Food Insecurity and Affective Well-Being in Low-Income Adults: An Ecological Momentary Assessment Study Over Two Months

Abstract

Abstract Objectives Food insecurity is a dynamic phenomenon within a given month and across seasons. It remains unknown how food insecurity influences low-income adults’ day-to-day affective well-being, which is associated with long-term mental and physical health. In this pilot study, we explored the association between daily food insecurity and affect over a 2-month period (spanning 2 seasons) in a sample of low-income adults in Central Pennsylvania. Methods A total of 22 healthy low-income adults were recruited during the fall months (September, October, or November) in 2019, 18 of whom were also followed in the winter months (February or March) in 2020. Using an ecological momentary assessment framework administered on smart phones over a three-week-long wave (2nd – 4th week) in each survey month, daily food insecurity (once daily), and positive and negative affect (5 times daily) were collected. Time Varying Effect Models were used to estimate the association between levels of daily food insecurity and daily aggregated positive/negative affect as a function of study day, adjusting for gender, race/ethnicity, employment, and poverty status. Results A total of 713 person-days (84.9% of what was possible) of daily-level data was collected. Food insecurity was reported in 42.9% and 36.0% of participants in the fall and winter months, respectively. Greater daily food insecurity was associated with significantly lower positive affect scores in the 3rd week of the fall months (β ranged from −1.40 (95% CI −2.62, −0.18) to −3.17 (95% CI: −5.93, −0.42)) and in the 4th week of the winter months (β ranged from −2.24 (95% CI: −4.08, −0.39) to −2.84 (95% CI: −4.28, −1.40)). No consistent association was identified between daily food insecurity and negative affect. Conclusions Daily food insecurity was associated with lower positive affect in the second half of the months in both fall and winter seasons. Future large observational studies should verify our study findings in order to better identify, target, and intervene in food insecure adults who are at-risk of adverse mental health outcomes. Funding Sources The National Center for Advancing Translational Sciences, National Institutes of Health (UL1TR002014) and the Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention.