title: Maternal depression, changing public assistance, food security, and child health status.
abstract: OBJECTIVE
  To examine the association of positive report on a maternal depression screen (PDS) with loss or reduction of welfare support and foods stamps, household food insecurity, and child health measures among children aged < or =36 months at 6 urban hospitals and clinics.
  
  
  METHODS
  A convenience sample of 5306 mothers, whose children <36 months old were being seen in hospital general clinics or emergency departments (EDs) at medical centers in 5 states and Washington, District of Columbia, were interviewed from January 1, 2000 until December 31, 2001. Questions included items on sociodemographic characteristics, federal program participation and changes in federal benefits, child health status rating, child's history of hospitalizations since birth, household food security status, and a 3-question PDS. For a subsample interviewed in the ED, whether the child was admitted to the hospital that day was recorded.
  
  
  RESULTS
  PDS status was associated with loss or reduction of welfare support and food stamps, household food insecurity, fair/poor child health rating, and history of child hospitalization since birth but not low child growth status measures or admission to the hospital at the time of ED visit. After controlling for study site, maternal race, education, and insurance type as well as child low birth weight status, mothers with PDS were more likely to report fair/poor child health (adjusted odds ratio [AOR]: 1.58; 95% confidence interval [CI]: 1.33-1.88) and hospitalizations during the child's lifetime (AOR: 1.20; 95% CI: 1.03-1.39), compared with mothers without PDS. Controlling for the same variables, mothers with PDS were more likely to report decreased welfare support (AOR: 1.52; 95% CI: 1.03-2.25), to have lost food stamps (AOR: 1.56; 95% CI: 1.06-2.30), and reported more household food insecurity (AOR: 2.69; 95% CI: 2.33-3.11) than mothers without PDS.
  
  
  CONCLUSIONS
  Positive maternal depression screen status noted in pediatric clinical samples of infants and toddlers is associated with poorer reported child health status, household food insecurity, and loss of federal financial support and food stamps. Although the direction of effects cannot be determined in this cross-sectional survey, child health providers and policy makers should be aware of the potential impact of maternal depression on child health in the context of welfare reform.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. caseypatrickh@uams.edu
authors.forename: Patrick
authors.initials: P
authors.lastname: Casey
authors.forename: Susan
authors.initials: S
authors.lastname: Goolsby
authors.forename: Carol
authors.initials: C
authors.lastname: Berkowitz
authors.forename: Deborah
authors.initials: D
authors.lastname: Frank
authors.forename: John
authors.initials: J
authors.lastname: Cook
authors.forename: Diana
authors.initials: D
authors.lastname: Cutts
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
authors.forename: Nieves
authors.initials: N
authors.lastname: Zaldivar
authors.forename: Suzette
authors.initials: S
authors.lastname: Levenson
authors.forename: Tim
authors.initials: T
authors.lastname: Heeren
authors.forename: Alan
authors.initials: A
authors.lastname: Meyers
mesh_terms: D001835:Body Weight; D002675:Child, Preschool; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D011632:Public Assistance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology