Childhood food insecurity: exploring long-term impacts and a public policy mitigation strategy

The physiological, biological, and metabolic impacts of food insecurity experienced in childhood may influence health throughout the lifecourse. In this three-paper dissertation, we explore whether a cohort of Black and White women’s experiences of childhood food insecurity are associated with their weight in young adulthood, their weight in midlife, as well as the weight of their children. In addition, we also investigate whether a direct federal income transfer program targeting families with children can improve food insecurity parameters in Canada, particularly among economically vulnerable groups. Paper 1 and Paper 2 derive data from one site of the National Heart, Lung and Blood Institute Growth and Health Study (NGHS). NGHS is a longitudinal cohort that recruited 883 9-10-year-old Black and White girls in 1987/8 from Contra Costa County, California. Participants provided health, lifestyle, and anthropomorphic data from annual clinic visits and questionnaires for ten years (through 1997/8). From 2015-2019, researchers re-recruited 624 original participants (ages 36-43) and 559 of their children (boys and girls, ages 2-17) to participate in a second wave, which implemented a retrospective measure to gauge the frequency in which the quantity and diversity of their available food was impacted by resource shortages from ages 5-11. We used responses to characterize experiences of childhood food insecurity.Paper 1 assesses the relationship between childhood food insecurity and Body Mass Index (BMI) in young adulthood (age 18-20) and midlife (age 36-43) among Black and White women. We identified a higher average BMI among Black women reporting moderate childhood food insecurity than Black or White women reporting full food security in young adulthood (N=593) that abated by midlife. As well, a substantially larger average BMI among White women reporting severe childhood food insecurity compared to White women reporting full food security during midlife (N=617). These findings suggest that childhood food insecurity may have a lasting association with weight status and that racial differences and age moderate the relationship between childhood food insecurity and BMI. Paper 2 investigates whether maternal childhood food insecurity is associated with odds of overweight/obesity among offspring (N=483), presenting findings for effect modification by age (continuous), current household food security status (food secure vs. food insecure) and maternal race (Black or White). We found no significant difference in the odds of overweight/obesity among most levels of food insecurity, but significantly lower odds among children whose mothers reported moderate child food insecurity. This relationship was strongest among children currently living in food secure homes, with White mothers, and between the ages of 2-5, respectively. We believe that mothers’ desire to protect their children from their own adverse experiences may serve as a protective factor against food and dietary behaviors that may increase overweight/obesity risk.Paper 3 assesses whether the roll-out of the Canada Child Benefit (CCB), a federal direct income transfer program, offered protection against food insecurity among Canadian households with children among three groups with different income thresholds: households reporting any income (N=41,455), the median income or less (N=18,191) and the Low Income Measure (LIM) or less (N=7,579). Data are derived from the Canadian Community Health Survey (CCHS), an annual, cross-sectional study that collects health, sociodemographic, and health-related information at the sub-provincial level from a representative sample of Canadians. Households with children experienced greater drops in the likelihood of experiencing severe food insecurity following CCB than those without, most dramatically among those reporting the LIM or less, which suggests that CCB disproportionately benefited families most susceptible to food insecurity. As well, that food insecurity may be impacted by even modest changes to economic circumstance, speaking to the potential of income transfers to help people meet their basic needs.

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