| Nurturing, sensitive care in early childhood stimulates the developing brain and promotes optimal development, whereas disrupted parenting negatively impacts children's development (Thompson & Nelson, 2001). Food insecurity, caregiver depression, and anemia increase a child's risk for negative developmental outcomes, with chronic experiences having the most negative long-term effects (Campbell & Cohn, 1995; Garmezy, Masten, & Tellegen, 1984; McCann & Ames, 2007; McLoyd, 1998b; NICHD, 2005; Rose-Jacobs, Black, Casey et al., 2008). The current study examined the roles that anemia and maternal depression play in the relation between food insecurity and developmental risk among a low-income, urban, African American sample of young children. This study was part of a larger cross-sectional study of parents with children under age three who seek treatment at pediatric emergency departments or primary care clinics. Participants were approached in waiting rooms and asked if they would like to participate in a survey. Participants who completed surveys in Baltimore's primary care clinic were eligible to be included in the current study if they were a female caregiver and had complete medical record data (i.e., anemia and developmental risk status). Logistic regressions revealed that anemia, defined as hgb < 11 g/dL and hct < 33%, was statistically significantly related to developmental risk (OR = 2.247 [CI: 1.03-4.902], p < .05), suggesting that children with anemia were 2.25 times more likely to be at developmental risk compared to those without anemia. When examined separately, developmental risk, as indicated by the screening instruments (ASQ and DDSTII), was not related to anemia; nor was developmental risk as indicated by the referral and problem list in the medical record. Caregiver report of one or more developmental concerns (OR = 3.372 [95% CI: 1.241-9.166], p < .05), and two or more developmental concerns were positively associated with anemia at the hgb<11.0 and hct<33% level (OR = 6.577 [95% CI: 1.559-27.746, p < .01). Food insecure caregivers were 2.26 times more likely to report depressive symptoms compared with food secure caregivers (OR = 2.261 [95% CI 1.038-4.924], p < .05). These findings highlight both the importance of listening to caregiver's concerns for their children's development and intervening when families experience food insecurity and child anemia. |
