Maternal Depression, Changing Public Assistance, Food Security, and Child Health Status

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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 ≤36 months at 6 urban hospitals and clinics. Methods. A convenience sample of 5306 mothers, whose children 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. Conclusion. 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.