Depression has been linked to food security, particularly among low-income mothers. However, less is known about the relationship between CHAOS (Confusion, Hubbub, and Order Scale), a measure of family functioning such as timeliness and order, and varying levels food security. The purpose of this paper was to evaluate the relationship between depression, CHAOS, and sociodemographics on the level of food insecurity in a cross-sectional sample of low-income households with children, ages 0-18 years.

Participants were recruited from low-income communities in a medium sized Midwestern city in the United States. Eligible participants were ≥19 years of age, a parent or primary caregiver to at least one child, and English- or Spanish- speaking. Survey items included participation in the Supplemental Nutrition Assistance Program (SNAP), food security, depression, CHAOS, and sociodemographics/family characteristics. Descriptives and Chi-square tests were conducted for all variables. Potential covariates were assessed (e.g., age, income, education, race/ethnicity, sex, SNAP participation, number of children and adults in the household, and marital status) and included in the final logistic regression model through backward elimination. All statistics were conducted using SAS (version 9.4, SAS Institute Inc., Cary, NC).

Participants (N=252) were 75% female, 42% Non-Hispanic Black, 31% Non-Hispanic White, 12% Hispanic, and 15% other race categories. The mean number of children in households was 2.33 (SD=1.58), and half of the respondents reported earning ≤$10,000/year. Chi-Square tests showed univariate relationships between study variables and varying household food security levels. Those in the “high” and “medium” groups for depression and CHAOS were both more likely than the “low” groups to experience low or very low food security. Income and education were also related to food security, with low levels of education and low income being associated with low or very low food security. Age, sex, race/ethnicity, and marital status were not associated with food security status.

The fully adjusted logistic regression models of depression and CHAOS accounted for 10% and 14% of the variance in food security, respectively (depression: (OR=0.31, CI=0.15-0.65; pp

In the current study, CHAOS demonstrated a stronger relationship with food security than depression, when controlling for sociodemographics. CHAOS is a measurement that has not been tested widely among food insecure populations, but has been shown to be an influencing factor on child development, and might help explain some of the stress experienced by low-income families. Understanding more about the psychological aspects of food insecurity may help inform the development of tailored interventions to alleviate food insecurity in low-income households, and ultimately improve health, achievement and related outcomes in children.

Key Take Away Points

  • Addressing mental health issues such as depression is a potentially important factor in reducing the experience of food security. Directionality of this relationship has not yet been determined (mental health issues may be resultant to the experience of food insecurity, or bidirectional).
  • Household CHAOS is a relatively underutilized construct and assessment tool that has significant implications in low-income households. CHAOS may be a marker of the experience of stress and related to parenting style and overall household environment.
  • Holistic approaches to addressing poverty and food insecurity will have the highest likelihood of positively impacting children’s lives and protecting them from food insecurity while enhancing their opportunities to thrive.

Author Biography

Courtney Pinard, Ph.D., MHK is a Research Scientist at the GSCN and also has an appointment as Adjunct Assistant Professor in the Department of Health Promotion, Social and Behavioral Health at in the College of Public Health at the University of Nebraska Medical Center (UNMC). Dr. Pinard has led and collaborated on studies in areas including obesity prevention, local food systems and health, and food insecurity, using range of approaches such as secondary and primary data analysis, qualitative methodology, and intervention at individual, community and policy levels. Eric Calloway, Ph.D., R.D. is a postdoctoral fellow at the Gretchen Swanson Center for Nutrition (GSCN). Dr. Calloway research interests include food purchasing, hunger, food insecurity, and obesity prevention among low-income populations. Previous to GSCN, he worked as a project specialist for the Center for Nutrition Policy and Promotion developing evidence reviews for the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, including authoring evidence reviews relating to dietary patterns, food insecurity, and cancer risk. Hollyanne Fricke, MPH, is a Project Manager at the Gretchen Swanson Center for Nutrition. Ms. Fricke has experience researching childhood obesity, hunger and food security, local food systems, local and statewide needs for increasing Supplemental Nutrition Assistance Program (SNAP) participation, as well as relationships between dietary intake, food security, and food sufficiency. At GSCN, Ms. Fricke primarily oversees a multi-year collaborative, community-based project to alleviate childhood hunger in the Omaha, Nebraska metro area. Amy Yaroch, Ph.D. is the Executive Director at the Gretchen Swanson Center for Nutrition and also has an appointment as Adjunct Professor in the Department of Health Promotion, Social and Behavioral Health at in the College of Public Health at UNMC. Before joining the Center six years ago, Dr. Yaroch was a Program Director and Behavioral Scientist in the Health Promotion Research Branch at the National Cancer Institute, where she oversaw research efforts in the areas of nutrition, obesity prevention, and behavioral sun safety/skin cancer prevention.