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Journal Article

WIC Participation and Attenuation of Stress-Related Child Health Risks of Household Food Insecurity and Caregiver Depressive Symptoms

By Black M, Quigg A, Cook J, Casey P, Cutts D, Chilton M, Meyers A, Ettinger de Cuba S, Heeren T, Coleman S, Rose-Jacobs R, Frank D


Objectives: To examine how family stressors (household food insecurity and/or caregiver depressive symptoms) relate to child health and whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) attenuates stress-related child health risks.

Design: Cross-sectional family stress and cumulative stress models from January 1, 2000, through December 31, 2010.

Setting: Families recruited from emergency departments and/or primary care in Baltimore, Boston, Little Rock, Los Angeles, Minneapolis, Philadelphia, and Washington, DC.

Participants: Participants included 26,950 WIC-eligible caregivers and children younger than 36 months; 55.2% were black, 29.9% were Hispanic, and 13.0% were white. Caregivers’ mean age was 25.6 years; 68.6% were US-born, 64.7% had completed high school, 38.0% were married, and 36.5% were employed.

Main Exposures: Of the participants, 24.0% had household food insecurity and 24.4% had depressive symptoms; 9.1% had both stressors, 29.9% had 1 stressor, and 61.0% had neither; 89.7% were WIC participants.

Outcome Measures: Caregivers reported child health, lifetime hospitalizations, and developmental risk. Weight and length were measured. We calculated weight-for-age and length-for-age z scores and the risk of underweight or overweight. The well-child composite comprised good/excellent health, no hospitalizations, no developmental risk, and neither underweight nor overweight.

Results: In multivariate analyses adjusted for covariates, as stressors increased, odds of fair/poor health, hospitalizations, and developmental risk increased and odds of well-child status decreased. Interactions between WIC participation and stressors favored WIC participants over nonparticipants in dual stressor families on 3 child health indicators: (1) fair/poor health: WIC participants, adjusted odds ratio (aOR), 1.89 (95% CI, 1.66-2.14) vs nonparticipants, 2.35 (2.16-4.02); (2) well-child status: WIC participants, 0.73 (0.62-0.84) vs nonparticipants, 0.34 (0.21-0.54); and (3) overweight: WIC participants, 1.01 (0.88-1.16) vs nonparticipants, 1.48 (1.04-2.11) (P = .06).

Conclusions: As stressors increased, child health risks increased. WIC participation attenuates but does not eliminate child health risks.

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Date Added
March 21, 2018

Black, M, Quigg, A, Cook, J, Casey, P, Cutts, D, Chilton, M, Meyers, A, Ettinger de Cuba, S, Heeren, T, Coleman, S, Rose-Jacobs, R, & Frank, D 2012, 'WIC participation and attenuation of stress-related child health risks of household food insecurity and caregiver depressive symptoms', Archives Of Pediatrics & Adolescent Medicine, 166, 5, pp. 444-451. Available online: https://www.ncbi.nlm.nih.gov/pubmed/?term=WIC+participation+and+attenuation+of+stress-related+child+health+risks+of+household+food+insecurity+and+caregiver+depressive+symptoms