title: Household Food Insecurity and Mental Health Problems Among Adolescents: What Do Parents Report?
abstract: OBJECTIVE
  To investigate whether adolescents living in households with food insecurity have poorer parent-reported mental health (MH) than peers.
  
  
  METHODS
  We analyzed cross-sectional data from ∼8600 adolescents who participated in the 2007 (8th grade) wave of the Early Childhood Longitudinal Study-Kindergarten. Household food insecurity (HFI) was assessed by parental report on the 18-item US Household Food Security Scale. Total Difficulties score >13 on the parent-reported Strengths and Difficulties Questionnaire (SDQ) indicated problems with adolescent MH. SDQ subscale scores (Emotional, Conduct, Hyperactivity, Peer Problems) were also calculated. Associations between HFI and MH were explored in bivariate and multivariable analyses. Interactions of HFI and gender and HFI and receipt of free/reduced-price school lunch were analyzed with regard to problems with MH.
  
  
  RESULTS
  A total of 10.2% of adolescents lived with HFI; 11.2% had SDQ >13. Adolescents with HFI had higher rates of overall MH problems (28.7% vs 9.2%), emotional problems (21.6% vs 6.6%), conduct problems (26.5% vs 11.6%), hyperactivity (22.4% vs 11.3%), and peer problems (19.8% vs 8.6%) (all P < .01). After adjustment for confounders, the association between HFI and overall MH problems (odds ratio 2.3; 95% confidence interval 1.6-3.3) remained. Interactions of HFI and gender and HFI and free/reduced-price school lunch were not significant.
  
  
  CONCLUSIONS
  HFI was associated with increased risk of parent-reported MH problems among both male and female adolescents. Free/reduced-price school lunch did not significantly alter this relationship. Effective interventions to promote MH and reduce HFI among adolescents are necessary.
authors.affiliation: Department of Pediatrics, Weill Cornell Medical College, Division of Child Development, New York, NY. Electronic address: elp9066@med.cornell.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Poole-Di Salvo
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Division of General Pediatrics, Bronx, NY; The Children's Hospital at Montefiore, Division of General Pediatrics, Bronx, NY.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Silver
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Division of General Pediatrics, Bronx, NY; The Children's Hospital at Montefiore, Division of General Pediatrics, Bronx, NY.
authors.forename: Ruth E K
authors.initials: RE
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D019955:Conduct Disorder / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D010290:Parents; D000066553:Problem Behavior; D019727:Proxy; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Strengths and Difficulties Questionnaire; adolescent; food insecurity; mental health; parent report