Psychosocial Factors and Socioeconomic Indicators Are Associated with Household Food Insecurity among Pregnant Women

Abstract

Household food insecurity has been associated with several negative health outcomes, yet little is known about the prevalence and correlates of household food insecurity during pregnancy. This study was conducted as part of the Pregnancy, Infection, and Nutrition prospective cohort study to identify risk factors of preterm birth. The USDA 18-item scale was used to assess the prevalence of food insecurity among pregnant women with incomes <or= 400% of poverty. Descriptive statistics and logistic regression were used to identify socioeconomic, demographic, and psychosocial predictors of household food insecurity. Among 606 pregnant women, 75% were from fully food-secure, 15% from marginally food-secure, and 10% from food-insecure households. Women from marginally food-secure and food-insecure households had significantly less income, less education, and were older than women from fully food-secure households. In bivariate analysis, all psychosocial factors were significantly associated with household food insecurity and showed a dose-response relation with increasing food insecurity. Socioeconomic and demographic predictors for household food insecurity were income, black race, and age. After controlling for socioeconomic and demographic variables, psychosocial indicators of perceived stress, trait anxiety, and depressive symptoms, and a locus of control attributed to chance were positively associated with any household food insecurity. Conversely, self-esteem and mastery were inversely associated with any household food insecurity. Psychosocial factors as well as socioeconomic and demographic indicators are associated with household food insecurity among pregnant women; however, the direction of causation between psychosocial indicators and food insecurity cannot be determined in these data.

Food insecurity among adults residing in disadvantaged urban areas: potential health and dietary consequences

“…Other potential determinants of food insecurity include belonging to an ethnic minority (10,(16)(17)(18) , having a lower level of education (10,(15)(16)(17) , being of younger age (16,19) and family type (single-parent family v. couples with children) (9,10,14,20) . Food insecurity may be associated with lower fruit and vegetable intakes (21)(22)(23)(24)(25) , lower consumption of lean meats (21,23) , poorer general health (13,20,21,23,(26)(27)(28)(29) , chronic conditions such as CVD (20,(30)(31)(32) and depression (26,27,(33)(34)(35)(36)(37) , and overweight or obesity among women (38)(39)(40)(41)(42)(43)(44) . There are several hypothesised mechanisms through which food insecurity may be associated with th...…”

Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

“…Women's responsibilities in managing family feeding (7) , gender bias in the experience of FI (8) and unequal control over household resources make them particularly vulnerable to FI and its consequences (3) . Data from the USA indicate that, when faced with FI, women suffer a range of negative nutritional (9) and psychosocial consequences (10,11) .Pregnant women are more likely to experience greater FI than non-pregnant women because they have higher nutrient demands, less physical ability to obtain and prepare food (especially later in pregnancy and early postpartum) and less ability to engage in income-generating labour (10) . The three studies to date about FI among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women's health (9)(10)(11) .…”

“…Data from the USA indicate that, when faced with FI, women suffer a range of negative nutritional (9) and psychosocial consequences (10,11) .…”

“…Pregnant women are more likely to experience greater FI than non-pregnant women because they have higher nutrient demands, less physical ability to obtain and prepare food (especially later in pregnancy and early postpartum) and less ability to engage in income-generating labour (10) . The three studies to date about FI among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women's health (9)(10)(11) .…”

“…The three studies to date about FI among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women's health (9)(10)(11) . However, all of these studies were done in the USA and contextual differences between resource-rich and resource-poor settings make the generalizability of these findings questionable.…”