Adverse childhood experiences and food insecurity in emerging adulthood: findings from the EAT 2010-2018 study

Objective: Low childhood socioeconomic status (SES) and adverse childhood experiences (ACEs) are associated with poor health outcomes in adulthood. Determining how ACEs may be linked to food insecurity among young people from socioeconomically diverse households can inform health-protective strategies. This study examined if ACEs are associated with food insecurity during the transition to adulthood, and investigated prevalence differences across SES strata. Setting: Participants were recruited from 20 secondary schools in Minneapolis-St. Paul, Minnesota. Participants: The analytic sample (n1,518) completed classroom surveys in 2009-2010 (mean age14.5 years) and follow-up surveys in 2017-2018 (mean age22.0 years). Design: Past-year food insecurity was reported at both time points and ACEs were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle, high). Results: The adjusted prevalence of food insecurity was 45.3% among emerging adults who reported three or more ACEs compared to 23.6% among those with one or two ACEs, and 15.5% among those with no ACE (P<0.001). All forms of ACEs were related to an elevated prevalence of food insecurity in emerging adulthood. ACE-food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. Conclusions: Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACEs.