Abstract
To estimate the association between food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. Cross-sectional study. Multiple logistic regression models were used to estimate the associations between food insufficiency and mental health service utilisation. US Census Household Pulse Survey data collected in October 2020. Nationally representative sample of 68611 US adults. After adjusting for sociodemographic factors, experiencing food insufficiency was associated with higher odds of unmet mental health need (adjusted OR (AOR) 2·90; 95 % CI 2·46, 3·43), receiving mental health counselling or therapy (AOR 1·51; 95 % CI 1·24, 1·83) and psychotropic medication use (AOR 1·56; 95 % CI 1·35, 1·80). Anxiety and depression symptoms mediated most of the association between food insufficiency and unmet mental health need but not the associations between food insufficiency and either receiving mental health counselling/therapy or psychotropic medication use. Clinicians should regularly screen patients for food insufficiency, especially in the wake of the COVID-19 pandemic. Expanding access to supplemental food programmes may help to mitigate the need for higher mental health service utilisation during the COVID-19 pandemic.
Highlights
Unmet mental health need, receiving mental health counselling and psychotropic medication use were higher among people with food insufficiency compared with those without food insufficiency
In models adjusting for sociodemographic factors, experiencing food insufficiency was associated with an unmet mental health need, receiving mental health counselling or therapy and psychotropic medication use
We find that anxiety and depression symptoms mediate 76·1 % of the association between food insufficiency and unmet mental health need
Summary
On the Census Bureau website, along with additional details about the Household Pulse Survey study and data collection process[24]. Independent variables Participants were asked, ‘In the last 7 d, which of these statements best describes the food eaten in your household?’ Response options included ‘Enough of the kinds of food (I/we) wanted to eat’, ‘Enough, but not always the kinds of food (I/we) wanted to eat’, ‘Sometimes not enough to eat’ and ‘Often not enough to eat’ The former two response options were coded as food sufficient, while the latter two were coded as food insufficient, consistent with the US Household Food Security Survey Module[25]. Examined the extent to which depression and anxiety symptoms mediated the association between food insecurity and mental health service utilisation[27]. Analyses were conducted using Stata 15.1 (StataCorp.) in 2021
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