Does food security predict poor mental health?

Abstract

Purpose The purpose of this paper is to assess food security as a risk factor in the development of poor mental health among younger populations in the USA over an eight-year period using a nationally representative cross-sectional sample. Design/methodology/approach Using data from individuals who participated in the National Health and Nutrition Examination Survey between 2005 and 2012, respondents were classified as either having “poor mental health” or “good mental health.” Multivariate logistic regression models based on this dichotomy are employed to estimate the odds ratios in the association of household food security and mental health using three cut-off points that correspond to these models. Findings Respondents from very low food security had higher odds (OR=2.06, p<0.0001; OR=1.98, p<0.0001; OR=1.94, p=0.01) of suffering from poor mental health compared with participants from fully food secure households. These findings indicate the robustness of the results across all three separate regression models. Research limitations/implications Causality cannot be determined from the cross-sectional design. Although potential endogeneity could invalidate the conclusions, these findings inform public policy that food security is a contributory factor in the development of poor mental health at an early age. It suggests that interventions to alleviate food insecurity could improve mental health among younger populations in the USA. Originality/value Several cut-off points are developed to distinguish between “poor” and “good” mental health to assess the robustness of the findings. This approach has the potential to minimize the misclassification of mental health outcomes. Very low food security is a strong predictor of poor mental health regardless of the cut-off point used.

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

“…Within the three models that included the food security indicators the first model included only one measure of financial resources, an indicator that household income was below 130% FPL, to be consistent with previous research that most commonly only includes an indicator of income [ 12 , 14 , 15 , 16 , 17 , 29 ]. The second model includes additional measures of financial resources including the indicator for renting a home, losing a job during pandemic, changes in monthly income, use of savings, utilizing charitable food sources, and receiving a coronavirus stimulus check.…”

“…However, there is generally limited consideration for the influence of financial resources when examining the relationship between food security and mental health. Prior research tends to only control for income level or employment status [ 12 , 13 , 14 , 15 , 16 , 17 ], and only a few studies control for additional measures of financial resources, such as job or income loss, and participation in government safety net programs [ 18 , 19 ].…”

“…However, Fang et al (2021) [ 18 ] only used a binary indicator of food insecurity. This specification of the food security variable limited their ability to investigate a potential gradient in the influence of food security status on mental health that has been identified in previous literature, including during the pandemic [ 12 , 16 , 17 ].…”

Investigating the prevalence and predictors of food insecurity: a comparison of HFSSM and EU-SILC indicators

“…This finding provides a contribution to the literature on financial difficulty and health, previously identified as lacking (French and McKillop, 2017). However, although poor physical and mental health was statistically associated with food insecurity, it is unclear whether this association is causal or whether it is a consequence of being food insecure (Butcher et al , 2018), and it must be recognised that there are many other compounding factors which could also explain this association (Tevie and Shaya, 2018). Nonetheless, it is known that food insecurity can create new and exacerbate existing, health problems (Thompson et al , 2018; Mattheys et al , 2018).…”

Chronic disease treatment seeking and depression

“…However, few population-based studies investigating the negative effect of depression on medical treatment seeking in people with chronic conditions have been completed in countries with limited economic resources. Population-based research is especially important for these countries where mental health services are not readily available (Wilson et al, 2014) and where new policy initiatives are needed (see Tevie and Shaya, 2018). Pakistan only has an estimated 9.76 medical doctors per 10,000 people, 0.31 psychiatrists per 100,000 and spends 2.7 per cent of its GDP on health; compared to 28.06, 14.63 and 9.9 per cent for the UK (World Health Organization, 2015, 2017.…”