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Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.

ABSTRACT: Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19-24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=1,476). Food security status was measured using the 18-question USDA Household Food Security Module. Multivariable-adjusted logistic regression models examined the association between food insecurity and psychological distress outcomes and COVID-19-specific worries. Qualitative data from an open-response question were also analyzed. Results: More than one-third of low-income adults screened positive for depression (33%), anxiety (39%), and high stress (39%). Greater food insecurity was associated with a dose-response relationship with all psychological distress outcomes (all outcomes p-trend <0.001) and COVID-19-specific worries (all outcomes p-trend <0.001). Compared to food-secure adults, adults with very low food security were more likely to screen positive for depression (odds ratio [OR] 7.72; 95% confidence interval [CI]: 5.52-10.80), anxiety (OR 6.19; 95% CI: 4.51-8.51), and high perceived stress (OR 10.91; 95% CI: 7.78-15.30). Very low food security was also associated with increased worries about the effect of COVID-19 on one's health (OR 2.56; 95% CI: 1.90-3.45), income (OR 5.18; 95% CI: 3.78-7.06), and ability to feed one's family (OR 9.24; 95% CI: 6.61-12.92). Conclusions: The COVID-19 pandemic is negatively associated with the mental health of low-income adults in the United States, with disproportionate associations among adults experiencing food insecurity. These disparities have the potential to increase mental health disparities over the long term.

SUBMITTER: Wolfson JA

PROVIDER: S-EPMC7929913 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.

Wolfson Julia A JA Garcia Travertine T Leung Cindy W CW

Health equity 20210225 1

Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19-24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=1,476). Food security status was measured using the 18-question USDA Household Food Security Module. Multivariable-adjusted logis ...[more]

PMID: 33681691

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Project description:BackgroundFood insecurity, lack of consistent access to the food needed for an active, healthy life, harms population health. Although substantial biomedical evidence examines the connections between food insecurity and health, fewer studies examine why food insecurity occurs.MethodsWe propose a conceptual understanding of food insecurity risk based on institutions that distribute income-the factor payment system (income distribution stemming from paid labor and asset ownership), transfers within households, and the government tax-and-transfer system. A key feature of our understanding is 'roles' individuals inhabit in relation to the factor payment system: child, older adult, disabled working-age adult, student, unemployed individual, caregiver, or paid laborer. A second feature is that the roles of others in an individual's household also affect an individual's food insecurity risk. We tested hypotheses implied by this understanding, particularly hypotheses relating to role, household composition, and income support programs, using nationally-representative, longitudinal U.S. Current Population Survey data (2016-2019).ResultsThere were 16,884 participants (year 1 food insecurity prevalence: 10.0%). Inhabiting roles of child (Relative Risk [RR] 1.79, 95% Confidence Interval [95%CI] 1.67 to 1.93), disabled working age-adult (RR 3.74, 95%CI 3.25 to 4.31), or unemployed individual (RR 3.29, 95%CI 2.51 to 4.33) were associated with a greater risk of food insecurity than being a paid laborer. Most food insecure households, 74.8%, had members inhabiting roles of child or disabled working age-adult, and/or contained individuals who experienced job loss. Similar associations held when examining those transitioning from food insecurity to food security in year 2.ConclusionsThe proposed understanding accords with the pattern of food insecurity risk observed in the U.S. An implication is that transfer income programs for individuals inhabiting roles, such as childhood and disability, that limit factor payment system participation may reduce food insecurity risk for both those individuals and those in their household.

Dataset Information

Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.

Publications

Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.

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