The bad, the ugly and the monster behind the mirror - Food insecurity, mental health and socio-economic determinants

Abstract

IntroductionFood insecurity is associated with poor mental health outcomes, including depression and anxiety and COVID-19 could increase these relations. In this sense, we aimed to explore the relationship between food insecurity and mental health features and behaviors in adults from Portugal. MethodologyWe conducted a cross-sectional online snowball study from November 2020 until February 2021. A total of 882 Portuguese residents 18 years of age or older with food security data were included. Data on socio-demographics, food security status, and anxiety and depression symptoms were collected. Crude and adjusted logistic regression models were performed. Odds ratio (OR) and respective 95% confidence intervals (CI) were estimated. ResultsMost participants were women (71.3%), with a mean (SD) age of 36.8 (10.9) years, three-thirds had a university degree (76.7%), and 65.3% lived in the country's northern region. Regarding the characteristics associated with food insecurity, we observed that less-educated participants (OR = 7.84; 95% CI: 3.67–16.73), with depression symptoms (OR = 5.91; 95% CI: 3.12–11.19) and with anxiety symptoms (OR = 6.41; 95% CI: 3.02–13.59), had a higher odds of belonging to a food-insecure household. After adjustments less educated individuals (OR = 8.37; 95% CI: 3.81–18.35), those who faced a reduction in income (OR = 0.27; 95% CI: 0.13–0.53) and, presenting anxiety symptoms (OR = 7.32; 95% CI: 3.53–15.17) had a higher odds of belonging to a food-insecure household. ConclusionsApproaching food insecurity without addressing mental health, and the opposite is making partial and reductive interventions. It is important to have an integrative approach.