title: Childhood Adversity and Adult Reports of Food Insecurity Among Households With Children.
abstract: BACKGROUND
  Exposure to childhood adversity, including abuse, neglect, and household dysfunction, is associated with negative long-term health and economic outcomes. Little is known about how adversity exposure in parents' early lives may be related to later food insecurity for parents and their children. This study investigated the association between female caregivers' adverse childhood experiences (ACEs) and household and child food insecurity, taking into account depressive symptoms.
  
  
  METHODS
  This study used cross-sectional data from 1,255 female caregivers of children aged <4 years surveyed in an urban clinical setting from March 2012 through June 2014. Measures included sociodemographic characteristics; caregivers' ACEs, including abuse, neglect, and household dysfunction; depressive symptoms; and household and child food insecurity. Multinomial and logistic regression analyses assessed the relationship among ACEs, depressive symptoms, and household and child food security status.
  
  
  RESULTS
  Caregiver depressive symptoms modified associations between ACEs and food insecurity level. After adjusting for covariates, caregivers reporting both depressive symptoms and four or more ACEs were 12.3 times as likely to report low food security (95% CI=6.2, 24.7); 28.8 times as likely to report very low food security (95% CI=12.8, 64.8); and 17.6 times as likely to report child food insecurity (95% CI=7.3, 42.6) compared with those reporting no depressive symptoms and no ACEs.
  
  
  CONCLUSIONS
  Depressive symptoms and ACEs were independently associated with household and child food insecurity, and depressive symptoms modified the association between ACEs and household and child food insecurity. Comprehensive policy interventions incorporating nutrition assistance and behavioral health may address intergenerational transmission of disadvantage.
authors.affiliation: Department of Epidemiology, Drexel University School of Public Health, Philadelphia, Pennsylvania.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania.
authors.forename: Molly
authors.initials: M
authors.lastname: Knowles
authors.affiliation: Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania.
authors.forename: Falguni
authors.initials: F
authors.lastname: Patel
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Frank
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.affiliation: Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania. Electronic address: mmc33@drexel.edu.
authors.forename: Mariana
authors.initials: M
authors.lastname: Chilton
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005191:Family Characteristics; D005195:Family Relations; D005260:Female; D005523:Food Supply; D006801:Humans; D007223:Infant; D016015:Logistic Models; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult