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Health Equity. 2017 Sep 1;1(1):127-133. doi: 10.1089/heq.2016.0023. eCollection 2017.

Examining Material Hardship in Mothers: Associations of Diaper Need and Food Insufficiency with Maternal Depressive Symptoms.

Author information

1
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
2
Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina.
3
Child Study Center, Yale University School of Medicine, New Haven, Connecticut.
4
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.

Abstract

Objectives: Material hardship represents a potential mechanism by which poverty influences the mental health of mothers. This study examined the association between two forms of material hardship, diaper need and food insufficiency, and maternal depressive symptoms. Methods: Data were from a cross-sectional study of 296 urban, pregnant or parenting, low-income women. A linear regression model was used to examine the association of maternal depressive symptoms, measured by the Center for Epidemiologic Studies Depression (CES-D) score, with diaper need and food insufficiency, after adjustment for demographic factors. Results: More than half of women reported diaper need (50.3%) and food insufficiency (54.7%). Nearly one-third of women who reported diaper need did not report food insufficiency (32.2%). In bivariate analyses, diaper need and food insufficiency were associated with maternal CES-D score. In multivariate analyses, women who reported diaper need had a significantly higher CES-D score than women who did not report diaper need (β=3.5, p=0.03). Women who reported food insufficiency did not have a significantly higher CES-D score than women who did not report food insufficiency (β=2.4, p=0.15). Conclusions: Diaper need is a form of material hardship that has received little attention in the research literature. Diapers, unlike food, are currently not an allowable expense in U.S. antipoverty programs. Diaper need may contribute to maternal depressive symptoms, beyond the contribution of other forms of material hardship, because there are no supports in place to provide assistance meeting this basic need. Importantly, diaper need is a malleable factor amenable to public health and policy interventions.

KEYWORDS:

child health; material hardship; maternal health; mental health; poverty

Conflict of interest statement

Ms. Austin has no conflicts of interest to report. Dr. Smith is a board member of the National Diaper Bank Network and Huggies/Kimberly Clark is a sponsor of that organization.

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