Moderation of the Association Between Individual Food Security and Poor Mental Health by the Local Food Environment Among Adult Residents of Flint, Michigan.

Rachel S Bergmans,Daniel Kruger,Andrew D Jones,Richard C Sadler,Julia A Wolfson

doi:10.1089/heq.2018.0103

Rachel S Bergmans, Daniel Kruger + Show 3 more

Open Access

https://doi.org/10.1089/heq.2018.0103

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Abstract

Purpose: Food insecurity is a psychosocial stressor with deleterious effects on mental health. This study examined whether the local food environment moderates the association of individual food insecurity with poor mental health.Methods: Cross-sectional survey data were collected from adult residents of Flint, Michigan (n=291), in 2015. Multivariate logistic models assessed whether quality of the local food environment moderated the relationship of food insecurity with poor mental health. A binary indicator of poor mental health was created. Participants were asked to rate their overall “mental or emotional health” using a 5-point Likert scale. Individuals were classified as having either good mental health (i.e., ratings of good, very good, or excellent) or poor mental health (i.e., ratings of fair or poor).Results: In fully adjusted models, food insecurity was associated with 3.2 (95% confidence interval [CI]: 1.6–6.2) times higher odds of poor mental health. However, increased proximate access to vegetables and fruits moderated this association. For example, those in the bottom 25th percentile of access to vegetables had 7.4 (95% CI: 2.7–20.5) times higher odds of poor mental health. In contrast, for those in the top 25th percentile of vegetable access, food insecurity was only marginally associated with poor mental health (odds ratio=2.2; 95% CI: 1.0–4.7).Conclusion: Greater proximate access to vegetables and fruits moderated food insecurity's association with poor mental health. Longitudinal evaluation of programs and policies that improve availability of nutrient-rich foods in food insecure communities is needed to determine whether they yield a mental health benefit.

Highlights

Poor mental health is among the most debilitating consequences of food insecurity,[1] including acute psychological pain, anxiety, shame, and depression.[2]While the link between food insecurity and depression has been demonstrated independent of other socioeconomic resources,[3] evidence-based strategies that reduce the impact of food insecurity on mental health are not well established
This study examines the extent to which the quality of local food environment moderates the link between food insecurity and mental health among adult residents of Flint, Michigan
Speak to Your Health (STYH) was approved by the University of Michigan Institutional Review Board for Health and Behavioral Sciences and permission was granted by the STYH survey Committee to use these data for the analyses presented in this study

Summary

Introduction

Poor mental health is among the most debilitating consequences of food insecurity,[1] including acute psychological pain, anxiety, shame, and depression.[2]. While the link between food insecurity and depression has been demonstrated independent of other socioeconomic resources,[3] evidence-based strategies that reduce the impact of food insecurity on mental health are not well established. In the United States, roughly 12% of the population faces some level of food insecurity, and rates are even higher—upwards of 20%— among non-white households.[4] Identifying modifiable community-level characteristics that moderate the influence of food insecurity on mental health a Rachel S.

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