Food Insecurity is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers

Abstract

This study aimed to explore the association between food insecurity and depression among early care and education (ECE) workers, a vulnerable population often working in precarious conditions. We utilized cross-sectional data from a study exploring the effects of wage on ECE centers. Participants were enrolled between August 2017 and December 2018. Food insecurity was measured using the validated six-item U.S. Household Food Security Survey Module and participants were categorized as food secure (score=0-1), low food security (score=2- 4), and very low food security (score=5-6). Depression (defined as a score ≥16) was measured using the 20-item Center for Epidemiologic Studies Depression Scale-Revised. We employed a logistic regression model to examine the relationship between food insecurity and depression. All models controlled for marital status, nativity, race/ethnicity, number of children in the household, job title, weekly hours of work, education, income, and study site. Participants were from Seattle (40%) and South King County (26%), Washington, and Austin, Texas (34%). Participants included 313 ECE workers from 49 ECE centers. A majority of participants were female, non-Hispanic White, born in the U.S., and did not have children. Compared to being food secure, very low and low food insecurity were associated with a 4.95 (95% CI: 2.29, 10.67) and 2.69 (95% CI: 1.29, 5.63) higher odds of depression, respectively. Policies and center-level interventions that address both food insecurity and depression may be warranted, in order to protect and improve the health of this valuable, yet vulnerable, segment of the U.S. workforce.