Steven Garasky

Linking psychosocial stressors and childhood obesity

Research has established a wide array of genetic and environmental factors that are associated with childhood obesity. The focus of this review is on recent work that has established the relationship between one set of environmental factors, stressors and childhood obesity. These stressors are particularly prevalent for low‐income children, a demographic group that has high rates of obesity in the USA and other developed countries. In this review, we begin by summarizing the psychosocial stressors faced by children followed by health outcomes associated with exposure to these stressors documented in the literature. We then summarize 11 articles which examined the connection between psychosocial stressors in the household and obesity and eight articles which examined the connection between individual psychosocial stressors and obesity. Policy recommendations emerging from this research include recognizing reductions in childhood obesity as a potential added benefit of social safety net programmes that reduce financial stress among families. In addition, policies and programmes geared towards childhood obesity prevention should focus on helping children build resources and capacities to teach them how to cope effectively with stressor exposure. We conclude with suggestions for future research.

Food Security, Maternal Stressors, and Overweight Among Low-Income US Children: Results From the National Health and Nutrition Examination Survey (1999–2002)

OBJECTIVE. A high proportion of children in the United States are overweight, suffer from food insecurity, and live in households facing maternal stressors. The objective of this article was to identify the associations of food insecurity and maternal stressors with childhood overweight among low-income children. We hypothesized that maternal stressors may exacerbate the relationship between food insecurity and child obesity. METHODS. The sample included 841 children (3–17 years old) and their mothers with incomes below 200% of the poverty line from the 1999–2002 National Health and Nutrition Examination Survey. Food insecurity was based on US Department of Agriculture protocol, maternal stressors were assessed from survey questions, and BMI was used to classify weight status. Probit regression models predicted the probability of a child being overweight or obese. RESULTS. In most specifications, there was no direct association between food insecurity or maternal stressors and overweight for children of any age. Among 3- to 10-year-olds, the interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight; more specifically, an increase in maternal stressors amplified a food secure childs probability of being overweight or obese. This result is robust to alternative specifications. However, these results were not found among 11- and 17-year-old youth. CONCLUSIONS. Younger children in food secure, low-income households in the United States who are experiencing higher levels of maternal stressors have a greater probability of being overweight than food insecure children. This finding was contrary to the hypothesis; 3 reasons for this are covered in the article. Those who create policies that address childhood obesity could consider the benefits to low-income childrens well-being resulting from reducing their mothers stressors. Because most children in the United States are food secure, these policies could have a profound impact on childhood overweight.

Is food insecurity related to overweight and obesity in children and adolescents? A summary of studies, 1995-2009.

In the USA, several nutrition‐related issues confront the normal growth, maturation and development of children and adolescents including obesity and food insecurity. The purpose of this paper is to provide a review of the concept of food insecurity and a summary of studies that have examined the association between food insecurity and overweight/obesity in children and adolescents. Besides the initial case report, we review 21 studies (16 cross‐sectional and five prospective studies) that have been published on this topic as of December 2009. As there is limited literature in this area, we review studies that sample children and adolescents in the USA. The results are mixed with positive, negative and null associations. The reasons for the mixed results are difficult to disentangle. Among earlier studies, small samples hampered definitive conclusions. More recent studies with larger samples have overcome these limitations and tend to find no associations between these constructs. Nonetheless, all of the studies to date have shown that food insecurity and overweight co‐exist – that is, even though there may not be statistically significant differences in overweight between food‐insecure and food‐secure children, the prevalence of overweight remains relatively high in food‐insecure children.

Custodial Fathers: Myths, Realities, and Child Support Policy

Men are increasingly receiving custody of their children, and single-father families with children are increasing at a faster rate than even single-mother families. Howewer, many observers still believe that there are few custodial fathers. Indeed, there are number of myths concerning custodial fathers. We examine three data sets and determine that many of these assumptions about custodial fathers are simply not true. We argue that current child support policies should be re-examined to ensure that they follow the same principles when the custodial parent is the father as when the custodial parent is the mother.

Food Insecurity Is Not Associated with Childhood Obesity as Assessed Using Multiple Measures of Obesity

There has been extensive previous research examining the connection between obesity and food insecurity, 2 serious nutrition challenges facing low-income children in the US. All of this work used BMI to categorize a child as obese. Although BMI is one way to categorize the obesity status of a child, other measures have not been used to understand the connection between food insecurity and obesity. In response, this study used multiple measures of obesity taken from the 2001 to 2004 NHANES. The sample included 2516 children between the ages of 8 and 17 y in households with annual incomes <200% of the poverty line. Within this sample, 36.6% of children were in food-insecure households. The prevalence of obesity depended on the measure employed (BMI, waist circumference, triceps skinfold thickness, trunk fat mass, body fat), with prevalence rates ranging from 15.4 to 44.8%. Logistic regression models estimated the probability of a child being obese using multiple measures of obesity conditional on food-insecurity status and other covariates. The results indicated that food-insecure children were no more likely to be obese than their food-secure counterparts across all measures of obesity. This relationship held after controlling for other factors and examining subpopulations based on race/ethnicity, gender, and race/ethnicity and gender. These results suggest that efforts to alleviate food insecurity and childhood obesity will work independently.

Adolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family Stressors

PURPOSEnA high proportion of adolescents living in low-income households in the United States are overweight or obese, food insecure, or exposed to high levels of individual, maternal, and family stressors. The aim of this paper was to identify the associations of food insecurity and the aforementioned stressors with an adolescents propensity to be overweight or obese. We hypothesized that individual, maternal, and family stressors may exacerbate the relationship between food insecurity and adolescent overweight/obesity.nnnMETHODSnThe sample included 1011 adolescents aged 10 to 15 years and their mothers in families with incomes below 200% of the poverty line from Wave 1 of the Welfare, Children, and Families: A Three-City Study (Three-City Study).nnnRESULTSnA series of logistic regressions predicted the probability of an adolescent being overweight or obese. Overall, higher levels of individual stressors increased the probability of being overweight or obese for adolescents, whereas there was no direct association between food insecurity, maternal, or family stressors and overweight or obesity. The interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight or obese; more specifically, an increase in maternal stressors amplified a food insecure adolescents probability of being overweight or obese.nnnCONCLUSIONSnPolicies addressing adolescent obesity should consider the benefits to reducing the individual stressors facing low-income adolescents and, for food insecure adolescents, the benefits to reducing their mothers stressors.

Where are they going? A comparison of urban and rural youths' locational choices after leaving the parental home

Abstract The decision for adolescents and young adults to leave their parents and their home community is complex and difficult. This study of youth migration focuses on the geographical location to which urban and rural youths relocate upon exiting their parental household. Little is known about destination choices of youths, especially how they differ for youths from urban and rural areas. A multinomial logit model of migration destination choices that incorporates individual, household, and community-level factors is estimated with data from the 1979 cohort of the National Longitudinal Survey of Youth. Results indicate that while the local economy and labor market are important to the migration decision, the magnitudes of these effects are generally small. Non-economic individual, household, and community factors play an important role in the migration process, as well. The magnitudes of non-economic factor effects generally are greater for rural youths compared to urban youths.

Reconsidering the increase in father-only families

Previously reported estimates of rapid growth rates among father-only families did not account for cohabitation. An explicit treatment of cohabitation removes about half of the presumed growth. Nevertheless, we find that the number of father-only families grew at more than double the rate of mother-only families during the 1980s. Decomposition analyses show that the largest factor associated with the increase is that fathers now head a greater proportion of all formerly married single-parent families with children. Although the share of single-parent families headed by fathers is larger in 1990 than in 1980 even after controlling for cohabitation, it is smaller than in 1970.

The Effects of the Local Food Environment and Social Support on Rural Food Insecurity

ABSTRACT Local food environments and the social relationships of people across rural communities are part of the infrastructure that supports rural quality of life. In this study, we examine the relationship between a weak food infrastructure and rural food insecurity to discover differences among rural places in the American Midwest. We find that high local food prices and an inadequate number of food stores are viewed by families as obstacles to meeting their food needs. Some households counteract the local environment by shopping outside the county, farming, or relying on informal support networks. Transportation difficulties exacerbate food acquisition problems, while institutional support provided through food programs is not always effective. Implications for involving low-income rural families in program development are provided.

The Supplemental Nutrition Assistance Program, Financial Stress, and Childhood Obesity

The Supplemental Nutrition Assistance Program (SNAP) is the largest nutritional assistance program addressing food insecurity in the United States. Due to the programs reach, SNAP has been called upon to address other nutrition-related challenges facing low-income Americans, including childhood obesity. This study considers the effect of SNAP participation on child weight outcomes after controlling for household financial stress, an important determinant of child overweight status that disproportionately affects low-income households. Using data from the Survey of Household Finances and Childhood Obesity and instrumental variable methods, we find that SNAP participation is negatively associated with obesity among eligible children.