Food Insecurity and Children’s Mental Health: A Prospective Birth Cohort Study

Food insecurity (which can be defined as inadequate access to sufficient, safe, and nutritious food that meets individuals’ dietary needs) is concurrently associated with children’s psychological difficulties. However, the predictive role of food insecurity with regard to specific types of children’s mental health symptoms has not previously been studied. We used data from the Longitudinal Study of Child Development in Québec, LSCDQ, a representative birth cohort study of children born in the Québec region, in Canada, in 1997–1998 (n = 2120). Family food insecurity was ascertained when children were 1½ and 4½ years old. Children’s mental health symptoms were assessed longitudinally using validated measures of behaviour at ages 4½, 5, 6 and 8 years. Symptom trajectory groups were estimated to identify children with persistently high levels of depression/anxiety (21.0%), aggression (26.2%), and hyperactivity/inattention (6.0%). The prevalence of food insecurity in the study was 5.9%. In sex-adjusted analyses, children from food-insecure families were disproportionately likely to experience persistent symptoms of depression/anxiety (OR: 1.79, 95% CI 1.15–2.79) and hyperactivity/inattention (OR: 3.06, 95% CI 1.68–5.55). After controlling for immigrant status, family structure, maternal age at child’s birth, family income, maternal and paternal education, prenatal tobacco exposure, maternal and paternal depression and negative parenting, only persistent hyperactivity/inattention remained associated with food insecurity (fully adjusted OR: 2.65, 95% CI 1.16–6.06). Family food insecurity predicts high levels of children’s mental health symptoms, particularly hyperactivity/inattention. Addressing food insecurity and associated problems in families could help reduce the burden of mental health problems in children and reduce social inequalities in development.     

Seasonal changes in household food insecurity and symptoms of anxiety and depression

There is growing awareness that common mental health disorders are key contributors to the burden of disease in developing countries. Studies examining the correlates of mental health have primarily been carried out in urban settings and focused on the burden rapid economic change places on individuals. In these settings, poverty and low education are consistent predictors of anxiety and depressive symptoms. We argue here that these variables are proxies for insecurity, and that a more general model of symptoms of depression and anxiety should focus on locally salient forms of insecurity. Building on previous work in a seasonal subsistence setting, we identify food insecurity as a potent source of insecurity in a rural African setting, and then test whether seasonal changes in food insecurity are correlated with concomitant changes in a measure of symptoms of anxiety and depression among 173 caretakers. Results indicate that food insecurity is a strong predictor of symptoms of anxiety and depression (P < 0.0001), that changes in food insecurity across the seasons predict changes in symptoms of anxiety and depression (P < 0.0001), and that this is robust to the inclusion of covariates for material assets and household production. These results hold for individuals in both ethnic groups studied (Pimbwe and Sukuma); however, at the group level the burden falls disproportionately on Pimbwe. The results add to the growing literature on the causes of population level differences in mental health disorders and suggest new research avenues and strategies to link mental health disorders with variation in physical and biosocial outcomes.     

Niveles de micronutrientes en niños escolares colombianos e inseguridad alimentaria

Introduction:

Half of the Colombian households experience some degree of food insecurity. Food insecurity has been associated with malnutrition, which could result in micronutrient deficiencies in children; however, the evidence is not conclusive.

Objective:

To examine the associations between food insecurity and blood concentrations of hemoglobin, ferritin, vitamin A, vitamin B12, folate, and zinc in school-age children from Bogotá, Colombia.

Materials and methods:

We conducted a cross-sectional study among 2,660 children aged 5-12 from Bogotá''s public schools. We assessed their household food insecurity level with the Spanish version of the Household Food Security Survey Module (HFSSM), a validated scale, and quantified blood biomarkers of iron, vitamin A, folate, vitamin B12, and zinc status. We examined the associations between food insecurity, severe hunger, and micronutrient status biomarkers using propensity scores.

Results:

Three-quarters of households had some degree of food insecurity and 12 % had food insecurity and severe hunger. Prevalence of marginal vitamin B12 status and vitamin A and zinc deficiencies were, respectively, 17%, 14%, and 1.4%. Compared with children from households without severe hunger, those exposed to it had lower adjusted mean concentrations of vitamin A, vitamin B12, and folate, but these differences were not statistically significant.

Conclusion:

Food insecurity with severe hunger was not associated with micronutrient status biomarkers in Colombian school-age children. The HFSSM may adequately measure hardship in food acquisition due to lack of resources, but it does not yield an index that is associated with micronutrient status biomarkers.     

Can the world afford to ignore biotechnology solutions that address food insecurity?

Genetically engineered (GE) crops can be used as part of a combined strategy to address food insecurity, which is defined as a lack of sustainable access to safe and nutritious food. In this article, we discuss the causes and consequences of food insecurity in the developing world, and the indirect economic impact on industrialized countries. We dissect the healthcare costs and lost productivity caused by food insecurity, and evaluate the relative merits of different intervention programs including supplementation, fortification and the deployment of GE crops with higher yields and enhanced nutritional properties. We provide clear evidence for the numerous potential benefits of GE crops, particularly for small-scale and subsistence farmers. GE crops with enhanced yields and nutritional properties constitute a vital component of any comprehensive strategy to tackle poverty, hunger and malnutrition in developing countries and thus reduce the global negative economic effects of food insecurity.     

Effects of welfare reform on household food insecurity across generations

This study estimates the effects of welfare reform in the 1990s, which permanently restructured and contracted the cash assistance system in the U.S., on food insecurity—a fundamental form of material hardship—of the next generation of households. An implicit goal underlying welfare reform was the disruption of an assumed intergenerational transmission of disadvantage; however, little is known about the effects of welfare reform on the well-being of the next generation of adults. Using intergenerational data from the Panel Study of Income Dynamics and a variation on a difference-in-differences framework, this study exploits 3 sources of variation in childhood exposure to welfare reform: (1) risk of exposure across birth cohorts; (2) variation of exposure within cohorts because different states implemented welfare reform in different years; and (3) variation between individuals with the same exposure who were more likely and less likely to rely on welfare. We found that exposure to welfare reform led to decreases in food insecurity of the next generation of households, by about 10% for a 5-year increase in exposure, with stronger effects for individuals exposed for longer durations during childhood, individuals exposed in early childhood (0–5 years), and women. We also found smaller favorable effects for individuals whose mothers had less than a high school education, indicating that in terms of food insecurity, welfare reform led to relative disadvantages among the most disadvantaged and thus could be exacerbating socioeconomic and health inequalities.     

Food Insecurity as a Barrier to Sustained Antiretroviral Therapy Adherence in Uganda

Background

Food insecurity is emerging as an important barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, but little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions.

Methodology

We conducted in-depth, open-ended interviews with 47 individuals (30 women, 17 men) living with HIV/AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interferes with ARV therapy regimens. Interviews were transcribed, coded for key themes, and analyzed using grounded theory.

Findings

Food insecurity was common and an important barrier to accessing medical care and ARV adherence. Five mechanisms emerged for how food insecurity can contribute to ARV non-adherence and treatment interruptions or to postponing ARV initiation: 1) ARVs increased appetite and led to intolerable hunger in the absence of food; 2) Side effects of ARVs were exacerbated in the absence of food; 3) Participants believed they should skip doses or not start on ARVs at all if they could not afford the added nutritional burden; 4) Competing demands between costs of food and medical expenses led people either to default from treatment, or to give up food and wages to get medications; 5) While working for food for long days in the fields, participants sometimes forgot medication doses. Despite these obstacles, many participants still reported high ARV adherence and exceptional motivation to continue therapy.

Conclusions

While reports from sub-Saharan Africa show excellent adherence to ARVs, concerns remain that these successes are not sustainable in the presence of widespread poverty and food insecurity. We provide further evidence on how food insecurity can compromise sustained ARV therapy in a resource-limited setting. Addressing food insecurity as part of emerging ARV treatment programs is critical for their long-term success.     

High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal,West Africa

Background

Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes.

Methods

We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review.

Results

One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01).

Conclusions

Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population.     

Bayesian inference of genetic parameters for ultrasound scanning traits of Kivircik lambs

Ultrasound scanning traits have been adapted in selection programs in many countries to improve carcass traits for lean meat production. As the genetic parameters of the traits interested are important for breeding programs, the estimation of these parameters was aimed at the present investigation. The estimated parameters were direct and maternal heritability as well as genetic correlations between the studied traits. The traits were backfat thickness (BFT), skin+backfat thickness (SBFT), eye muscle depth (MD) and live weights at the day of scanning (LW). The breed investigated was Kivircik, which has a high quality of meat. Six different multi-trait animal models were fitted to determine the most suitable model for the data using Bayesian approach. Based on deviance information criterion, a model that includes direct additive genetic effects, maternal additive genetic effects, direct maternal genetic covariance and maternal permanent environmental effects revealed to be the most appropriate for the data, and therefore, inferences were built on the results of that model. The direct heritability estimates for BFT, SBFT, MD and LW were 0.26, 0.26, 0.23 and 0.09, whereas the maternal heritability estimates were 0.27, 0.27, 0.24 and 0.20, respectively. Negative genetic correlations were obtained between direct and maternal effects for BFT, SBFT and MD. Both direct and maternal genetic correlations between traits were favorable, whereas BFT–MD and SBFT–MD had negligible direct genetic correlation. The highest direct and maternal genetic correlations were between BFT and SBFT (0.39) and between MD and LW (0.48), respectively. Our results, in general, indicated that maternal effects should be accounted for in estimation of genetic parameters of ultrasound scanning traits in Kivircik lambs, and SBFT can be used as a selection criterion to improve BFT.     

HIV/AIDS,Food Supplementation and Livelihood Programs in Uganda: A Way Forward?

Background

Over the last decade, health, nutrition and policy experts have become increasingly aware of the many ways in which food insecurity and HIV infection negatively impact and reinforce one another. In response, many organizations providing HIV care began supplying food aid to clients in need. Food supplementation, however, was quickly recognized as an unsustainable and incomplete intervention. Many HIV care organizations therefore developed integrated HIV and livelihood programs (IHLPs) to target the root causes of food insecurity.

Methods and Findings

We conducted a qualitative study using in-depth interviews with 21 key informants who worked at seven organizations providing HIV care, food aid, or IHLPs in Kampala, Uganda in 2007-2008 to better understand the impact of IHLPs on the well-being of people living with HIV and AIDS (PLWHAs) and the challenges in transitioning clients from food aid to IHLPs. There was strong consensus among those interviewed that IHLPs are an important intervention in addressing food insecurity and its adverse health consequences among PLWHAs. Key informants identified three main challenges in transitioning PLWHAs from food supplementation programs to IHLPs: (1) lack of resources (2) timing of the transition and (3) logistical considerations including geography and weather. Factors seen as contributing to the success of programs included: (1) close involvement of community leaders (2) close ties with local and national government (3) diversification of IHLP activities and (4) close integration with food supplementation programs, all linked through a central program of HIV care.

Conclusion

Health, policy and development experts should continue to strengthen IHLPs for participants in need. Further research is needed to determine when and how participants should be transitioned from food supplementation to IHLPs, and to determine how to better correlate measures of food insecurity with objective clinical outcomes so as to better evaluate program results.     

MAGNITUDE AND TIMING OF INBREEDING DEPRESSION IN SCOTS PINE (PINUS SYLVESTRIS L.)

Inbreeding depression is a major selective force favoring outcrossing in flowering plants. However, some self-fertilization should weaken the harmful effects of inbreeding by exposing deleterious alleles to selection. This study examines the maintenance of inbreeding depression in the predominantly outcrossing species Pinus sylvestris L. (Scots pine). Open-pollinated and self-fertilized progeny of 23 maternal trees, originating from a natural stand in southern Finland, were grown at two sites. We observed significant inbreeding depression in two of the four life stages measured. Inbreeding depression was largest for seed maturation (δ = 0.74), where seedset in open-pollinated strobili (70.9%) was about four times higher than in selfed strobili (18.3%). Inbreeding depression in postgermination survival (upto an age of 23 years) was also high (δ = 0.62–0.75). No significant differences in height (δ = 0.05) or flowering (δ = 0.14) of the trees after 23 years were observed. Cumulative inbreeding depression was high (δ = 0.90–0.94) and differed significantly among maternal families (range 0.45–1.00). The magnitude of inbreeding depression among the 23 maternal parents was not significantly correlated between early (seed maturation) and later (postgermination survival) life stages, suggesting that its genetic basis varies across the life cycle. Size differences among the progeny types diminished in time due to nonrandom size-specific mortality, causing a decrease in the inbreeding depression estimates for height over time. Our results indicate that Scots pine exhibits high levels of inbreeding depression during both early and later stages of the life cycle. It is argued that self-fertilization in Scots pine is inefficient in purging the genetic load caused by highly deleterious mutations because of the nearly complete loss of selfed individuals over time. This results in an effectively random mating outcrossing population.     

Stability and Change in In-Group Mate Preferences among Young People in Ethiopia Are Predicted by Food Security and Gender Attitudes,but Not by Expected Pathogen Exposures

There is broad anthropological interest in understanding how people define “insiders” and “outsiders” and how this shapes their attitudes and behaviors toward others. As such, a suite of hypotheses has been proposed to account for the varying degrees of in-group preference between individuals and societies. We test three hypotheses related to material insecurity, pathogen stress, and views of gender equality among cross-sectional (n = 1896) and longitudinal (n = 1002) samples of young people in Ethiopia (aged 13–17 years at baseline) to explore stability and change in their preferences for coethnic spouses. We show that food insecurity is associated with a greater likelihood of intolerant mate preferences. We also find that young people who hold more gender equitable attitudes tended to hold more tolerant mate preferences. Finally, we find no support for the hypothesis that expected pathogen exposure is associated with intolerant mate preferences. Our results most strongly support a material insecurity hypothesis of in-group bias, which assumes that uncertainty over meeting basic needs leads people to favor those in their in-group. As such, our findings join a small but growing group of studies that highlight the importance of material insecurity for understanding tolerance, xenophobia, in-group bias, and favoritism.     

Food insecurity and increased BMI in young adult women

Food insecurity has been associated with weight status in children and adults although results have been mixed. We aimed to identify whether food insecurity was associated with BMI in young adults and whether this association differed by gender and was modified by food stamp use and the presence of children in the home. Cross-sectional data from wave 4 (2007-2008) of the National Longitudinal Study of Adolescent Health were analyzed. Multiple linear regression was used to investigate the association between food insecurity and BMI in gender stratified models of young adult women (n = 7,116) and men (n = 6,604) controlling for age, race/ethnicity, income, education, physical activity, smoking, alcohol use, the presence of children in the home, and food stamp use in young adulthood and/or adolescence. Food insecurity was more common in young adult women (14%) than young adult men (9%). After controlling for a variety of individual variables, food insecure women had a BMI that was on average 0.9 kg/m(2) units higher than women who were food secure. This difference in BMI persisted after controlling for recent or past food stamp use and was not different among women with or without children in the household. No relationship was found between food insecurity and BMI in young adult men. Providers should inquire about food insecurity, especially when treating obesity, and policy initiatives should address the role of access to healthy food in those facing food insecurity.     

Maternal depressive symptoms not associated with reduced height in young children in a US prospective cohort study

Background

Shorter stature is associated with greater all cause and heart disease mortality, but taller stature with increased risk of cancer mortality. Though childhood environment is important in determining height, limited data address how maternal depression affects linear growth in children. We examined the relationships between antenatal and postpartum depressive symptoms and child height and linear growth from birth to age 3 years in a U.S. sample.

Methods

Subjects were 872 mother-child pairs in Project Viva, a prospective pre-birth cohort study. The study population is relatively advantaged with high levels of income and education and low risk of food insecurity. We assessed maternal depression at mid-pregnancy (mean 28 weeks'' gestation) and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score > = 13 on 0–30 scale indicating probable depression). Child outcomes at age 3 were height-for-age z-score (HAZ) and leg length. HAZ was also available at birth and ages 6 months, 1, 2, and 3 years.

Findings

Seventy (8.0%) women experienced antenatal depression and 64 (7.3%) experienced postpartum depression. The mean (SD) height for children age 3 was 97.2 cm (4.2), with leg length of 41.6 cm (2.6). In multivariable linear regression models, exposure to postpartum depression was associated with greater HAZ (0.37 [95% confidence interval: 0.16, 0.58]) and longer leg length (0.88 cm [0.35, 1.41]). The relationship between postpartum depression and greater HAZ was evident starting at 6 months and continued to age 3. We found minimal relationships between antenatal depression and child height outcomes.

Conclusion

Our findings do not support the hypothesis that maternal depression is associated with reduced height in children in this relatively advantaged sample in a high-income country.     

Prevalence and Correlates of Food Insecurity among Palestinian Refugees in Lebanon: Data from a Household Survey

Lebanon hosts the highest per capita refugee concentration worldwide. The Palestinian presence in Lebanon dates from 1948 and they remain a marginalized population. No information on their food security status has been reported previously. A survey of a representative sample of Palestinian refugee households in Lebanon (n = 2501) was conducted using a stratified two stage cluster sampling approach. We measured food insecurity using a modified USDA household food security module, locally validated. We collected data on household demographic, socioeconomic, health, housing, coping strategies and household intake of food groups and analysed these by food security status. About 41% (CI: 39-43) of households reported being food insecure and 20% (CI: 18-22) severely food insecure. Poor households were more likely to be severely food insecure (OR 1.41 (1.06-1.86)) while higher education of the head of household was significantly associated with protection against severe food insecurity (OR 0.66 (0.52-0.84)). Additionally, higher food expenditure and possession of food-related assets were significantly associated with food security (OR 0.93 (0.89-0.97) and OR 0.74 (0.59-0.92), respectively). After adjusting for confounders, households where at least one member suffered from an acute illness remained significantly more likely to be severely food insecure (OR 1.31(1.02-1.66)), as were households whose proxy respondent reported poor mental health (OR 2.64 (2.07-3.38)) and poor self-reported health (OR 1.62 (1.22-2.13). Severely food insecure households were more likely to eat cheaper foods when compared to non-severely food insecure households (p<0.001) and were more likely to rely on gifts (p<0.001) or welfare (p<0.001). They were also more likely to have exhausted all coping strategies, indicating significantly more frequently that they could not do anything (p = 0.0102). Food insecurity is a significant problem among Palestinian refugees in Lebanon and is likely to be exacerbated at this time when the Syrian crisis amplifies the problem.     

Food insecurity among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007–2008

Background

Food security (i.e., a condition in which all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life) has been noted to be lower in indigenous communities in Canada. We investigated the prevalence of inadequate food security, or food insecurity, among Inuit households with preschool children.

Methods

We conducted a cross-sectional survey of the health status of 388 randomly selected Inuit children aged three to five years in 16 Nunavut communities during the period from 2007 to 2008. From the survey data, we classified levels of food insecurity specifically among children. We also classified levels of overall food insecurity of the household of each child. We calculated the weighted prevalence of levels of child food insecurity and of household food insecurity.

Results

Nearly 70% of Inuit preschoolers resided in households rated as food insecure (69.6%; 95% confidence interval [CI] 64.7%–74.6%). Overall, 31.0% of children were moderately food insecure, and 25.1% were severely food insecure, with a weighted prevalence of child food insecurity of 56.1% (95% CI 51.0%–61.3%). Primary care-givers in households in which children were severely food insecure reported experiencing times in the past year when their children skipped meals (75.8%), went hungry (90.4%) or did not eat for a whole day (60.1%). Primary caregivers in households in which children were moderately food insecure reported experiencing times in the past year when they worried food would run out (85.1%), when they fed their children less expensive food (95.1%) and when their children did not eat enough because there was no money for food (64.3%).

Interpretation

We observed a high prevalence of household food insecurity, with a substantial proportion of children with severely food insecure status. Interventions are needed to ensure a healthy start in life for Inuit preschoolers.According to the 1996 World Food Summit, food security exists when “all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.”¹ Food security is essential for public health² and important for child development. Suboptimal food security, or food insecurity, has deleterious effects on children’s academic performance and psychosocial development.^3,4 In Canada, food insecurity is higher in the three territories than in the provinces.⁵ According to limited data, a high degree of food insecurity exists among Inuit in particular.^6,7 Further, in most remote communities, the cost of food is at least double that in southern Canadian cities.⁸We assessed the prevalence of food insecurity among Inuit preschool-aged children.     

Food Insecurity,Food Based Coping Strategies and Suboptimal Dietary Practices of Adolescents in Jimma Zone Southwest Ethiopia

Despite the high prevalence of adolescent food insecurity in Ethiopia, there is no study which documented its association with suboptimal dietary practices. The objective of this study is to determine the association between adolescent food insecurity and dietary practices. We used data on 2084 adolescents in the age group of 13–17 years involved in the first round survey of the five year longitudinal family study in Southwest Ethiopia. Adolescents were selected using residence stratified random sampling methods. Food insecurity was measured using scales validated in developing countries. Dietary practices were measured using dietary diversity score, food variety score and frequency of consuming animal source food. Multivariable regression models were used to compare dietary behaviors by food security status after controlling for socio-demographic and economic covariates.Food insecure adolescents had low dietary diversity score (P<0.001), low mean food variety score (P<0.001) and low frequency of consuming animal source foods (P<0.001). After adjusting for other variables in a multivariable logistic regression model, adolescent food insecurity (P<0.001) and rural residence (P<0.001) were negatively associated with the likelihood of having a diversified diet (P<0.001) and frequency of consuming animal source foods, while a high household income tertile was positively associated. Similarly, multivariable linear regression model showed that adolescent food insecurity was negatively associated with food variety score, while residence in semi-urban areas (P<0.001), in urban areas (P<0.001) and high household income tertile (P = 0.013) were positively associated. Girls were less likely to have diversified diet (P = 0.001) compared with boys.Our findings suggest that food insecurity has negative consequence on optimal dietary intake of adolescents. Food security interventions should look into ways of targeting adolescents to mitigate these dietary consequences and provide alternative strategies to improve dietary quality of adolescents in Southwest Ethiopia.     

Postpartum depression: Etiology,treatment and consequences for maternal care

This article is part of a Special Issue “Parental Care”. Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10–15% of women and impairs mother–infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the “father of motherhood”, Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother–infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring.     

The perils of climate change: In utero exposure to temperature variability and birth outcomes in the Andean region

The discussion on the effects of climate change on human activity has primarily focused on how increasing temperature levels can impair human health. However, less attention has been paid to the effect of increased climate variability on health. We investigate how in utero exposure to temperature variability, measured as the fluctuations relative to the historical local temperature mean, affects birth outcomes in the Andean region. Our results suggest that exposure to a temperate one standard deviation relative to the municipality’s long-term temperature mean during pregnancy reduces birth weight by 20 g. and increases the probability a child is born with low birth weight by a 0.7 percentage point. We also explore potential channels driving our results and find some evidence that increased temperature variability can lead to a decrease in health care and increased food insecurity during pregnancy.     

Is WIC effective in improving pregnancy-related outcomes? An empirical reassessment

This study provides new evidence on how prenatal WIC participation influences pregnancy-related outcomes, using a large dataset of Medicaid mothers with two or more singleton births. Our analysis suggests there is negative selection by maternal unobserved factors even with a relatively homogenous sample and a rich set of observed characteristics. The conservative estimates from multiple regression which doesn’t address maternal unobserved heterogeneity already demonstrate beneficial effects on a range of outcomes. The concern of mis-specification or extrapolation in the linear model is also ruled out. Controlling for the mother fixed effects, we find more statistically significant estimates which are usually larger in size. The within-mother estimates are robust in a series of sensitivity checks especially multiple inference adjustments. Overall, we find WIC does work to improve infant health and maternal health behaviors as well as reduce usage of costly maternity care.     

Features of Child Food Insecurity after the 2010 Haiti Earthquake: Results from Longitudinal Random Survey of Households

Background

Recent commentary on the health consequences of natural disasters has suggested a dearth of research on understanding the antecedents prior to the disaster that are associated with health consequences after the disaster. Utilizing data from a two-wave panel survey of Port-au-Prince, Haiti, conducted just prior to and six weeks after the January 2010 earthquake, we test factors prior to the quake hypothesized to be associated with food insecurity after the quake.

Methods

Using random Global Positioning System (GPS) sampling, we re-interviewed 93.1% (N = 1732) of the original 1,800 households interviewed in 2009. Respondents were queried with regard to mortalities, injuries, food security, housing, and other factors after the quake.

Findings

Child food insecurity was found to be common on all three indices of food security (17.2%–22.6%). Additionally, only 36.5% of school-aged children were attending school prior to the quake. Findings suggest that prior schooling was associated with a substantial reduction on food insecurity indices (OR 0.62–0.75). Findings further suggest that several household characteristics were associated with food insecurity for children. Prior chronic/acute illnesses, poor living conditions, remittances from abroad, primary respondent mental health, and histories of criminal and other human rights violations committed against family members prior to the quake were associated with food insecurity after the earthquake. Earned household income after the quake was only associated with one of the measures of food insecurity.

Interpretation

Food insecurity for children was common after the quake. Those households vulnerable on multiple dimensions prior to the quake were also vulnerable to food insecurity after the quake. Remittances from abroad were leading protective factors for food security. Because Haiti is well known for the potentiality of both hurricanes and earthquakes, reconstruction and redevelopment should focus on ameliorating potential vulnerabilities to poor outcomes in these natural disasters.