Maternal and Child Health Research Program

Advancing Applied MCH Research

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(SDAS) A Longitudinal Analysis of Maternal Depression and its Associations with Child Obesity and Health Care Use.

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Project Number: R40MC23630
Grantee: American University
Department/Center: Public Administration & Policy School of Public Affairs
Project Date: 04/01/2012

Final Report

Submitted

Principal Investigator

Taryn W Morrissey, Ph.D.
Assistant Professor
4400 Massachusetts Ave., NW
Washington, DC  20016-8070
Phone: 202-885-6323
Email: morrisse@american.edu

Age

  • Infancy (0-12 months)
  • Toddlerhood (1-2 years)
  • Early Childhood (3-5 years)

Abstract

Depression affects an estimated 13% to 24% of mothers with young children (Lyons-Ruth et al. 2002; McLennan & Kotelchuck, 2000; O'Hara & Swain, 1996), and has severe implications for children's development (e.g., Brennan et al., 2000); however, less is known about how maternal depression affects children's risk for obesity and health care use. Household production theory maintains that families "produce" child outcomes through parental resources or a lack thereof (Becker, 1981). As the primary caregiver, mothers play an important role in children's development, and maternal depression may affect children's health through parenting practices. Maternal depression has been associated with increased television watching among preschool children (Burdette et al., 2003) and poorer adherence to routines such as mealtimes (McLearn et al., 2006), but its impacts on children's eating habits and obesity have received less attention. Maternal depression is also associated with the decreased use of well-child visits (Sills et al., 2007), which may moderate the impact of depression on child obesity. Given that 31% of children aged 2 to 19 are considered overweight (Ogden et al., 2010), and obesity early in life has effects on health and economic outcomes into adulthood (Cawley, 2010), understanding how maternal depression contributes to child obesity, and how well-child visits moderate this relationship, can illuminate opportunities for clinical and policy interventions. This project will examine the associations between maternal depression, child obesity, and children's health care use using data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a comprehensive, nationally representative study of nearly 11,000 children from birth through kindergarten entry. Data were collected at five waves (9 months, 2 years, preschool, and 2 waves at kindergarten entry) using parent surveys, direct child assessments, and observations of the home and child care environments. Specifically, this project will address three aims: (1) examine the associations between maternal depression and child obesity; (2) examine the extent to which the associations between maternal depression and children's obesity are mediated by children's eating habits; and (3) examine the extent to which the associations between maternal depression and children's body mass index (BMI: a measure of weight-for-height) are moderated by children's health care use. We will use rigorous longitudinal methods including within-child fixed effects models to limit potential omitted variable bias. This project relates to Strategic Research Issues II, III, and IV by investigating: disparities in health and health care use among children exposed to maternal depression; the extent to which these children receive preventive health care to promote healthy development; and the longitudinal physical development of children exposed and not exposed to maternal depression.

Publications

Pending

Keywords

Depression, Health Care Utilization, Mental Health & Wellbeing, Nutrition & Diet, Obesity & Weight, Well-Child Pediatric Care

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