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Aljahdali AA, Ludwig-Borycz E, Leung CW. Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study. Brain Behav Immun 2024; 119:28-35. [PMID: 38552920 PMCID: PMC11162895 DOI: 10.1016/j.bbi.2024.03.034] [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: 09/20/2023] [Revised: 12/10/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Food insecurity (FI) is a pressing public health concern among older adults and has been associated with adverse cardiovascular outcomes. Greater systemic inflammation may provide a pathway to explain these associations, but few studies have examined the link between FI and markers of inflammation. Thus, the objective of the present study was to evaluate the associations between FI and multiple inflammatory and immune functioning biomarkers using a nationally representative study of US adults aged > 50 years. METHOD Participants (n = 3,924) were drawn from the longitudinal Health and Retirement Study (HRS). Household FI was assessed using the six-item Short Form Food Security Survey Module from the 2013 HRS Health Care and Nutrition Study. Markers of inflammation (neutrophil-lymphocyte ratio, albumin, hs-CRP, IL6, IL10, IL-1Ra, sTNFR-1, and TGFβ-1) and immune functioning (CMV) were collected during the 2016 HRS Venous Blood Study. Multivariate logistic and linear regression models were used to evaluate associations between household FI and inflammatory and immune functioning biomarkers, adjusting for individual and household sociodemographic characteristics. RESULTS The weighted prevalence of FI was 18.8 %. Age and sex-adjusted mean showed that FI was associated with higher levels of inflammation and impaired immune functioning (Ps-value < 0.05). Older adults with FI had higher mean levels of albumin, hs-CRP, IL6, IL10, IL-1Ra, TGFß-1, and CMV seronegative and borderline (Ps-value < 0.05). Multivariate-adjusted regression model showed that FI was associated with high-risk categories of hs-CRP (OR 1.34, 95 % CI 1.06, 1.68), IL-6 (OR 1.66, 95 % CI 1.28, 2.14), IL-1Ra (OR 0.67, 95 % CI 0.48, 0.93), TGFß-1 (OR 1.87, 95 % CI 1.45, 2.42), seronegativity for CMV (OR 0.48, 95 % CI 0.35, 0.64). CONCLUSION In this nationally representative sample of older adults, FI was positively associated with multiple markers of systemic inflammation and impaired immune functioning. Public health efforts that directly work to reduce FI among older adults are warranted and may result in further improvements in their health and well-being.
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Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA.
| | | | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA 02115, USA.
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Al-Amin NS, McBryde-Redzovic A, Gutierrez-Kapheim M, Mitchell UA. COVID-Related Stressors and Psychological Distress Among Chicago Residents: the Moderating Role of Race. J Racial Ethn Health Disparities 2024; 11:598-610. [PMID: 36877378 PMCID: PMC9987389 DOI: 10.1007/s40615-023-01544-2] [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: 11/15/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Racial and ethnic minorities have been disproportionately affected by the COVID-19 pandemic and have experienced greater financial loss, housing instability, and food insecurity due to COVID-related restrictions. As a result, Black and Hispanic communities may be at greater risk of experiencing psychological distress (PD). METHODS Using data collected between October 2020 and January 2021from 906 Black (39%), White (50%), and Hispanic (11%) adults, we assessed racial/ethnic differences in the effect of three COVID-related stressors-employment stress, housing instability, and food insecurity-on PD using ordinary least square regression. RESULTS Black adults reported lower PD levels compared to White adults (β = - 0.23, P < 0.001), but Hispanic adults did not differ significantly from White adults. COVID-related housing instability (β = 0.46, P < 0.001), food insecurity (β = 0.27, P < 0.001), and employment stress (β = 0.29, P < 0.001) were associated with higher PD. Employment stress was the only stressor to differentially affect PD by race/ethnicity. Among those that reported employment stress, Black adults had lower levels of distress compared to Whites (β = - 0.54, P < 0.001) and Hispanics (β = - 0.04, P = 0.85). CONCLUSION Despite relatively high exposure to COVID-related stressors, Black respondents had lower levels of PD compared to Whites and Hispanics which may reflect differences in race-specific coping mechanisms. Future research is needed to elucidate the nuances of these relationships and identify policies and interventions that prevent and minimize the impact of employment, food, and housing-related stressors and support coping mechanisms that promote mental health among minority populations, such as policies that support easier access to mental health and financial and housing assistance.
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Affiliation(s)
- Nadia S Al-Amin
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA.
| | - Aminah McBryde-Redzovic
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Gutierrez-Kapheim
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Uchechi A Mitchell
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
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El-Krab R, Kalichman SC, Eaton LA, Shkembi B, Kalichman MO. Stigmatization of food insecurity helps explain the association between food insecurity and medication nonadherence among people living with HIV. PSYCHOL HEALTH MED 2024:1-11. [PMID: 38493507 DOI: 10.1080/13548506.2024.2329911] [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] [Received: 10/19/2022] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
Food insecurity is an established barrier to antiretroviral therapy (ART) adherence among people living with HIV (LWHIV). While insufficient access to food reliably impedes medication adherence, the link between food insecurity and ART nonadherence has not been fully explained. In addition, depression is reliably associated with both food insecurity and ART nonadherence, but again the link between food insecurity and depression is not understood. A potential explanatory mechanism in the associations among food insecurity, depression and ART nonadherence is the experience of food insecurity stigma (FI-stigma). The current study tested FI-stigma in relation to depression as explanatory mechanisms in the association between food insecurity and ART nonadherence. Men and women (n = 495) LWHIV in the southeastern United States completed confidential surveys that included measures of food insecurity, FI-stigma, depression, and ART adherence. Results from the serial mediation model indicated significant direct effects of food insecurity and depression on ART adherence. In addition, food insecurity was indirectly associated with ART adherence through FI-stigma and depression symptoms. Results suggest that the stigmatization of food insecurity predicts increased depression which in turn predicts ART nonadherence, with both FI-stigma and depression symptoms partially mediating the relationship between food insecurity and ART nonadherence. Interventions aimed to reduce food insecurity should include it's associated stigma to improve treatment adherence among people LWHIV.
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Affiliation(s)
- Renee El-Krab
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Lisa A Eaton
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Bruno Shkembi
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Moira O Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
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Sokol RL, Austin AE. State expansion of Supplemental Nutrition Assistance Program eligibility and rates of firearm-involved deaths in the United States. Inj Prev 2024:ip-2023-045035. [PMID: 38365447 DOI: 10.1136/ip-2023-045035] [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: 07/06/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Poverty is a consistent correlate of firearm-involved mortality, yet little work has considered the effects of social and economic policies on these deaths. This study examined associations of state elimination of the asset test and increases in the income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility with rates of firearm-involved suicide and homicide deaths in the United States. METHODS This ecological repeated cross-sectional study used 2015-2019 data from the SNAP Policy Database and death certificate data from the National Vital Statistics System. The exposures were (1) state elimination of the asset test for SNAP eligibility and (2) state elimination of the asset test and increases in the income limit for SNAP eligibility, compared with (3) state adoption of neither policy. The outcomes were firearm-involved suicide deaths and firearm-involved homicide deaths. The research team conducted mixed-effects regressions to estimate associations. RESULTS State elimination of the asset test for SNAP eligibility (incidence rate ratio (IRR), 0.67; 95% CI, 0.48 to 0.91) and state adoption of both eliminating the asset test and increasing the income limit for SNAP eligibility (IRR, 0.68; 95% CI, 0.49 to 0.92) were associated with decreased rates of firearm-involved suicide deaths compared with state adoption of neither policy. There were no associations with state firearm-involved homicide rates. CONCLUSIONS SNAP is an important social safety net programme that addresses food insecurity, and the present results suggest it may also contribute to reducing firearm-involved suicide.
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Affiliation(s)
- Rebeccah Lyn Sokol
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
| | - Anna E Austin
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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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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Rudel RK, Byhoff E, Strombotne KL, Drainoni ML, Greece JA. Healthcare-based food assistance programmes in the United States: a scoping review and typology. J Nutr Sci 2023; 12:e128. [PMID: 38155805 PMCID: PMC10753472 DOI: 10.1017/jns.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
This scoping review aimed to identify the breadth of healthcare-based food assistance programmes in the United States and organize them into a typology of programmes to provide implementation guidance to aspiring food assistance programmers in healthcare settings. We searched PubMed, Cochrane, and CINAHL databases for peer-reviewed articles published between 1 January 2010 and 31 December 2021, and mined reference lists. We used content analysis to extract programmatic details from each intervention and to qualitatively analyse intervention components to develop a typology for healthcare institutions in the United States. Eligible articles included descriptions of patient populations served and programmatic details. Articles were not required to include formal evaluations for inclusion in this scoping review. Our search resulted in 8706 abstracts, which yielded forty-three articles from thirty-five interventions. We identified three distinct programme types: direct food provision, referral, and voucher programmes. Programme type was influenced by programme goals, logistical considerations, such as staffing, food storage or refrigeration space, and existence of willing partner CBOs. Food provision programmes (n 13) were frequently permanent and leveraged partnerships with community-based organisations (CBOs) that provide food. Referral programmes (n 8) connected patients to CBOs for federal or local food assistance enrollment. Voucher programmes (n 14) prioritised provision of fruits and vegetables (n 10) and relied on a variety of clinic staff to refer patients to months-long programmes. Healthcare-based implementers can use this typology to design and maintain programmes that align with the needs of their sites and patient populations.
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Affiliation(s)
- Rebecca K. Rudel
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, Massachusetts 02118
- Department of Medicine, Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, Massachusetts 02118
| | - Elena Byhoff
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue, North Worcester, Massachusetts 01655
| | - Kiersten L. Strombotne
- Department of Health, Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston Massachusetts 02118
| | - Mari-Lynn Drainoni
- Department of Medicine, Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, Massachusetts 02118
- Department of Health, Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston Massachusetts 02118
- Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, Massachusetts 02118
| | - Jacey A. Greece
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, Massachusetts 02118
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Partap U, Nyundo A, Manu A, Regan M, Ismail A, Chukwu A, Dessie Y, Njau T, Kaaya SF, Fawzi WW. Depressive symptoms among adolescents in six sub-Saharan African countries: A pooled analysis of associated factors. Prev Med Rep 2023; 36:102499. [PMID: 38116275 PMCID: PMC10728441 DOI: 10.1016/j.pmedr.2023.102499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/23/2023] [Accepted: 11/05/2023] [Indexed: 12/21/2023] Open
Abstract
There is a need to identify risk factors, including nutrition-related factors, for depressive disorders among sub-Saharan African (SSA) adolescents. We examined the association of multiple measures with depressive symptoms among adolescents living across six SSA countries. Building on previous analyses, we used data from a cross-sectional study conducted from 2015 to 2017 among adolescents aged 10-19 years in six SSA countries (N = 7512). Depressive symptoms were defined as highest tertile of the 6-item Kutcher Adolescent Depression Scale score. Using mixed-effects Poisson regression models, we pooled data across sites and examined the association of sociodemographic, nutrition, and other indices with depressive symptoms. We additionally assessed effect modification by sex, age, and school-going status. We observed higher risk of depressive symptoms among girls (adjusted risk ratio [RR]: 1.29, 95 % confidence interval [95 % CI]: 1.05-1.58, P = 0.016), older adolescents (RR for 18-19 years: 1.59, 95 % CI: 1.44-1.76, P < 0.001), and adolescents experiencing bullying (RR: 1.43, 95 % CI: 1.26-1.62, P < 0.001) or violence (RR: 1.34, 95 % CI: 1.24-1.45, P < 0.001). Adolescents experiencing food insecurity also had a higher risk of depressive symptoms (RR: 1.90, 95 % CI: 1.64-2.19, P < 0.001) along with those consuming ≥ 5 servings of fruit and vegetables per day (RR: 1.18, 95 % CI: 1.03-1.34, P = 0.015); conversely, those who consumed grains, roots and tubers in the past day were at decreased risk (RR: 0.73, 95 % CI: 0.69-0.77, P < 0.001). There was no strong evidence of effect modification of associations. This study reinforces the potential role of multiple sociodemographic and nutrition-related measures on risk of depressive symptoms in these populations.
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Affiliation(s)
- Uttara Partap
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Azan Nyundo
- Department of Psychiatry and Mental Health, School of Medicine, University of Dodoma, Dodoma, Tanzania
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mathilda Regan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Abbas Ismail
- Department of Mathematics and Statistics, University of Dodoma, Dodoma, Tanzania
| | - Angela Chukwu
- Department of Statistics, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tasiana Njau
- Department of Psychiatry and Mental Health, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sylvia F. Kaaya
- Department of Psychiatry and Mental Health, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Putra IGNE, Pradnyani PE, Putra GW, Astiti NLEP, Derayanti NW, Artini NNA, Astuti PAS, Dendup T, Ratan ZA. Gender differences in social environmental factors of psychological distress among Indonesian adolescents: Findings from the 2015 Global School-based Student Health Survey. J Biosoc Sci 2023; 55:1101-1118. [PMID: 36320184 DOI: 10.1017/s0021932022000426] [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: 11/06/2022]
Abstract
BACKGROUND This study aimed to investigate gender differences in social environmental factors of psychological distress among Indonesian adolescents. METHODS This was a cross-sectional study using the data from the 2015 Indonesia Global School-based Student Health Survey. Binary logistic regression was used to assess the influences of main independent variables - social environmental factors (i.e., peer support, having close friends, bullying victimisation, physical fight, physical attack, parental supervision, connectedness, bonding), demographic characteristics, and health-related behaviours on the measures of psychological distress (loneliness, anxiety-induced sleep disturbance, and a combination of both measures as psychological distress). RESULTS The prevalence of psychological distress measured as loneliness, anxiety-induced sleep disturbance, and combined psychological distress was 6.12%, 4.52%, and 8.04%, respectively. Findings from multivariate analyses indicated that bullying victimisation, physical attack, experience of hunger (a proxy of socioeconomic status), and sedentary behaviour were associated with all measures of psychological distress. Meanwhile, age, gender, drug use, parental connectedness and bonding, and having no close friends were correlates of one or two measures of psychological distress. Based on gender-stratified analyses, experience of hunger, sedentary behaviour, bullying victimisation, and having no close friends were consistently associated with measures of psychological distress among both girls and boys. In addition, the influence of some social environmental factors, such as parental connectedness, peer support, and physical attack, were more salient among girls. CONCLUSIONS The findings suggest that social environmental factors, demographic characteristics, and health-related behaviours were associated with psychological distress, and the associations appeared to differ by gender. Interventions that include improving positive social environmental factors (e.g., reducing interpersonal violence, encouraging positive relationships with parents and peers) and promoting healthy behaviours (e.g., less sedentary behaviour, preventing substance use) might help reduce the risk of psychological distress among Indonesian adolescents.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Institute of Population Health, University of Liverpool, Liverpool, UK
- Mandala Data, Denpasar, Indonesia
| | - Putu Erma Pradnyani
- Health Polytechnic Kartini Bali, Denpasar, Indonesia
- Mandala Data, Denpasar, Indonesia
| | - Gede Wirabuana Putra
- Health Polytechnic Kartini Bali, Denpasar, Indonesia
- Mandala Data, Denpasar, Indonesia
| | | | | | | | - Putu Ayu Swandewi Astuti
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | | | - Zubair Ahmed Ratan
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
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Saif-Nijat J, Pakravan-Charvadeh MR, Gholamrezai S, Rahimian M, Lane G, Béland D, Koc M, Clark N, Omidvar N, Sadeghi R, Vatanparast H. The association of the quality of life with Afghan households' food insecurity before and after the recent political change in Afghanistan: a comparative analysis. BMC Public Health 2023; 23:2066. [PMID: 37872537 PMCID: PMC10591381 DOI: 10.1186/s12889-023-16967-z] [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: 12/27/2022] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
The overreaching objective of the current study is to investigate the association of quality of life with Afghan households' food insecurity. The data was collected immediately after the Taliban took control of a large part of Afghanistan. About a total of 555 households' heads participated in a face-to-face interview, using the HFIAS and WHOQOL-100 questionnaires along with some questions related to their socioeconomic characteristics at two different times, before and after the Taliban's takeover. The comparative analysis showed that 98% of Afghan households were food insecure after the Taliban takeover, while 70% of them faced food insecurity before the Taliban's takeover. The quality of life in the Taliban era is worse than before the Taliban. All dimensions of quality of life have decreased, and this decrease was more pronounced for the psychological, environmental, and physical domains. It is recommended that international organizations, NGOs, and local agents focus on these dimensions of the quality of life to improve food security.
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Affiliation(s)
- Jumakhan Saif-Nijat
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | | | - Saeed Gholamrezai
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | - Mehdi Rahimian
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Lorestan, Iran
| | - Ginny Lane
- College of Agricultural and Life Sciences, Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | - Daniel Béland
- Department of Political Science, McGill University, Montreal, QC, Canada
| | - Mustafa Koc
- Department of Sociology, Centre for Studies in Food Security, Toronto Metropolitan University (formerly known as Ryerson University), Toronto, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tajrish, Velenjak, Iran
| | - Rasoul Sadeghi
- Faculty of Social Science, University of Tehran, Tehran, Iran
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
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Alhomsi A, Strassle PD, Ponce S, Mendez I, Quintero SM, Wilkerson M, Stewart AL, Napoles AM. Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States. Health Equity 2023; 7:395-405. [PMID: 37483650 PMCID: PMC10362911 DOI: 10.1089/heq.2022.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction While financial hardship has been consistently linked to psychological distress, little research exists on associations between financial hardship experienced during the pandemic and mental health. Methods We conducted a nationally representative, online survey of American Indian/Alaska Native, Asian, Black/African American, Latino (English and Spanish speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults, 12/2020-2/2021 (n=5500). Six financial hardship domains were measured (lost income, debt, unmet expenses, unmet health care expenses, housing insecurity, and food insecurity). Psychological distress measures included anxiety-depression symptoms (Patient Health Questionnaire-4), perceived stress (modified Perceived Stress Scale), and loneliness-isolation ("In the past month, how often have you felt lonely and isolated?"). Associations between financial hardship and psychological distress were estimated using multinomial logistic regression. Results Overall, 70.3% of participants reported experiencing financial hardship (substantial hardship: 21.3%; some hardship: 27.4%; and a little hardship: 21.6%), with Spanish-speaking Latino (87.3%) and Native Hawaiian/Pacific Islander (79.2%) adults being most likely. Debt (57.6%), lost income (44.5%), and unmet expenses (33.7%) were the most common. There was a dose-response association between financial hardship and moderate/severe anxiety-depression symptoms (a little hardship: adjusted odds ratio [aOR]=1.42, 95% confidence interval [CI]=1.12-1.80; some hardship: aOR=3.21, 95% CI=2.58-3.98; and substantial hardship: aOR=8.15, 95% CI=6.45-10.29). Similar dose-response trends were observed with perceived stress and loneliness-isolation. No racial-ethnic difference in the association between financial hardship during the pandemic and psychological distress was seen. Discussion Financial hardship has had a major impact on psychological distress during the pandemic; moreover, while no racial-ethnic difference in the effect of financial hardship was observed, because racial-ethnic minorities experienced greater hardship, financial hardship may exacerbate psychological distress disparities.
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Affiliation(s)
- Alia Alhomsi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Izzy Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Stephanie M. Quintero
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Miciah Wilkerson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Anita L. Stewart
- Center for Aging in Diverse Communities, Institute for Health and Aging, University of California San Francisco, San Francisco, California, USA
| | - Anna M. Napoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
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11
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Zierath R, Claggett B, Hall ME, Correa A, Barber S, Gao Y, Talegawkar S, Ezekwe EI, Tucker K, Diez-Roux AV, Sims M, Shah AM. Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Individuals in the US From the Jackson Heart Study. JAMA Netw Open 2023; 6:e2252055. [PMID: 36689225 PMCID: PMC9871801 DOI: 10.1001/jamanetworkopen.2022.52055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/10/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Food insecurity disproportionately affects Black individuals in the US. Its association with coronary heart disease (CHD), heart failure (HF), and stroke is unclear. Objective To evaluate the associations of economic food insecurity and proximity with unhealthy food options with risk of incident CHD, HF, and stroke and the role of diet quality and stress. Design, Setting, and Participants This cohort study was a time-to-event analysis of 3024 Black adult participants in the Jackson Heart Study (JHS) without prevalent cardiovascular disease (CVD) at visit 1 (2000-2004). Data analysis was conducted from September 1, 2020, to November 30, 2021. Exposures Economic food insecurity, defined as receiving food stamps or self-reported not enough money for groceries, and high frequency of unfavorable food stores (>2.5 unfavorable food stores [fast food restaurants, convenience stores] within 1 mile). Main Outcomes and Measures The main outcomes were incident CVD including incident CHD, stroke, and HF with preserved ejection fraction and with reduced ejection fraction (HFrEF). During a median follow-up of 13.8 (IQR, 12.8-14.6) years, the associations of measures of food inadequacy with incident CVD (CHD, stroke, and HF) were assessed using multivariable Cox proportional hazards regression models. Results Among the 3024 study participants, the mean (SD) age was 54 (12) years, 1987 (66%) were women, 630 (21%) were economically food insecure, and 50% (by definition) had more than 2.5 unfavorable food stores within 1 mile. In analyses adjusted for cardiovascular risk and socioeconomic factors, economic food insecurity was associated with higher risk of incident CHD (hazard ratio [HR], 1.76; 95% CI, 1.06-2.91) and incident HFrEF (HR, 2.07; 95% CI, 1.16-3.70), but not stroke. These associations persisted after further adjustment for diet quality and perceived stress. In addition, economic food insecurity was associated with higher high-sensitivity C-reactive protein and renin concentrations. High frequency of unfavorable food stores was not associated with CHD, HF, or stroke. Conclusions and Relevance The findings of this cohort study suggest that economic food insecurity, but not proximity to unhealthy food options, was associated with risk of incident CHD and HFrEF independent of socioeconomic factors, traditional cardiovascular risk factors, diet quality, perceived stress, and other health behaviors. Economic food insecurity was also associated with markers of inflammation and neurohormonal activation. Economic food insecurity may be a promising potential target for the prevention of CVD.
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Affiliation(s)
- Rani Zierath
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Brian Claggett
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | - Sharrelle Barber
- Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Yan Gao
- University of Mississippi Medical Center, Jackson
| | - Sameera Talegawkar
- Milken Institute of Public Health at the George Washington University, Washington, DC
| | | | - Katherine Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell
| | - Ana V. Diez-Roux
- Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Mario Sims
- University of Mississippi Medical Center, Jackson
| | - Amil M. Shah
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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12
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Luo Y, Li Q, Jeong H, Cheatham L. The association between social determinants of health and psychological distress during the COVID-19 pandemic: a secondary analysis among four racial/ethnic groups. BMC Public Health 2022; 22:2193. [PMID: 36443734 PMCID: PMC9702892 DOI: 10.1186/s12889-022-14486-x] [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: 04/22/2022] [Accepted: 10/29/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Racial disparities in psychological distress associated with COVID-19 remain unclear in the U.S. This study aims to investigate the associations between social determinants of health and COVID-19-related psychological distress across different racial/ethnic groups in the US (i.e., non-Hispanic Whites, Hispanic, non-Hispanic Asians, and non-Hispanic African Americans). METHODS This study used cross-sectional data from the 2020 California Health Interview Survey Adult Data Files (N = 21,280). Adjusting for covariates-including age, gender, COVID-19 pandemic challenges, and risk of severe illness from COVID-19-four sets of weighted binary logistic regressions were conducted. RESULTS The rates of moderate/severe psychological distress significantly varied across four racial/ethnic groups (p < 0.001), with the highest rate found in the Hispanic group. Across the five domains of social determinants of health, we found that unemployment, food insecurity, housing instability, high educational attainment, usual source of health care, delayed medical care, and low neighborhood social cohesion and safety were associated with high levels of psychological distress in at least one racial/ethnic group (p < 0.05). CONCLUSION Our study suggests that Hispanic adults face more adverse social determinants of health and are disproportionately impacted by the pandemic. Public health practice and policy should highlight social determinants of heath that are associated with different racial/ethnic groups and develop tailored programs to reduce psychological distress.
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Affiliation(s)
- Yan Luo
- grid.411015.00000 0001 0727 7545School of Social Work, The University of Alabama, Tuscaloosa, AL 35401 USA ,grid.410445.00000 0001 2188 0957The University of Hawaiʻi at Mānoa, HI Honolulu, USA
| | - Qingyi Li
- grid.5386.8000000041936877XDepartment of Psychology, Cornell University, Ithaca, NY 14850 USA
| | - Haelim Jeong
- grid.411015.00000 0001 0727 7545School of Social Work, The University of Alabama, Tuscaloosa, AL 35401 USA
| | - Leah Cheatham
- grid.411015.00000 0001 0727 7545School of Social Work, The University of Alabama, Tuscaloosa, AL 35401 USA
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13
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Islam JY, Awan I, Kapadia F. Food Insecurity, Financial Hardship, and Mental Health Among Multiple Asian American Ethnic Groups: Findings from the 2020 COVID-19 Household Impact Survey. Health Equity 2022; 6:435-447. [PMID: 35801150 PMCID: PMC9257551 DOI: 10.1089/heq.2021.0179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has adversely impacted the financial and mental well-being of U.S. adults, however, Asian American (AA)-specific data are lacking, particularly disaggregated by AA ethnicity. Our objective was to evaluate food insecurity (FI), financial hardship, and mental health among disaggregated AA ethnic groups during the COVID-19 pandemic. Methods: We used data from the COVID-19 Household Impact Survey, a sample of 10,760 U.S. adults weighted to reflect the U.S. population (weighted n: 418,209,893). AA ethnic categories were based on self-report (n=312, 5.1%; weighted n: 21,143,079) and provided as follows: Chinese American, South Asian, Filipino+Vietnamese, and Japanese+Korean. We estimated the prevalence of FI and financial hardship across AA ethnic categories. We estimated the demographic determinants of FI, including financial hardship, among AA adults using multivariable Poisson regression. We calculated the prevalence of mental health symptoms among food-insecure AA adults, as well as among AA adults experiencing both FI and financial hardship. Results: Overall, the prevalence of FI and financial hardship among AA adults was highest among Filipino+Vietnamese adults (52.9–24.5%) and lowest among Japanese+Korean adults (13.9–8.6%). Determinants of FI among AA adults included Filipino+Vietnamese ethnicity (adjusted prevalence ratios [aPR]: 2.81, 95% confidence interval [CI]: 1.49–5.29), being widowed/divorced/separated (aPR: 3.14, 95% CI: 1.37–7.23), high school graduate only (aPR: 3.46, 95% CI: 1.96–6.11), having low income <$30,000 (aPR: 2.54, 95% CI: 1.27–5.06), and living in rural areas (aPR: 7.65, 95% CI: 1.17–50.14). Eighty-one percent and 63% of AA adults with anxiety and hopelessness at least 3–7 days/week, respectively, were food insecure and experiencing financial hardship. Conclusion: Disparities exist in FI and financial hardship among AA adults, particularly Filipino+Vietnamese adults, and are associated with increased self-reporting of feelings of anxiety and hopelessness.
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Affiliation(s)
- Jessica Y. Islam
- Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Iman Awan
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Farzana Kapadia
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York, USA
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14
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The Psychological Distress of Food Insecurity: A Qualitative Study of the Emotional Experiences of Parents and Their Coping Strategies. J Acad Nutr Diet 2022; 122:1903-1910.e2. [DOI: 10.1016/j.jand.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
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15
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Shepherd DL. Food insecurity, depressive symptoms, and the salience of gendered family roles during the COVID-19 pandemic in South Africa. Soc Sci Med 2022; 301:114830. [PMID: 35367907 PMCID: PMC8882481 DOI: 10.1016/j.socscimed.2022.114830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/22/2022] [Accepted: 02/15/2022] [Indexed: 12/12/2022]
Abstract
Extensive research has indicated food insecurity to be associated with depressive symptoms, both of which have been indicated to increase globally during the COVID-19 pandemic. Few studies, however, have made use of nationally representative and longitudinal data to investigate this relationship, making causal claims difficult. In South Africa (SA), as with other low- and middle-income contexts, population-based studies have generally focused on mothers during the perinatal period and other vulnerable groups. This study made use of Cross-Lagged Dynamic Panel Models to examine the relationship between household food insecurity and the depressive symptoms of adults across three waves of the National Income Dynamics Survey–Coronavirus Rapid Mobile Survey (NIDS-CRAM) study collected in 2020 and 2021, a dataset nationally representative of all adults in SA in 2017. Stratification of the sample by gender, parenthood and marital statuses allowed for the assessment of gender differences in family roles that might account for differential impacts of food insecurity on mental health outcomes. The findings of this study indicated a significant impact of food insecurity on the depressive symptoms of adults. Controlling for stable trait-like individual differences eliminated much of this relationship, indicating partial or full mediation by unobserved factors. Gender differences in food security's association with depressive symptoms amongst cohabitating parents following the inclusion of individual effects provided support for a gendered role response. These findings provide further evidence of the complex interactions between sex, gender and health.
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Affiliation(s)
- Debra L Shepherd
- Department of Economics, Faculty of Economic and Management Sciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
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16
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Finucane ML, Beckman R, Ghosh-Dastidar M, Dubowitz T, Collins RL, Troxel W. Do social isolation and neighborhood walkability influence relationships between COVID-19 experiences and wellbeing in predominantly Black urban areas? LANDSCAPE AND URBAN PLANNING 2022; 217:104264. [PMID: 34690393 PMCID: PMC8519605 DOI: 10.1016/j.landurbplan.2021.104264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 05/07/2023]
Abstract
Black Americans have been disproportionately affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) pandemic. Since the pandemic's start, we have observed compounded health, social, and economic impacts for communities of color, fueled in part by profound residential segregation in the United States that, for centuries prior to the pandemic, created differences in access to opportunity and resources. Based on a longitudinal cohort of Black residents living in two racially isolated Pittsburgh neighborhoods, we sought to: 1) describe the experiences of behavioral responses to COVID-19 conditions (e.g., closures of businesses, schools, government offices) and illness experiences reported by residents within these disinvested, urban areas and 2) determine if these experiences were associated with perceptions of risk, negative mental health outcomes, and food insecurity; and 3) examine whether any of the associations were explained by social isolation or modified by neighborhood walkability. We found direct associations between residents' experience with COVID-19-related closures and with the illness, with perceived risk, and change in psychological distress, sleep quality, and food insecurity from pre-COVID-19 levels. Social isolation was a statistically significant mediator of all of these associations, most strongly mediating the pathway to psychological distress. We found neighborhood walkability to be a significant moderator of the association between closure experiences and sleep quality. The results suggest that experiences of COVID-19 closures and illness were associated with serious threats to public health in Black, disinvested, urban neighborhoods, beyond those caused directly by the virus. Outcomes of the pandemic appear very much dependent on the extent to which social and physical resources are available to meet the demands of stress.
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17
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Joseph C, Feiner C, Leung CW. Food insecurity is associated with serious psychological distress among low-income California adults. J Health Psychol 2021; 27:2249-2260. [PMID: 34213360 DOI: 10.1177/13591053211028913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined differences in the associations between food insecurity and serious psychological distress (SPD) by key sociodemographic factors in a population-based sample of low-income adults from the 2017 California Health Interview Survey (n = 6266). After adjusting for sociodemographic characteristics, low food security, and very low food security were both positively associated with SPD among all low-income adults. Upon stratification, these associations were most pronounced among adults under age 50, males, and in adults with children. Understanding disparities in the associations between food insecurity and psychological distress is critical in developing effective programs or policies to target the most vulnerable sub-groups.
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18
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Hill LH, Holland R. Health disparities, race, and the global pandemic of COVID‐19: The demise of Black Americans. NEW DIRECTIONS FOR ADULT AND CONTINUING EDUCATION 2021. [PMCID: PMC8652746 DOI: 10.1002/ace.20425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article examines the chronic health conditions of African Americans who experience disparities because of poverty, low literacy, and cultural practices that affect decisions about food, nutrition, and health care. It will examine governmental policies, for example, the Affordable Care Act (ACA) (Artiga et al., 2020), and how these policies contribute to health and wellbeing of people from low‐income communities. Furthermore, it explores the overrepresented deaths among African Americans and other communities of color resulting from the pandemic—deaths that result from co‐existing health conditions and the inability to afford immediate care.
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Affiliation(s)
- Lilian H. Hill
- University of Southern Mississippi Hattiesburg Mississippi USA
| | - Rebecca Holland
- University of Southern Mississippi Hattiesburg Mississippi USA
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19
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A Myers
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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20
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Agampodi TC, Hromi-Fiedler A, Agampodi SB, Amarasinghe GS, Wickramasinghe ND, Jayasinghe IU, Hettiarachchi AU, Perez-Escamilla R. A self-applied valid scale for rapid tracking of household food insecurity among pregnant women in Sri Lanka. MATERNAL AND CHILD NUTRITION 2021; 17:e13165. [PMID: 33733618 PMCID: PMC8189217 DOI: 10.1111/mcn.13165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
Rapid household food insecurity (HFI) tracking has been identified as a priority in the context of the COVID-19 pandemic and its aftermath. We report the validation of the Latin American and Caribbean Food Security Scale (Escala Latinoamericana y Caribena de Seguridad Alimentaria [ELCSA]) among pregnant women in Sri Lanka. The eight-item adult version of the ELCSA was translated from English to Sinhala and Tamil. Cognitive testing (on 10 pregnant women and five local experts) and psychometric validation of the self-administered HFI tool were conducted among pregnant women (n = 269) attending the special clinics of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura in February 2020. We assessed the psychometric properties and fit using a one parameter logistic model (Rasch model analysis) using STATA Version 14 and WINSTEP software Version 4.3.4. Concurrent validity was tested using psychological distress. The scale was internally consistent (Cronbach's alpha = 0.79) and had a good model fit (Rasch items infit statistic range: 0.85 to 1.07). Item 8 ('did not eat for the whole day') was removed from the model fit analysis, as it was not affirmed by respondent. Item severity scores ranged from -2.15 for 'not eating a diverse diet' to 4.43 for 'not eating during the whole day'. Concurrent validity between HFI and psychological distress was confirmed (r = 0.15, p < 0.05). The self-applied version of ELCSA-pregnancy in Sri Lanka (ELCSA-P-SL) is a valid and feasible valid tool. We recommend it to track HFI among pregnant women in lower income countries during the COVID-19 pandemic.
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Affiliation(s)
- Thilini C Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Amber Hromi-Fiedler
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Suneth B Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Gayani S Amarasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Nuwan D Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Imasha U Jayasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Ayesh U Hettiarachchi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Rafael Perez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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21
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Payán DD, Díaz Rios LK, Ramírez AS, De Trinidad Young ME. Structural Barriers Influencing Food Insecurity, Malnutrition, and Health Among Latinas During and After COVID-19: Considerations and Recommendations. J Acad Nutr Diet 2021; 121:837-843. [PMID: 33568334 PMCID: PMC9391034 DOI: 10.1016/j.jand.2021.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 01/05/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Denise D Payán
- (1)Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced (UC Merced), Merced, CA.
| | - L Karina Díaz Rios
- (2)Division of Agriculture and Natural Resources, Department of Public Health, UC Merced, Merced, CA
| | - A Susana Ramírez
- (1)Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced (UC Merced), Merced, CA
| | - Maria-Elena De Trinidad Young
- (1)Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced (UC Merced), Merced, CA
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22
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Kim-Mozeleski JE, Poudel KC, Tsoh JY. Examining Reciprocal Effects of Cigarette Smoking, Food Insecurity, and Psychological Distress in the U.S. J Psychoactive Drugs 2020; 53:177-184. [PMID: 33143564 DOI: 10.1080/02791072.2020.1845419] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the U.S., cigarette smoking is increasingly concentrated in disadvantaged and vulnerable populations, such as populations with lower income and with mental health needs. Food insecurity is linked with psychological distress and is an independent risk factor for smoking. We prospectively examined how cigarette smoking, food insecurity, and psychological distress operate as risk factors for one another in a 2-year longitudinal analysis of U.S. adults from the 2015 and 2017 Panel Study of Income Dynamics, a nationally representative household survey (N = 7946). Using cross-lagged panel analysis, cross-lagged regression coefficients were estimated simultaneously with direct-effect paths, controlling for covariates. Results showed significant bidirectional associations between smoking and food insecurity: 2015 smoking predicted 2017 food insecurity, and 2015 food insecurity predicted 2017 smoking. Food insecurity and psychological distress also had significant bidirectional associations. However, the association between smoking and psychological distress was unidirectional: 2015 psychological distress predicted 2017 smoking, but not vice versa. The findings suggest a cyclical possibility that smoking exacerbates food insecurity, food insecurity exacerbates psychological distress, and psychological distress exacerbates smoking. There is a need to replicate with more timepoints, but our results highlight the importance of examining the overlapping health burdens of smoking, food insecurity, and psychological distress.
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Affiliation(s)
- Jin E Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Krishna C Poudel
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
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23
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Robles B, Jewell MP, Thomas Tobin CS, Smith LV, Kuo T. Varying levels of depressive symptoms and lifestyle health behaviors in a low income, urban population. J Behav Med 2020; 44:212-221. [PMID: 32936373 DOI: 10.1007/s10865-020-00179-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/02/2020] [Indexed: 01/02/2023]
Abstract
This study examined the relationships between varying levels of depressive symptoms and key dietary indicators of chronic disease risk, sugar-sweetened beverage (SSB) and fruit and vegetable (F + V) consumption, among a racially/ethnically diverse urban population in Los Angeles County (LAC). Analyses were carried out using data from a 2012 cross-sectional health survey of 1401 low-income public health center clients. Participants with a high level of depressive symptoms consumed 30% more SSBs (IRR = 1.30, 95% CI = 1.08, 1.55) than participants with a lower level of these symptoms. Other predictors of higher SSB consumption included being African American/Black (IRR = 1.65, 95% CI = 1.32, 2.05), male (IRR = 1.20, 95% CI = 1.06, 1.35), U.S. born (IRR = 1.32, 95% CI = 1.11, 1.57), and using tobacco (IRR = 1.26, 95% CI = 1.11, 1.43). Similar associations with F + V consumption were not found. Findings suggest that depressive symptoms may influence certain health behaviors in certain groups under certain situations. Policy and practice implications are discussed within this context.
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Affiliation(s)
- Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA. .,Department of Community Health Sciences, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA.
| | - Mirna Ponce Jewell
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA
| | - Lisa V Smith
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Suite 127, Los Angeles, CA, 90012, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA
| | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA, 90024, USA.,Population Health Program, UCLA Clinical and Translational Science Institute, BE-144 Center of Health Sciences, Los Angeles, CA, 90095, USA
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24
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Koh K, Kaiser ML, Sweeney G, Samadi K, Hyder A. Explaining Racial Inequality in Food Security in Columbus, Ohio: A Blinder-Oaxaca Decomposition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5488. [PMID: 32751387 PMCID: PMC7432289 DOI: 10.3390/ijerph17155488] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/02/2022]
Abstract
Food insecurity is a leading public health challenge in the United States. In Columbus, Ohio, as in many American cities, there exists a great disparity between Black and White households in relation to food insecurity. This study investigates the degree to which this gap can be attributed to differences in food shopping behavior, neighborhood perception, and socioeconomic characteristics. A Blinder-Oaxaca decomposition method is used to analyze a household survey dataset collected in 2014. We find a 34.2 percent point difference in food security between White and Black households. Variables related to food shopping behavior, neighborhood perception, and socioeconomic characteristics explain 13.8 percent, 11.6 percent, and 63.1 percent of the difference, respectively. These independent variables combined can explain 68.2 percent of the food security gap between White and Black households. Most of this is attributable to socioeconomic variables. Sense of friendship in neighborhood, use of private vehicles, and satisfaction of neighborhood food environment also partially contribute to the food security gap.
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Affiliation(s)
- Keumseok Koh
- Department of Geography, University of Hong Kong, Hong Kong, China
| | - Michelle L. Kaiser
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Glennon Sweeney
- Kirwan Institute for the Study of Race and Ethnicity; Department of City and Regional Planning, The Ohio State University, Columbus, OH 43210, USA;
| | - Karima Samadi
- College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Ayaz Hyder
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
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25
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A. Myers
- Pennington Biomedical Research Center, Baton Rouge, 70808, Louisiana, USA,Corresponding author at: Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA, , Tel: (225) 763-2849
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Paschal AM, Mitchell JB, Burton WM, Nickelson J, Murphy PZ, Ford F. Using Community-Based Participatory Research to Explore Food Insecurity in African American Adults. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1744491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Crosby RA, Kubicek K, Kipke MD. Is the experience of hunger associated with risk of engaging in condomless anal sex among minority young men who have sex with men? Int J STD AIDS 2020; 31:447-453. [PMID: 32208817 PMCID: PMC8437430 DOI: 10.1177/0956462420911562] [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] [Indexed: 11/16/2022]
Abstract
Although emerging evidence suggests that hunger may be a risk factor for engaging in risk behaviors that lead to HIV acquisition, this has rarely been explored for young minority men who have sex with men (YMSM). This study explored a range of sexual risk behaviors for associations with a measure of hunger, assessed among 448 YMSM residing in Los Angeles, CA. Forty-five percent experienced hunger (past 12 months). Hunger was significantly associated with engaging in any condomless anal receptive sex (CARS) (adjusted odds ratio 1.74; 95% confidence interval 1.01–3.01; P .049). Further, hunger was also significantly associated with a greater percentage of CARS (Beta .12; t 2.18; P .03). Parallel effects were not observed relative to condomless anal insertive sex. Findings suggest that the experience of hunger among young minority MSM is generally not associated with a milieu of sexual risk. One important exception is that hunger may lead to having CARS. This suggests a potential ‘trade off’ for receptive partners experiencing hunger and partially supports the idea that at hunger may predispose minority YMSM to partner demands not to use condoms.
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Affiliation(s)
- Richard A Crosby
- Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Katrina Kubicek
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Michele D Kipke
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Analysis of risk and protective factors for psychosocial distress among in-school adolescents in Tanzania. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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A Systematic Review and Meta-analysis of Depression, Anxiety, and Sleep Disorders in US Adults with Food Insecurity. J Gen Intern Med 2019; 34:2874-2882. [PMID: 31385212 PMCID: PMC6854208 DOI: 10.1007/s11606-019-05202-4] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION A large number of peer-reviewed studies, with various methodologies and populations, have addressed the effects of food insecurity (FIS) on mental health conditions such as depression, anxiety, and sleep disorders. There are currently, however, no published systematic assessments or meta-analyses of this literature. METHODS A systematic search of the literature was conducted in PubMed, PsycInfo, Embase, Scopus, and Web of Science. Cross-sectional studies assessing the association between food insecurity and depression, anxiety, or sleep disorders were identified. For each of the three health outcomes, we extracted (or calculated when possible) the following effect sizes: odds ratio (OR), Hedges' g, Pearson correlation coefficients r, or bivariate coefficients. Then, for each mental health-outcome/effect-size pair, the available studies were combined using the random effect model. Heterogeneity, publication bias, and subgroup dependence, for each meta-analysis, were also assessed. RESULTS Fifty-seven studies provided cross-sectional data on the relationship between FIS and depression (n = 169,433), 13 on anxiety and psychological distress (n = 91,957), and 8 studies provided data on sleep disorders (n = 85,788). Meta-analysis showed that FIS is associated with an increased risk of testing positive for depression OR = 2.74 [95% CI 2.52-2.97, n = 135,500, Q(df = 41) = 69, I2 = 40%], anxiety OR = 2.41 [95% CI 1.81-3.22, n = 51,541, Q(df = 3) = 8, I2 = 63%], and sleep disorders OR = 1.80 [95% CI 1.51-2.15, n = 84,800, Q(df = 5) = 13, I2 = 62%]. The highest risks were found for depression and anxiety which had statistically similar values. The results were robust to covariates and population groups. DISCUSSION This systematic review and meta-analysis demonstrates a strong association between FIS and depression, anxiety, and sleep disorders, for which more longitudinal studies addressing effect sizes are warranted to further study causation.
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Becerra MB, Mshigeni SK, Becerra BJ. The Overlooked Burden of Food Insecurity among Asian Americans: Results from the California Health Interview Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081684. [PMID: 30087306 PMCID: PMC6121379 DOI: 10.3390/ijerph15081684] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 01/22/2023]
Abstract
Objective: Food insecurity remains a major public health issue in the United States, though lack of research among Asian Americans continue to underreport the issue. The purpose of this study was to evaluate the prevalence and burden of food insecurity among disaggregated Asian American populations. Methods: The California Health Interview Survey, the largest state health survey, was used to assess the prevalence of food insecurity among Asian American subgroups with primary exposure variable of interest being acculturation. Survey-weighted descriptive, bivariate, and multivariable robust Poisson regression analyses, were conducted and alpha less than 0.05 was used to denote significance. Results: The highest prevalence of food insecurity was found among Vietnamese (16.42%) and the lowest prevalence was among Japanese (2.28%). A significant relationship was noted between prevalence of food insecurity and low acculturation for Chinese, Korean, and Vietnamese subgroups. Language spoken at home was significant associated with food insecurity. For example, among Chinese, being food insecure was associated with being bilingual (prevalence ratio [PR] = 2.51) or speaking a non-English language at home (PR = 7.24), while among South Asians, it was associated with speaking a non-English language at home was also related to higher prevalence (PR = 3.62), as compared to English speakers only. Likewise, being foreign-born also related to being food insecure among Chinese (PR = 2.31), Filipino (PR = 1.75), South Asian (PR = 3.35), Japanese (PR = 2.11), and Vietnamese (PR = 3.70) subgroups, when compared to their US-born counterparts. Conclusion: There is an imperative need to address food insecurity burden among Asian Americans, especially those who have low acculturation.
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Affiliation(s)
- Monideepa B Becerra
- Department of Health Science and Human Ecology, California State University, 5500 University Parkway, San Bernardino, CA 92407, USA.
| | - Salome Kapella Mshigeni
- Department of Health Science and Human Ecology, California State University, 5500 University Parkway, San Bernardino, CA 92407, USA.
| | - Benjamin J Becerra
- School of Allied Health Professions, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA 92350, USA.
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Tarasuk V, Cheng J, Gundersen C, de Oliveira C, Kurdyak P. The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:557-569. [PMID: 29307216 PMCID: PMC6099753 DOI: 10.1177/0706743717752879] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the relationship between household food insecurity status over a 12-month period and adults' use of publicly funded health care services in Ontario for mental health reasons during this period. METHODS Data for 80,942 Ontario residents, 18 to 64 years old, who participated in the Canadian Community Health Survey in 2005, 2007-2008, 2009-2010, or 2011-2012 were linked to administrative health care data to determine individuals' hospitalizations, emergency department visits, and visits to psychiatrists and primary care physicians for mental health reasons. Household food insecurity over the past 12 months was assessed using the Household Food Security Survey Module. Logistic regression models were used to estimate the odds of mental health service utilization in the past 12 months by household food insecurity status, adjusting for sociodemographic factors and prior use of mental health services. RESULTS In our fully adjusted models, in comparison to food-secure individuals, the odds of any mental health care service utilization over the past 12 months were 1.15 (95% confidence interval [CI], 1.04 to 1.29) for marginally food-insecure individuals, 1.39 (95% CI, 1.19 to 1.42) for moderately food-insecure individuals, and 1.50 (95% CI, 1.35 to 1.68) for severely food-insecure individuals. A similar pattern persisted across individual types of services, with odds of utilization highest with severe food insecurity. CONCLUSIONS Household food insecurity status is a robust predictor of mental health service utilization among working-age adults in Ontario. Policy interventions are required to address the underlying causes of food insecurity and the particular vulnerability of individuals with mental illness.
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Affiliation(s)
- Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario
| | - Joyce Cheng
- Centre for Addiction and Mental Health, Toronto, Ontario
- Institute for Clinical Evaluative Sciences, Toronto, Ontario
| | - Craig Gundersen
- Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Claire de Oliveira
- Institute for Clinical Evaluative Sciences, Toronto, Ontario
- Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, Champaign, Illinois
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Toronto, Ontario
- Institute for Clinical Evaluative Sciences, Toronto, Ontario
- Department of Psychiatry and Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario
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Kim-Mozeleski JE, Tsoh JY. Food Insecurity and Psychological Distress Among Former and Current Smokers With Low Income. Am J Health Promot 2018; 33:199-207. [PMID: 29950100 DOI: 10.1177/0890117118784233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE To examine how food insecurity and psychological distress interact in its association with smoking and to explore how food insecurity and psychological distress are associated with quitting smoking using quit ratio estimates. DESIGN Cross-sectional study. SETTING Data from the 2015 California Health Interview Survey. PARTICIPANTS A total of 3007 lower income adults who have ever smoked. MEASURES Ever smoking was defined as smoking 100+ cigarettes in the entire lifetime, with current smoking defined as smoking "every day" or "some days" and former smoking defined as smoking "not at all." Psychological distress and food insecurity were measured by the 6-item K6 Psychological Distress Scale and the 6-item Food Security Survey Short Form, respectively. ANALYSIS Multiple logistic regression analysis was used to examine correlates of smoking status. Quit ratios (percentage of ever smokers who have quit) were calculated across study variables. RESULTS Reporting food insecurity with psychological distress was independently associated with lower odds of being a former smoker, compared to reporting food security without psychological distress. The quit ratio was lower among ever smokers reporting food insecurity with distress (41%) compared to ever smokers reporting food security without distress (63%). CONCLUSIONS Specific conditions of impoverishment, such as food insecurity, interact with psychological distress in its association with continued smoking. Interventions to reduce socioeconomic disparities in smoking should consider the interacting role of food insecurity and psychological distress.
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Affiliation(s)
- Jin E Kim-Mozeleski
- 1 Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- 2 Department of Psychiatry, University of California, San Francisco, CA, USA
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