The roots of children's hunger today may stretch back, in part, to the past childhood trauma of their caregivers. Evidence amassed over the past two decades has demonstrated that stress and deprivation during childhood have lifelong consequences on health, as well as school and job performance. A new small-scale study from Drexel University now suggests a strong relationship between exposure to adverse childhood experiences (ACEs) and household food insecurity among mothers of young children.
"This is brutal stuff," said Mariana Chilton, PhD, an associate professor and director of the Center for Hunger-Free Communities in the Drexel University School of Public Health, who was lead author of the study now published in the journal Public Health Nutrition. "The causes and realities of hunger and poverty are complicated and difficult to unravel. We are seeing one component of them is that, for many people, experiences of hunger have trauma and adversity at their core."
This Childhood Stress study, led by Chilton with several Drexel M.P.H. graduates, used both quantitative and qualitative methods to gather information about 31 Philadelphia mothers' experience with deprivation, abuse, violence and neglect, as well as their experiences with hunger, education and employment and more.
The findings, Chilton and colleagues say, show that trauma and chronic stress are a largely overlooked part of the picture of why one in five American households with young children live with food insecurity. They say it indicates a greater need for public assistance programs to provide support for families' emotional needs in addition to their material needs.
While the team's quantitative surveys were small in number, the results still point clearly to a value in considering adverse childhood experiences as a contributor to food insecurity. Higher scores on the adverse childhood experiences survey, for instance, were significantly associated with the severity of participants' household food insecurity.
In interviews, the study participants relayed their perceptions of how emotional and physical abuse in childhood affected their lives, including physical health, school performance and ability to maintain employment—all factors directly linked to household income and ability to afford enough healthy food for their own children.
"If a person always says you're nothing; you're nothing. Then for a while I used to think I'm not anything," said 22-year-old Tamira (a pseudonym), a study participant who experienced abandonment by her mother at age five, then abuse and rape by members of her caregiver family at age six, and was emotionally and physically abused by her grandmother who took her in at the age of seven. Tamira experienced homelessness in her teens after her grandmother kicked her out, but eventually still graduated from high school. In her interview she described a connection between her childhood struggles with physical and emotional abuse and her ability to provide for her young daughter today: "So maybe that's how I don't have a job, because I'm thinking I'm nothing. I'm not ever going to have a job. I'm not going to be [anything], like my grandma said. [...] Because I can't find a job I cannot feed my daughter. How am I supposed to? I cannot buy her what she needs."
Other study participants described experiences of physical neglect, household drug abuse, exposure to violence at home and in their communities and other adverse experiences in childhood. Many said they felt these experiences affected their lifelong abilities to succeed—although many simultaneously expressed strong feelings of resilience and hope to change the story for their own young children.
"This study has been difficult for us, because examining the relationship between food insecurity and adverse experiences in childhood may simply add more stigma to families already stigmatized and blamed for the hardships that they face," said Molly Knowles, a Drexel M.P.H. graduate, research coordinator at the center, and a co-author of the study. "It's important to be clear that childhood adversity is one factor interrelated with many others, including low wages, insufficiently and inequitably funded education systems, racism and discrimination, lack of safe and affordable housing and an inadequate safety net."
The researchers recommend that those working to address poverty and hunger in children should include emotional health of parents and caregivers in a more comprehensive approach to policy and services. Such an approach should include ensuring parents and caregivers have safe places to live, access to behavioral health support and opportunities to develop positive social relationships. They also recommend providing public assistance programs that recognize widespread exposure to trauma and violence, offering additional support to participants with behavioral health barriers to employment, and implementing programs in ways that avoid re-traumatization.
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Public Health Nutrition, dx.doi.org/10.1017/S1368980014003036