Although we live in a wealthy Nation, food insecurity—that is, when individuals and families have limited access to food or their ability to obtain food is limited or uncertain due to lack of financial resources—continues to affect millions of American families. According to the most recent data released in 2005 by USDA, food insecurity affected 11.9 percent of U.S households in 2004.
African-American female-headed households are more likely to experience food insecurity than other groups
Analyses of national survey data by researchers of USDA’s Economic Research Service also documented racial and regional differences in the likelihood of food insecurity and hunger among households. African-American and Hispanic households are more likely than White households to be food insecure and hungry, and rural African-Americans are especially vulnerable group. Further, households at higher risk of being unable to secure adequate amounts of food because of financial constraints are generally headed by single women, particularly African-American women.
Although analyses at the national level have produced new insights into some aspects of the prevalence of food insecurity and hunger, the adverse health impact of food insecurity is not well described. Little systematic information exists that delineates the harmful health consequences of food insecurity as measured with the USDA 18-item Core Food Security Module (CFSM). The limited information available suggests that children from food-insufficient and hungry homes have poorer overall health than children from food-secure households. Furthermore, children who live in food-insufficient households are more likely to have poorer mental health and be withdrawn or socially disruptive. Some studies have examined the impact of food insufficiency as measured by a scale derived from National Health and Nutrition Examination Survey III on health status among adults in urban areas. In these studies, poor or fair self-rated health status and depression are associated with food insufficiency. However, reports of the relationship between household food insecurity and health status in rural areas are limited. Despite its potential impact on health and well-being, surprisingly little research has been done on the relationship between household food insecurity as measured by the CFSM and the physical and mental health among poor female-headed families in the rural South. Therefore, the purpose of this study is to determine the prevalence of food insecurity and describe the association of food insecurity with health status and depression.
The sample for this study, 300 female-headed families who were receiving welfare and/or food stamp benefits, was drawn from a list of families in five counties that participated in previous studies. Subjects were selected using random stratified sampling methodology. Participants in previous studies were low-income individuals living in neighborhoods characterized by high rates of poverty or welfare receipt. The location of single mothers was reestablished through contacts with community informants, contact at previous addresses, and local churches. Face-to-face, in-home, structured interviews were conducted from June 2005 to September 2006. The interviews lasted about 90 minutes. Prevalence of food insecurity and self-reported health status were measured using a structured questionnaire based on the CFSM and other questionnaires constructed and previously used that were approved by the Human Subject Participants Review Committee, Tuskegee University. Depression was measured using the Center for Epidemiological Studies Depression Scale. Descriptive statistics and multivariate analyses (multiple regression) were used in data analyses.
Food insecurity among single mothers in the five Alabama counties well exceeded State and national averages.
The study found that about 36 percent of the single mothers were food insecure. That is, at some time between 2004 and 2005, these low-income single women had difficulty providing enough food for their children due to lack of resources. The prevalence of food insecurity in the study region was about three times the average for the Nation (11.9 percent) and for the State of Alabama (12.2 percent) between 2002 and 2004.
Consistent with some previous research, the study also found that the association between food insecurity and depression is statistically significant. Single mothers that are food insecure report significantly higher levels of depression. Food insecurity explains about 10 percent of the variation in depression. Health status follows a similar pattern. Food insecurity is statistically associated with self-reported health status in this sample. Single mothers who are food insecure are significantly more likely to report poor or fair health than those who are food secure.
The multiple regression analyses, controlling for background and sociodemographic factors, indicated that, among the predictor variables, food insecurity is still a statistically significant predictor of depression and self-reported health. Food insecurity is by far the strongest predictor of depression among these low-income single mothers in rural Alabama. In accordance with earlier studies, single mothers with less education and who were unemployed at the time of the interview reported significantly higher levels of depression.
Taken together, this set of analyses provides support for the hypothesis that food insecurity is associated with depression and self-reported health status even when sociodemographic variables are controlled. The results of the study suggest that, using the USDA food security scale, more than a third of low-income single mothers from rural Alabama are food insecure.
Overall, the findings of the study are consistent with growing evidence that food insufficiency is associated with depression and self-reported health status. The only difference is that, while this study used the CFSM to measure food insecurity, a majority of the previous studies used a single-item measure of food insufficiency. The study suggests to program administrators and policymakers that preventive measures to decrease food insecurity among low-income single mothers may lower the risk of major depression. Finally, the study recommends that further research is needed. The cross-sectional nature of the study, limitations of measurements, and self-reported data must be considered when interpreting the results of the analyses.