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Darlington WS, Syed S, Wroblewski K, Lapping-Carr G, Lindau ST, Peddinti R. Food insecurity and quality of life in patients with sickle cell disease. Pediatr Blood Cancer 2024; 71:e31045. [PMID: 38687256 DOI: 10.1002/pbc.31045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/21/2024] [Accepted: 04/13/2024] [Indexed: 05/02/2024]
Abstract
Little is known about the relationship between quality of life (QOL) and food insecurity (FI) among patients with sickle cell disease (SCD). We hypothesized FI is associated with lower QOL in children and young adults with SCD. Overall (N = 99), 22% screened positive for FI. Supplemental Nutrition Assistance Program (SNAP) enrollment was 50 and 71% among people from food secure and FI households, respectively. A higher FI score was correlated with lower overall QOL (r = -0.22, p = .03), specifically lower QOL in worry and communication domains. Interventions for FI beyond SNAP may be important for QOL among people living with SCD.
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Affiliation(s)
- Wendy S Darlington
- Department of Pediatrics, Section of Hematology/Oncology and Stem Cell Transplantation, University of Chicago, Chicago, USA
- Department of Pediatrics, University of Chicago Comer Children's Hospital, Chicago, USA
| | - Sharjeel Syed
- Department of Medicine, University of Chicago, Chicago, USA
| | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, USA
| | - Gabrielle Lapping-Carr
- Department of Pediatrics, Section of Hematology/Oncology and Stem Cell Transplantation, University of Chicago, Chicago, USA
- Department of Pediatrics, University of Chicago Comer Children's Hospital, Chicago, USA
| | - Stacy Tessler Lindau
- Department of Obstetrics and Gynecology-Gynecologic Oncology, University of Chicago, Chicago, USA
- Department of Medicine-Geriatrics and Palliative Medicine, University of Chicago, Chicago, USA
- University of Chicago Comprehensive Cancer Center, Chicago, USA
| | - Radhika Peddinti
- Department of Pediatrics, Section of Hematology/Oncology and Stem Cell Transplantation, University of Chicago, Chicago, USA
- Department of Pediatrics, University of Chicago Comer Children's Hospital, Chicago, USA
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2
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Rudel RK, Byhoff E, Fielman SB, Strombotne KL, Drainoni ML, Greece JA. A Qualitative Study of A Health Center-Based Mobile Produce Market. J Ambul Care Manage 2024; 47:134-142. [PMID: 38771169 DOI: 10.1097/jac.0000000000000496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Healthcare-based food assistance programs have the potential to improve patients' food security, but are underutilized. We conducted a qualitative study of user and staff perceptions of an on-site mobile market at a federally-qualified health center (FQHC). Five themes were identified: 1) financial need drives the decision to use the market, 2) people attend specifically to receive healthy food, 3) users feel a connection to the FQHC, which increases participation, 4) social networks increase usage of the program, and 5) long lines, inclement weather, inaccessibility, and inconsistent marketing and communication are attendance barriers. Findings should inform implementation of future healthcare-based food assistance programs.
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Affiliation(s)
- Rebecca K Rudel
- Author Affiliations: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts (Drs Rudel and Greece); Department of Medicine, Section of Infectious Diseases, Boston University Chobanian Avedisian School of Medicine/Boston Medical Center, Boston, Massachusetts (Drs Rudel and Drainoni); Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts (Dr Byhoff); Boston University School of Public Health, Department of Health, Law, Policy and Management, Boston, Massachusetts (Drs Strombotne and Drainoni); and Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian Avedisian School of Medicine, Boston, Massachusetts, (Dr Drainoni)
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Cho S. Child meal support program, food and nutrition insecurity, and health among Korean children. Nutr Health 2024:2601060241261437. [PMID: 38887061 DOI: 10.1177/02601060241261437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND Korea's child meal support program (CMSP) aims to reduce food and nutrition insecurity (FNI) and improve health among children from low-income households. AIM We examined the impact of different types of CMSP on children's FNI and health in Korea, analyzing meal frequency and healthful food consumption (FNI), and general health and depression (health) among child meal card (CMC) and facility meal service (FMS) participants compared with nonparticipants. METHODS The 2018 Comprehensive Survey on Korean Children data were analyzed. Precisely, 847 children from low-income households aged 9-17 were categorized into CMC (n = 331), FMS (n = 209), and income-eligible nonparticipants (n = 307). Propensity score-weighted generalized linear models assessed CMSP's impact on FNI and health. Stratified generalized linear models examined heterogeneity in FNI-health associations by CMSP status. RESULTS CMC participants reported more frequent breakfast consumption (odds ratio [OR] = 0.662, p < 0.05) but poorer self-rated general health (OR = 1.890, p < 0.05); FMS participants were less likely to have three meals (OR = 1.814, p < 0.05), fruits and vegetables (OR = 2.194, p < 0.001), and protein-rich foods daily (OR = 1.695, p < 0.05) than nonparticipants. Health risks associated with healthful food consumption and meal frequency were more pronounced among CMC and FMS/nonparticipants, respectively. CONCLUSION CMSP had a limited impact on reducing FNI and improving health among children from low-income households. CMC appeared more effective than FMS in alleviating FNI, notwithstanding potential health concerns. Food assistance programs should seek comprehensive enhancements in children's food and nutrition security and health.
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Affiliation(s)
- Seongha Cho
- Department of Social Welfare, Seoul National University, Seoul, Republic of Korea
- Institute of Social Welfare, Seoul National University, Seoul, Republic of Korea
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Meller FDO, Quadra MR, Santos LPD, Dumith SC, Eugenio FD, Silva TJD, Mendes JVS, Schäfer AA. Association between job lost and mental health outcomes during the COVID-19 pandemic and the role of food insecurity as mediator of this relationship. CAD SAUDE PUBLICA 2024; 40:e00110523. [PMID: 38896594 PMCID: PMC11178371 DOI: 10.1590/0102-311xen110523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional population-based study was conducted with adults (≥ 18 and < 60 years) during the COVID-19 outbreak in two cities from Southern Brazil. Employment status was categorized into working, not working, and lost job. The mental health outcomes evaluated were depressive symptoms, perceived stress, and sadness. Food insecurity was identified by the short-form version of the Brazilian Food Insecurity Scale. Adjusted analyses using Poisson regression were performed to assess the association between employment status and mental health. Mediation analysis was performed to investigate the direct and indirect effects of employment status on mental health outcomes. In total, 1,492 adults were analyzed. The not working status was associated with 53% and 74% higher odds of perceived stress and of sadness, respectively. Being dismissed during the pandemic increased the odds of depressive symptoms, perceived stress, and sadness by 68%, 123%, and 128%, respectively. Mediation analyses showed that food insecurity was an important mediator of the association between employment status and depressive symptoms and sadness, but not of perceived stress. The complexity of these results highlights economic and nutritional aspects involved in mental health outcomes.
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Giles EL, Eskandari F, McGeechan G, Scott S, Lake AA, Teasdale S, Ekers D, Augustine A, Le Savauge N, Lynch C, Moore H, Smith J. Food insecurity in adults with severe mental illness living in Northern England: Peer research interview findings. Int J Ment Health Nurs 2024; 33:671-682. [PMID: 38059552 DOI: 10.1111/inm.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Abstract
Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. Food insecurity can lead to many health problems such as obesity, heart disease, diabetes, and other long term health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without mental illness. Peer-led in-depth interviews were conducted with adults with severe mental illness from Northern England, during which their experiences of food insecurity and strategies to tackle food insecurity were discussed. Interviews took place between March and December 2022, with interviews being transcribed and analysed using deductive and inductive thematic analysis. Thirteen interviews were conducted, finding that food insecurity in adults with severe mental illness was often a long-standing issue. Unemployment, the cost-of-living crisis and fuel poverty impacted on experiences of food insecurity. Difficulties accessing food banks such as transport, stigma, and the limited selection of available food was also discussed. Strategies to tackle food insecurity centred on making food banks more accessible and improving the quality of available food. Future research should aim to eradicate food insecurity for adults with severe mental illness, as limited research and action focuses on this population group over and above 'mental illness' or 'poor mental health'. Removing barriers to accessing food such as lack of transport, and providing food which is of adequate nutritional quality, should be prioritised, as well as tackling the stigma and accessibility issues surrounding food banks use.
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Affiliation(s)
- Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Fatemeh Eskandari
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Grant McGeechan
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Centre for Applied Psychological Science, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Steph Scott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Scott Teasdale
- Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David Ekers
- Department of Health Sciences, University of York (Mental Health and Addictions Research Group), York, UK
- Flatts Lane Centre, Tees, Esk and Wear Valleys NHS Foundation Trust Flatts Lane, Normanby, Tees Valley, Middlesbrough, UK
| | | | | | | | | | - Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Flatts Lane Centre, Tees, Esk and Wear Valleys NHS Foundation Trust Flatts Lane, Normanby, Tees Valley, Middlesbrough, UK
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Landry MJ, Heying E, Qamar Z, Hagedorn-Hatfield RL, Savoie-Roskos MR, Cuite CL, Zigmont VA, OoNorasak K, Chen S. Advancing college food security: priority research gaps. Nutr Res Rev 2024; 37:108-120. [PMID: 37158045 DOI: 10.1017/s0954422423000094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Despite over a decade of both quantitative and qualitative studies, food insecurity among US college/university students remains a pervasive problem within higher education. The purpose of this perspective piece was to highlight research gaps in the area of college food insecurity and provide rationale for the research community to focus on these gaps going forward. A group of food insecurity researchers from a variety of higher education institutions across the United States identified five thematic areas of research gaps: screening and estimates of food insecurity; longitudinal changes in food insecurity; impact of food insecurity on broader health and academic outcomes; evaluation of impact, sustainability and cost effectiveness of existing programmes and initiatives; and state and federal policies and programmes. Within these thematic areas, nineteen specific research gaps were identified that have limited or no peer-reviewed, published research. These research gaps result in a limited understanding of the magnitude, severity and persistence of college food insecurity, the negative short- and long-term impacts of food insecurity on health, academic performance and overall college experience, and effective solutions and policies to prevent or meaningfully address food insecurity among college students. Research in these identified priority areas may help accelerate action and interdisciplinary collaboration to alleviate food insecurity among college students and play a critical role in informing the development or refinement of programmes and services that better support college student food security needs.
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Affiliation(s)
- Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Emily Heying
- Department of Nutrition, College of Saint Benedict & Saint John's University, Saint Joseph, MN, USA
| | - Zubaida Qamar
- Department of Family, Interiors, Nutrition and Apparel, San Francisco State University, San Francisco, CA, USA
| | | | - Mateja R Savoie-Roskos
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, USA
| | - Cara L Cuite
- Department of Human Ecology, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Victoria A Zigmont
- Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, Oxford, MS, USA
| | - Kendra OoNorasak
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, USA
| | - Susan Chen
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, CA, USA
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Chiu DT, Parker JE, Wiley CR, Epel ES, Laraia BA, Leung CW, Tomiyama AJ. Food insecurity, poor diet, and metabolic measures: The roles of stress and cortisol. Appetite 2024; 197:107294. [PMID: 38479471 PMCID: PMC11149909 DOI: 10.1016/j.appet.2024.107294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/24/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36-43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.
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Affiliation(s)
- Dorothy T Chiu
- Osher Center for Integrative Health, University of California, San Francisco, 1545 Divisadero St 4th Floor, San Francisco, CA, 94115, USA.
| | - Jordan E Parker
- Department of Psychology, University of California, Los Angeles, 1285 Psychology Building Box 951563, Los Angeles, CA, 90095, USA.
| | - Cameron R Wiley
- Department of Psychological Science, University of California, Irvine, 4201 Social & Behavioral Sciences Gateway, Irvine, CA, 92697, USA.
| | - Elissa S Epel
- Weill Institute for Neurosciences, University of California, San Francisco, 675 18th Street, #5104, San Francisco, CA, 94107, USA.
| | - Barbara A Laraia
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720, USA.
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Building 2, 3rd Floor, Boston, MA, 02115, USA.
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, 1285 Psychology Building Box 951563, Los Angeles, CA, 90095, USA.
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Hoenink JC, Garrott K, Jones NRV, Conklin AI, Monsivais P, Adams J. Changes in UK price disparities between healthy and less healthy foods over 10 years: An updated analysis with insights in the context of inflationary increases in the cost-of-living from 2021. Appetite 2024; 197:107290. [PMID: 38462051 DOI: 10.1016/j.appet.2024.107290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/23/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
Food prices and affordability play an important role in influencing dietary choices, which in turn have implications for public health. With inflationary increases in the cost-of-living in the UK since 2021, understanding the dynamics of food prices becomes increasingly important. In this longitudinal study, we aimed to examine changes in food prices from 2013 to 2023 by food group and by food healthiness. We established a dataset spanning the years 2013-2023 by combining price data from the UK Consumer Price Index for food and beverage items with nutrient and food data from the UK nutrient databank and UK Department of Health & Social Care's National Diet and Nutrition Survey data. We calculated the price (£/100 kcal) for each food item by year as well as before and during the period of inflationary pressure, and classified items into food groups according to the UK Eatwell Guide and as either "more healthy" or "less healthy" using the UK nutrient profiling score model. In 2023, bread, rice, potatoes and pasta was cheapest (£0.12/100 kcal) and fruit and vegetables most expensive (£1.01/100 kcal). Less healthy food was cheaper than more healthy food (£0.33/100 kcal versus £0.81/100 kcal). Before the inflationary pressure period (from 2013 to late 2021), the price of foods decreased by 3%. After this period, the price of food increased by 22%: relative increases were highest in the food group milk and dairy food (31%) and less healthy category (26%). While healthier foods saw smaller relative price increases since 2021, they remain more expensive, potentially exacerbating dietary inequalities. Policy responses should ensure food affordability and mitigate price disparities via, for example, healthy food subsidies.
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Affiliation(s)
- Jody C Hoenink
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
| | - Kate Garrott
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | | | - Annalijn I Conklin
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada; Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, Canada; Edwin S.H. Leong Centre for Healthy Aging, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Pablo Monsivais
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, USA
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
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Ling J, Miller AL, Robbins LB, Zhang N. Elevated parent and child hair cortisol moderated the efficacy of a mindful eating intervention. Stress Health 2024; 40:e3333. [PMID: 37853993 DOI: 10.1002/smi.3333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
To explore whether elevated baseline hair cortisol moderated effects of a mindful eating intervention on anthropometrics, blood pressure (BP), household food insecurity, eating behaviour, and various psychosocial outcomes. The 14-week intervention included a parent Facebook-based programme, 3 parent meetings, preschooler letters connecting school learning to home practices, and a preschool-based mindful eating programme. Among 107 parent-preschooler dyads, mean age was 47.32 months for preschoolers and 30.12 years for parents. Among preschoolers, 54.2% were female, 8.4% were Hispanic, and 19.6% were Black. Among parents, 95.3% were female, 6.5% were Hispanic, 15.0% were Black, 39.4% were single, and 43.4% were unemployed. Preschoolers' elevated hair cortisol was related to a smaller reduction in preschoolers' % body fat (r =.31) and smaller increases in parents' perceived responsibility for child feeding (r = -.37). Parents' elevated hair cortisol was associated with smaller decreases in preschoolers' emotional eating (r = .39) and household food insecurity (r = .44). Relationships between baseline hair cortisol and post-intervention outcomes (BP, emotional eating, fruit/vegetable intake, food insecurity, and coping) varied by baseline values of outcome variables. Given that stress may attenuate intervention effects, a stress management component may be necessary to foster positive behavioural changes. Moreover, interventions should be tailored according to participants' characteristics to achieve optimal effects.
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Affiliation(s)
- Jiying Ling
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Alison L Miller
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Lorraine B Robbins
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Nanhua Zhang
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Belarmino EH, Conway CM, Kolodinsky J, Daylor KM, Spence E. Diaper need in the United States: A nationally representative study during the COVID-19 pandemic. Heliyon 2024; 10:e31344. [PMID: 38807893 PMCID: PMC11130655 DOI: 10.1016/j.heliyon.2024.e31344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
Background Diapers represent a unique financial burden for those with young children. Pre-pandemic, approximately one in three U.S. households with young children reported diaper need or an insufficient supply of diapers. To support this population, policymakers, clinicians, and service providers need a better understanding of the groups most commonly affected and the ways that families cope with deprivation. Methods An online survey was administered between February and July 2021 to a national sample of U.S. caregivers of at least one child aged 0-4 years in diapers (n = 881), investigating diaper need, diaper access, and how household expenses are balanced and prioritized vis-à-vis diapers. We use bivariate and multivariable models to assess factors associated with diaper need, and examine coping strategies, tradeoffs made to purchase diapers, and how caregivers would reallocate their money if diapers were accounted for. Findings The prevalence of diaper need (46 %) exceeded pre-pandemic estimates. Diaper need was more prevalent among Hispanic respondents, lower income respondents, cloth diaper users, those with more than one child in diapers, caretakers with depression, and those with a negative financial change in the past year. Caretakers with diaper need were more likely to utilize a range of resources to access diapers and to use diapers for longer than desired to extend their supply. Those with diaper need also made more economic tradeoffs to afford diapers and indicated that they would reallocate resources to cover other unmet basic needs if they did not have to buy diapers. Interpretation Our results indicate elevated levels of diaper need even after the U.S. economy had largely rebounded and raise concerns that inequities in diaper access may impact families' abilities to meet other basic needs. Diapers may be an important target for policies and interventions aimed at improving the well-being of families with young children.
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Affiliation(s)
- Emily H. Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 350 Carrigan Wing, Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Gund Institute for Environment, University of Vermont, Farrell Hall, 210 Colchester Avenue, Burlington, VT, 05405, USA
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Carollyne M. Conway
- Environmental Science Program, College of Agriculture and Life Sciences, Morrill Hall, University of Vermont, Burlington, VT, 05405, USA
| | - Jane Kolodinsky
- Gund Institute for Environment, University of Vermont, Farrell Hall, 210 Colchester Avenue, Burlington, VT, 05405, USA
- Department of Community Development and Applied Economics, University of Vermont, 202 Morrill Hall, Burlington, VT, 05405, USA
- Center for Rural Studies, University of Vermont, 206 Morrill Hall, Burlington, VT, 05405, USA
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Kaya M. Daylor
- Data Science Program, Department of Mathematics and Statistics, E220 Innovation Hall, 82 University Place, University of Vermont, Burlington, VT, 05405, USA
| | - Emma Spence
- Food Systems Program, University of Vermont, 236 Marsh Life Science, 109 Carrigan Drive, Burlington, VT, 05405, USA
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11
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Baker S, Gallegos D, Rebuli MA, Taylor AJ, Mahoney R. Food Insecurity Screening in High-Income Countries, Tool Validity, and Implementation: A Scoping Review. Nutrients 2024; 16:1684. [PMID: 38892619 PMCID: PMC11174716 DOI: 10.3390/nu16111684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Household food insecurity has significant negative implications across the lifespan. While routine screening is recommended, particularly in healthcare, guidelines are lacking on selection of screening tools and best-practice implementation across different contexts in non-stigmatizing ways. The objective of this scoping review was to synthesize evidence on household food insecurity screening tools, including psychometrics, implementation in a range of settings, and experiences of carrying out screening or being screened. Four electronic databases were searched for studies in English published from 1990 until June 2023. A total of 58 papers were included, 21 of which focused on tool development and validation, and 37 papers described implementation and perceptions of screening. Most papers were from the USA and described screening in healthcare settings. There was a lack of evidence regarding screening in settings utilized by Indigenous people. The two-item Hunger Vital Sign emerged as the most used and most valid tool across settings. While there is minimal discomfort associated with screening, screening rates in practice are still low. Barriers and facilitators of screening were identified at the setting, system, provider, and recipient level and were mapped onto the COM-B model of behavior change. This review identifies practical strategies to optimize screening and disclosure.
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Affiliation(s)
- Sabine Baker
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | | | - Amanda J. Taylor
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Ray Mahoney
- Australian e-Health Research Centre, CSIRO Health and Biosecurity, Herston, QLD 4029, Australia;
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12
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Mauldin K, Pignotti GAP, Gieng J. Measures of nutrition status and health for weight-inclusive patient care: A narrative review. Nutr Clin Pract 2024. [PMID: 38796769 DOI: 10.1002/ncp.11158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/07/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024] Open
Abstract
In healthcare, weight is often equated to and used as a marker for health. In examining nutrition and health status, there are many more effective markers independent of weight. In this article, we review practical and emerging clinical applications of technologies and tools used to collect non-weight-related data in nutrition assessment, monitoring, and evaluation in the outpatient setting. The aim is to provide clinicians with new ideas about various types of data to evaluate and track in nutrition care.
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Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
- Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Giselle A P Pignotti
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
| | - John Gieng
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
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13
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Livings MS, Bruine de Bruin W, Wasim N, Wilson JP, Lee BY, de la Haye K. Food and Nutrition Insecurity: Experiences That Differ for Some and Independently Predict Diet-Related Disease, Los Angeles County, 2022. J Nutr 2024:S0022-3166(24)00297-9. [PMID: 38801862 DOI: 10.1016/j.tjnut.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/30/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND National surveillance shows that food insecurity affects ≥1 in 10 Americans each year. Recently, experts have advocated for surveillance of nutrition and food insecurity. Nutrition security refers to the nutritional adequacy of accessible food and factors that impact one's ability to meet food preferences. OBJECTIVES This study presents representative estimates of food insecurity and nutrition insecurity for Los Angeles County, CA, United States; compares predictors of these constructs; and examines whether they independently predict diet-related health outcomes. METHODS In December 2022, a representative sample of Los Angeles County adults participating in the Understanding America Study (N = 1071) was surveyed about household food insecurity and nutrition insecurity over the past 12 mo. Data were analyzed in 2023. RESULTS Reported rates were similar for food insecurity (24%) and nutrition insecurity (25%), but the overlap of these subgroups was <60%. Logistic regression models indicated that non-Hispanic Asian individuals had higher odds of nutrition insecurity but not food insecurity. Moreover, nutrition insecurity was a stronger predictor of diabetes compared with food insecurity, and both constructs independently predicted poor mental health. CONCLUSIONS Food and nutrition insecurity affect somewhat different populations. Both constructs are valuable predictors of diet-related health outcomes. Monitoring nutrition insecurity in addition to food insecurity can provide new information about populations with barriers to healthy diets.
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Affiliation(s)
- Michelle Sarah Livings
- Center for Research on Child and Family Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ, United States.
| | - Wandi Bruine de Bruin
- Department of Psychology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States; Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States; Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States; Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Natasha Wasim
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - John P Wilson
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Spatial Sciences Institute, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States; Department of Sociology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States; Departments of Civil and Environmental Engineering and Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States; School of Architecture, University of Southern California, Los Angeles, CA, United States
| | - Bruce Y Lee
- Graduate School of Public Health and Health Policy, City University of New York, NY, United States; Center for Advanced Technology and Communication in Health, City University of New York, NY, United States
| | - Kayla de la Haye
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
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14
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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the Family Stress Model to responsive feeding and early obesity prevention. Appetite 2024; 200:107515. [PMID: 38797237 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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15
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Inoue M, Masa R, Prieto L, Baruah D, Kellermeyer K, Booker E, Sweeney G. Prevalence and Correlates of Food Insecurity Among Older Adults in the United States. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-18. [PMID: 38739384 DOI: 10.1080/01634372.2024.2339975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
This study analyzed the 2021 National Health Interview Survey (NHIS) to assess food insecurity among adults aged 65 and older. Among 8,877 older adults, 4 percent (N=287) reported low or very low food security levels. Those who identified as Black or African American and Hispanic or Latino were more likely to experience food insecurity compared to White individuals. The study found that merely surpassing the poverty threshold might not be sufficient to protect against food insecurity. It also underscored socioemotional support's protective role in older adults' food security. Social workers must recognize various factors influencing food security among older adults.
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Affiliation(s)
- Megumi Inoue
- Department of Social Work, George Mason University, Virginia, USA
| | - Rainier Masa
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lucas Prieto
- Department of Social Work, George Mason University, Virginia, USA
| | - Dicky Baruah
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Emma Booker
- Department of Social Work, George Mason University, Virginia, USA
| | - Grace Sweeney
- Department of Social Work, George Mason University, Virginia, USA
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16
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Spence EH, Niles MT, Bertmann F, Mares T, Belarmino EH. Higher rates of food insecurity and stress experienced by food systems workers during the first year of the COVID-19 pandemic. Front Nutr 2024; 11:1274656. [PMID: 38774263 PMCID: PMC11106489 DOI: 10.3389/fnut.2024.1274656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/09/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction The present study examined the prevalence of food insecurity and perceived stress among food system workers relative to other members of the population during the first year of the COVID-19 pandemic. It also explored perspectives on the role of food system workers during the pandemic and their experiences working during this time. Methods Data were collected via an online survey in spring 2021. The sample was comprised of 441 residents of Vermont, United States, including 41 food system workers. Results Regression models identified higher rates of food insecurity and perceived stress among food system workers during the first year of the pandemic. However, these relationships were not maintained when the models were adjusted for income and job disruption, suggesting that the associations were primarily due to the economic vulnerability of food system workers. Most respondents indicated concern for the health and well-being of food system workers, felt that food system workers were undervalued, and agreed that the well-being of food system workers should be prioritized. However, opinions were split regarding whether it was worth the health risk to require farms and food processing plants to stay open to maintain the food supply. Half of food system workers believed that their work had compromised their well-being during the pandemic, although several also identified their jobs as pathways for accessing food. Discussion The findings provide valuable information for decision-makers seeking to increase the resilience of the food supply and the food system workforce.
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Affiliation(s)
- Emma H. Spence
- Food Systems Program, University of Vermont, Burlington, VT, United States
| | - Meredith T. Niles
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
- Gund Institute for Environment, University of Vermont, Burlington, VT, United States
| | - Farryl Bertmann
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
| | - Teresa Mares
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Anthropology, University of Vermont, Burlington, VT, United States
| | - Emily H. Belarmino
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
- Gund Institute for Environment, University of Vermont, Burlington, VT, United States
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17
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Vu H, Green TL, Swan LET. Born on the wrong side of the tracks: Exploring the causal effects of segregation on infant health. JOURNAL OF HEALTH ECONOMICS 2024; 95:102876. [PMID: 38763530 DOI: 10.1016/j.jhealeco.2024.102876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/24/2024] [Accepted: 03/15/2024] [Indexed: 05/21/2024]
Abstract
Prior research has found that a high level of residential racial segregation, or the degree to which racial/ethnic groups are isolated from one another, is associated with worsened infant health outcomes, particularly among non-Hispanic (NH) Black infant populations. However, because exposure to segregation is non-random, it is unclear whether and to what extent segregation is causally linked to infant health. To overcome this empirical limitation, we leverage exogenous variation in the placement of railroad tracks in the 19th century to predict contemporary segregation, an approach first introduced by Ananat (2011). In alignment with prior literature, we find that residential segregation has statistically significant associations with negative birth outcomes among Black infant populations in the area. Using OLS methods underestimates the negative impacts of segregation on infant health. We fail to detect comparable effects on health outcomes among NH White infant populations. Further, we identify several key mechanisms by which residential segregation could influence health outcomes among Black infant populations, including lower access to prenatal care during the first trimester, higher levels of anti-Black prejudice, greater transportation barriers, and increased food insecurity. Given that poor birth outcomes have adverse effects on adults' health and well-being, the findings suggest that in-utero exposure to residential segregation could have important implications for Black-White inequality over the life course.
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Affiliation(s)
- Hoa Vu
- School of Education and Social Policy, Northwestern University, United States of America.
| | - Tiffany L Green
- Department of Population Health Sciences, University of Wisconsin-Madison, United States of America.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin-Madison, United States of America.
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18
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Park S, Ortega AN, Chen J, Mortensen K, Bustamante AV. Association of food insecurity with health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic. Public Health 2024; 230:183-189. [PMID: 38565064 DOI: 10.1016/j.puhe.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To examine the associations between food insecurity and health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic and examine whether the associations were less pronounced among adults with safety nets. STUDY DESIGN We conducted a retrospective longitudinal cohort study using the 2020-2021 Medical Expenditure Panel Survey. METHODS Linear probability models were used to assess the associations between food insecurity in one year and the outcomes of interest in the following year while adjusting for baseline characteristics. We performed the analyses for the entire population and then conducted stratified analyses for adults with and without Supplemental Nutrition Assistance Program (SNAP) benefits or Medicaid coverage. RESULTS Compared with food-secure adults, food-insecure adults were 9.1 percentage points less likely to report life satisfaction and 9.9, 10.2, and 13.2 percentage points more likely to experience delays in getting medical care, postpone or forgo medical care because of cost, and struggle with paying medical bills. Food-insecure adults were 30.4, 27.2, and 23.5 percentage points more likely to face challenges in affording necessities, paying utility bills, and meeting rent or mortgage payments on time than food-secure adults. Notably, the strengths of these associations were attenuated among adults with SNAP benefits or Medicaid coverage. CONCLUSIONS Food insecurity was associated with poor health, limited access to and affordability of care, and a greater financial burden of care among US adults during the pandemic. Nevertheless, safety net programs can play a critical role in alleviating adverse consequences.
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Affiliation(s)
- S Park
- Department of Health Policy and Management, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea; Department of Healthcare Sciences, Graduate School, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea; L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - A N Ortega
- Thompson School of Social Work and Public Health, University of Hawai'i at Manoa, 2430 Campus Rd, Honolulu, HI, 96822, USA.
| | - J Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland, 4200 Valley Dr, College Park, MD, 20742, USA.
| | - K Mortensen
- Department of Health Management and Policy, Hebert Business School, University of Miami, 5250 University Dr, Coral Gables, FL 33146, USA.
| | - A V Bustamante
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, UCLA Latino Policy and Politics Institute, 650 Charles Young Dr. S., Los Angeles, CA, 90095, USA.
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19
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Roggema R, Krstikj A, Flores B. Spatial Barriers to Transforming toward a Healthy Food System in the Noreste of Mexico. Nutrients 2024; 16:1259. [PMID: 38732506 PMCID: PMC11085837 DOI: 10.3390/nu16091259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
In the past five decades, global food systems have undergone a notable transition, moving from predominantly rural settings to increasingly urban and industrialized environments, largely driven by processes of globalization and supply chain integration. However, this evolution has not adequately addressed equitable access to nutritious diets and food environments, resulting in adverse health outcomes. This study delves into the spatial and non-spatial barriers that impede the adoption of healthy diets in the Noreste of Mexico, particularly focusing on the challenges associated with accessing and cultivating plant-based foods. Through an examination of suitable areas for urban agriculture and an exploration of the socio-cultural factors influencing the adoption of plant-based diets, the research focuses on interventions aimed at promoting healthier and more sustainable eating practices in Monterrey. The findings of the study reveal significant disparities in food access across the Monterrey metropolitan area, with central urban zones exhibiting superior access to fresh foods compared to suburban and peripheral regions. This inequality disproportionately affects marginalized areas characterized by higher poverty rates, exacerbating issues of food insecurity. Nevertheless, traditional dietary practices could offer promising avenues for creating culturally significant and healthier dietary transitions, even amidst the ongoing process of urbanization.
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Affiliation(s)
- Rob Roggema
- School of Architecture, Art and Design, Campus Monterrey, Tecnologico de Monterrey, Monterrey 64849, Mexico
| | - Aleksandra Krstikj
- School of Architecture, Art and Design, Campus State of Mexico, Tecnologico de Monterrey, López Mateos 52926, Mexico;
| | - Brianda Flores
- School of Humanities and Education, Campus Monterrey, Tecnologico de Monterrey, Monterrey 64849, Mexico;
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20
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Abo Hamza E, Tindle R, Pawlak S, Bedewy D, Moustafa AA. The impact of poverty and socioeconomic status on brain, behaviour, and development: a unified framework. Rev Neurosci 2024; 0:revneuro-2023-0163. [PMID: 38607658 DOI: 10.1515/revneuro-2023-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/17/2024] [Indexed: 04/13/2024]
Abstract
In this article, we, for the first time, provide a comprehensive overview and unified framework of the impact of poverty and low socioeconomic status (SES) on the brain and behaviour. While there are many studies on the impact of low SES on the brain (including cortex, hippocampus, amygdala, and even neurotransmitters) and behaviours (including educational attainment, language development, development of psychopathological disorders), prior studies did not integrate behavioural, educational, and neural findings in one framework. Here, we argue that the impact of poverty and low SES on the brain and behaviour are interrelated. Specifically, based on prior studies, due to a lack of resources, poverty and low SES are associated with poor nutrition, high levels of stress in caregivers and their children, and exposure to socio-environmental hazards. These psychological and physical injuries impact the normal development of several brain areas and neurotransmitters. Impaired functioning of the amygdala can lead to the development of psychopathological disorders, while impaired hippocampus and cortex functions are associated with a delay in learning and language development as well as poor academic performance. This in turn perpetuates poverty in children, leading to a vicious cycle of poverty and psychological/physical impairments. In addition to providing economic aid to economically disadvantaged families, interventions should aim to tackle neural abnormalities caused by poverty and low SES in early childhood. Importantly, acknowledging brain abnormalities due to poverty in early childhood can help increase economic equity. In the current study, we provide a comprehensive list of future studies to help understand the impact of poverty on the brain.
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Affiliation(s)
- Eid Abo Hamza
- College of Education, Humanities & Social Sciences, 289293 Al Ain University , 64141, Al Jimi, UAE
- Faculty of Education, Tanta University, Al-Geish St., 122011, Tanta, Egypt
| | - Richard Tindle
- JMS Allied Services, 1109 Coffs Harbour , NSW, 2452, Australia
| | - Simon Pawlak
- Department of Psychological Sciences, Swinburne University of Technology, John Street, Hawthorn, VIC 3122, Australia
| | - Dalia Bedewy
- Department of Psychology, College of Humanities and Sciences, 59104 Ajman University , University Street, Al jerf 1, Ajman, UAE
- Department of Psychology, Faculty of Education, Tanta University, Al-Geish St., 122011, Tanta, Egypt
- 59104 Humanities and Social Sciences Research Center (HSSRC), Ajman University , University Street, Al jerf 1, Ajman, UAE
| | - Ahmed A Moustafa
- Department of Human Anatomy and Physiology, The Faculty of Health Sciences, University of Johannesburg, Cnr Kingsway & University Roads, Auckland Park, Johannesburg, 2092, South Africa
- School of Psychology, Faculty of Society and Design, 448704 Bond University , 14 University Dr, Robina QLD 4226, Gold Coast, QLD, Australia
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21
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Pengpid S, Peltzer K. Longitudinal Associations Between Food Insecurity and Mental Health in Aging Adults in South Africa. Clin Gerontol 2024:1-9. [PMID: 38600746 DOI: 10.1080/07317115.2024.2341328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The aim of this study was to assess the longitudinal unidirectional and bidirectional associations between food insecurity and mental health among aging adults in South Africa. METHODS The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa (HAALSI) study. RESULTS The proportion of food insecurity was 20.2% in 2015, 24.1% in 2019 and 18.4% in 2021/2022. Food insecurity was positively associated depressive symptoms, poor life satisfaction, poor sleep quality, PTSD, loneliness, impaired cognition, and current tobacco use. Compared to without food insecurity in all three study waves, having food insecurity in one wave and/or two to three waves was positively associated with incident depressive symptoms, incident poor life satisfaction, incident poor sleep quality, incident PTSD, incident loneliness, incident current tobacco use, and incident current heavy alcohol use. PTSD, impaired cognition, current tobacco use and current heavy alcohol use were positively associated with incident food insecurity. CONCLUSION We found that food insecurity was unidirectionally associated with depressive symptoms, poor life satisfaction, poor sleep quality and loneliness, and bidirectionally associated with PTSD, impaired cognition, current tobacco use and current heavy alcohol use. CLINICAL IMPLICATIONS Enhanced screening and management of food insecurity may reduce mental ill-health in South Africa.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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22
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Dlamini SN, Mtintsilana A, Craig A, Mapanga W, Norris SA. Food insecurity and coping strategies associate with higher risk of anxiety and depression among South African households with children. Public Health Nutr 2024; 27:e116. [PMID: 38576137 PMCID: PMC11036448 DOI: 10.1017/s1368980024000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To investigate food insecurity and related coping strategies, and their associations with the risk of anxiety and depression, among South African households with children. DESIGN Nationally representative cross-sectional study. Tools for assessing food insecurity, coping strategies, risk of anxiety and depression were assessed from the Community Childhood Hunger Identification Project, Coping Strategies Index, Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. We used ordered logistic regression to test associations of food insecurity and coping strategies with the risk of anxiety and depression. Moderating effects of each coping strategy were tested in the associations of food insecurity with anxiety and depression. SETTING South Africa, post COVID-19 restrictions, May-June 2022. PARTICIPANTS 1,774 adults, weighted to 20,955,234 households. RESULTS Food insecurity prevalence was 23·7 % among households with children. All coping strategies were used to some extent, but relying on less preferred and less expensive foods was the most used strategy (85·5 % of food-insecure households). Moving to a higher level of food insecurity was associated with >1·6 greater odds of being in a higher risk of anxiety and depression. Sending a household member to beg for food was the strongest associated factor (OR = 1·7, P < 0·001). All coping strategies partly moderated (lessened) the associations of food insecurity with a higher risk of anxiety and depression. CONCLUSIONS Food insecurity among households with children was high following the COVID-19 pandemic. Collaborative efforts between government, private sector and civil society to eradicate food insecurity should prioritise poorer households with children, as these populations are the most vulnerable.
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Affiliation(s)
- Siphiwe N Dlamini
- School of Physiology, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South
Africa
| | - Asanda Mtintsilana
- School of Physiology, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South
Africa
| | - Ashleigh Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
| | - Witness Mapanga
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg,
South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
- School of Human Development and Health, University of
Southampton, Southampton, UK
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23
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Coughenour C, Chien LC, Gakh M, Labus B, McDonough IK, Grigsby TJ, Usufzy P. Food and Housing Insecurity in Nevada During the COVID-19 Pandemic. J Community Health 2024; 49:296-313. [PMID: 37932626 DOI: 10.1007/s10900-023-01284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 11/08/2023]
Abstract
The COVID-19 pandemic intensified concerns regarding food and housing insecurity in the United States, particularly among vulnerable populations. After the pandemic prompted a shutdown of nonessential businesses in Nevada, unemployment rose dramatically as the gaming, tourism, and hospitality industries struggled. This study analyzed the results of two telephone surveys of Nevada adults' experiences in 2020 (n = 1000) and 2021 (n = 1002). The results demonstrate between 2020 and 2021 an 8.24 percentage point decline in food insecurity (FI) from 30.2% to 21.96% and a 12.58 percentage point increase in housing insecurity (HI) from 12.27% to 24.85%. Age, disability status, and certain categories of race/ethnicity and income were associated with both HI and FI in 2020, but disability was no longer significant in 2021. Instead, spouse/partner-status, living with children ≤ 18-years-old and receipt of SNAP benefits were significantly associated with FI in 2021. In particular, health status became a significant factor of both HI and FI. People of color experienced FI disparities compared to Whites. Asians/Hawaiians/Pacific Islanders were 3.22 times (95% CI 1.51, 6.86) more likely to experience FI in 2021 than Whites. A matched, longitudinal analysis also revealed that Whites experienced a significant 9.1 percentage point estimated decline in the probability of FI between 2020 and 2021. However, the reduction among non-White participants was statistically insignificant at 2.5 percentage points. Results indicate the importance of supporting the food and housing needs of people of color and individuals with disabilities. Further research should especially investigate the comparative FI rate among Asians/Hawaiians/Pacific Islanders in 2021 and offer solutions to the soaring prevalence of housing insecurity.
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Affiliation(s)
- Courtney Coughenour
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA.
| | - Lung-Chang Chien
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Maxim Gakh
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Brian Labus
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Ian K McDonough
- Department of Economics, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Timothy J Grigsby
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Pashtana Usufzy
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
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Dualle MA, Robinette LM, Hatsu IE. Food Related Challenges and Mental Health Among U.S. African Migrants: A Narrative Review. J Immigr Minor Health 2024; 26:371-384. [PMID: 37400706 DOI: 10.1007/s10903-023-01512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
The United States' (US) African immigrant (AI) population is growing, yet they are underrepresented in health and nutrition research. This population experiences difficulties finding culturally appropriate foods and navigating the US food environment (FE), is highly food insecure (FI), and vulnerable to mental disorders. This review examined the current evidence for AIs' food and mental health outcomes and connections; and identified gaps in the literature and future research opportunities. A literature search was conducted using Google Scholar, PubMed, CINAHL, MEDLINE, and SCOPUS. Twenty-one studies were identified, reporting high (37-85%) FI rates, poor diet quality, and increased risk of mental disorders among participants. Challenges in the FE, lack of transportation, limited access to ethnic foods, low SES, and language barriers were associated with FI and poor diet quality. Similarly, discrimination, substance use, and immigration status were associated with depression and anxiety. However, studies examining the connection between AI's food experience and mental health are lacking. AIs are at a higher risk for FI, poor diet quality, and mental disorders. Ethnic-specific research to understand the connection between their food and mental health is needed to reduce nutrition and mental health disparities.
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Affiliation(s)
- Maryan A Dualle
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Lisa M Robinette
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Irene E Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA.
- College of Education and Human Ecology, Department of Human Sciences | Human Nutrition Program, 341 Campbell Hall, 1787 Neil Ave, Columbus, OH, 43210, USA.
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Aktary ML, Dunn S, Sajobi T, O'Hara H, Leblanc P, McCormack GR, Caron-Roy S, Lee YY, Reimer RA, Minaker LM, Raine KD, Godley J, Downs S, Nykiforuk CIJ, Olstad DL. The British Columbia Farmers' Market Nutrition Coupon Program Reduces Short-Term Household Food Insecurity Among Adults With Low Incomes: A Pragmatic Randomized Controlled Trial. J Acad Nutr Diet 2024; 124:466-480.e16. [PMID: 37806435 DOI: 10.1016/j.jand.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The British Columbia Farmers' Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers' markets. OBJECTIVE To examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention. DESIGN Secondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention. PARTICIPANTS/SETTING Adults ≥18 years with low incomes were randomized to an FMNCP group (n = 143) or a no-intervention control group (n = 142). INTERVENTION Participants in the FMNCP group received 16 coupon sheets valued at $21 Canadian dollars (CAD)/sheet over 10 to 15 weeks to purchase healthy foods from farmers' markets and were eligible to participate in nutrition skill-building activities. MAIN OUTCOME MEASURES Outcomes included short-term household food insecurity (modified version of Health Canada's 18-item Household Food Security Survey Module), malnutrition risk (Malnutrition Universal Screening Tool), mental well-being (Warwick-Edinburgh Mental Well-Being Scale), sense of community (Brief Sense of Community Scale), and subjective social status (MacArthur Scale of Subjective Social Status community scale). STATISTICAL ANALYSIS Mixed-effects linear regression and multinomial logistic regression examined between-group differences in outcomes post-intervention and 16 weeks post-intervention. RESULTS The risk of marginal and severe short-term household food insecurity was lower among those in the FMNCP group compared with those in the control group (relative risk ratio [RRR] 0.15, P = 0.01 and RRR 0.16, P = 0.02) post-intervention, with sustained reductions in severe household food insecurity 16 weeks post-intervention (RRR 0.11, P = 0.01). No statistically significant differences were observed in malnutrition risk, mental well-being, sense of community, or subjective social status post-intervention or 16 weeks post-intervention. CONCLUSIONS The BC FMNCP reduced short-term household food insecurity but was not found to improve malnutrition risk or psychosocial well-being among adults with low incomes compared with a no-intervention control group.
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 DOI: 10.1016/j.chiabu.2024.106701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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27
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Castro LF, Adu Y, Castro M, Palacios C, Sheikh M, Barrios Y, Bennett K, Prabhu F. Investigating level of food security among patients with hypertension and diabetes at a student-run free clinic. Proc AMIA Symp 2024; 37:598-601. [PMID: 38910821 PMCID: PMC11188835 DOI: 10.1080/08998280.2024.2333231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/05/2024] [Indexed: 06/25/2024] Open
Abstract
Background Nutritional recommendations for patients with type 2 diabetes mellitus (T2DM) and hypertension assume high food security. However, food insecurity is estimated to affect 10% of the US population and more so patients at our student-run free clinic (SRFC). The aims of the study were to (1) assess food security in patients with a diagnosis of T2DM, hypertension, or both and (2) examine the relationship between food security and glycated hemoglobin (HbA1C) or blood pressure at an SRFC. Methods Eligible participants completed a 10-item food security questionnaire and an item addressing perceived barriers. Most recent HbA1C and blood pressure measurements were gathered. Comparisons were made using univariate or multivariate linear regression analysis. Results Results from 79 participants showed that 25.3% experienced high food security, 29.1% had marginal food security, 13.9% had low food security, and 30.4% had very low food security. No statistically significant association was found between food security category and HbA1C or blood pressure. However, we did find that approximately 73% of patients experienced some degree of food insecurity. Conclusions Patients at our SRFC are ethnically and racially diverse, most have a high school education or less, and most have food insecurity. No association between food security category and HbA1C or blood pressure control was found. Providers should consider the degree of food insecurity and incorporate a culturally sensitive approach when making nutritional recommendations.
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Affiliation(s)
- Luis F Castro
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Yaw Adu
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Maribel Castro
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Clarissa Palacios
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Muneeza Sheikh
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Yesenia Barrios
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Kelly Bennett
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Fiona Prabhu
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Garrity K, Krzyzanowski Guerra K, Hart H, Al-Muhanna K, Kunkler EC, Braun A, Poppe KI, Johnson K, Lazor E, Liu Y, Garner JA. Local Food System Approaches to Address Food and Nutrition Security among Low-Income Populations: A Systematic Review. Adv Nutr 2024; 15:100156. [PMID: 38616069 PMCID: PMC11031423 DOI: 10.1016/j.advnut.2023.100156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 04/16/2024] Open
Abstract
Food and nutrition insecurity disproportionately impact low-income households in the United States, contributing to higher rates of chronic diseases among this population. Addressing this challenge is complex because of various factors affecting the availability and accessibility of nutritious food. Short value chain (SVC) models, informally known as local food systems, offer a systemic approach that aims to optimize resources and align values throughout and beyond the food supply chain. Although specific SVC interventions, such as farmers markets, have been studied individually, a comprehensive review of SVC models was pursued to evaluate their relative impact on food security, fruit and vegetable intake, diet quality, health-related markers, and barriers and facilitators to participation among low-income households. Our systematic literature search identified 37 articles representing 34 studies from 2000-2020. Quantitative, qualitative, and mixed-method studies revealed that farmers market interventions had been evaluated more extensively than other SVC models (i.e., produce prescription programs, community-supported agriculture, mobile markets, food hubs, farm stands, and farm-to-school). Fruit and vegetable intake was the most measured outcome; other outcomes were less explored or not measured at all. Qualitative insights highlighted common barriers to SVC use, such as lack of program awareness, limited accessibility, and cultural incongruence, whereas facilitators included health-promoting environments, community cohesion, financial incentives, and high-quality produce. Social marketing and dynamic nutrition education appeared to yield positive program outcomes. Financial incentives were used in many studies, warranting further investigation into optimal amounts across varying environmental contexts. SVC models are increasingly germane to national goals across the agriculture, social, and health care sectors. This review advances the understanding of key knowledge gaps related to their implementation and impact; it emphasizes the need for research to analyze SVC potential comprehensively across the rural-urban continuum and among diverse communities through long-term studies of measurable health impact and mixed-method studies investigating implementation best practices. This trial was registered at PROSPERO as CRD42020206532.
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Affiliation(s)
- Katharine Garrity
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | | | - Hannah Hart
- College of Public Health, The Ohio State University
| | - Khawlah Al-Muhanna
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | - Emily C Kunkler
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | - Ashlea Braun
- Department of Nutritional Sciences, College of Education and Human Sciences, Oklahoma State University
| | | | - Kara Johnson
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | - Emma Lazor
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | - Yang Liu
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University
| | - Jennifer A Garner
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University; John Glenn College of Public Affairs, The Ohio State University.
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29
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Chai L. Food insecurity and its association with multiple health outcomes among Indigenous peoples in Canada: the buffering role of culture-based resources. ETHNICITY & HEALTH 2024; 29:371-394. [PMID: 38297918 DOI: 10.1080/13557858.2024.2311419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes - self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity - among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. DESIGN The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. RESULTS Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. CONCLUSION The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Canada
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30
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Aldubaybi AA, Coneyworth LJ, Jethwa PH. Assessing the prevalence and potential drivers of food insecurity and the relationship with mental wellbeing in UK university students: A cross-sectional study. NUTR BULL 2024; 49:96-107. [PMID: 38311588 DOI: 10.1111/nbu.12662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
Food insecurity (FI) among university students in the United States has been associated with poor mental wellbeing, but very little is known about the relationship between FI and mental wellbeing in the UK university population. Here we examined the prevalence of FI, determined potential drivers for it and its relationship with mental wellbeing and coping ability. Students studying at UK universities (n = 289) completed an online self-reported questionnaire to obtain socio-economic characteristics including financial status, FI status (Household Food Insecurity Access scale), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale) and coping ability (coping flexibility scale). FI was observed in 28% of the participants and was associated with financial independence, running out of money, borrowing money and lacking confidence to purchase healthy foods (p < 0.05). Although we cannot determine directionality, logistic regression analysis revealed those who were judged as FI were more likely to shop often (OR = 3.139 95% CI 1.533-6.429), never snacked between meals (OR = 4.261 95% CI 1.309-13.875) and the amount of food purchased was affected by perceptions of the price of food in general (OR = 2.954 95% CI 1.675-5.210). Financial instability and the inability to access nutritious food may contribute to the decrease in mental wellbeing (p < 0.01) and lower ability to cope with stressful situations (p < 0.01) in food-insecure students although the direction of these relationships cannot be determined from this cross-sectional study. This study has identified that there is a need to develop appropriate strategies to combat FI in university students and to improve mental health.
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Affiliation(s)
- Afnan A Aldubaybi
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
| | - Lisa J Coneyworth
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
| | - Preeti H Jethwa
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
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31
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Odoms-Young A, Brown AGM, Agurs-Collins T, Glanz K. Food Insecurity, Neighborhood Food Environment, and Health Disparities: State of the Science, Research Gaps and Opportunities. Am J Clin Nutr 2024; 119:850-861. [PMID: 38160801 DOI: 10.1016/j.ajcnut.2023.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024] Open
Abstract
Food insecurity and the lack of access to affordable, nutritious food are associated with poor dietary quality and an increased risk of diet-related diseases, including cardiovascular disease, diabetes, and certain types of cancer. Those of lower socioeconomic status and racial and ethnic minority groups experience higher rates of food insecurity, are more likely to live in under-resourced food environments, and continue to bear the greatest burden of diet-related chronic diseases in the United States. Despite the growing body of literature in this area, there are still significant gaps in our understanding of the various pathways that link food insecurity and neighborhood food environments to racial/ethnic and socioeconomic disparities in health and the most effective intervention strategies to address these disparities. To better understand the science in this area, the National Institutes of Health, in collaboration with the Centers for Disease Control (CDC) and Prevention and the United States Department of Agriculture (USDA), convened a virtual 3-d workshop 21-23 September 2021: Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science. The workshop brought together a diverse group of researchers, practitioners, policymakers, and federal partners with expertise in nutrition, the food environment, health and social policy, and behavioral and social sciences. The workshop had the following 3 research objectives: 1) summarize the state of the science and knowledge gaps related to food insecurity, neighborhood food environments, and nutrition health disparities, 2) identify research opportunities and strategies to address research gaps, and 3) examine evidence-based interventions and implementation approaches to address food insecurity and neighborhood food environments to promote health equity. This article summarizes workshop proceedings and describes research gaps and future opportunities that emerged from discussions.
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Affiliation(s)
- Angela Odoms-Young
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Alison G M Brown
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States.
| | - Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
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32
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Masa R, Inoue M, Prieto L, Baruah D, Nosrat S, Mehak S, Operario D. Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey. J Appl Gerontol 2024; 43:276-286. [PMID: 37801680 PMCID: PMC10809733 DOI: 10.1177/07334648231203838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/08/2023] Open
Abstract
This study explored differences among older adults in mental health by sexual minority status. Data came from the 2021 U.S. National Health Interview Survey. The study sample included older adults (or those aged ≥50 years, N = 15,559), and of those, two percent (n = 380) self-identified as lesbian, gay, or bisexual (LGB). Older LGB adults had significantly higher odds of reporting a diagnosis of depression and anxiety and experiencing serious psychological distress than older non-LGB adults. Additionally, older LGB adults reported higher odds of experiencing depression and anxiety more frequently than older non-LGB adults. Significant covariates included age, sex, housing, food security, and social support. Increased risk for mental illness may be long-term consequences of stigma and discrimination that this population has experienced over the life course. The combination of structural interventions and affirming mental healthcare that recognizes the cumulative negative experience among older LGB adults is necessary to achieve mental health equity.
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Affiliation(s)
- Rainier Masa
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Global Social Development Innovations, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megumi Inoue
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Lucas Prieto
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Dicky Baruah
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah Nosrat
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Samreen Mehak
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Heller DJ, Madden D, Berhane T, Bickell NA, Van Hyfte G, Miller S, Ozbek U, Lin JY, M Schwartz R, Lopez RA, Arniella G, Mayer V, Horowitz CR, Benn EK, Vangeepuram N. Emotional and Financial Stressors in New York City During the COVID-19 Pandemic: A Consecutive Cross-Sectional Analysis. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01921-5. [PMID: 38381324 DOI: 10.1007/s40615-024-01921-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/22/2024]
Abstract
Mental and financial hardship during the COVID-19 pandemic in New York City was severe, but how vulnerable groups have been disproportionately impacted is incompletely understood. In partnership with community stakeholders, we administered a web-based survey to a convenience sample of New York City residents (18 + years) from May 2020 to April 2021 to evaluate their financial and emotional stressors. We analyzed outcomes by race, ethnicity, and education level. A total of 1854 adults completed the survey across three consecutive non-overlapping samples. Fifty-five percent identified other than non-Latinx White. Sixty-four percent reported emotional stress; 38%, 32%, and 32% reported symptoms of anxiety, depression, and post-traumatic stress disorder respectively; and 21% reported a large adverse financial impact. The leading unmet needs were mental health and food services (both 19%), and health services (18%). Need for both resources grew over time. Adverse financial impact directly correlated with presence of all four adverse mental health outcomes above. In multivariate analysis, non-White race and lack of college degree were associated with adverse financial impact, whereas LGBT identity and lack of college degree were associated with mental health impact. Throughout the COVID-19 pandemic, participants in this research demonstrated a large and growing mental and financial strain, disproportionately associated with lower education level, non-White race, and LGBT status. Our findings suggest an urgent need to differentially target COVID-19 mental health and resource support in New York City to persons in these vulnerable communities.
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Affiliation(s)
- David J Heller
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Devin Madden
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Timnit Berhane
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Nina A Bickell
- Institute for Health Equity Research (IHER), Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Grace Van Hyfte
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Sarah Miller
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Umut Ozbek
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Jung-Yi Lin
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | | | - Robert A Lopez
- Treadwell Data, 2738 53rd Ave. SW, Seattle, WA, 98116, USA
| | - Guedy Arniella
- Institute for Family Health, 2006 Madison Avenue, New York, NY, 10035, USA
| | - Victoria Mayer
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Carol R Horowitz
- Institute for Health Equity Research (IHER), Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Emma K Benn
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Nita Vangeepuram
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
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34
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Diaz-Amaya Y, Star Z, McClure ST. Food security and diet quality, not vitamin D status are significantly associated with depression: Results from NHANES 2015-2018. J Affect Disord 2024; 347:150-155. [PMID: 38000464 DOI: 10.1016/j.jad.2023.11.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/11/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Observational research has suggested a link between vitamin D insufficiency and depression, while evidence from randomized trials examining the association have yielded inconsistent results. Food security and diet quality are also associated with both vitamin D insufficiency and depression. However, the potential interactions between these factors have not been well described. METHODS In order to examine the associations between depression, vitamin D status, food security, and diet quality, data from 8988 US adults (≥20 years) in NHANES (National Health and Nutrition Examination Surveys) 2015-2018 were analyzed. Questionnaire-assessed depression, food security, and diet quality and laboratory-analyzed serum vitamin D were used. RESULTS Lack of full food security and a 10-point decrease in Healthy Eating Index 2015 score were independently associated with higher risk of mild to severe depression (OR 3.72 and 1.20, respectively, p < 0.001). The association between insufficient serum vitamin D (<75 nmol/L) and depression was fully attenuated after adjusting for food security and diet quality (p = 0.41). LIMITATIONS A major limitation of this paper, like all analyses of NHANES, is the inability to establish the temporality of the relationships between food security and diet quality with depression. CONCLUSIONS Food security and diet quality, but not vitamin D status, were significantly associated with depression. This highlights how evaluating food security and diet quality are critical in research and public health interventions related to depression. Future interventions, especially into vitamin D insufficiency, as well as health policies should assess and address these factors.
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Affiliation(s)
- Yohanna Diaz-Amaya
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA
| | - Zoe Star
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA
| | - Scott T McClure
- Department of Public Health, College of Arts and Sciences, Shenandoah University, Winchester, VA, USA.
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Kent K, Schumacher T, Kocar S, Seivwright A, Visentin D, Collins CE, Lester L. Increasing food insecurity severity is associated with lower diet quality. Public Health Nutr 2024; 27:e61. [PMID: 38311345 PMCID: PMC10897580 DOI: 10.1017/s1368980024000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. DESIGN A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0–73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. SETTING Tasmania, Australia. PARTICIPANTS Community-dwelling adults (aged 18 years and over). RESULTS The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = –2·7; 95 % CI (–5·11, –0·34); P = 0·03) and reduced by six points for moderately (B = –5·6; 95 % CI (–7·26, –3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = –11·5; 95 % CI (–13·21, –9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. CONCLUSIONS Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.
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Affiliation(s)
- Katherine Kent
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong. Wollongong, NSW2522, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, Tamworth, NSW2340, Australia
| | - Sebastian Kocar
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Ami Seivwright
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Launceston, Tasmania7250, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW2305, Australia
| | - Libby Lester
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
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Kirkbride JB, Anglin DM, Colman I, Dykxhoorn J, Jones PB, Patalay P, Pitman A, Soneson E, Steare T, Wright T, Griffiths SL. The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry 2024; 23:58-90. [PMID: 38214615 PMCID: PMC10786006 DOI: 10.1002/wps.21160] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants that cause mental ill health. Relying as far as possible on high-quality evidence, we first map out the literature that supports a causal link between social determinants and later mental health outcomes. Given the breadth of this topic, we focus on the most pervasive social determinants across the life course, and those that are common across major mental disorders. We draw primarily on the available evidence from the Global North, acknowledging that other global contexts will face both similar and unique sets of social determinants that will require equitable attention. Much of our evidence focuses on mental health in groups who are marginalized, and thus often exposed to a multitude of intersecting social risk factors. These groups include refugees, asylum seekers and displaced persons, as well as ethnoracial minoritized groups; lesbian, gay, bisexual, transgender and queer (LGBTQ+) groups; and those living in poverty. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health. Following this, we provide a review of the evidence concerning candidate preventive strategies to intervene on social determinants of mental health. These interventions fall broadly within the scope of universal, selected and indicated primary prevention strategies, but we also briefly review important secondary and tertiary strategies to promote recovery in those with existing mental disorders. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health.
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Affiliation(s)
| | - Deidre M Anglin
- City College, City University of New York, New York, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Praveetha Patalay
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Thomas Steare
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Talen Wright
- Division of Psychiatry, University College London, London, UK
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Aljahdali AA, Na M, Leung CW. Food insecurity and health-related quality of life among a nationally representative sample of older adults: cross-sectional analysis. BMC Geriatr 2024; 24:126. [PMID: 38302907 PMCID: PMC10835917 DOI: 10.1186/s12877-024-04716-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Food insecurity is a significant health issue among older adults and contributes to poorer quality of life and mental health. However, limited evidence is available among older adults. Thus, the study evaluated the associations between food security and multiple outcomes related to health-related quality of life. We examined whether participants' sex and participation in the federal Supplemental Nutrition Assistance Program (SNAP)/or receiving the Food Stamp program might modify these associations. METHODS Cross-sectional analysis of the 2007-2012 National Health and Nutrition Examination Surveys (NHANES). A sample of 3,375 adults aged ≥ 60 years with household incomes ≤ 300% of the federal poverty level (FPBL). Food security was assessed using the 18-item US Household Food Security Survey Module and categorized as food security, marginal food security, and food insecurity. Outcomes were the CDC Health-Related Quality of Life measures (HRQOL-4). RESULTS Approximately 8% experienced marginal food security and 12% experienced food insecurity. Over the past month, food insecurity was significantly associated with ≥ 16 days of poor physical health (OR 1.88, 95% CI 1.23, 2.85, P-trend = 0.005), ≥ 16 days of poor mental health (OR 2.22, 95% CI 1.50, 3.28, P-trend < 0.0001), and ≥ 16 days of feeling anxious (OR 3.33, 95% CI 2.30, 4.81, P-trend < 0.0001) after multivariate adjustment. The association between food insecurity and poor physical health was stronger in females (P-interaction = 0.02). There was no evidence for effect modification in any of these associations among those receiving benefits from the federal SNAP/Food Stamp program. CONCLUSIONS Food insecurity was positively associated with multiple adverse health outcomes. Public health programs and policies targeted for older adults are needed to mitigate the extent of food insecurity to promote overall health and well-being.
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Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences , King Abdulaziz University, 21589, Jeddah, Saudi Arabia.
- Department of Nutritional Sciences, University of Michigan, 48109, Ann Arbor, MI, USA.
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences , King Abdulaziz University, 21589, Jeddah, Saudi Arabia.
| | - Muzi Na
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan, 48109, Ann Arbor, MI, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA
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Mathson LR, Lak KL, Gould JC, Higgins RM, Kindel TL. The Association of Preoperative Food Insecurity With Early Postoperative Outcomes After Bariatric Surgery. J Surg Res 2024; 294:51-57. [PMID: 37864959 DOI: 10.1016/j.jss.2023.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION To assess the rate of food insecurity in patients undergoing bariatric surgery. To compare the rates of 30-d postoperative complications based on food security status. METHODS Patients undergoing primary Roux-en-Y gastric bypass or sleeve gastrectomy between 7/2020 - 3/2022 were screened for food insecurity via telephone using questions from the Accountable Health Communities Health-Related Social Needs Screening Tool. Screens were matched to patient data and 30-d outcomes from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. RESULTS In total, 213 (59%) of the 359 bariatric surgery patients were screened with 81 (38%) screening positive for food insecurity. Evaluation of preoperative variables based on food security status showed comparable age, body mass index, and comorbidity status. Food insecure patients were found to have an increased length of stay following surgery compared to food secure patients (P = 0.003). Food insecurity was not associated with higher rates of Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program reported 30-d postoperative complications including emergency department/urgent care visits (P = 0.34) and hospital readmissions (P = 0.94). CONCLUSIONS Food insecurity was prevalent at 38% of the bariatric surgical population. Food insecure patients had a statistically longer length of stay after primary bariatric surgery but were not associated with an increased risk of 30-d complications. Future studies are needed to determine the mid-term and long-term effects of food insecurity status on bariatric surgical outcomes and the potential impact of food insecurity on length of stay.
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Affiliation(s)
- Lucas R Mathson
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kathleen L Lak
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jon C Gould
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rana M Higgins
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tammy L Kindel
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Alwis I, Baminiwatta A, Chandradasa M. Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024; 59:353-373. [PMID: 37256323 PMCID: PMC10230494 DOI: 10.1007/s00127-023-02495-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, assess its variability across subgroups, and identify associated factors within each subgroup. METHODS PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. RESULTS A total of 33 studies representing a total of 52,778 participants were included. Overall, the pooled prevalence of depression was 19.4% [14.44-25.54%]. Among subpopulations, the highest prevalence was reported among young persons (39%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 16.9%, respectively. Prevalence estimates were higher when based on screening instruments (21.2%) compared to diagnostic interviews (4.3%). A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances and broader environmental factors, is reported for each age group. CONCLUSION Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. The heterogeneity of studies limits the inferences drawn from this review.
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Affiliation(s)
- Inosha Alwis
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
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Pike Moore S, Gunzler DD, Spears CA, Shaikh NI, Kim-Mozeleski JE. Longitudinal experience of food insecurity & cigarette use in the early COVID-19 Pandemic, United States. Prev Med Rep 2024; 38:102624. [PMID: 38375176 PMCID: PMC10874846 DOI: 10.1016/j.pmedr.2024.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Food insecurity is associated with cigarette smoking, yet little is known about how variability in the experience of food insecurity may relate to patterns of cigarette use. We sought to examine patterns of food insecurity and cigarette use during the COVID-19 pandemic (April 2020-March 2021). We analyzed longitudinal survey data from a nationally representative panel of adults in the United States (N = 7,880) from the Understanding Coronavirus in America Study. The primary independent variable was ten trajectories of food insecurity. Our dependent variable was past 7-day cigarette use (count of days used cigarettes). Poisson regression using generalized estimating equations was run controlling for key covariates. The prevalence of cigarette use on at least one day in the past week was lowest (17.5 %) for those who Remained Food Secure, and highest (57.9 %) among those who Became Fully Food Insecure, a group characterized by having high probability of becoming food insecure during the study period. Among those who reported at least one day of cigarette use in the past week, fewer than half (40.1 %) reported sustained use across all waves of the study. Those who Became Fully Food Insecure had an incidence rate ratio (IRR) of 1.73 (95 % CI: 1.18, 2.54) compared to those who Remained Food Secure with respect to number of smoking days. While different patterns of food insecurity are related to cigarette smoking at the population level, these results highlight that food insecurity, a key social need, may represent a novel strategy for informing reduction of tobacco use disparities.
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Affiliation(s)
- Stephanie Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
| | - Claire A. Spears
- Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Nida I. Shaikh
- Department of Nutrition, Byrdine F. Lewis College of Nursing & Health, Georgia State University, Atlanta, GA, USA
| | - Jin E. Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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Chambers S, Machray K, Fergie G. Food insecurity in children and young people in Scotland. Proc Nutr Soc 2024:1-13. [PMID: 38250796 DOI: 10.1017/s0029665124000090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
The aim of this review is to highlight the key issues in relation to food insecurity among children and young people living in Scotland. It provides an overview of the current context of food insecurity more generally within the UK and specifically in Scotland. Food insecurity has risen in Scotland evidenced through responses to national surveys and the dramatic increase in households relying on emergency food provision. Food insecurity is highest among young people, single parent families and single men. The key drivers of food insecurity include insufficient income, welfare reform, food inflation and geo-political events. Evidence suggests that food insecurity is negatively related to sufficient nutritional intake, and the implications for physical and mental health are profound. Policy actions implemented to mitigate the impact of food insecurity on children and young people include the introduction of the Scottish Child Payment, food voucher schemes, free school meals, and holiday food provision. Further evidence is required to evaluate the success of these policies in reducing or mitigating food insecurity. The review concludes by considering the ways in which a rights-based approach to food might benefit children and young people living in Scotland, and argues that wider systemic change is required.
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Affiliation(s)
- Stephanie Chambers
- School of Social and Political Sciences, University of Glasgow, 28 Bute Gardens, GlasgowG12 8RS, Scotland
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Kathryn Machray
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Gillian Fergie
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
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Hilal S, Kolozsvári LR, Indrayathi PA, Saeed SN, Rurik I. Psychological Distress and Food Insecurity among International Students at a Hungarian University: A Post-Pandemic Survey. Nutrients 2024; 16:241. [PMID: 38257134 PMCID: PMC10820830 DOI: 10.3390/nu16020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of the present study was two-fold: Firstly, to estimate the prevalence of psychological distress among international students at a Hungarian university two years after the COVID-19 outbreak; and secondly, to identify its demographic and socioeconomic factors, with special regard to the students' food-security status. A cross-sectional study using a self-administered questionnaire was carried out from 27 March to 3 July 2022 among international students at the University of Debrecen. The questionnaire included information on demographic and socioeconomic characteristics, food-security status (six-item United States Department of Agriculture Food Security Survey Module (USDA-FSSM)), and psychological distress (Depression, Anxiety and Stress Scale (DASS-21)). Bivariate analysis was conducted to examine the potential associations between demographic/socioeconomic factors and psychological distress. Additionally, multiple logistic regression was employed to further analyze these associations. Of 398 participants, 42.2%, 48.7%, and 29.4% reported mild to extremely severe depression, anxiety, and stress, respectively. The ages 18-24 (AOR = 2.619; 95% CI: 1.206-5.689) and 25-29 (AOR = 2.663; 95% CI: 1.159-6.119), reporting a low perception of health status (AOR = 1.726; 95% CI: 1.081-2.755), and being food insecure (AOR = 1.984; 95% CI: 1.274-3.090) were significantly associated with depressive symptoms. Being female (AOR = 1.674; 95% CI: 1.090-2.571), reporting a low perception of health status (AOR = 1.736; 95% CI: 1.098-2.744), and being food insecure (AOR = 2.047; 95% CI: 1.327-3.157) were significantly associated with anxiety symptoms. Furthermore, being female (AOR = 1.702; 95% CI: 1.026-2.824)), living with roommates (AOR = 1.977; 95% CI: 1.075-3.635), reporting a low perception of health status (AOR = 2.840; 95% CI: 1.678-4.807), and being food insecure (AOR = 2.295; 95% CI:1.398-3.767) were significantly associated with symptoms of stress. Psychosocial programs combined with strategies to alleviate food insecurity are required to enhance international students' mental health and well-being.
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Affiliation(s)
- Soukaina Hilal
- Department of Family and Occupational Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.R.K.); (P.A.I.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (S.N.S.); (I.R.)
| | - László Róbert Kolozsvári
- Department of Family and Occupational Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.R.K.); (P.A.I.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (S.N.S.); (I.R.)
| | - Putu Ayu Indrayathi
- Department of Family and Occupational Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.R.K.); (P.A.I.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (S.N.S.); (I.R.)
| | - Sami Najmaddin Saeed
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (S.N.S.); (I.R.)
- Department of Public Health and Epidemiology, University of Debrecen, 4028 Debrecen, Hungary
| | - Imre Rurik
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (S.N.S.); (I.R.)
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary
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Gawlik KS, Teall AM, Zeno R, Newtz C, Conrad K, Kolcun K, Bobek H, Deerhake A, Sullivan K, Rengers B, O'Hara S. Integrating wellness into curricula using the ten dimensions of wellness as a framework. J Prof Nurs 2024; 50:73-82. [PMID: 38369375 DOI: 10.1016/j.profnurs.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 02/20/2024]
Abstract
Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.
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Affiliation(s)
- Kate Sustersic Gawlik
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA.
| | - Alice M Teall
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Rosie Zeno
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Christa Newtz
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Katey Conrad
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Kaitlyn Kolcun
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Heidi Bobek
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Ann Deerhake
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Kelly Sullivan
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Brooke Rengers
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Susan O'Hara
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
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Chiong R, Salas J, Kohn J, St John E, Figueroa R. A Formative Evaluation of an Online Meal Kit and Grocery Platform for Supplemental Nutrition Assistance Program Recipients. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:43-53. [PMID: 37999697 DOI: 10.1016/j.jneb.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To assess the barriers and facilitators to online food purchasing through a meal kit and grocery shopping website titled NY SNAP Express among Supplemental Nutrition Assistance Program (SNAP) beneficiaries. METHODS A purposive sample of SNAP-eligible adults residing in New York State participated in interviews guided by the Capabilities, Opportunities, Motivations, and Behaviors Model. RESULTS Barriers to online food purchasing among participants (n = 32) include physiological and health conditions, the weight of food, technology, language, the price of foods, transportation challenges, the stigma associated with SNAP, and concerns regarding the quantity and quality of meal kits. Facilitators include health and nutrition improvements, knowledge and skills, saving money, culturally relevant meals, increased efficiency in food purchases and preparation, and customization. CONCLUSIONS AND IMPLICATIONS Online platforms such as NY SNAP Express have the potential to increase nutritious food access and resources among SNAP recipients; however, improvements are necessary to meet the needs of its audience.
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Affiliation(s)
- Reah Chiong
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY.
| | - Julio Salas
- Department of Sociology, University of California, Berkeley, Berkeley, CA
| | - Julia Kohn
- College of Human Ecology, Cornell University, Ithaca, NY
| | - Emily St John
- College of Agriculture and Life Sciences, Cornell University, Ithaca, NY
| | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
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45
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Oh H, Du J, Karcher NR, van der Ven E, DeVylder JE, Smith L, Koyanagi A. The separate and joint effects of recent interpersonal abuse and cannabis use on psychotic experiences: findings from students in higher education in the United States. Soc Psychiatry Psychiatr Epidemiol 2024; 59:77-85. [PMID: 37093229 PMCID: PMC10799783 DOI: 10.1007/s00127-023-02483-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Various forms of interpersonal abuse (e.g., physical, emotional, sexual) and cannabis use across the lifespan have both been known to increase odds of psychotic experiences; however, there have been few studies examining their separate and joint effects in the United States. METHODS We analyzed data from the Healthy Minds Study (2020-2021) and used multivariable logistic regression and interaction contrast ratios to assess separate and joint effects of interpersonal abuse (past 12 months) and cannabis use (past 30 days) on psychotic experiences (past 12 months). RESULTS Students who only used cannabis had significantly greater odds of psychotic experiences (aOR: 1.70; 95% CI 1.58-1.82), as well as those who only experienced interpersonal abuse (aOR: 2.40; 95% CI 2.25-2.56). However, those who reported both cannabis use and interpersonal abuse had the greatest odds, exceeding the sum of these individual effects (the combined effect aOR: 3.46; 95% CI 3.19-3.76). CONCLUSIONS Recent interpersonal abuse and recent cannabis use both separately and jointly increase odds of having recent psychotic experiences. Future research should continue to examine the potential interactive and additive impact of multiple known exposures to better inform primary and secondary prevention efforts.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, USA.
| | - Jinyu Du
- Southern Methodist University, Dallas, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
- ICREA, Barcelona, Spain
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Zinga J, van der Pligt P, Lindberg R, Vasilevski V, Lee A, McKay F. Food insecurity screening procedures used in reproductive healthcare settings. Nutr Rev 2023; 82:76-89. [PMID: 37120152 DOI: 10.1093/nutrit/nuad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
CONTEXT Food insecurity is an important determinant of health and should be identified by clinicians during routine reproductive healthcare. The procedures used in reproductive healthcare settings to identify people experiencing food insecurity have not been fully researched. OBJECTIVE The objective of this study was to synthesize evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15 years-49 years). DATA SOURCES Four databases were searched in April 2022 to identify studies that met the eligibility criteria. DATA EXTRACTION Studies that used tools that were both validated or newly developed were considered, as were studies that incorporated food insecurity screening as part of a multidomain screening tool. Two authors completed the screening, data extraction, and quality assessment independently. DATA ANALYSIS There were 1075 studies identified; after screening, 7 studies were included in the narrative synthesis, including studies relating to women who were pregnant or in the postpartum period; none of the included studies related to women in the preconception stage. Four screening tools were identified: 2- and 6-item tools specifically focused on food insecurity, a 58-item multidomain tool incorporating 4 food insecurity items, and a modified version of the 2-item tool. Methods of implementing screening varied across studies. Three described subsequent processes that supported food-insecure patients once identified. CONCLUSION Few published studies have investigated optimal screening tools and their implementation within reproductive healthcare settings to address food insecurity for this priority population group. Further research is required to determine: the optimal tool, preferable screening methods from the perspectives of both patients and clinicians, and potential strategies for implementation in countries outside of the United States. An additional evidence gap remains about referral pathways and appropriate supports for this population once food insecurity is identified. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022319687.
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Affiliation(s)
- Julia Zinga
- are with the School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- are with the Nutrition and Dietetics Department, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Paige van der Pligt
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- is with the Department of Nutrition, Western Health, Footscray, Victoria, Australia
| | - Rebecca Lindberg
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Vidanka Vasilevski
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- is with the School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Amelia Lee
- are with the Nutrition and Dietetics Department, Royal Women's Hospital, Parkville, Victoria, Australia
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Fiona McKay
- are with the School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
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47
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Adzrago D, Williams F. Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants. SSM Popul Health 2023; 24:101522. [PMID: 37822807 PMCID: PMC10563063 DOI: 10.1016/j.ssmph.2023.101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/22/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023] Open
Abstract
Background Life satisfaction contributes to improved long and healthy lives, enhanced biological function, better mental health, and decreased mortality risks. Social needs (e.g., food security, employment, healthcare utilization) are important determinants of mental health and life satisfaction among immigrants. However, there is limited literature on how social needs influence mental health, which, in turn, affects life satisfaction among immigrants. We examined whether mental health influences the mechanisms of the relationship between social needs and life satisfaction among immigrants. Methods We used the 2021 cross-sectional National Health Interview Survey data on U.S. immigrants (n = 4320) aged ≥18 years. We conducted weighted mediation analyses with multiple linear regression. Life satisfaction (scores 0-10; ≥1 as higher life satisfaction) was the dependent variable; independent variables were food security, employment, and healthcare utilization; and the mediator, serious psychological distress (SPD: scores 0-24; ≥1 as higher SPD). Results The total effect (not accounting for SPD) of food insecurity (vs. secure) on life satisfaction was negative (β = -0.61, p < 0.001); the direct effect (after accounting for SPD) was not statistically significant (β = -0.21, p = 0.153), while the indirect effect (food insecurity's effect explained by SPD) was negative (β = -0.40, p < 0.001). The total (β = 0.32, p < 0.001), direct (β = 0.24, p = 0.004), and indirect (β = 0.09, p = 0.006) effects of being employed (vs. unemployed) on life satisfaction were positive. The total (β = -0.12, p = 0.116) and direct (β = -0.03, p = 0.683) effects of healthcare utilization within the past year (vs. more than a year) on life satisfaction were not statistically significant, whereas the indirect effect was negative (β = -0.09, p < 0.001). Conclusions SPD mediates the effect of food security, healthcare utilization, and employment on life satisfaction, suggesting the need to improve social needs and mental health among immigrants.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Morales L, Yowell L, Molina T, Smith C, Arizcuren J, McClain AC. Across-Agency Partnerships and Within-Agency Capacities Facilitate Holistic, Tailored Approaches to Addressing Food Insecurity: A Qualitative Study. J Acad Nutr Diet 2023; 123:1749-1762.e2. [PMID: 37516352 PMCID: PMC10817997 DOI: 10.1016/j.jand.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Capacity-oriented approaches have the potential to reduce food insecurity (FI) and promote nutrition and health equity in low-resource settings. OBJECTIVE The objective of this study was to identify multilevel capacities in San Diego County, CA that key informants from diverse food- and nutrition-related stakeholder agencies perceived to be helping to address FI. DESIGN Trained qualitative interviewers conducted face-to-face, semi-structured interviews (30-60 minutes) with key informants. The Socioecological Model and a capacity-oriented approach informed interview guides. PARTICIPANTS/SETTING Participants were key informants (n = 23) from diverse purposively sampled stakeholder agencies (n = 16) providing food or nutrition services and programs across San Diego County. Interviews were conducted between April 2019 and December 2021. ANALYSES PERFORMED Interviews were audio-recorded, transcribed verbatim, and checked for accuracy. The research team conducted thematic content analysis to identify themes. RESULTS Two interrelated themes, within-agency capacities and across-agency partnerships, collectively appeared to influence each individual agency's ability to provide tailored, holistic care to their clients and, thus, expand each agency's reach and impact to address the 4 domains of food security (ie, quantity, quality, psychological, and social). Multilevel (ie, individual, interpersonal, organizational, and macro) within-agency human, social, and cultural capital (eg, volunteers, staff-client relationships, and cultural competency) positively influenced the reach and impact of the individual agencies by enabling them to provide clients with personalized, holistic care. Alongside within-agency capacities, multilevel (ie, interpersonal, organizational, community, and macro levels) across-agency partnerships allowed individual agencies to address FI more effectively and holistically by connecting clients to other services (eg, housing and mental health) related to the circumstances of FI. CONCLUSIONS In San Diego County, multilevel capacities in the form of within-agency capacities and across-agency partnerships collectively influenced the effectiveness of stakeholder agencies in addressing the 4 domains of FI among at-risk households. Future research should consider how to evaluate the impact of these existing capacities on FI.
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49
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Kötzsche M, Teuber R, Jordan I, Heil E, Torheim LE, Arroyo-Izaga M. Prevalence and predictors of food insecurity among university students - Results from the Justus Liebig University Giessen, Germany. Prev Med Rep 2023; 36:102526. [PMID: 38116256 PMCID: PMC10728436 DOI: 10.1016/j.pmedr.2023.102526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/11/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023] Open
Abstract
This study aimed to assess the prevalence and associated factors of food insecurity (FI) among university students in Germany during the COVID-19 pandemic. We conducted a cross-sectional study (n = 626) between November and December 2021 at the Justus Liebig University in Giessen, Germany, using an online questionnaire. The analysis of FI was based on the Food Insecurity Experience Scale (FIES) by the Food and Agriculture Organization (FAO). We statistically validated our data using the Rasch model. Moreover, demographic, socio-economic and educational variables were collected using a questionnaire developed by the Food Insecurity among European University Students during the COVID-19 Pandemic (FINESCOP) consortium. Overall, 27.5 % of the university students are food insecure. The proportion of university students experiencing moderate or severe food insecurity (FImod+sev) is 10.4 % and the proportion experiencing severe food insecurity (FIsev) 0.9 %. Results from a logistic regression showed that students have a higher chance to be food insecure if they were not born in Europe and if their parents have a secondary or lower educational level. We further found an association between age and FI. Also receiving a student loan during the pandemic and getting food assistance increased the likelihood of being food insecure. Our results show that FI is prevalent among this particularly vulnerable population group. Thus, public health, as well as policy efforts may need to become more target group-specific in accordance with the identified circumstances and specific characteristics to avoid that university students suffer from FI.
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Affiliation(s)
- Maike Kötzsche
- Justus Liebig University Giessen, Faculty of Agricultural Sciences, Nutritional Sciences and Environmental Management, Chair of Agricultural and Food Market Analysis, Senckenbergstraße 3, 35390 Giessen, Germany
| | - Ramona Teuber
- Justus Liebig University Giessen, Faculty of Agricultural Sciences, Nutritional Sciences and Environmental Management, Chair of Agricultural and Food Market Analysis, Senckenbergstraße 3, 35390 Giessen, Germany
- Justus Liebig University Giessen, Centre for Sustainable Food Systems, Senckenbergstr. 3, 35390 Giessen, Germany
| | - Irmgard Jordan
- Alliance of Bioversity International and CIAT, Food Environment and Consumer Behaviour, Africa Hub, P.O. Box 823-00621, Nairobi, Kenya
| | - Eleonore Heil
- Justus Liebig University Giessen, Faculty of Agricultural Sciences, Nutritional Sciences and Environmental Management, Working group of Nutrition Ecology, Senckenbergstraße 3, 35390 Giessen, Germany
| | - Liv E. Torheim
- Oslo Metropolitan University (OsloMet), Department of Nursing and Health Promotion, Faculty of Health Sciences, 0130 Oslo, Norway
| | - Marta Arroyo-Izaga
- University of the Basque Country UPV/EHU, Department of Pharmacy and Food Sciences, Faculty of Pharmacy, BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Bioaraba, BA04.03, 01006 Vitoria-Gasteiz, Spain
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50
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Ganson KT, Pang N, Testa A, Jackson DB, Nagata JM. Food insecurity is associated with muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults. Body Image 2023; 47:101628. [PMID: 37738777 DOI: 10.1016/j.bodyim.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
Prior research has documented the association between food insecurity and eating disorders, disordered eating behaviors, and body dissatisfaction. No known research has investigated whether food insecurity is associated with muscle dysmorphia symptomatology, which was the aim of this study. Data from 912 adolescents and young adults in Canada were analyzed. Linear regression analyses were used to determine the association between experiencing past year food insecurity and current muscle dysmorphia symptomatology. Among the sample, 15.7% reported experiencing any food insecurity. In regression analyses, food insecurity was significantly associated with greater overall muscle dysmorphia symptomatology and symptoms of Functional Impairment and Appearance Intolerance. Nearly one in five (18.5%) participants who reported food insecurity were at clinical risk for muscle-dysmorphia. Findings add to the growing literature on the adverse correlates of food insecurity and underscore the need for more research and intervention efforts to address the relationship between food insecurity and muscle dysmorphia symptomatology.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Nelson Pang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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