By Sacrificing for Their Children, Some Low-Income Mothers Jeopardize Their Health

    • July 19, 2012

In a family facing food insecurity—where there is not enough money to buy the kind or quantity of food needed—mothers often resort to a host of strategies to stretch their limited resources and feed their children. They may buy food in bulk for themselves or to be divided among multiple families, clip coupons, or shop at more than one store to find the best prices.

But other mothers go even further, says Molly Martin, PhD, MS, and in doing so, they put their health at risk.

“This started from a puzzle,” says Martin, a Robert Wood Johnson Foundation Health & Society Scholars program alumna (2003-2005). “We think of poor kids as being overweight and obese because they lack access to nutritious food and are more likely to consume high calorie, but nutrient-deficient foods,” she explains. But in study after study with nationally-representative samples, the data was showing something different. The children in impoverished households were not more likely to be obese, nor were the men. Low-income women, on the other hand, showed an undeniable tendency toward being overweight or obese.

“I couldn’t wrap my head around why the increased risk for obesity was there for women, but not children or men, given that they often share the same households,” Martin, an associate professor of sociology and demography at Penn State, says. “It was very striking for me.”

“We expect mothers to put their children’s needs first, and in a food-insecure household this likely means that a mother’s dietary needs are not met,” Martin says. As a result, she predicted, food-insecure mothers’ waistlines would increase, but the same obesity risks would not be true for food-insecure women who do not care for children or for all food-insecure men.

Martin and co-author Adam M. Lippert, MA, used a social science database called the Panel Study of Income Dynamics (PSID) that has information on all household members to analyze data on adults’ weight and food insecurity experiences. Their study was published in a June 2012 special issue of Social Science & Medicine, coordinated and partially supported by the RWJF Health & Society Scholars program at Columbia University. The special issue explored gender-related health issues.

The research team found that food-insecure mothers—whether biological mothers or “social mothers” who have taken on the caregiving role—are more likely to be overweight or obese, and gain excess weight over time. Mothers are most likely fulfilling a traditional feminine responsibility of “feeding the family,” Martin explains, eating irregularly or skipping meals altogether to give their children the most nutritious food. Their bodies likely assume there is food scarcity, and begin packing on the pounds to keep in reserve. The traditional gender roles of child care explain why food insecurity predicted obesity for women, but not men in the same households or for their food-insecure, but child-free female counterparts.

Because the trends were common among both biological and social mothers, the researchers ruled out metabolic changes after pregnancy as a cause of the weight gain among the women. They also ruled out other factors that might explain the trend by analyzing self-reported data from the PSID: physical activity, smoking, drinking, food stamp receipt, and Women, Infants and Children (WIC) participation.

“It’s really the intersection of gender roles, caregiving and poverty that’s creating risks for obesity among food-insecure American mothers,” Martin says. “These mothers are not able to provide a nutritious meal for every member of the family and they’re bearing the brunt of it. They’re putting themselves at increased risk for health problems, and potentially causing increased economic and financial risks for their children and families. While they’re trying to protect their children, it’s probably a risky strategy in the long run.”

Changing Stigmas

“These mothers are doing the best they can to take care of their families,” says Martin. “They understand that they should give their children good food when possible. But what they’re trying to do and what they’re actually doing doesn’t seem to be well aligned.”

Many of the assumptions and biases about obese people—that they are lazy or don’t know any better—are unfounded in this situation, Martin says. “What they’re doing is actually quite purposeful.”

The authors write in the study: “To the extent that poor, food insecure mothers are at greater risk for obesity, the prior literature suggests that it is certainly not attributable to sloth or absent-mindedness. Instead, we suspect that their active management and protection of their children creates risks for obesity and weight gain. Beyond drawing our attention to the generally hidden work of poor mothers, these results demonstrate that our socially constructed roles and responsibilities can generate risks for individual health and well-being.”

Martin plans to continue her research on this topic, and hopes the findings will call attention to these misconceptions and the need for a more family-targeted solution to this growing public health problem.

“This wouldn’t have been possible if I hadn't participated in the Health & Society Scholars program,” she says. “As a sociologist I never would’ve thought to look at this problem through all these lenses. The program gave me the tools to think across the disciplines of sociology, public health and nutrition.”