The relationship between childhood adversity and food insecurity: ‘It’s like a bird nesting in your head

• Published in: Public health nutrition Vol. 18; no. 14; pp. 2643 - 2653
• Main Authors: Chilton, Mariana, Knowles, Molly, Rabinowich, Jenny, Arnold, Kimberly T
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2015
• Subjects: academic achievement; Adolescent; Adult; Adults; Adverse childhood experiences; Anxiety; Caregivers; Caregivers - psychology; Child; Child Abuse; Child development; Child Health; childhood; children; Children & youth; Community nutrition; Domestic violence; Drug abuse; Employment; Families & family life; Family Characteristics; Female; Food security; Food stamps; Food Supply; Households; Humans; Hunger; Interviews; issues and policy; Low income groups; Male; Mental depression; Mental Health; mothers; Mothers - psychology; Nesting; Nutrition; Pennsylvania; Perception; Philadelphia; Poverty; Public assistance programs; Research Papers; Risk Factors; Sex crimes; Social Environment; Social isolation; Socioeconomic Factors; Stress; substance abuse; surveys; Trauma; violence; Young Adult; Philadelphia; United States > US; Pennsylvania; Food insecurity; Adverse childhood experiences; Violence; Very low food security
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980014003036

Adverse childhood experiences, including abuse, neglect and household instability, affect lifelong health and economic potential. The present study investigates how adverse childhood experiences are associated with food insecurity by exploring caregivers' perceptions of the impact of their childhood adversity on educational attainment, employment and mental health. Semi-structured audio-recorded in-person interviews that included (i) quantitative measures of maternal and child health, adverse childhood experiences (range: 0-10) and food security using the US Household Food Security Survey Module; and (ii) qualitative audio-recorded investigations of experiences with abuse, neglect, violence and hunger over participants' lifetimes. Households in Philadelphia, PA, USA. Thirty-one mothers of children <4 years old who reported low or very low household food security. Twenty-one caregivers (68 %) reported four or more adverse childhood experiences, and this severity was significantly associated with reports of very low food security (Fisher's exact P=0·021). Mothers reporting emotional and physical abuse were more likely to report very low food security (Fisher's exact P=0·032). Qualitatively, participants described the impact of childhood adverse experiences with emotional and physical abuse/neglect, and household substance abuse, on their emotional health, school performance and ability to maintain employment. In turn, these experiences negatively affected their ability to protect their children from food insecurity. The associations between mothers' adverse experiences in childhood and reports of current household food security should inspire researchers, advocates and policy makers to comprehensively address family hardship through greater attention to the emotional health of caregivers. Programmes meant to address nutritional deprivation and financial hardship should include trauma-informed approaches that integrate behavioural interventions.