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Children's Health Status: Examining the Associations among Income Poverty, Material Hardship, and Parental Factors

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  • Godwin S Ashiabi
  • Keri K O'Neal

Abstract

Background: We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a) poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b) material hardship will be associated with parental depression, parenting behaviors, and health status; and (c) parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. Methods and Results: We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. Conclusions: Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health would require a multi-pronged approach involving income transfers, health insurance coverage, food and nutrition assistance, and parenting interventions.

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  • Godwin S Ashiabi & Keri K O'Neal, 2007. "Children's Health Status: Examining the Associations among Income Poverty, Material Hardship, and Parental Factors," PLOS ONE, Public Library of Science, vol. 2(9), pages 1-9, September.
    • Handle: RePEc:plo:pone00:0000940
    DOI: 10.1371/journal.pone.0000940
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    References listed on IDEAS

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    6. Alaimo, K. & Olson, C.M. & Frongillo E.A., Jr. & Briefel, R.R., 2001. "Food insufficiency, family income, and health in US preschool and school-aged children," American Journal of Public Health, American Public Health Association, vol. 91(5), pages 781-786.
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    Cited by:

    1. Katherine R. Arlinghaus & Melissa N. Laska, 2021. "Parent Feeding Practices in the Context of Food Insecurity," IJERPH, MDPI, vol. 18(2), pages 1-12, January.
    2. Wenqiang Sun & Dongping Li & Wei Zhang & Zhenzhou Bao & Yanhui Wang, 2015. "Family Material Hardship and Chinese Adolescents’ Problem Behaviors: A Moderated Mediation Analysis," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-22, May.
    3. Conrad-Hiebner, Aislinn & Paschall, Katherine W., 2017. "Determining risk for child physical harm through the classification of economic insecurity," Children and Youth Services Review, Elsevier, vol. 78(C), pages 161-169.
    4. Martha Okafor & Daniel F. Sarpong & Aneeqah Ferguson & David Satcher, 2013. "Improving Health Outcomes of Children through Effective Parenting: Model and Methods," IJERPH, MDPI, vol. 11(1), pages 1-16, December.
    5. Miriam Blume & Petra Rattay & Stephanie Hoffmann & Jacob Spallek & Lydia Sander & Raphael Herr & Matthias Richter & Irene Moor & Nico Dragano & Claudia Pischke & Iryna Iashchenko & Claudia Hövener & B, 2021. "Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics," IJERPH, MDPI, vol. 18(15), pages 1-33, July.
    6. Mulusew G Jebena & David Lindstrom & Tefera Belachew & Craig Hadley & Carl Lachat & Roos Verstraeten & Nathalie De Cock & Patrick Kolsteren, 2016. "Food Insecurity and Common Mental Disorders among Ethiopian Youth: Structural Equation Modeling," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-20, November.
    7. Xu, Yanfeng & Zhao, Qianwei & Schuler, Brittany R. & Levkoff, Sue E., 2022. "Material hardship among custodial grandparents in COVID-19 and its associations with Grandchildren’s physical and mental health: A latent class analysis," Children and Youth Services Review, Elsevier, vol. 132(C).

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