Maternal precarious employment and child overweight/obesity in the United States

The prevalence of childhood obesity has increased over the past three decades in the United States (U.S.) (Cunningham et al., 2022; Ogden et al., 2022; Skinner et al., 2018), with current estimates indicating that 42% of children and adolescents have overweight/obesity (Fryar et al., 2020). Concurrently, there has been a rise in precarious employment (Oddo et al., 2021), which is generally defined as the accumulation of poor employment conditions, such as low wages, insecure employment contracts, irregular hours, and limited workplace decision-making ability (Benach et al., 2014; Bodin et al., 2020; Julia et al., 2017). Women are disproportionately employed in precarious jobs (Andrea et al., 2022; Eisenberg-Guyot et al., 2020; Oddo et al., 2021) and are often the primary caregiver of children, which could affect child overweight/obesity through a variety of mechanisms, including time scarcity, poor diet quality, and stress (Conger et al., 1994; Devine et al., 2003; Devine et al., 2009; Lampard et al., 2013; Lundahl et al., 2013; Park and Walton-Moss, 2012; Parks et al., 2012; Pilgrim et al., 2012; Schneider and Harknett, 2019; Tate et al., 2015). However, the association between maternal precarious employment and child overweight/obesity has yet to be explored in the U.S.

We can draw on prior studies, albeit limited in number, that have found an association between precarious employment and self-reported health (Bambra et al., 2014; Benach et al., 2014; Daly et al., 2020; Kim and von dem Knesebeck, 2015) and higher body mass index (BMI) (Oddo et al., 2023) among adults. Additionally, one prior study finds that precarious employment is associated with a low birth weight delivery in the U.S. (Patil et al., 2020), which in turn, has been associated with abdominal obesity (Wu et al., 2021; Zarrati et al., 2013) and comorbidities, such as insulin resistance among school-aged children (Martin-Calvo et al., 2022), and severe obesity in a cohort of children aged 3 to 12 years (Chen et al., 2019). We can also draw on prior empirical evidence that finds that maternal employment (versus non-employment) is associated with an increase in infant and child overweight/obesity risk (Hope et al., 2015; Meyer, 2016), potentially due to less time spent on activities that relate to child diet and physical activity (Cawley and Liu, 2012). Additionally, prior research suggests that singular aspects of maternal employment, including non-standard work schedules (Kachi et al., 2021; Miller and Han, 2008), longer work hours (Kim et al., 2018; Li et al., 2019; Meyer, 2016; Phipps et al., 2006), and temporary unemployment without benefits (Stewart et al., 2012), are associated with a higher risk of child overweight/obesity. However, a key limitation of this literature is that individual indicators do not capture the inherently multidimensional nature of precarious employment, as employment conditions (e.g., wages, hours, fringe benefits) are interrelated.

The objective of this study was to investigate the association between maternal precarious employment and incident child overweight/obesity in the U.S, using a multidimensional indicator. A higher incidence of children with overweight/obesity may have important implications, given the increasing burden of comorbidities during childhood (e.g., type 2 diabetes) and their long-term health consequences into adulthood. Additionally, precarious employment is intervenable through policies. Thus, a better understanding of the relation between maternal precarious employment and overweight/obesity among children may be important for obesity prevention.

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