Household Food Insecurity Narrows the Sex Gap in Five Adverse Mental Health Outcomes among Canadian Adults

The mitigating role of social capital on the association between food insecurity and psychological distress among Chinese adults

BACKGROUND

Food insecurity, a pervasive global issue exacerbated by the COVID-19 pandemic, has been linked to adverse mental health outcomes. However, the role of social capital in mitigating this relationship remains understudied, particularly in the Chinese context.

AIMS

This study investigated the associations between food insecurity and psychological distress (depressive and anxiety symptoms) and examined the potential moderating effects of bonding and bridging social capital among Chinese adults in Shanghai.

METHODS

This cross-sectional study included 3,220 Chinese adults (mean age: 34.45; 51.5% male) in Shanghai. Food insecurity was assessed using the modified Household Food Insecurity Access Scale, psychological distress was measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, and social capital was evaluated using the Revised Personal Social Capital Scale.

RESULTS

Multivariable linear regression analyses revealed that food insecurity was significantly positively associated with both depressive (β = 0.449, SE = 0.024) and anxiety symptoms (β = 0.391, SE = 0.022), after adjusting for sociodemographic characteristics, health status, and COVID-19-related factors. Higher levels of bonding and bridging social capital were significantly associated with fewer depressive and anxiety symptoms. Significant interactions (p < .001) between bonding social capital and food insecurity indicated that the associations between food insecurity and psychological distress were less pronounced among adults with higher bonding social capital.

CONCLUSIONS

These findings highlight the critical role of food insecurity as a risk factor for psychological distress and the importance of bonding social capital in mitigating its impact on mental health. Policies and interventions targeting food insecurity prevention and bonding social capital enhancement may promote better mental health outcomes among Chinese adults.

The joint effect of female sex and food insecurity on self-reported mood disorder among Canadian adults: the Canadian community health survey

BACKGROUND

Food insecurity is prevalent in Canada and may influence mental health, particularly among females. The present study examined the joint effect of female sex and food insecurity on mood disorders.

METHODS

The study used data from 104,420 adults aged 18 years or older who participated in the 2017/2018 Canadian Community Health Survey (CCHS). Log-binomial models explored the independent and joint associations of female sex and food insecurity with the prevalence of self-reported mood disorder. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated. Relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were used to assess the additive interaction of female sex and food insecurity. The complex survey design was taken into consideration.

RESULTS

The prevalence of mood disorder was 6.7% for males and 11.4% for females, with an adjusted prevalence ratio being 1.59 (95% CI 1.51, 1.68) for females versus males. Mood disorder was associated with moderate food insecurity (PR 2.06, 95% CI 1.91, 2.23) and severe food insecurity (PR 3.29, 95% CI 3.06, 3.55). There was a significant additive interaction between female sex and food insecurity in association with the prevalence of mood disorders among females aged 18 to 39 years (RERI 1.19, 95% CI 0.27,2.08).

CONCLUSION

Food insecurity was associated with an increased prevalence of mood disorders, especially in younger females. Interventions that facilitate access to food while being cognizant of the socioeconomic vulnerabilities of females may have substantial benefits for the prevention and management of mood disorders.

Food worry and mental health outcomes during the COVID-19 pandemic

Background

There is limited and inconsistent literature examining the relationship between food worry and mental health in the context of the COVID-19 pandemic. This study examined the association between food worry and mental health among community dwelling Canadian adults during the COVID-19 pandemic.

Methods

Adults age 16 years and older completed an anonymous online questionnaire between April 1, 2020 and November 30 2020. Measures of pre-pandemic and current food worry, depression (PHQ-2), anxiety (GAD-2), and sociodemographic variables were included. Multivariable logistic regression models were used to determine the association between food worry and symptoms of depression and anxiety.

Results

In total, 1605 participants were included in analyses. Worry about affording food was reported by 320 (14.78%) participants. In models adjusting for sociodemographic covariates, compared with people without food worry, participants who had food worry were 2.07 times more likely to report anxiety symptoms (aOR 2.07, 95% CI: 1.43 – 2.98, p < .001) and were 1.9 times more likely to report depressive symptoms (aOR 1.89, 95% CI: 1.39–2.57, p < .0001). Lower income, lower education, and pre-existing mental health conditions were significant predictors of symptoms of depression. Female gender, younger age, lower education, lower income, and pre-existing mental health condition were significant predictors of anxiety symptoms.

Conclusion

Our study highlights the relationship between food worry and poor mental health. Policy supports such as improved income supports, clinical implications such as screening for food worry in primary care, referral to emergency food programs and support with meal planning may help mitigate mental health symptoms during the current pandemic, during future societal recovery from this pandemic and during future pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13410-7.

Depression mediates the links between climacteric symptoms and food and nutritional insecurity

OBJECTIVE

This study is perhaps the first to evaluate the influence of depression on the relationship between climacteric symptoms and food and nutritional insecurity (FNI).

METHODS

In this cross-sectional study with a relatively large sample of climacteric women (N = 400), sociodemographic and clinical variables were investigated. We measured FNI, depression and climacteric symptoms with psychometrically sound instruments, namely the Brazilian Food Security Scale, the Center for Epidemiologic Studies Depression Scale and the Kupperman Index, respectively.

RESULTS

Statistically significant differences were observed in the means of FNI according to education, income, marital status, history of depression, use of antidepressants and current depression. Furthermore, depression had strong indirect effects on the relationship between climacteric symptoms and FNI.

CONCLUSION

Our study suggests that targeting depression could benefit climacteric women, especially those with severe symptoms and in FNI.

Female sex and food insecurity in relation to self-reported poor or fair mental health in Canadian adults: a cross-sectional study using national survey data

BACKGROUND

Women with food insecurity are at higher risk for mental health disorders. This study examined the joint effect of female sex and food insecurity on self-reported poor or fair mental health in Canadian adults.

METHODS

The analysis was based on data from adults (age ≥ 18 yr) who participated in the Canadian Community Health Survey (CCHS) 2015-2016. We determined past-year food security level (secure, moderately insecure or severely insecure) based on 18 questions. We used log-binomial regression to explore associations of sex and food insecurity with self-reported poor or fair mental health. We measured additive interaction between female sex and food insecurity using relative excess risk due to interaction (RERI).

RESULTS

The overall response rate for the CCHS was 59.5%. Data for 61 446 respondents were analyzed. Poor or fair mental health was reported by 4107 participants (6.1% when weighted to the Canadian population). Increased risk of poor or fair mental health was associated with female sex (prevalence ratio [PR] 1.22, 95% confidence interval [CI] 1.12 to 1.31), and moderate (PR 2.50, 95% CI 2.21 to 2.82) and severe (PR 4.03, 95% CI 3.59 to 4.52) food insecurity. Significant additive interaction between female sex and severe food insecurity was found for those aged 40-64 years (RERI 1.38, 95% CI 0.29 to 2.47), and the PR for poor or fair mental health for severely food-insecure women was 5.55 (95% CI 4.48 to 6.89) compared to food-secure men of the same age group.

INTERPRETATION

Poor or fair mental health is common in the food-insecure population, and there exists synergism between female sex and severe food insecurity among middle-aged people. This suggests the need to develop targeted mental health support strategies for food-insecure people, specifically middle-aged women.

A rapid assessment of migrant careworkers' psychosocial status during Israel's COVID-19 lockdown

BACKGROUND

Israel hosts nearly 70,000 migrant careworkers. Migrant careworkers work and live with populations extremely vulnerable to the novel Coronavirus, including the elderly and people with pre-existing physical conditions. This rapid assessment aimed to explore psychosocial status and mental wellbeing of migrant careworkers in Israel during the ongoing Covid-19 pandemic and determine risk and protective factors associated with mental distress, anxiety, and depression.

METHODS

This quantitative study was conducted via an online survey. The online survey collected social and demographic data, including country of origin, residence, age, sex, and time in Israel. In addition, questions were asked about knowledge of COVID-19 guidelines, access to supplies, and COVID-related racism. Respondents also completed a psychosocial screening tools, the Hopkins Symptom Checklist-10 (HSCL-10), which was used to screen for depression and anxiety.

RESULTS

As of May 3rd, 2020, 307 careworkers responded to the online survey, of whom 120 (39.1%) were found symptomatic using the HSCL-10. Separating the HSCL-10 into subscales, 28.0% were symptomatically anxious, and 38.1% were symptomatic for depression. In multivariate regression, emotional distress was associated with household food insecurity (OR: 5.85; p < 0.001), lack of confidence to care for oneself and employer during the pandemic (OR: 3.85; p < 0.001), poorer general health (OR: 2.98; p < 0.003), non-Philippine country of origin (OR: 2.83; p < 0.01), female sex (OR: 2.34; p < 0.04),, and inversely associated with age (p < 0.03). While 87.6% of careworkers reported having access to hand sanitization materials regularly, only 58.0% had regular access to a medical grade mask, and 21.5% reported household food insecurity. Moreover, 40.0% of careworkers claimed to lack confidence to care for themselves and their employer during the COVID-19 pandemic.

CONCLUSIONS

Migrant careworkers exhibited high levels of mental distress during the COVID-19 lockdown, associated with lack of confidence or resources to properly care for themselves and their employer. Guidelines and support programs specific to the carework sector, that respect their rights and guard their health, must be developed as part of a coordinated COVID-19 response.

Addressing Food and Nutrition Security in Developed Countries

The guest editors of the special issue on Addressing Food and Nutrition Security in Developed Countries reflect on the 26 papers that were published as part of this issue and the scope of research contained therein. There is an extensive body of work, which focuses on topics ranging from the prevalence of food insecurity in developed countries, associations and determinants, measurement and monitoring, to reports of the lived experience and coping strategies of people who are living with food insecurity or and those who are a part of the charitable food sector. Very few solutions to address the problem of food insecurity in developed countries were offered, and many challenges highlighted. Further research is required to find the solutions to address the problem of food insecurity in developed countries, and important principles and values are proposed for those undertaking this work to embrace.

Food Insecurity and Hunger in Rich Countries-It Is Time for Action against Inequality

Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches have the potential to address the structural causes, not just the symptoms of food insecurity. Despite most developed countries ratifying the Covenant on Economic, Social and Cultural Rights over 40 years ago, food insecurity rates suggest current social protections are inadequate. The contemporary framing of the solution to food insecurity in developed countries is that of diverting food waste to the hungry to meet the United Nations Sustainable Development Goals agenda (Goals 2 and 12.3). An estimated 60 million people or 7.2% of the population in high income countries used food banks in 2013. Although providing food assistance to those who are hungry is an important strategy, the current focus distracts attention away from the ineffectiveness of government policies in addressing the social determinants of food insecurity. Much of the action needed to improve household food security falls to actors outside the health sector. There is evidence of promising actions to address the social determinants of food insecurity in some developed countries. Learning from these, there is a strong case for government leadership, for action within and across government, and effective engagement with other sectors to deliver a coordinated, collaborative, and cooperative response to finding pathways out of food insecurity.