Traumatic experiences in childhood are predictive of food insecurity for adults, researchers at the Drexel University School of Public Health report in a Jan. 22 study in Public Health Nutrition. Conducted by the school’s Center for Hunger-Free Communities, the study examined 31 mothers of children under age 4, and was published as “The Relationship Between Childhood Adversity and Food Insecurity.” In addition to Drexel’s Mariana Chilton, Molly Knowles and Kimberly Arnold, the research team included Jenny Rabinowich of Liberian-American charity Last Mile Health.
Knowles, the qualitative research coordinator at the Center for Hunger-Free Communities, said in an online interview that the idea was inspired by a previous study. The findings of “Witnesses to Hunger” showed that “families experiencing food insecurity were also often dealing with issues of trauma and exposure to violence,” she said. Around the time the study was being conducted, the Center for Hunger-Free Communities was also learning more about Adverse Childhood Experiences.
In the field of public health, ACEs can be defined as “stressful experiences before the age of 18 that include: emotional and physical abuse; emotional and physical neglect; and household instability, including parental separation, domestic violence, and mental illness, substance abuse, or incarceration of a household member,” according to the research brief associated with the study. The brief also stated that “ACEs are associated with poor adult mental and physical health and economic outcomes.” The study was meant to examine and investigate the relationship between ACEs and food security in households.
Participants in the study were first quantitatively surveyed and given an ACE “score” from 0 to 10, which reflected the participant’s cumulative number of adverse or traumatic childhood experiences. Jocelyn, 20-year-old mother of one, scored 9 on her ACEs test. Jocelyn’s traumatic childhood experiences include her parents’ drug abuse and physical fighting, her parents’ separation, her experience of being raped by her stepbrother, being diagnosed with depression and the following hospitalization, school enrollment changes, and finally, young motherhood and moving back in with her abusive mother.
The interview portion of the study was used to help the researchers define the ways in which ACEs and traumatic childhood events had serious and lasting impacts on caregivers and their relationships with their own children. Emotional and physical abuse and neglect as well as drug or substance abuse that could lead to either of those factors was key in defining relationships that appear to exist between ACEs and adult food insecurity.
Jocelyn described instances of having little to no food availability as a child. “We barely had food. I don’t even know if food stamps existed,” Jocelyn said. She also described in the interview being so hungry as a child that she would eat the paint chips off her wall, which eventually gave her lead poisoning. After being fired from the only job she ever had, Jocelyn was forced to move back into her neglectful mother’s house where her younger siblings still lived. Now, Jocelyn struggles to feed her own child, in addition to her siblings, and admits to skipping meals or stretching budgets to ensure her family has enough to eat.
The research brief defined household food insecurity as a “lack of access to enough food for an active and healthy life due to economic hardship.” There are two types of food insecurity: ;ow food security, which indicates issues with access to food and poor diets in households; and very low food security, which shows that at least one household member has reduced their food intake, and that eating patterns within the household have been disrupted due to inadequate food or money resources. Using the U.S. Household Food Security Survey Module, the researchers were able to identify caregivers of children younger than the age of 4 who could be classified as being either household or child low or very low food secure.
Claudia, a 22-year-old mother of one, scored a 9 on her ACEs test and was ranked as household very low food secure and child low food secure. Claudia’s descriptions of childhood hunger showed how much of an effect ACEs have on food insecurity for adults who went through those experiences. In her interview, Claudia said, “I know how much my stomach hurt from the hunger, how much my body ached, having pains and not having the medication for it, you know? … The hunger, the pain, the depression — it always comes back. It’s like a bird nesting in your head.” Claudia’s descriptions of being haunted by her childhood hunger depicted the relationship later found to exist by the researchers between ACEs and adult food insecurity.
The emotional abuse endured by some participants can be modeled by Tamira. With an ACEs score of 9, and a reported household with very low food secure and child low food secure, Tamira’s emotional abuse and neglect as a child showed strong reasons why she still suffers from food insecurity now as a 22-year-old mother of one. “If a person always says you’re nothing; you’re nothing. Then for a while I used to think I’m not anything. … Because I can’t find a job I cannot feed my daughter. How am I supposed to? I cannot buy her what she needs.”
Knowles commented on the emotional difficulty of the qualitative interviews conducted in the study: “Some of the stories the mothers told us were very painful, and many of them have really stayed with me. But we also saw a lot of resilience — many of the moms talked about how their experiences made them stronger and more determined to ensure that their kids didn’t experience the same adversity.” In a blog post, Knowles also said it was upsetting to realize how incapable current aids-programs and social support services are of assisting with behavioral and trauma-induced issues. She wrote: “According to the moms we spoke with, social service providers often re-traumatize families through punitive policies and negative attitudes that stigmatize those seeking help.”
A strong relationship between higher ACEs scores and low food security or very low food security was found in the study’s results. Of the 19 households defined as very low food secure, 16 scored above a four on the ACEs test, while only three scored between zero and three on the ACEs test. Statistical testing verified this relationship, according to the published findings. These findings will be used to redefine how policies and programs dealing with needy families treat mental and behavioral health of the caregivers as a primary issue in moving forward.
Knowles commented that the Center for Hunger-Free Communities “will continue educating policymakers on how trauma and violence affect families experiencing poverty and food insecurity… [The center is] also trying to work with other faculty and staff at Drexel who work on issues of trauma to figure out how to best prevent and address trauma in Philadelphia and throughout the country.”
Editor’s note: Pseudonyms were used for the names of the participants of the survey.