have implications for better understanding how perceived and physiological stress may alter neural development during childhood.

Hard Times: Routine Schedule Unpredictability and Material Hardship among Service Sector Workers

American policymakers have long focused on work as a key means to improve economic wellbeing. Yet, work has become increasingly precarious and polarized. This precarity is manifest in low wages, but also in unstable and unpredictable work schedules that often vary significantly week-to-week with little advance notice. We draw on new survey data from The Shift Project on 37,263 hourly retail and food service workers in the United States. We assess the association between routine unpredictability in work schedules and household material hardship. Using both cross-sectional models and panel models, we find that workers who receive shorter advanced notice, those who work on-call, those who experience last minute shift cancellation and timing changes, and those with more volatile work hours are more likely to experience hunger, residential, medical, and utility hardships as well as more overall hardship. Just-in-time work schedules afford employers a great deal of flexibility, but at a heavy cost to workers' economic security.

The Effect of the US Safety Net on Material Hardship over Two Decades

We address a question at the center of many policy debates: how effective is the US safety net? Many existing studies evaluate the effect of one program on economic hardship in isolation, though families typically participate in multiple programs. Using 1992-2011 data from the Survey of Income and Program Participation, our analyses examine the simultaneous effect of participation in three programs, TANF, SNAP, or Medicaid/SCHIP, on a set of outcomes of intrinsic importance-measures of material hardship. We find that a 10 percentage point increase in participation in any of these three safety net programs by low-to-moderate income families with children reduces their average number of hardships by 0.11 (-0.41 elasticity), and the incidence of food insufficiency by 1.7 percentage points (-1.27 elasticity). This analysis suggests that hardship would be even more prevalent in the United States without the existence of the current safety net programs.

Hardship Among Immigrants and the Native-born in the United States

This study examines the prevalence of several types of hardship (e.g., bill paying and housing hardships) among immigrants by race and ethnicity in the United States using data from the 2008 and 2014 panels of the Survey of Income and Program Participation and logistic regressions. I find that Blacks, and to some extent Hispanics, are more likely to report hardships than Whites and Asians, who are about equally likely to report hardships. Exploring results by nativity and citizenship status, I find that immigrants who became U.S. citizens are less likely than the native-born population to report some kinds of hardship. Undocumented immigrants, however, are more likely to report some kinds of hardships, particularly in the 2008 panel conducted at the time of the Great Recession, which hit immigrants especially hard; this relationship, however, is explained by the lower incomes of undocumented immigrant households in the 2008 panel. Results within racial and ethnic groups are generally in the same direction but are less frequently statistically significant. Overall, these findings suggest that immigrants are not particularly prone to hardship, especially when other characteristics are controlled for. In fact, the lower likelihood of some hardships among foreign-born citizens suggests that they are positively selected: they may have unobserved characteristics that are protective, such as better health, stronger social networks, or money management skills. Because the foreign-born are less likely to be disadvantaged vis-à-vis the native-born when hardship rather than the official income poverty measure is used, this study highlights the importance of using multiple measures when assessing the well-being of immigrants.

Assessing the level of the material deprivation of European Union countries

The purpose of this paper is to assess the level of material deprivation in European Union countries in 2016 from both a local and a global perspective. The Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) was used in the study. Based on research, five main types of the level of the material deprivation of European Union countries were identified. Research findings suggest that the population of old EU countries is less severely affected by material deprivation than people living in new member states. Also, the level of global material deprivation was assessed. The study was based on 2016 statistical data delivered by Eurostat.

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.

A Framework for Explaining Black-White Inequality in Homeownership Sustainability

To explain racially differential housing outcomes, previous studies have tended to concentrate on discriminatory processes within the mortgage market while ignoring homeowning families' broad socioeconomic challenges. This study proposes a conceptual framework for understanding Black-White inequality in homeownership sustainability, which emphasizes Black homeowners' socioeconomic challenges that are external to mortgage market evaluations, with a particular focus on the mediating role of liquid assets. Based on the Panel Study of Income Dynamics, the framework is put to an empirical test on the differential exit rates between Black and White homeowners in the United States during the recent housing crisis. The findings indicate that the racial gap in homeownership exit is eliminated after liquid wealth is controlled in the model alongside other covariates and that the inclusion of liquid wealth renders all mortgage-oriented variables nonsignificant with regard to their explanatory power for Black-White inequality in exit rates. Policy implications of the findings are also discussed.

Socioeconomic Disparities in Chronic Physiologic Stress Are Associated With Brain Structure in Children

BACKGROUND

Socioeconomic factors have been consistently linked with the structure of children's hippocampus and anterior cingulate cortex (ACC). Chronic stress-as indexed by hair cortisol concentration-may represent an important mechanism underlying these associations. Here, we examined associations between hair cortisol and children's hippocampal and ACC structure, including across hippocampal subfields, and whether hair cortisol mediated associations between socioeconomic background (family income-to-needs ratio, parental education) and the structure of these brain regions.

METHODS

Participants were 5- to 9-year-old children (N = 94; 61% female) from socioeconomically diverse families. Parents and children provided hair samples that were assayed for cortisol. High-resolution, T1-weighted magnetic resonance imaging scans were acquired, and FreeSurfer 6.0 was used to compute hippocampal volume and rostral and caudal ACC thickness and surface area (n = 37 with both child hair cortisol and magnetic resonance imaging data; n = 41 with both parent hair cortisol and magnetic resonance imaging data).

RESULTS

Higher hair cortisol concentration was significantly associated with smaller CA3 and dentate gyrus hippocampal subfield volumes but not with CA1 or subiculum volume. Higher hair cortisol was also associated with greater caudal ACC thickness. Hair cortisol significantly mediated associations between parental education level and CA3 and dentate gyrus volumes; lower parental education level was associated with higher hair cortisol, which in turn was associated with smaller volume in these subfields.

CONCLUSIONS

These findings point to chronic physiologic stress as a potential mechanism through which lower parental education level leads to reduced hippocampal volume. Hair cortisol concentration may be an informative biomarker leading to more effective prevention and intervention strategies aimed at childhood socioeconomic disadvantage.

Social determinants of health and disparities in prenatal care utilization during the Great Recession period 2005-2010

BACKGROUND

Early, regular prenatal care utilization is an important strategy for improving maternal and infant health outcomes. The purpose of this study is to better understand contributing factors to disparate prenatal care utilization outcomes among women of different racial/ethnic and social status groups before, during, and after the Great Recession (December 2007-June 2009).

METHODS

Data from 678,235 Washington (WA) and Florida (FL) birth certificates were linked to community and state characteristic data to carry out cross-sectional pooled time series analyses with institutional review board approval for human subjects' research. Predictors of on-time as compared to late or non-entry to prenatal care utilization (late/no prenatal care utilization) were identified and compared among pregnant women. Also explored was a simulated triadic relationship among time (within recession-related periods), social characteristics, and prenatal care utilization by clustering individual predictors into three scenarios representing low, average, and high degrees of social disadvantage.

RESULTS

Individual and community indicators of need (e.g., maternal Medicaid enrollment, unemployment rate) increased during the Recession. Associations between late/no prenatal care utilization and individual-level characteristics (including disparate associations among race/ethnicity groups) did not shift greatly with young maternal age and having less than a high school education remaining the largest contributors to late/no prenatal care utilization. In contrast, individual maternal enrollment in a supplemental nutrition program for women, infants, and children (WIC) exhibited a protective association against late/no prenatal care utilization. The magnitude of association between community-level partisan voting patterns and expenditures on some maternal child health programs increased in non-beneficial directions. Simulated scenarios show a high combined impact on prenatal care utilization among women who have multiple disadvantages.

CONCLUSIONS

Our findings provide a compelling picture of the important roles that individual characteristics-particularly low education and young age-play in late/no prenatal care utilization among pregnant women. Targeted outreach to individuals with high disadvantage characteristics, particularly those with multiple disadvantages, may help to increase first trimester entry to utilization of prenatal care. Finally, WIC may have played a valuable role in reducing late/no prenatal care utilization, and its effectiveness during the Great Recession as a policy-based approach to reducing late/no prenatal care utilization should be further explored.

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.

Influence of changes in the Spanish labor market during the economic crisis (2007-2011) on perceived health

PURPOSE

We analyze the influence of the dramatic changes in the Spanish labor market during the crisis on the perceived health of the Spanish population.

METHODS

We use the longitudinal Living Conditions Survey database and multilevel longitudinal logistic models between 2007 and 2011, before and during the economic crisis in one of the European countries most affected by its consequences.

RESULTS

Unemployment (OR 1.75; p < 0.001), job insecurity (OR 1.38; p < 0.001), and being part of a household with severe material deprivation (OR 1.87; p = 0.004) increase the risk of having worsened perceived health. Available income, on the other hand, is a protective factor (OR 0.72; p < 0.001). Public expenditure policies have little impact on the perceived health. Labor market reforms reducing the degree of job insecurity and unemployment, together with income transfers to those at greater risk of social deprivation, can be more effective in improving the health of the population than the increase of aggregated social or health care expenditure.

CONCLUSIONS

This study provides evidence of the influence that unemployment, job insecurity, and poverty exert on the perceived health of individuals, with data collected in Spain after the onset of the financial crisis. In addition, after analyzing public social expenditure, only expenditure on FPS seems to influence self-reported health, although to a very limited degree.

Assets among low-income families in the Great Recession

This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898), we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents) and by race/ethnicity (White, Black, and Hispanic mothers). Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty.

Giving Unto Others: Private Financial Transfers and Hardship Among Families with Children

Prior research shows that financial assistance from family and friends is an important source of support for families with children. However, research on financial transfers has largely focused on the recipients of transfers. In this study, using longitudinal data from the Fragile Families and Child Wellbeing Study (n~16,000 person-waves), we examine the association between the provision of financial assistance to family and friends and material hardship. Results from pooled regression and fixed effects models indicate that providing financial transfers is associated with an increased risk of hardship. The most economically disadvantaged groups, single mothers, those in the bottom income tertile, and black mothers, are the most likely to experience hardship after giving a transfer. These findings have important implications for understanding why families may have difficulty meeting basic and essential needs, and how social networks may exacerbate the challenges of escaping poverty and establishing economic self-sufficiency.

The Great Recession and risk for child abuse and neglect

This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N = 3,177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007-2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health.

Intimate Partner Violence in the Great Recession

In the United States, the Great Recession was marked by severe negative shocks to labor market conditions. In this study, we combine longitudinal data from the Fragile Families and Child Wellbeing Study with U.S. Bureau of Labor Statistics data on local area unemployment rates to examine the relationship between adverse labor market conditions and mothers' experiences of abusive behavior between 2001 and 2010. Unemployment and economic hardship at the household level were positively related to abusive behavior. Further, rapid increases in the unemployment rate increased men's controlling behavior toward romantic partners even after we adjust for unemployment and economic distress at the household level. We interpret these findings as demonstrating that the uncertainty and anticipatory anxiety that go along with sudden macroeconomic downturns have negative effects on relationship quality, above and beyond the effects of job loss and material hardship.

Determinants of Health and Pediatric Primary Care Practices

More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association's Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty's negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of poverty-related risks in ways that promote long-term health and well-being for children.

Getting help from 2-1-1: A statewide study of referral outcomes

The 2-1-1 information and referral helpline connects economically vulnerable Americans with needed health and social services in their communities. This longitudinal study followed a random sample of 2-1-1 callers in Missouri (n=1,235) to determine the results of the referrals they received. One month after calling 2-1-1, most remembered receiving (93%), tried contacting (91%) and reached (82%) at least one referral they received. Far fewer (36%) received assistance from the referral, ranging from 17% for housing assistance to 67% for food assistance. Callers receiving assistance were much more likely than those not receiving assistance to report at 1-month follow-up that their problem had been resolved (OR=3.0, 95% CI=2.2, 4.1), although this was less true among callers with multiple unmet basic needs. Findings explain how 2-1-1 helps callers resolve problems, but also identifies missed opportunities in the current system. Future research could elucidate how 2-1-1 callers resolve problems and find ways to improve outcomes for the most disadvantaged 2-1-1 callers.

Socioeconomic Variation in the Effect of Economic Conditions on Marriage and Nonmarital Fertility in the United States: Evidence From the Great Recession

The United States has become increasingly characterized by stark class divides in family structure. Poor women are less likely to marry than their more affluent counterparts but are far more likely to have a birth outside of marriage. Recent theoretical and qualitative work at the intersection of demography and cultural sociology suggests that these patterns are generated because poor women have high, nearly unattainable, economic standards for marriage but make a much weaker connection between economic standing and fertility decisions. We use the events of the Great Recession, leveraging variation in the severity of the crisis between years and across states, to examine how exposure to worse state-level economic conditions is related to poor women’s likelihood of marriage and of having a nonmarital birth between 2008 and 2012. In accord with theory, we find that women of low socioeconomic status (SES) exposed to worse economic conditions are indeed somewhat less likely to marry. However, we also find that unmarried low-SES women exposed to worse economic conditions significantly reduce their fertility; economic standing is not disconnected from nonmarital fertility. Our results suggest that economic concerns were connected to fertility decisions for low-SES unmarried women during the Great Recession.

The impact of cumulative family risks on various levels of food insecurity

The study uses the Fragile Families and Child Well-being Study (N=2025) to examine the relationship between four cumulative family risk indices and refined measures of food hardship: marginal food security, low food security, and very low food security. Regression analyses indicate that cumulative family risk indices are useful in differentiating various levels of food insecurity. Specifically, the maternal poor health and risky health behaviors index is pertinent for distinguishing (1) food insecure from marginal food secure households and (2) very low food secure from low food secure households. In addition, the financial strain index is pertinent for differentiating between marginal food secure families from food secure families among non-poor households. Connecting food assistance programs with established social services may decrease the negative impact that cumulative family-level risk factors have on families' varying levels of food insecurity.

Private Financial Transfers, Family Income, and the Great Recession

Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,701; 1998-2010), the authors studied whether the unemployment rate was associated with private financial transfers (PFTs) among urban families with young children and whether family income moderated these associations. They found that an increase in the unemployment rate was associated with greater PFT receipt and that family income moderated the association. Poor and near-poor mothers experienced increases in PFT receipt when unemployment rates were high, whereas mothers with incomes between 2 and 3 times the poverty threshold experienced decreases. Simulations estimating the impact of the Great Recession suggest that moving from 5% to 10% unemployment is associated with a 9-percentage-point increase in the predicted probability of receiving a PFT for the sample as a whole, with greater increases in predicted probabilities among poor and near poor mothers.

The Great Recession and the risk for child maltreatment

This study draws on the Fragile Families and Child Wellbeing Study (N=2,032), a birth cohort study of families with children from 20 U.S. cities. Interviews occurred between August 2007, and February 2010, when the children were approximately 9 years old. Macro-economic indicators of the Great Recession such as the Consumer Sentiment Index and unemployment and home foreclosure rates were matched to the data to estimate the links between different measures of the Great Recession and high frequency maternal spanking. We find that the large decline in consumer confidence during the Great Recession, as measured by the Consumer Sentiment Index, was associated with worse parenting behavior. In particular, lower levels of consumer confidence were associated with increased levels of high frequency spanking, a parenting behavior that is associated with greater likelihood of being contacted by child protective services.