Food insecurity and mental health: Surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis

Abstract

The 2008 food crisis may have increased household food insecurity and caused distress among impoverished populations in low-income countries. Policy researchers have attempted to quantify the impact that a sharp rise in food prices might have on population wellbeing by asking what proportion of households would drop below conventional poverty lines given a set increase in prices. Our understanding of the impact of food crises can be extended by conducting micro-level ethnographic studies. This study examined self-reported household food insecurity (FI) and common mental disorders (CMD) among 110 community health AIDS care volunteers living in Addis Ababa, Ethiopia during the height of the 2008 food crisis. We used generalized estimating equations that account for associations between responses given by the same participants over 3 survey rounds during 2008, to model the longitudinal response profiles of FI, CMD symptoms, and socio-behavioral and micro-economic covariates. To help explain the patterns observed in the response profiles and regression results, we examine qualitative data that contextualize the cognition and reporting behavior of AIDS care volunteers, as well as potential observation biases inherent in longitudinal, community-based research. Our data show that food insecurity is highly prevalent, that is it associated with household economic factors, and that it is linked to mental health. Surprisingly, the volunteers in this urban sample did not report increasingly severe FI or CMD during the peak of the 2008 food crisis. This is a counter-intuitive result that would not be predicted in analyses of population-level data such as those used in econometrics simulations. But when these results are linked to real people in specific urban ecologies, they can improve our understanding of the psychosocial consequences of food price shocks.

Coping and the biosocial consequences of food insecurity in the 21st century

“…Subsequent work in Ethiopia showed a similar effect: even after controlling for a wide range of covariates, food insecurity was associated with nearly three times greater odds of scoring high on symptoms of anxiety and depression . In an urban developing country context, Maes et al (2010) explored links between symptoms of common mental disorders and food insecurity among a cohort of low-income volunteer health workers. This study indicated a cleardose response relationship between measures of mental health and the HFIAS.…”

Examining health-care volunteerism in a food- and financially-insecure world

“…3,4 Further, many volunteers involved in the struggle to roll out antiretroviral therapies say that they derive spiritual satisfaction and meaningful relationships by helping others. 5 Thus from this perspective, community health programmes have the potential to generate psychosocial and health "capital" derived from volunteers' pro-social motivations. This is a far cry from straightforward labour exploitation.…”

Food Insecurity Is Associated with Greater Acute Care Utilization among HIV-Infected Homeless and Marginally Housed Individuals in San Francisco

“…13,14 Food insecurity, the limited availability of nutritionally adequate or safe food, or the inability to procure food in socially acceptable ways, 15 is an important form of socioeconomic marginalization. In the general population, food insecurity has been associated with many adverse health impacts, including poor nutritional status, [16][17][18][19][20][21] depression, [22][23][24][25][26] suicidal ideation, 26 obesity, 27 and increased cardiovascular risk. 28,29 Cross-sectional studies among non-HIV infected individuals in the US found that food insecurity is associated with postponing needed medications and care, increased emergency department use, and increased hospitalizations.…”