Food Insecurity and Mental Health Status Among Immigrants in High-Income Countries Between 2014–2017

Abstract

Abstract Objectives To assess the prevalence and trend of food insecurity (FI), mental wellbeing and their associations in the understudied immigrants living in high-income countries between 2014–2017. Methods Using nationally representative Gallup World Poll data from 2014 to 2017, a total of 15,343 immigrants from 48 World Bank defined high-income countries were included. Individual FI status was measured by the Food Insecurity Experience Scale (FIES) and categorized into food secure and mild, moderate and severe FI groups. Mental wellbeing was assessed by the Negative Experience Index (NEI, the greater the worse) and the Positive Experience Index (PEI, the greater the better). Multiple linear regression models were used to examine the association between FI and NEI/PEI, adjusting for age, gender, marital status, education, employment status, annual household income, residency, household size, and the number of children younger than 15 y in the household. Results The prevalence of FI in immigrants decreased from 38.4% in 2014 to 28.9% in 2017 globally (p-trend <0.001). During 2014–2017, the overall mental wellbeing in immigrants improved as the mean (SD) NEI decreased from 32.8 (1.1) to 27.8 (0.5) and PEI increased from 63.1 (1.1) to 73.2 (0.5), respectively (both p-trend <0.001). In the pooled adjusted model, FI was dose-responsively associated with greater NEI in mild (12.8 [11.7, 14.1]), moderate (20.5 [18.7,22.3]), and severe FI groups (28.3 [26.1, 30.5]) as compared to the food secure referent. By year analyses revealed that the gap in NEI between immigrants in the severe FI and food secure group widened by ∼10 points from 22.7 [14.7, 30.8] in 2014 to 32.3 [28.24, 36.38] in 2017. The dose-responsive association and its trend over time was less clear in PEI. Conclusions Progressive FI is significantly associated with poor mental wellbeing among immigrants in high income countries. Despite the improvement in food security and mental health status in immigrants, severely food insecure immigrants have had worsened mental wellbeing in recent years. Future policies are required to address disparities in food access and mental health in vulnerable immigrants. Funding Sources FAO's Voices of the Hungry Project for having granted access to the full GWP data set and supporting materials, which allowed the present study to be conducted.