Author

Adiba M. Ali

Date

June 2013

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Background: Sharing family meals together is an important component of the family environment that can influence early childhood development and protect against negative health outcomes such as obesity, depression, and substance abuse. Routinely shared mealtime can improve life-style related health behaviors and enhance family cohesion. Previous research on family meals has primarily been limited to Caucasian families with adolescents. While socioeconomic disparities have been shown for adverse health outcomes, there is little research exploring the demographic characteristics associated with sharing family meals. This study estimates the prevalence of sharing family meals among Oregon families with two-year old children, and tests the hypothesis that race/ethnicity and poverty status are associated with family meal frequency. Methods: The Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based survey on experiences before, during and after pregnancy; PRAMS-2 is a follow-up survey conducted when the child reaches 2 years of age. This study analyzes the PRAMS-2 survey responses of women who had live births in 2004 and 2005. The PRAMS-2 survey asked, “Does your family eat meals together?” Mothers who reported “always” or “usually” having family meals were compared with those who reported “sometimes” or “never.” A multivariate logistic regression model was developed using weighted survey techniques to evaluate the associations between those who reported “always or usually” having family meals and multiple socioeconomic characteristics. Results: Of the 1,911 respondents to the PRAMS-2 survey, 87.8% reported always or usually having family meals together. In a multivariate model, race/ethnicity, poverty status, and birth order were significantly associated with family meal frequency, after adjusting for marital status, vii maternal age, and maternal employment. Compared to Non-Hispanic (NH) Whites, NH Blacks (adjusted odds ratio (ORa): 0.46; 95% confidence interval (CI): 0.27, 0.81), Hispanics (ORa: 0.42; 95% CI: 0.26, 0.70), and NH Asians/Pacific Islanders (PI) (ORa: 0.50; 95% CI: 0.31, 0.81) had a lower odds of always or usually having family meals. The odds of frequent family meals among mothers with a household income at or above 100% of the Federal Poverty Level (OR[subscript a]: 1.80; 95% CI: 1.02, 3.15) was greater than the odds of frequent family meals among those living below the federal poverty line. Similarly, the odds of frequent family meals among mothers with more than one child (OR[subscript a: 1.60; 95% CI: 1.02, 2.52) was greater than the odds among mothers with one child. Discussion & Conclusions: Racial/ethnic and income disparities are highlighted among families reporting eating meals together. Employment and marital status were not significant in the final model but trends of increasing family meals were observed with having full-time employment and being married. These findings may reflect socioeconomic patterns of financial stress and unstable home environments since racial/ethnic minorities may share similar economic constraints. The stratified sampling design is a major strength of this study, allowing for population-based estimates. A limitation of this study is the lack of precision in the measurement of family meal frequency, since the survey question offers broad response options that are subject to individual interpretation. This study explores the demographic characteristics of families with two-year old children who share meals together, and identifies disparities during early childhood that may eventually influence adolescent health. These findings can guide public health policy and family-based interventions to help maintain a healthy family environment. Educational campaigns to encourage family meals and address barriers may be targeted to high-risk populations. Future research is needed to quantify family meal frequency with precision, and further identify risk factors and consequences of family routines.

Identifier

doi:10.6083/M4NZ85PF

School

School of Medicine

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