Abstract
Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. The research databases PubMed, EMBASE, and psycINFO were searched using keywords capturing food insecurity, mental health, and women. Thirty-nine articles (representing 31 unique studies/surveys) were identified. Three-quarters of the articles drew upon data from a version of the United States Department of Agriculture Household Food Security Survey Module. A range of mental health measures were used, most commonly to measure depression and depressive symptoms, but also anxiety and stress. Most research was cross-sectional and showed associations between depression and food insecurity; longitudinal analyses suggested bidirectional relationships (with food insecurity increasing the risk of depressive symptoms or diagnosis, or depression predicting food insecurity). Several articles focused on vulnerable subgroups, such as pregnant women and mothers, women at risk of homelessness, refugees, and those who had been exposed to violence or substance abuse. Overall, this review supports a link between food insecurity and mental health (and other factors, such as housing circumstances and exposure to violence) among women in high-income countries and underscores the need for comprehensive policies and programs that recognize complex links among public health challenges.
Highlights
Food insecurity is a growing and persistent concern in high-income countries [1,2]
The majority (n = 34) analyzed data from studies conducted in the United States, three focused on studies conducted in Canada [16,17,32], one was focused on a sample in New Zealand [43], and one was conducted in England [44]
All studies assessed the association between food insecurity and a mental health condition or state in some manner, the particular research questions and analytic approaches varied
Summary
Food insecurity is a growing and persistent concern in high-income countries [1,2]. In NorthAmerica, rates of household food insecurity have remained stable or risen in the last several years [3,4].High rates have been documented in the UK and Australia [5,6]. According to the Food and Agriculture Organization, “food security exists when all people, at all times, have physical, social, and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life” [7].Conceptualizations of food insecurity in high-income countries primarily focus on the economic aspect; for example, the Household Food Security Survey. Module (HFSSM) [8], which is commonly used in the United States and Canada, measures uncertain or inadequate access to food due to financial constraints. This conceptualization aligns with literature linking vulnerability to food insecurity to high rates of poverty, among population subgroups, such as single-parent households, racial/ethnic minorities, and those relying on social assistance [2–4,9–13]. Public Health 2018, 15, 1424; doi:10.3390/ijerph15071424 www.mdpi.com/journal/ijerph
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