101
|
Burke MP, Martini LH, Çayır E, Hartline-Grafton HL, Meade RL. Severity of Household Food Insecurity Is Positively Associated with Mental Disorders among Children and Adolescents in the United States. J Nutr 2016; 146:2019-2026. [PMID: 27581581 DOI: 10.3945/jn.116.232298] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/12/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Household food insecurity and mental disorders are both prevalent conditions among children and adolescents (i.e., youth) in the United States. Although some research has examined the association between the 2 conditions, it is not known whether more severe food insecurity is differently associated with mental disorders in youth. OBJECTIVE We investigated the association between severity of household food insecurity and mental disorders among children (aged 4-11 y) and adolescents (aged 12-17 y) using valid and reliable measures of both household food security status and mental disorders. METHODS We analyzed cross-sectional data on 16,918 children and 14,143 adolescents whose families participated in the 2011-2014 National Health Interview Survey. The brief Strengths and Difficulties Questionnaire and the 10-item USDA Household Food Security Survey Module were used to measure mental disorders and food security status, respectively. Multinomial logistic regressions were used to test the association between household food security status and mental disorders in youth. RESULTS There was a significant linear trend in ORs, such that as severity of household food insecurity increased so did the odds of youth having a mental disorder (P < 0.001). Other selected results included the following: compared with food-secure households, youth in marginally food-secure households had higher odds of having a mental disorder with impairment [child OR: 1.26 (95% CI: 1.05, 1.52); adolescent OR: 1.33 (95% CI: 1.05, 1.68)]. In addition, compared with food-secure households, youth in very-low-food-secure households had higher odds of having a mental disorder with severe impairment [child OR: 2.55 (95% CI: 1.90, 3.43); adolescent OR: 3.44 (95% CI: 2.50, 4.75)]. CONCLUSIONS The severity of household food insecurity is positively associated with mental disorders among both children and adolescents in the United States. These results suggest that improving household food security status has the potential to reduce mental disorders among US youth.
Collapse
Affiliation(s)
- Michael P Burke
- Food and Nutrition Service, USDA, Alexandria, VA; Center for Research in Nutrition and Health Disparities and Departments of
| | - Lauren H Martini
- Center for Research in Nutrition and Health Disparities and Departments of Epidemiology and Biostatistics and
| | - Ebru Çayır
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Randa L Meade
- Department of Nutrition, University of Tennessee, Knoxville, TN
| |
Collapse
|
102
|
Banach LP. Hospitalization: Are We Missing an Opportunity to Identify Food Insecurity in Children? Acad Pediatr 2016; 16:438-445. [PMID: 26785379 DOI: 10.1016/j.acap.2016.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 01/07/2016] [Accepted: 01/10/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Food security is the ability to access sufficient food to maintain a healthy, active life. Previous studies link food insecurity with adverse health outcomes. Our objectives were to determine the prevalence of food insecurity, identify sociodemographic risk factors, and quantify receipt of public nutrition assistance among recently hospitalized children in the United States. METHODS Cross-sectional analyses of a representative sample of the US population aged 0 to 19 years from the National Health and Nutrition Examination Survey, 2007 to 2012 (N = 12,627). Consistent with previous literature, households were defined as food insecure if they answered "yes" to 3 or more of 18 food security questions. Children were considered recently hospitalized if admitted overnight in the past year (n = 706). Descriptive statistics characterized food insecurity and receipt of nutrition assistance. Multiple logistic regression analyses evaluated associations of food insecurity with age, sex, race/ethnicity, insurance status, family income, and hospitalization. RESULTS One-quarter (25.3%) of recently hospitalized children lived in food insecure households. More than one-third of recently hospitalized low-income, uninsured, or Hispanic children lived in food insecure households. In the adjusted analysis, recently hospitalized low-income children and girls had significantly greater odds of living in food insecure households. Of potentially eligible hospitalized children, 26.9% had not received Women, Infants, and Children benefits and 31.0% had not received Supplemental Nutrition Assistance Program benefits in the past year. CONCLUSIONS One-quarter of recently hospitalized children lived in food insecure households. Many eligible families were not enrolled in public nutrition programs. Hospitalization represents a potential opportunity to identify these children and help families access nutrition assistance.
Collapse
Affiliation(s)
- Laurie P Banach
- Division of Hospital Medicine, Children's National Health System, Washington, DC.
| |
Collapse
|
103
|
Collins PA, Gaucher M, Power EM, Little MH. Implicating municipalities in addressing household food insecurity in Canada: A pan-Canadian analysis of news print media coverage. Canadian Journal of Public Health 2016; 107:e68-e74. [PMID: 27348113 DOI: 10.17269/cjph.107.5231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/11/2016] [Accepted: 11/06/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Household food insecurity (HFI) affects approximately 13% of Canadian households and is especially prevalent among low-income households. Actions to address HFI have been occurring primarily at the local level, despite calls for greater income supports from senior governments to reduce poverty. News media may be reinforcing this trend, by emphasizing food-based solutions to HFI and the municipal level as the site where action needs to take place. The objective of this study was to examine the level and framing of print news media coverage of HFI action in Canada. METHODS Using a quantitative newspaper content analysis approach, we analyzed 547 articles gathered from 2 national and 16 local/regional English-language newspapers published between January 2007 and December 2012. RESULTS News coverage increased over time, and over half was produced from Ontario (33%) and British Columbia (22%) combined. Of the 374 articles that profiled a specific action, community gardens/urban agriculture was most commonly profiled (17%), followed by food banks/meal programs (13%); 70% of articles implicated governments to take action on HFI, and of these, 43% implicated municipal governments. Article tone was notably more negative when senior governments were profiled and more neutral and positive when municipal governments were profiled. CONCLUSION News media reporting of this issue in Canada may be placing pressure on municipalities to engage in food-based actions to address HFI. A more systematic approach to HFI action in Canada will require more balanced media reporting that acknowledges the limitations of food-based solutions to the income-based problem of HFI.
Collapse
Affiliation(s)
- Patricia A Collins
- Department of Geography and Planning, Queen's University, 138 Union Street, Robert Sutherland Hall 531, Kingston, ON, K7L 3N6, Canada.
| | - Megan Gaucher
- Department of Gender and Women's Studies, Trent University, Peterborough, ON, Canada
| | - Elaine M Power
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Margaret H Little
- Departments of Political Studies and Gender Studies, Queen's University, Kingston, ON, Canada
| |
Collapse
|
104
|
McIntyre L, Lukic R, Patterson PB, Anderson LC, Mah CL. Legislation Debated as Responses to Household Food Insecurity in Canada, 1995–2012. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2016.1157551] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
105
|
Romo ML, Abril-Ulloa V, Kelvin EA. The relationship between hunger and mental health outcomes among school-going Ecuadorian adolescents. Soc Psychiatry Psychiatr Epidemiol 2016; 51:827-37. [PMID: 27083901 DOI: 10.1007/s00127-016-1204-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 03/16/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Mental health and food insecurity are major public health issues among adolescents in Ecuador. Our objective was to determine the relationship between hunger, symptoms of depression, and suicidal ideation among school-going Ecuadorian adolescents. METHODS We conducted crude and multivariable logistic regression models using data from the 2007 Global School-based Student Health Survey from Quito, Guayaquil, and Zamora, Ecuador (N = 5524). Hunger was defined as having gone hungry in the past 30 days due to lack of food in the home. Outcomes of interest were symptoms of depression and suicidal ideation with or without planning in the past year. RESULTS Overall, 41.2 % (2200/5467) of students reported experiencing hunger. In multivariable logistic regression models, hunger had an increasing exposure-response relationship with symptoms of depression [sometimes hungry odds ratio (OR) 1.80, P = 0.0001; most of the time or always hungry OR 2.01, P < 0.0001] and suicidal ideation with planning (sometimes hungry OR 1.55, P = 0.04; most of the time or always hungry OR 2.63, P = 0.001). CONCLUSION Hunger was associated with increased odds of symptoms of depression and suicidal ideation with planning. Strategies to improve mental health among adolescents in Ecuador should consider the potential contribution of hunger and food insecurity.
Collapse
Affiliation(s)
- Matthew L Romo
- Epidemiology and Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY, 10035, USA.,CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.,Dirección de Investigación, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
| | - Victoria Abril-Ulloa
- Dirección de Investigación, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
| | - Elizabeth A Kelvin
- Epidemiology and Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY, 10035, USA. .,CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA. .,Doctor of Public Health Program, The Graduate Center, City University of New York, New York, NY, USA.
| |
Collapse
|
106
|
Intimate partner violence, common mental disorders and household food insecurity: an analysis using path analysis. Public Health Nutr 2016; 19:2965-2974. [DOI: 10.1017/s1368980016001178] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractObjectiveTo investigate the direct and indirect associations between psychological and physical intimate partner violence and the occurrence of common mental disorders (CMD) and how they relate to the occurrence of household food insecurity (HFI).DesignThis was a population-based cross-sectional study. Intimate partner violence was assessed using the Brazilian version of the Revised Conflict Tactics Scale (CTS2) and HFI was assessed using the Brazilian Food Insecurity Scale. The propositional analytical model was based on a review of the literature and was tested using path analysis.SettingDuque de Caxias, Greater Rio de Janeiro, Brazil (April–December 2010).SubjectsWomen (n 849) who had been in a relationship in the 12 months preceding the interview.ResultsBoth psychological and physical violence were found to be major risk factors of HFI. Psychological violence was associated with HFI indirectly via physical violence and CMD, and directly by an unidentified path. The effects of physical violence seemed to be manifested exclusively through CMD. Most of the variables in the propositional model related to socio-economic position, demographic characteristics, degree of women’s social support and partner alcohol misuse were retained in the ‘final’ model, indicating that these factors contribute significantly to the increased likelihood of HFI.ConclusionsThe results reinforce the importance of considering domestic violence and other psychosocial aspects of family life when implementing interventions designed to reduce/eradicate HFI.
Collapse
|
107
|
Willis DE, Fitzpatrick KM. Psychosocial factors as mediators of food insecurity and weight status among middle school students. Appetite 2016; 103:236-243. [PMID: 27107857 DOI: 10.1016/j.appet.2016.04.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 04/13/2016] [Accepted: 04/17/2016] [Indexed: 01/01/2023]
Abstract
Research regarding the association between food insecurity and weight status among youth has produced mixed results. However, few studies on this topic have utilized data that includes survey responses from children themselves regarding their experience with food insecurity. This study was undertaken to examine the association between food insecurity and weight status among youth, as well as the potential mediation by psychosocial factors. A survey of 5th-7th grade students was administered to gather information on food insecurity, social and psychological resources, and health. The primary analysis includes OLS (Ordinary Least Squares) regression conducted using SPSS software and Sobel's test for mediation. Results suggest a positive association between food insecurity and weight status even when controlling for key demographic variables. In addition, we find that this association is mediated by psychosocial factors-namely, perceived social status and depression. Insights from this work highlight the need to consider non-nutritional pathways through which food insecurity impacts health as well the need to continue surveying youth directly when examining their experiences with food insecurity.
Collapse
Affiliation(s)
- Don E Willis
- Department of Sociology, 312 Middlebush Hall, University of Missouri, Columbia, MO, 65211-6100, USA.
| | - Kevin M Fitzpatrick
- Department of Sociology & Criminal Justice, 211 Old Main, University of Arkansas, Fayetteville, AR 72701, USA
| |
Collapse
|
108
|
Sriram U, Tarasuk V. Economic Predictors of Household Food Insecurity in Canadian Metropolitan Areas. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1045670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
109
|
Mangini LD, Hayward MD, Dong YQ, Forman MR. Household Food Insecurity is Associated with Childhood Asthma. J Nutr 2015; 145:2756-64. [PMID: 26491120 DOI: 10.3945/jn.115.215939] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/22/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In 2013, 20% of U.S. households with children experienced food insecurity. Asthma afflicts over 7 million children; prevalence has steadily increased while incidence peaks in young children. Asthma and food insecurity share the determinants of poverty and race that are associated with weight, yet limited research on the relation between food insecurity and asthma exists. OBJECTIVE The objective of this study was to determine the association between food insecurity and asthma in a diverse sample of children. METHODS Cross-sectional data from grade 3 of the Early Childhood Longitudinal Study-Kindergarten Cohort were analyzed (n = 11,099). Food security based on the USDA module and asthma diagnosis were reported by parents; anthropometric factors were measured. Multivariate logistic regression models of food security and asthma were analyzed overall and by race/ethnicity. RESULTS Children in food-insecure households had a 4% higher adjusted odds of asthma (95% CI: 1.02, 1.06). Adjusted odds of asthma were also higher by 70% for males (95% CI: 1.69, 1.71), 53% for non-Hispanic black (NHB) children (95% CI: 1.51, 1.54), 20% for Hispanic children (95% CI: 1.19, 1.21), 38% for overweight children (95% CI: 1.36, 1.39), 67% for obese children (95% CI: 1.65, 1.68), 23% for low-birth weight children (95% CI: 1.21, 1.24), 24% if mothers had a high school diploma (95% CI: 1.23, 1.26), and 33% if mothers had some college education (95% CI: 1.32, 1.35). High-birth weight children (OR: 0.84; 95% CI: 0.83, 0.85) and those with foreign-born mothers (OR: 0.52; 95% CI: 0.51, 0.53) had lower odds of asthma. Being food-insecure remained positively associated with asthma in non-Hispanic whites and Hispanics but was inversely associated with odds among NHBs. Odds of asthma doubled (OR: 2.00; 95% CI: 1.97, 2.03) for all children in households that were both food-insecure and poor; this relation remained positive in race/ethnicity-specific models. CONCLUSIONS Food insecurity is positively associated with asthma in U.S. third graders, and household poverty strengthens the association.
Collapse
Affiliation(s)
| | - Mark D Hayward
- Department of Sociology and Population Research Center, The University of Texas at Austin, Austin, TX
| | | | | |
Collapse
|
110
|
Higashi RT, Craddock Lee SJ, Leonard T, Cuate EL, Cole J, Pruitt SL. Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site. Clin Transl Sci 2015; 8:584-90. [PMID: 26277918 DOI: 10.1111/cts.12325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. METHODS Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. RESULTS Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CONCLUSION CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population.
Collapse
Affiliation(s)
- Robin T Higashi
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Simon J Craddock Lee
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, Dallas, Texas, USA
| | - Tammy Leonard
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Economics Department, University of Dallas, Dallas, Texas, USA
| | - Erica L Cuate
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jay Cole
- Crossroads Community Services, Dallas, Texas, USA
| | - Sandi L Pruitt
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, Dallas, Texas, USA
| |
Collapse
|
111
|
Tarasuk V, Cheng J, de Oliveira C, Dachner N, Gundersen C, Kurdyak P. Association between household food insecurity and annual health care costs. CMAJ 2015; 187:E429-E436. [PMID: 26261199 DOI: 10.1503/cmaj.150234] [Citation(s) in RCA: 179] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Household food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs. METHODS We obtained data for 67 033 people aged 18-64 years in Ontario who participated in the Canadian Community Health Survey in 2005, 2007/08 or 2009/10 to assess their household food insecurity status in the 12 months before the survey interview. We linked these data with administrative health care data to determine individuals' direct health care costs during the same 12-month period. RESULTS Total health care costs and mean costs for inpatient hospital care, emergency department visits, physician services, same-day surgeries, home care services and prescription drugs covered by the Ontario Drug Benefit Program rose systematically with increasing severity of household food insecurity. Compared with total annual health care costs in food-secure households, adjusted annual costs were 16% ($235) higher in households with marginal food insecurity (95% confidence interval [CI] 10%-23% [$141-$334]), 32% ($455) higher in households with moderate food insecurity (95% CI 25%-39% [$361-$553]) and 76% ($1092) higher in households with severe food insecurity (95% CI 65%-88% [$934-$1260]). When costs of prescription drugs covered by the Ontario Drug Benefit Program were included, the adjusted annual costs were 23% higher in households with marginal food insecurity (95% CI 16%-31%), 49% higher in those with moderate food insecurity (95% CI 41%-57%) and 121% higher in those with severe food insecurity (95% CI 107%-136%). INTERPRETATION Household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food insecurity could offset considerable public expenditures in health care.
Collapse
Affiliation(s)
- Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill.
| | - Joyce Cheng
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill
| | - Claire de Oliveira
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill
| | - Naomi Dachner
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill
| | - Craig Gundersen
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill
| | - Paul Kurdyak
- Department of Nutritional Sciences, University of Toronto (Tarasuk, Dachner); Centre for Addiction and Mental Health (Cheng, de Oliveira, Kurdyak); Institute for Clinical and Evaluative Sciences (Cheng, Kurdyak); Institute for Health Policy, Management and Evaluation, University of Toronto (de Oliveira, Kurdyak), Toronto, Ont.; Department of Agricultural and Consumer Economics, University of Illinois (Gundersen), Urbana, Ill
| |
Collapse
|
112
|
Davison KM, Marshall-Fabien GL, Tecson A. Association of moderate and severe food insecurity with suicidal ideation in adults: national survey data from three Canadian provinces. Soc Psychiatry Psychiatr Epidemiol 2015; 50:963-72. [PMID: 25652592 DOI: 10.1007/s00127-015-1018-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/27/2015] [Indexed: 02/01/2023]
Abstract
PURPOSE Although the important public health issues of food insecurity and suicide may be interconnected, they are rarely studied. Using data from a national survey, we examined whether household food insecurity was associated with suicidal ideation after adjusting for relevant covariates. METHODS We examined cross-sectional data from three Canadian provinces (n = 5,270) that were derived from the 2007 Canadian Community Health Survey and included adults (18+ years). Suicidal ideation was based on affirmative response to the question of whether or not the participant had seriously considered committing suicide in the previous 12 months. The Household Food Security Survey Module provided measures of moderate (indication of compromise in quality and/or quantity of food consumed) and severe (indication of reduced food intake and disrupted eating patterns) food insecurity status. Logistic regression determined associations between food insecurity and suicidal ideation with adjustment for demographics, body mass index, and presence of a mood disorder. RESULTS There were differences in the proportion experiencing suicide ideation according to moderate (14.7 vs 10.0 % without suicide ideation) and severe (16.4 vs 7.1 % without suicide ideation) food security (p < 0.001). With covariate adjustment, suicidal ideation was significantly associated with moderate (adjusted OR = 1.32, 95 % CI 1.06-1.64) and severe (adjusted OR = 1.77, 95 % CI 1.42-2.23) food insecurity. CONCLUSIONS The findings of a robust association between food insecurity and suicidal ideation suggest that interventions targeted at food security may reduce suicide-related morbidity and mortality. Longitudinal investigations that examine various dimensions of food insecurity will advance understanding of etiological pathways involved in food insecurity and suicide.
Collapse
Affiliation(s)
- Karen M Davison
- School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada,
| | | | | |
Collapse
|
113
|
Sriram U, Tarasuk V. Changes in household food insecurity rates in Canadian metropolitan areas from 2007 to 2012. Canadian Journal of Public Health 2015; 106:e322-7. [PMID: 26451995 DOI: 10.17269/cjph.106.4893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/29/2015] [Accepted: 03/07/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The socio-demographic characteristics of food-insecure households in Canada have been well characterized, but there is little understanding of what drives the prevalence rates. This study was undertaken to estimate the prevalence of household food insecurity by census metropolitan area (CMA), compare prevalence rates within CMAs and within provinces over time, and assess the effect of local area economic characteristics on changes in CMA food insecurity rates. METHODS Data from the 2007-2012 annual components of the Canadian Community Health Survey were used to generate food insecurity rates for 33 CMAs and the corresponding nine provinces, and to compare changes in prevalence over time. Fixed-effects multiple linear regression analysis was applied to examine associations between changes in food insecurity and local area economic factors, considering peak unemployment rate, average number of Employment Insurance beneficiaries, vacancy rate, poverty rate and poverty gap. RESULTS Food insecurity rates ranged from 19.9% in Halifax to 9.0% in Quebec City in 2011-2012. Rates within and between CMAs were much more variable than provincial rates. Between 2007-2008 and 2011-2012, the prevalence increased significantly in Halifax, Montreal, Peterborough, Guelph, Calgary and Abbotsford, but decreased in Hamilton. Among the economic characteristics examined, only rising peak unemployment rates were linked to increases in food insecurity in CMAs. CONCLUSIONS Our results suggest that policy initiatives to expand employment opportunities, improve the quality and stability of employment, and increase benefits for disadvantaged workers could reduce the prevalence of food insecurity within CMAs.
Collapse
Affiliation(s)
- Urshila Sriram
- Department of Nutritional Sciences, University of Toronto, Toronto, ON.
| | | |
Collapse
|
114
|
Ke J, Ford-Jones EL. Food insecurity and hunger: A review of the effects on children's health and behaviour. Paediatr Child Health 2015; 20:89-91. [PMID: 25838782 DOI: 10.1093/pch/20.2.89] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 11/14/2022] Open
Abstract
Food insecurity and hunger are significant problems in Canada, with millions of Canadians experiencing some level of food insecurity. The purpose of the present article is to review what is currently known about the effects of food insecurity and hunger on children. Longitudinal studies in Canada indicate that hunger is related to poor health outcomes, including a higher risk of depression and suicidal ideation in adolescents, and chronic conditions, particularly asthma. In addition, nutrient deficiencies, such as iron deficiency, are known to impair learning and cause decreased productivity in school-age children, and maternal depressive disorders. School-based nutrition programs and innovations, such as subsidized food (apples, cheese, soy nuts, carrots and broccoli), are an essential immediate need, but long-term solutions lie in adequate incomes for families.
Collapse
Affiliation(s)
- Janice Ke
- McMaster University, Hamilton, Toronto, Ontario
| | - Elizabeth Lee Ford-Jones
- Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children & University of Toronto, Toronto, Ontario
| |
Collapse
|
115
|
Dietary Research to Reduce Children's Oral Health Disparities: An Exploratory Cross-Sectional Analysis of Socioeconomic Status, Food Insecurity, and Fast-Food Consumption. J Acad Nutr Diet 2015; 115:1599-604. [PMID: 25840937 DOI: 10.1016/j.jand.2015.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 02/04/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Tooth decay is the most common childhood disease and it disproportionately affects low-income children. The dietary risk factors associated with socioeconomic status (SES), such as food insecurity and fast-food consumption, are poorly understood. OBJECTIVE To better understand how upstream social factors are related to dietary behaviors by testing the hypothesis that food insecurity mediates the SES-fast-food consumption relationship. DESIGN A 36-item survey was administered to caregivers of children younger than age 18 years (n=212). The predictor variable was SES, measured by whether the child was insured by Medicaid (no/yes). Food insecurity, the potential dietary mediator, was measured using the six-item US Department of Agriculture Household Food Security Survey (food secure/food insecure without hunger/food insecure with hunger). The outcome variable was whether the household reported eating at a fast-food restaurant ≥2 times a week (no/yes). We used logistic structural equation and mediation models to test our hypothesis. RESULTS About 63% of children were classified as low SES. Thirty percent of caregivers reported food insecurity (with or without hunger) and 18.6% of households consumed fast food ≥2 times per week. Lower SES was significantly associated with food insecurity (odds ratio [OR] 3.03, 95% CI 1.51 to 6.04; P=0.002), but SES was not related to fast-food consumption (OR 1.94, 95% CI 0.86 to 4.36; P=0.11). Food insecurity was not associated with fast-food consumption (OR 1.76, 95% CI 0.86 to 3.62; P=0.12). The mediation analyses suggest food insecurity does not mediate the relationship between SES and fast-food consumption. However, there are important potential differences in fast-food consumption by SES and food insecurity status. CONCLUSIONS Future dietary research focusing on tooth decay prevention in vulnerable children may need to account for the differential effects of SES on food insecurity and dietary behaviors like fast-food consumption. Studies are needed to further elucidate the mechanisms linking SES, dietary behaviors, and tooth decay in children.
Collapse
|
116
|
Tarasuk V, Dachner N, Hamelin AM, Ostry A, Williams P, Bosckei E, Poland B, Raine K. A survey of food bank operations in five Canadian cities. BMC Public Health 2014; 14:1234. [PMID: 25432209 PMCID: PMC4289166 DOI: 10.1186/1471-2458-14-1234] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food banks have emerged in response to growing food insecurity among low-income groups in many affluent nations, but their ability to manage this problem is questionable. In Canada, in the absence of public programs and policy interventions, food banks are the only source of immediate assistance for households struggling to meet food needs, but there are many indications that this response is insufficient. The purpose of this study was to examine the factors that facilitate and limit food bank operations in five Canadian cities and appraise the potential of these initiatives to meet food needs. METHODS An inventory of charitable food provisioning in Halifax, Quebec City, Toronto, Edmonton, and Victoria, Canada was conducted in 2010. Of the 517 agencies that participated in a telephone survey of their operations, 340 were running grocery programs. Multivariate regression analyses were conducted to determine the association between program characteristics, volume of service, and indicators of strain in food banks' abilities to consistently achieve the standards of assistance they had established. RESULTS Extensive, well-established food bank activities were charted in each city, with the numbers of people assisted ranging from 7,111 in Halifax to 90,141 in Toronto per month. Seventy-two percent of agencies indicated that clients needed more food than they provided. The number of people served by any one agency in the course of a month was positively associated with the proportion of food distributed that came from donations (beta 0.0143, SE 0.0024, p 0.0041) and the number of volunteers working in the agency (beta 0.0630, SE 0.0159, p 0.0167). Food banks only achieved equilibrium between supply and demand when they contained demand through restrictions on client access. When access to assistance was less restricted, the odds of food banks running out of food and invoking measures to ration remaining supplies and restrict access rose significantly. CONCLUSIONS Despite their extensive history, food banks in Canada remain dependent on donations and volunteers, with available resources quickly exhausted in the face of agencies' efforts to more fully meet clients' needs. Food banks have limited capacity to respond to the needs of those who seek assistance.
Collapse
Affiliation(s)
- Valerie Tarasuk
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
117
|
Tarasuk V, Mitchell A, McLaren L, McIntyre L. Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. J Nutr 2013; 143:1785-93. [PMID: 23986364 DOI: 10.3945/jn.113.178483] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Analyses of cross-sectional population survey data in Canada and the United States have indicated that household food insecurity is associated with poorer self-rated health and multiple chronic conditions. The causal inference has been that household food insecurity contributes to poorer health, but there has been little consideration of how adults' health status may relate to households' vulnerability to food insecurity. Our objectives were to examine how the presence of an adult with one or more chronic physical or mental health conditions affects the odds of a household being food insecure and how the chronic ill-health of an adult within a food-insecure household affects the severity of that household's food insecurity. Using household- and respondent-level data available for 77,053 adults aged 18-64 y from the 2007-2008 Canadian Community Health Survey, we applied logistic regression analyses, controlling for household sociodemographic characteristics, to examine the association between health and household food insecurity. Most chronic conditions increased the odds of household food insecurity independent of household sociodemographic characteristics. Compared with adults with no chronic condition, the odds of household food insecurity were 1.43 (95% CI: 1.28, 1.59), 1.86 (95% CI: 1.62, 2.14), and 3.44 (95% CI: 3.02, 3.93) for adults with 1, 2, and 3 or more chronic conditions, respectively. Among food-insecure households, adults with multiple chronic conditions had higher odds of severe household food insecurity than adults with no chronic condition. The chronic ill-health of adults may render their households more vulnerable to food insecurity. This has important practice implications for health professionals who can identify and assist those at risk, but it also suggests that appropriate chronic disease management may reduce the prevalence and severity of food insecurity.
Collapse
Affiliation(s)
- Valerie Tarasuk
- Department of Nutritional Sciences, Faculty of Medicine, and
| | | | | | | |
Collapse
|