Tuesday, December 28, 2021

Food Insecurity in Childhood Linked to Cannabis Use, Bullying, School Dropout Risk

Children who experience food insecurity are more likely to use cannabis, be bullied by their peers, and drop out of school than those who do not, according to a report in JAMA Open Network.

“Although supplying food to families in precarious situations is a vital service and may play a role in alleviating some of this stress, we suggest that children at high risk for food insecurity receive broader psychosocial services … to help them fulfill their academic and social potentials,” wrote Vincent Paquin, M.D., of McGill University and colleagues.

The authors analyzed data on 2,032 participants in the Québec Longitudinal Study of Child Development who provided information on food insecurity. The study included children born in Québec, Canada, in 1997 and 1998 and followed up annually or biannually from 5 months to 15 years of age. The analysis of outcomes at 15 years of age was based on data from 1,441 adolescents. Data were analyzed from November 2020 to October 2021.

Food insecurity was reported by mothers when children were 1.5, 4, 8, 10, 12, and 13 years of age in response to the following question: “In the past 12 months, has a member of your family ever experienced being hungry because the family had run out of food or money to buy food?”

Mental health and functioning outcomes were reported by adolescents at 15 years of age. Four broad domains were investigated: externalizing problems (including attention-deficit/hyperactivity disorder, opposition or defiance, and conduct), internalizing problems (depression, social anxiety, and symptoms of generalized anxiety disorder), substance use (frequency of alcohol and cannabis use), and social adjustment problems (peer bullying, dropout potential).

Seventy-three children were defined as having a high risk of food insecurity, with a 50% probability of experiencing food insecurity at each age. In the high-risk group, all children were exposed to food insecurity at least once, and 56 (76.7%) were exposed at least twice.

A total of 1,959 were defined as low risk with just a 1% probability of food insecurity over time. In this group, most children (1,857) were never exposed to food insecurity, and 102 were exposed once; none was exposed more than once.

The high-risk trajectory of food insecurity was associated with higher levels of conduct problems, cannabis use, peer bullying, and dropout potential compared with the low-risk trajectory. After adjusting for possible confounding factors—including family income and parental history of mental illness—associations with cannabis use, peer bullying, and dropout potential remained significant, whereas the association with conduct problems did not.

“Familial dynamics related to food insecurity may explain the observed associations with cannabis use, bullying, and dropout potential,” the authors wrote. “For example, household food insecurity may be associated with increased parental stress, leading to more intimate partner violence and child maltreatment in affected families. In turn, by affecting how a child learns to interact with others and to cope with stress, this interpersonal adversity during childhood may be associated with subsequently higher levels of cannabis use, bullying, and academic difficulties during adolescence.”

The Presidential Task Force on Social Determinants of Mental Health, appointed by APA President Vivian Pender, M.D., is examining food insecurity, among other social determinants.

For related information, see the Psychiatric Services article “Addressing the Social Determinants of Mental Health: If Not Now, When? If Not Us, Who?

(Image: iStock/doble-d)

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