Food Security, Financial Resources, and Mental Health: Evidence during the COVID-19 Pandemic

Association between job lost and mental health outcomes during the COVID-19 pandemic and the role of food insecurity as mediator of this relationship

This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional population-based study was conducted with adults (≥ 18 and < 60 years) during the COVID-19 outbreak in two cities from Southern Brazil. Employment status was categorized into working, not working, and lost job. The mental health outcomes evaluated were depressive symptoms, perceived stress, and sadness. Food insecurity was identified by the short-form version of the Brazilian Food Insecurity Scale. Adjusted analyses using Poisson regression were performed to assess the association between employment status and mental health. Mediation analysis was performed to investigate the direct and indirect effects of employment status on mental health outcomes. In total, 1,492 adults were analyzed. The not working status was associated with 53% and 74% higher odds of perceived stress and of sadness, respectively. Being dismissed during the pandemic increased the odds of depressive symptoms, perceived stress, and sadness by 68%, 123%, and 128%, respectively. Mediation analyses showed that food insecurity was an important mediator of the association between employment status and depressive symptoms and sadness, but not of perceived stress. The complexity of these results highlights economic and nutritional aspects involved in mental health outcomes.

Malnutrition-related mortality trends in older adults in the United States from 1999 to 2020

BACKGROUND

Malnutrition mortality in older adults is underrepresented in scientific literature. This obscures any recent changes and hinders needed social change. This study aims to assess malnutrition mortality trends in older adults (≥ 65 years old) from 1999 to 2020 in the United States (U.S.).

METHODS

Mortality data from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiology Research (WONDER) database were extracted. The ICD-10 Codes E40 - E46 were used to identify malnutrition deaths. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) were extracted by gender, age, race, census region, and urban-rural classification. Joinpoint regression analysis was used to calculate annual percentage changes (APC) of AAMR by the permutation test and the parametric method was used to calculate 95% confidence intervals. Average Annual Percentage Changes (AAPC) were calculated as the weighted average of APCs.

RESULTS

Between 1999 and 2020, 93,244 older adults died from malnutrition. Malnutrition AAMR increased from 10.7 per 100,000 in 1999 to 25.0 per 100,000 in 2020. The mortality trend declined from 1999 to 2006 (APC = -8.8; 95% CI: -10.0, -7.5), plateaued till 2013, then began to rise from 2013 to 2020 with an APC of 22.4 (95% CI: 21.3, 23.5) and an overall AAPC of 3.9 (95% CI: 3.1, 4.7). Persons ≥ 85 years of age, females, Non-Hispanic Whites, residents of the West region of the U.S., and urban areas had the highest AAPCs in their respective groups.

CONCLUSION

Despite some initial decrements in malnutrition mortality among older adults in the U.S., the uptrend from 2013 to 2020 nullified all established progress. The end result is that malnutrition mortality rates represent a historical high. The burden of the mortality uptrends disproportionately affected certain demographics, namely persons ≥ 85 years of age, females, Non-Hispanic Whites, those living in the West region of the U.S., and urban areas. Effective interventions are strongly needed. Such interventions should aim to ensure food security and early detection and remedy of malnutrition among older adults through stronger government-funded programs and social support systems, increased funding for nursing homes, and more cohesive patient-centered medical care.

Use of food distribution resources among military families with young children since the COVID-19 pandemic

OBJECTIVE

The present study examined military families' use of food distribution resources and military (e.g. rank) and non-military (e.g. race/ethnicity) characteristics associated with using food distribution resources.

DESIGN

Secondary data analyses from a cross-sectional survey in the first 6 months of 2021.

SETTING

A national sample of eligible families completed an online survey.

PARTICIPANTS

8326 enlisted military families with an active duty service member in the United States Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association.

RESULTS

13·2 % of the families reported utilising a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilise such resources. Older (OR = 1·04, 95 % CI = 1·02, 1·05, P < 0·001), single-earner (OR = 0·73, 95 % CI = 0·61, 0·89, P = 0·001) families with a lower rank (OR = 0·69, 95 % CI = 0·64, 0·75, P < 0·001) and Army affiliation (compared with Air Force) (OR = 2·31, 95 % CI = 2·01, 2·67, P < 0·001) were more likely to utilise food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilise food distribution resources than White respondents (OR from 1·47 for multi-racial to 1·69 for Asians), as were families with more dependent children (OR = 1·35, 95 % CI = 1·25, 1·47, P < 0·001).

CONCLUSIONS

These results identify the extent of food distribution resource utilisation in military families with young children approximately 1 year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.

Household food insecurity during the COVID-19 pandemic is associated with anxiety and depression among US- and foreign-born adults: Findings from a nationwide survey

The COVID-19 pandemic led to significant disruptions to household food security with as many as 10.5 % of US households experiencing food insecurity during 2020. Food insecurity is associated with psychological distress including depression and anxiety. However, to the best of our knowledge, no study has analyzed the association between COVID-19 food insecurity and poor mental health outcomes by place of birth. The Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases national survey assessed the physical and psychosocial effects of social and physical distancing during the COVID-19 pandemic among a diverse population of US- and foreign-born adults. Multivariable logistic regression was used to assess the relationship between place of birth and food security status and anxiety (N = 4817) and depression (N = 4848) among US- and foreign-born individuals. Stratified models subsequently analyzed the associations between food security and poor mental health among US- and foreign-born populations separately. Model controls included sociodemographic and socioeconomic factors. Low and very low household food security were associated with greater odds of both anxiety (low: odds ratio (OR) [95 % confidence interval (CI)] = 2.07 [1.42-3.03]; very low: OR [95 % CI] = 3.35 [2.15-5.21]) and depression (low: OR [95 % CI] = 1.92 [1.33-2.78]; very low: OR [95 % CI] = 2.36 [1.52-3.65]). However, this relationship was attenuated among foreign-born individuals compared to US-born individuals in the stratified models. All models found a dose-response relationship between increasing levels of food insecurity and anxiety and depressive symptoms. Further research is needed to explore the factors that attenuated the relationship between food insecurity and poor mental health among foreign-born individuals.

Does the female-headed household suffer more than the male-headed from Covid-19 impact on food security? Evidence from Ethiopia

Covid-19 pandemic and accompanying policy measures affected women's economic and social lives differently from men. However, its effect on the food security situation of women and men remains unclear. This study investigated whether female-headed households suffer more from covid 19 impact on food security than male-headed households in Ethiopia using the World Bank High Frequency Phone Survey data. Food Insecurity Experience Scale (FIES) is applied to measure food insecurity and multilevel-mixed effect random intercept linear model is used to analyze the determinants. The survey data show that, during the pandemic in 2020, nearly 27% of households face moderate or severe food insecurity and close to 6% face severe food insecurity. Regression results revealed that the pandemic and accompanying policy measures affected food security of female-headed households differently from male-headed households. The likelihood of female-headed households experiencing moderate or severe food insecurity is significantly higher by 5.7% points than male-headed households. Education level of the household head is the critical determinant of women's food insecurity. Every additional year of education of female heads has a significantly higher impact in reducing the likelihood of experiencing food insecurity than that of male-headed households. It is also found that having access to basic food items reduces the likelihood of facing moderate or severe food insecurity by 7.4% points. Besides, education level of the household head, income change and family size are critical determinants for food insecurity of the sample households. It is recommended that stakeholders and policy makers focus in the gender aspect while designing policy measures to control pandemics and fucus on improving accessibility of basic needs such as food items to all.

Did Household Income Loss Have an Immediate Impact on Animal-Source Foods Consumption during the Early Stage of the COVID-19 Pandemic?

The outbreak of COVID-19 in 2020 caused extensive impact on household income and foods consumption. However, little attention has been paid to the immediate impact of income loss on animal-source foods consumption in the early stage of the COVID-19 pandemic. This paper aims to narrow this gap, and a total of 1301 valid samples of household food consumption surveys in Wuhan and Nanjing were obtained through specially designed online questionnaires. The surveys show that there were 69.6% (Wuhan) and 42.2% (Nanjing) of surveyed households whose animal-source foods consumption were affected, and there were 47.4% (Wuhan) and 18.9% (Nanjing) of surveyed households who suffered income loss. Furthermore, this paper makes an empirical study on the linkage between income loss and animal-source foods consumption. The results show that the pandemic affected household income, resulting in an immediate impact on animal-source foods consumption. This immediate impact may have been due to the combination of price increases, income loss and insufficient savings, which led to a "perfect storm" for animal-source foods consumption. Moreover, household income loss affected various animal-source foods consumption differently. For households suffering income losses, the odds of pork, beef and mutton, poultry, aquatic products, eggs and dairy products consumption being affected were increased by a factor of 1.894, 2.140, 2.773, 2.345, 1.802, 2.835, respectively, holding other variables constant. The results may be related to residents' consumption habits and food prices. During the COVID-19 pandemic, the reduction of animal-source foods consumption may have led to a state of tension concerning an increase in the development of nutrition intake and health, which may have led to increased food security risks.

Impact of COVID-19 on public social life and mental health: a statistical study of google trends data from the USA

The COVID-19 pandemic has caused a significant disruption in the social lives and mental health of people across the world. This study aims to asses the effect of using internet search volume data. We categorize the widely searched keywords on the internet in several categories, which are relevant in analyzing the public mental health status. Corresponding to each category of keywords, we conduct an appropriate statistical analysis to identify significant changes in the search pattern during the course of the pandemic. Binary segmentation method of changepoint detection, along with the combination of ARMA-GARCH models are utilized in this analysis. It helps us detect how people's behavior changed in phases and whether the severity of the pandemic brought forth those shifts in behaviors. Interestingly, we find that rather than the severity of the outbreak, the long duration of the pandemic has affected the public health status more. The phases, however, align well with the so-called COVID-19 waves and are consistent for different aspects of social and mental health. We further observe that the results are typically similar for different states as well.

Household living conditions and food insecurity in Nigeria: a longitudinal study during COVID-19 pandemic

OBJECTIVE

This study set out to investigate the risk of household food insecurity in Nigeria during the novel COVID-19 pandemic using a harmonised dataset of Nigeria's prepandemic face-to-face survey and two waves of the COVID-19 National Longitudinal Phone Survey (NLPS).

SETTING

Nigeria.

PARTICIPANTS

A representative sample of 1674 households is used in the analysis.

DESIGN

A longitudinal study.

RESULTS

Our longitudinal study reveals a significant increase in the prevalence of food insecurity in Nigeria during the COVID-19 crisis. For a sample of 1674 households used in the analysis, nearly 32% were moderately food insecure in the baseline survey (ie, the prepandemic period), compared with 74% and 72% that faced the same degree of food insecurity in the two waves of the COVID-19 phone survey. In like manner, not up to 4% of the households faced severe food insecurity in the prepandemic period, compared with 43% and 22% that experienced the same level of food insecurity during the period of the pandemic. Based on the available information in the dataset, we construct a composite non-monetary measure (or index) of household well-being and employ the binary logistic model to investigate the objects under study. The empirical results show that the well-being index has a strong negative association with household food insecurity. Further investigation reveals that the risk of being food insecure increases for households in relatively poor living conditions compared with those in the middle category and conversely declines for households in much better living conditions.

CONCLUSION

This study informs an understanding of the prevalence and risk of household food insecurity in Nigeria during the novel COVID-19 pandemic and provides insights that can guide policy actions in responding to the current wave of food crises in Nigeria.

Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic - findings from a pan-European study

HIGHLIGHTS

N =  4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic.The prevalence for probable posttraumatic stress disorder was 17.7%.We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

Financial Wellbeing and Quality of Life Among a Sample of the Lebanese Population: The Mediating Effect of Food Insecurity

Background

Lebanon is undergoing multiple overlapping crises, affecting the food security, financial well-being, and quality of life (QOL) of its residents.

Objective

The primary objective was to assess the food insecurity (FI) status of a sample of the Lebanese population. The second objective was to explore factors related to QOL parameters and evaluate the mediating effect of food security between financial well-being and QOL.

Methods

The study was cross-sectional and enrolled 412 participants recruited online using the snowball sampling technique. The survey included questions related to sociodemographic and economic characteristics of Lebanese households and validated scales to assess FI, QOL measures, financial well-being, and fear of COVID-19.

Results

Almost 43% of the study participants reported being food insecure, with 31% experiencing mild FI, 10% moderate FI, and 1.5% severe FI. Compared to food-insecure participants, food secure participants had a significantly higher income (58.5% vs. 39.2%, p < 0.001), a university education level (96.6% vs. 88.1%, p = 0.002), an average perceived financial status (83.9% vs. 65.9%), higher financial well-being scores (5.14 vs. 3.19, p < 0.001), and lower crowding index (0.94 ± 0.4 vs. 1.09, p = 0.002). Multivariate analysis showed that FI was not associated with physical (Beta = −1.48, 95% CI: −3.10; 0.13) and mental (Beta = −1.46, 95% CI −3.68; 0.75) QOL, after adjusting for other demographic and socioeconomic correlates. This association remained non-significant when introducing the financial well-being variable to the model. Mediation analyses showed that the FI variable mediated the association between financial well-being and physical QOL (Beta = 0.19, 95% CI: 0.02; 0.36), but not the mental QOL (Beta = −0.02, 95% CI: −0.20; 0.14).

Conclusion

Food insecurity was prevalent in our study sample, and it mediated the association between financial well-being and physical, but not mental, QOL parameters. These findings call for evidence-based policies and programs to help improve the food security and well-being of Lebanese households amidst these unprecedented circumstances.

Change in Employment Status Due to the COVID-19 Pandemic, SNAP Participation, and Household Food Insecurity among Black and Latino Adults in Illinois

The onset of the COVID-19 pandemic resulted in record-high unemployment rates. Black and Latino adults experienced disproportionately higher rates of unemployment. We aimed to examine associations between pandemic-related employment status change and household food insecurity among an economically diverse sample of Black and Latino adults in Illinois during the early months of the COVID-19 pandemic. Furthermore, we evaluated the significance of Supplemental Nutrition Assistance Program (SNAP) participation to determine if it modified associations. We analyzed cross-sectional data collected from 1,809 Black and Latino adults in two waves: May 2020 and June/July 2020. Participants listed their change in employment status as “lost job entirely”, “employed, but paid hours reduced”, “employed, but anticipate job lost”, or “no change”. Participants self-reported their SNAP status and completed the USDA’s six item U.S. Food Security Module to report household food security status. We used logistic regression to assess the significance of associations after controlling for socio-demographics. Approximately 15.5% of participants lost their job entirely, 25.2% were SNAP participants, and 51.8% reported low food security (LFS). All changes in employment were significantly associated with increased odds of LFS after adjusting for socio-demographics. SNAP participants who lost their job had higher odds of LFS (OR: 4.69; 95% CI: 2.69–8.17) compared to non-participants who lost their job (OR: 2.97; 95%: 1.95–4.52). In summary, we observed strong associations between changes in employment and household food insecurity, particularly among SNAP participants, which underscores the pandemic’s impact on low-income and minority populations.

The association of COVID-19 vaccine availability with mental health among adults in the United States

OBJECTIVE

To assess whether COVID-19 vaccine approval and availability was associated with reduction in the prevalence of depression and anxiety among adults in the United States.

METHODS

We adopted cross sectional and quasi-experimental design with mental health measurements before vaccine availability (June 2020, N = 68,009) and after vaccine availability (March 2021, N = 63,932) using data from Census Pulse Survey. Depression and anxiety were derived from PHQ-2 and GAD-2 questionnaires. We compared rates of depression and anxiety between June 2020 and March 2021. Unadjusted and adjusted analysis with replicate weights were conducted.

RESULTS

Depression prevalence was 25.0% in June 2020 and 24.6% in March 2021; anxiety prevalence was 31.7% in June 2020 and 30.0% in March 2021 in the sample. In adjusted analysis, there were no significant differences in likelihood of depression and anxiety between June 2020 and March 2021.

CONCLUSION

Depression and anxiety were not significantly different between June 2020 and March 2021, which suggests that the pandemic effect continues to persist even with widespread availability of vaccines.