Food Insufficiency Research Articles

Government Employees’ Experience and Expectation of COVID-19 Hardships: The Moderating Role of Gender and Race in the United States

This article examines government employees’ experience and expectation of socioeconomic hardships during the COVID-19 pandemic—employment income loss, housing instability, and food insufficiency—by focusing on the role of gender and race. Employing the Household Pulse Survey, a nationally representative and near real-time pandemic data deployed by the U.S. Census Bureau, we find that government employees were less affected by the pandemic than non-government employees across socioeconomic hardships. However, female and racial minorities, when investigated within government employees, have a worse experience and expectation of pandemic hardships than men and non-Hispanic Whites. Our findings suggest a clear gender gap and racial disparities in the experience and expectation of pandemic hardships.

The Mental Health Outcomes of Food Insecurity and Insufficiency in West Africa: A Systematic Narrative Review.

(1) Background: Food insufficiency is a global pandemic affecting many people, especially those residing in developing countries. African countries have been affected by food insufficiency, which is mostly caused by drought or wars. Famine or food insufficiency has been reported to have an impact on the psychological health and quality of life of people affected. This review assessed the mental health outcomes of famine and food insufficiency in West Africa. (2) Methods: A search of the published literature was conducted using PubMed, PsycExtra, Medline, and PsycINFO databases. The search was limited to papers published in English between the years 2010 and 2020. Two reviewers independently screened the titles and abstracts of the retrieved papers using pre-defined inclusion and exclusion criteria and a third reviewer resolved conflicts. Data were extracted and appraised using a data extraction form and an appraisal checklist. (3) Results: A total of 81 papers were identified through the journal databases search. Out of the seven papers that met the inclusion criteria, six papers used cross-sectional designs and one paper used an experimental design. The six papers used quantitative approach for data collection, while the one paper used a qualitative technique. The evidence synthesized from this review indicated that exposure to food insecurity or insufficiency is associated with increased psychological distress including anxiety, sleeplessness, intellectual disability, general mental, and emotional instability. (4) Conclusions: This review strongly highlights the need for further research across the sub-region. It further suggests that famine and food insufficiency are associated with significant mental health problems in adults and impacts the cognitive and intellectual development of children. Although there is paucity of literature about famine and its impact on mental health in West Africa, these findings are important for developing social policy initiatives for increasing food supply and mental health interventions for all ages.

Longitudinal Analysis of Food Insufficiency and Cardiovascular Disease Risk Factors in the CARDIA study

Most previous studies on food insecurity and cardiovascular disease risk factors are cross-sectional. Without longitudinal data, it is unclear whether food insecurity precedes poor health and how exposure timing impacts these relationships. Data from 2000 to 2001, 2005 to 2006, and 2010 to 2011 of the Coronary Artery Risk Development in Young Adults study were used. Food insufficiency-a screener measure related to food insecurity-was assessed in 2000-2001 and 2005-2006 using a single item. Cardiovascular disease risk factors were objectively assessed in 2010-2011. Impacts of food insufficiency patterns (food sufficient, food insufficient in 2000-2001 only, food insufficient in 2005-2006 only, food insufficient in both 2000-2001 and 2005-2006) on cardiovascular disease risk factors were estimated using inverse probability weighting of marginal structural models. Covariates that change over time were adjusted for using stabilized weights; baseline covariates were adjusted for in the marginal structural models. Analyses were conducted in 2020-2021. The baseline sample included 2,596 participants (56% women, 47% White). In unadjusted analyses, all food insufficiency patterns were associated with higher BMI, waist circumference, and blood pressure than food sufficiency. After accounting for covariates, estimates were attenuated but still consistent with adverse effects of food insufficiency, particularly among women. After covariate adjustment, food insufficiency was associated with several cardiovascular disease risk factors. Findings from this study should be replicated in other settings and populations. If verified, this evidence could provide justification for intervening in food insecurity to reduce future cardiovascular disease risk.

Mediated Relationships between Supplemental Nutrition Assistance Program Benefits, Food Hardships, Health Status, and Emergency Department Use Among Low‐Income Children with and without Special Health Care Needs

Research ObjectiveThe Supplemental Nutrition Assistance Program (SNAP) has been found to reduce food hardships, which are associated with poor health and health care outcomes among children. Evidence that SNAP improves adult health and healthcare outcomes is growing, but studies including children have been limited. The need to assess these potential relationships among children with special health care needs (SHCN) is particularly pronounced, given their heightened social and health care complexity. We therefore aimed to (i) examine relationships between SNAP, food hardships, health status, and health care use among children, and (ii) examine whether SHCN status modified any of these relationships.Study DesignTo estimate the relationship between SNAP and food hardships, we followed prior studies in using a bivariate probit model with state‐level SNAP administrative policies as instruments (to account for disproportionate self‐selection into SNAP among households with high food hardships). We estimated this model within a structural equation modeling framework to simultaneously estimate downstream associations with health status and health care use. Household food insufficiency (FI) and excellent health status (versus very good, good, fair, or poor; a robust dichotomization among children) were modeled as mediators of the relationship between any SNAP receipt and any emergency department (ED) use over the prior year. We interacted SHCN status with SNAP to assess modification, and we adjusted for sociodemographic and environmental variables (e.g., exposure to smoking). Associations were estimated as the combination of direct and indirect effects. Predicted probabilities were calculated for interpretability.Population StudiedUsing pooled 2016, 2017, and 2018 National Survey of Children's Health data (nationally representative), we examined 17,791 children in households with income below 150% of the federal poverty level (a cutoff used in prior studies), 4710 of whom had SHCN based on a validated instrument.Principal FindingsSNAP was associated with: decreased FI likelihood, increased excellent health status likelihood, and decreased ED use likelihood; SHCN status was associated with an increase in the magnitude of each of these relationships. All associations had p‐values ≤0.001. See table: FI Excellent Health Status ED Use Total No SHCN SHCN Total No SHCN SHCN Total No SHCN SHCN No SNAP 65% 63% 73% 46% 54% 22% 35% 29% 53% SNAP 32% 31% 35% 66% 74% 45% 21% 16% 33% Δ −33 −32 −37 +20 +20 +22 −14 −13 −19 ΔΔ −5 +3 −7 Δ: difference in percentage points (pp), SNAP vs. no SNAP ΔΔ: difference‐in‐difference in pp; (SNAP vs. no SNAP if SHCN) vs. (SNAP vs. no SNAP if no SHCN) ConclusionsSNAP was associated with significant beneficial effects regarding a child's likelihood of experiencing FI, excellent health status, and ED use, with even more beneficial effects found for children with SHCN.Implications for Policy or PracticeThough an incomplete solution, SNAP may improve child health and healthcare outcomes, particularly for children with elevated vulnerabilities. Greater investments in food hardship relief by healthcare systems (e.g., SNAP enrollment assistance, food Rx programs) and policymakers (e.g., increased SNAP benefits, reduced enrollment barriers) may pay substantial dividends in improved outcomes for these populations and the health systems providing them care.Primary Funding SourceNational Institutes of Health.

Associations of household food insufficiency with childhood depression and anxiety: a nationwide cross-sectional study in the USA

ObjectiveHousehold food insufficiency (HFIS) is a major public health threat to children. Children may be particularly vulnerable to HFIS as a psychological stressor due to their rapid growth and accelerated...

Historical Features Regarding the Neuropathic Outbreaks in Brazilian Troops in the Paraguayan War.

During the Paraguayan War, Brazilian army and navy officers attributed outbreaks of combatant limb weakness with particular features such as tingling to palustrian causes. A dietary basis was not fully suspected at the time, and the popular name beriberi had not been coined. During wartime, there was a shortage in the food supply in addition to poor environmental conditions and diarrheal diseases, and many reports of "palustrian cachexia" were made. There are also reports of the use of native flora to feed troops, as well as alcoholism. There are also accounts of the death of horses with symptoms similar to those of combatants. It was reported that black soldiers were more resistant to "palustrian cachexia." This article presents the disease ecology and clinical manifestations of beriberi at wartime, linked to starvation and consumption of pickled food and native flora. These military explorations and operations in the Paraguayan War happened more than 150 y ago and present some aspects of wilderness medicine in the past.

Histories of Urban Deltascapes: A Comparison of Arles and Kolkata

Abstract Delta cities are exposed to cycles of fluvial risks that have been managed across space and time. Floods and flood mitigation in urban deltascapes are therefore dependent on territorial and historicised dynamics. This paper uses historical urban political ecology (HUPE) to unravel the changing interactions between biophysical and political-economic processes affecting urban deltascapes in particular periods from the sixteenth century onwards. We present two case studies: Arles (on the Rhône Delta, France) and Kolkata (on the Bengal Delta, India). Our empirical findings point to the influence of connected global processes and to similarities in historical trajectories. In particular, both case studies reveal state efforts to 'fix' the fluid deltascape originally managed by local institutions, altered flood vulnerabilities (in terms of frequency, intensity and space), and more recent initiatives of mediation between interest groups. Through this unexpected comparison, more generally, we aim to contribute to a (global) environmental history that is sensitive both to local specificities and complexities and to the influence of global processes.

From Wetlands to Farmlands: A Campaign Against Nature on China's Chongming Island, 1960-1962

Abstract To confront food insufficiency caused by the Great Leap Forward, China's central government promoted a national policy of 'agriculture as the priority'. The Shanghai municipal government launched a campaign to expand cultivated land within its jurisdiction by transforming wetlands on Chongming Island through a military-style campaign. Tens of thousands of urban workers were drafted into a Land Reclamation Army to meet national and municipal food self-sufficiency goals. Their campaign featured both attacks on nature and interpersonal abuse. In accordance with the central directives, wetlands totalling 8,000 hectares were drained for conversion into farmland. This conversion proved to be costly, as land with low fertility was created through the permanent destruction of the wetland ecosystem and reclamation workers suffered physical and psychological mistreatment. Although the transformation of wetlands was completed quickly, food production fell far short of targets. Furthermore, the land reclamation campaign imposed irrevocable costs on the island's established communitiesotivations in authoritarian regimes operating diverse political and economic agendas.

Current and Future Food Insufficiency During Covid-19: Examining Disparities by Race/Ethnicity and Recent Work Loss

The Covid-19 pandemic, which began in early 2020, has eroded the previous decade’s reductions in food insecurity. Pandemic-related food insufficiency has been concentrated among Black and Hispanic households and those who have experienced a recent work loss. Households with children are particularly vulnerable. Using the first twenty-one weeks of the US Census Bureau’s Household Pulse Survey data from April 2020 through December of 2020, we examine the association between recent work losses and food insufficiency and document the extent to which the impact varies by race/ethnicity. Work loss is predictive of current and future food insufficiency, with the association most acutely experienced by Blacks and Hispanics and households with children. There is evidence of racial/ethnic disparities in current and future food insufficiency. The results provide insight into how the pandemic has widened racial/ethnic gaps in the experience of food insufficiency despite recent policy interventions.

Barriers to Accessing Healthy Food and Food Assistance During the COVID-19 Pandemic and Racial Justice Uprisings: A Mixed-Methods Investigation of Emerging Adults’ Experiences

BackgroundA steep rise in food insecurity is among the most pressing US public health problems that has resulted from the COVID-19 pandemic. ObjectiveThis study aimed to (1) describe how food-insecure emerging adults are adapting their eating and child-feeding behaviors during COVID-19 and (2) identify barriers and opportunities to improve local food access and access to food assistance. DesignThe COVID-19 Eating and Activity Over Time study collected survey data from emerging adults during April to October 2020 and completed interviews with a diverse subset of food-insecure respondents. Participants/settingA total of 720 emerging adults (mean age: 24.7 ± 2.0 years; 62% female; 90% living in Minnesota) completed an online survey, and a predominately female subsample (n = 33) completed an interview by telephone or videoconference. Main outcome measuresSurvey measures included the short-form of the US Household Food Security Survey Module and 2 items to assess food insufficiency. Interviews assessed eating and feeding behaviors along with barriers to healthy food access. Analyses performedDescriptive statistics and a hybrid deductive and inductive content analysis. ResultsNearly one-third of survey respondents had experienced food insecurity in the past year. Interviews with food-insecure participants identified 6 themes with regard to changes in eating and feeding behavior (eg, more processed food, sporadic eating), 5 themes regarding local food access barriers (eg, limited enforcement of COVID-19 safety practices, experiencing discrimination), and 4 themes regarding barriers to accessing food assistance (eg, lack of eligibility, difficulty in locating pantries). Identified recommendations include (1) expanding the distribution of information about food pantries and meal distribution sites, and (2) increasing fresh fruit and vegetable offerings at these sites. ConclusionsInterventions of specific relevance to COVID-19 (eg, stronger implementation of safety practices) and expanded food assistance services are needed to improve the accessibility of healthy food for emerging adults.

Food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic.

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.

Financial hardship and social assistance as determinants of mental health and food and housing insecurity during the COVID-19 pandemic in the United States.

BackgroundWhile social assistance through the U.S. federal CARES Act provided expanded unemployment insurance benefits during the COVID-19 pandemic until the summer of 2020, it is unclear whether social assistance was sufficient in subsequent months to meet everyday spending needs and to curb the adverse health-related sequelae of financial hardship.MethodsUsing multivariable Poisson log-binomial regression and repeated cross-sectional Household Pulse Survey data between September and December 2020 on 91,222 working-aged U.S. adults and 28,842 adult housing renters, this study explored the associations of financial hardship with mental health outcomes and food and housing insecurity after accounting for receipt of social assistance.ResultsFinancial hardship rose progressively from September to December 2020, and disproportionately affected Black non-Hispanic and Hispanic Americans and lower-income households. Experiencing considerable financial hardship (vs no hardship) predicted nearly 3-fold higher risks of anxiety and depressive symptoms (e.g., adjusted prevalence ratio, PR of depression = 2.75, 95% CI = 2.54–2.98, P < .001), a 23-fold higher risk of food insufficiency (PR = 22.71, 95% CI = 15.62–33.01, P < .001), and a 27-fold higher risk of a likely eviction (PR = 27.20, 95% CI = 10.63–69.59, P < .001). Across outcomes, these relationships were stronger at each successively higher level of financial hardship (all P values for linear trend <0.001), and more than offset benefits from social assistance.ConclusionsEven after accounting for social assistance receipt, working-aged adults experiencing financial hardship had markedly greater risks of anxiety and depressive symptoms, food insufficiency, and an anticipated housing eviction. These findings point to the urgent need for direct and sustained cash relief well in excess of current levels of social assistance to mitigate the pandemic's adverse impacts on the well-being of millions of Americans, including vulnerable minority and low-income populations.

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

Improving production and quality of life for smallholder farmers through a climate resilience program: An experience in the Brazilian Sertão.

We use a combination of economic and wellbeing metrics to evaluate the impacts of a climate resilience program designed for family farmers in the semiarid region of Brazil. Most family farmers in the region are on the verge of income and food insufficiency, both of which are exacerbated in prolonged periods of droughts. The program assisted farmers in their milk and sheepmeat production, implementing a set of climate-smart production practices and locally-adapted technologies. We find that the program under evaluation had substantive and significant impacts on production practices, land management, and quality of life in general, using several different quasi-experimental strategies to estimate the average treatment effect on the treated farmers. We highlight the strengths and limitations of each evaluation strategy and how the set of analyses and outcome indicators complement each other. The evaluation provides valuable insights into the economic and environmental sustainability of family farming in semiarid regions, which are under growing pressure from climate change and environmental degradation worldwide.

Regional differences in the impact of the COVID-19 pandemic on food sufficiency in California, April-July 2020: implications for food programmes and policies.

To evaluate regional differences in factors associated with food insufficiency during the initial months of the COVID-19 pandemic among three major metropolitan regions in California, a state with historically low participation rates in the Supplementation Nutrition Assistance Program, the nation's largest food assistance programme. Analysis of cross-sectional data from phase 1 (23 April-21 July 2020) of the US Census Household Pulse Survey, a weekly national online survey. California, and three Californian metropolitan statistical areas (MSA), including San Francisco-Oakland-Berkeley, Los Angeles-Long Beach-Anaheim and Riverside-San Bernardino-Ontario MSA. Adults aged 18 years and older living in households. Among the three metropolitan areas, food insufficiency rates were lowest in the San Francisco-Oakland-Berkeley MSA. Measures of disadvantage (e.g., having low-income, being unemployed, recent loss of employment income and pre-pandemic food insufficiency) were widely associated with household food insufficiency. However, disadvantaged households in the San Francisco Bay Area, the area with the lowest poverty and unemployment rates, were more likely to be food insufficient compared with those in the Los Angeles-Long Beach-Anaheim and Riverside-San Bernardino-Ontario MSA. Food insufficiency risk among disadvantaged households differed by region. To be effective, governmental response to food insufficiency must address the varied local circumstances that contribute to these disparities.

Association of Human Mobility Restrictions and Race/Ethnicity–Based, Sex-Based, and Income-Based Factors With Inequities in Well-being During the COVID-19 Pandemic in the United States

An accurate understanding of the distributional implications of public health policies is critical for ensuring equitable responses to the COVID-19 pandemic and future public health threats. To identify and quantify the association of race/ethnicity-based, sex-based, and income-based inequities of state-specific lockdowns with 6 well-being dimensions in the United States. This pooled, repeated cross-sectional study used data from 14 187 762 households who participated in phase 1 of the population-representative US 2020 Household Pulse Survey (HPS). Households were invited to participate by email, text message, and/or telephone as many as 3 times. Data were collected via an online questionnaire from April 23 to July 21, 2020, and participants lived in all 50 US states and the District of Columbia. Indicators of race/ethnicity, sex, and income and their intersections. Unemployment; food insufficiency; mental health problems; no medical care received for health problems; default on last month's rent or mortgage; and class cancellations with no distance learning. Race/ethnicity, sex, income, and their intersections were used to measure distributional implications across historically marginalized populations; state-specific, time-varying population mobility was used to measure lockdown intensity. Logistic regression models with pooled repeated cross-sections were used to estimate risk of dichotomous outcomes by social group, adjusted for confounding variables. The 1 088 314 respondents (561 570 [51.6%; 95% CI, 51.4%-51.9%] women) were aged 18 to 88 years (mean [SD], 51.55 [15.74] years), and 826 039 (62.8%; 95% CI, 62.5%-63.1%) were non-Hispanic White individuals; 86 958 (12.5%; 95% CI, 12.4%-12.7%), African American individuals; 86 062 (15.2%; 95% CI, 15.0%-15.4%), Hispanic individuals; and 50 227 (5.6%; 95% CI, 5.5%-5.7%), Asian individuals. On average, every 10% reduction in mobility was associated with higher odds of unemployment (odds ratio [OR], 1.3; 95% CI, 1.2-1.4), food insufficiency (OR, 1.1; 95% CI, 1.1-1.2), mental health problems (OR, 1.04; 95% CI, 1.0-1.1), and class cancellations (OR, 1.1; 95% CI, 1.1-1.2). Across most dimensions compared with White men with high income, African American individuals with low income experienced the highest risks (eg, food insufficiency, men: OR, 3.3; 95% CI, 2.8-3.7; mental health problems, women: OR, 1.9; 95% CI, 1.8-2.1; medical care inaccessibility, women: OR, 1.7; 95% CI, 1.6-1.9; unemployment, men: OR, 2.8; 95% CI, 2.5-3.2; rent/mortgage defaults, men: OR, 5.7; 95% CI, 4.7-7.1). Other high-risk groups were Hispanic individuals (eg, unemployment, Hispanic men with low income: OR, 2.9; 95% CI, 2.5-3.4) and women with low income across all races/ethnicities (eg, medical care inaccessibility, non-Hispanic White women: OR, 1.8; 95% CI, 1.7-2.0). In this cross-sectional study, African American and Hispanic individuals, women, and households with low income had higher odds of experiencing adverse outcomes associated with the COVID-19 pandemic and stay-at-home orders. Blanket public health policies ignoring existing distributions of risk to well-being may be associated with increased race/ethnicity-based, sex-based, and income-based inequities.

The effect of the US safety net on material hardship over two decades

We address a question at the center of many policy debates: how effective is the US safety net? Many existing studies evaluate the effect of one program on economic hardship in isolation, though families typically participate in multiple programs. Using 1992–2011 data from the Survey of Income and Program Participation, our analyses examine the simultaneous effect of participation in three programs, TANF, SNAP, or Medicaid/SCHIP, on a set of outcomes of intrinsic importance—measures of material hardship. We find that a 10 percentage point increase in participation in any of these three safety net programs by low-to-moderate income families with children reduces their average number of hardships by 0.11 (−0.41 elasticity), and the incidence of food insufficiency by 1.7 percentage points (−1.27 elasticity). This analysis suggests that hardship would be even more prevalent in the United States without the existence of the current safety net programs.

Strategies to Mitigate the Impact of COVID-19 on Food Security and Malnutrition in Nigeria

As a developing nation and the most populous nation in Africa, Nigeria has faced challenges associated with meeting the food needs of its expanding population over the years. This is due to the nation transitioning from a net exporter of foods to being dependent on food imports, leading to many people suffering from stunting and severe malnourishment. The COVID-19 pandemic has compounded this food insufficiency within the country with its attendant global impacts. The restrictions in the movement of people and goods in the country, due to the current pandemic, have affected access to food and agricultural input, heavily affecting the financial ability of families. This mini-review highlights the impact of COVID-19 on the country's nutritional status, the rising incidence of food insecurity and proposes approaches that can be employed to mitigate these adverse effects. Approaches to improving food security and the nutritional status of the country during the pandemic and post-pandemic era will involve deliberate policies of the government which focuses on increasing funding to local food producers, lifting restrictions on the transport of food commodities, encouraging markets for the retail of locally produced foods and more importantly instituting nutritional intervention programmes for children and the vulnerable within the community.

Maternal Stress Moderates the Relationship of Food Insufficiency with Body Mass Index Trajectories from Childhood to Early Adulthood among U.S. Rural Youth.

Background: Findings on the relationships between household food insufficiency (HFI), maternal stress, and youth body mass index (BMI) are mixed, possibly due to cross-sectional study designs and measurement issues. Furthermore, little is known about how childhood exposure to HFI and maternal stress influences BMI into young adulthood among rural youth. We aimed to determine the independent and moderating relationships of HFI and maternal perceived stress on youth BMI trajectories from age 9 to 24 years. Methods: We used longitudinal data from rural New York youth (n = 341). At youth age 9 years, parents reported HFI using a reliable one-item measure, and mothers responded to the 10-item Perceived Stress Scale (PSS; range: 0-40). BMI was calculated (kg/m2) from objective measures of height and weight at 9, 13, 17, and 24 years. Multivariate random-intercept trajectory models estimated the relationships of HFI and PSS on BMI trajectories (p < 0.05 for main effects, p < 0.10 for interactions). Results: At age 9 years, 16.4% experienced HFI and mean (standard deviation) BMI and PSS were 18.4 (3.6) kg/m2 and 7.7 (2.9), respectively. HFI and PSS were not associated with BMI trajectories (p = 0.18, p = 0.64, respectively), but their interaction was significant (p < 0.01). Each one-unit increase in PSS was associated with 0.6 (0.2) kg/m2 higher mean change in BMI trajectories for youth in food-insufficient, compared with food-sufficient, households. Conclusions: Higher levels of maternal stress in food-insufficient households may lead to greater increases in BMI from childhood to young adulthood. Public health interventions should simultaneously address parental stress and quality food access among low-income rural households.

Prevalence and psychosocial factors associated with self-injurious thoughts among people living with HIV presenting for HIV testing in Mozambique

ABSTRACT Self-injurious thoughts have been associated with psychiatric morbidity and suicide. Little is known about psychosocial factors associated with self-injurious thoughts among people newly diagnosed with HIV in sub-Saharan Africa. This study examined whether food insufficiency, mental health symptoms, or social support were associated with recent self-injurious thoughts among people newly diagnosed with HIV in Mozambique. The sample included 2001 PLWH aged ≥ 18 newly diagnosed with HIV at 10 health clinics in Mozambique between April 2013 and June 2015. Data were collected at time of HIV diagnosis. Multivariable logistic regression modeled the association of social support, affective mental health symptom severity, somatic mental health symptom severity, and food insufficiency on recent self-injurious thoughts. Ten percent of respondents reported recent self-injurious thoughts, which was higher among women than men (11% vs 7%). In multivariable analyses, food insufficiency [adjusted odds ratio (aOR) 1.7 (95% CI 1.3, 2.2)], and low [aORvs no = 4.8, 95% CI 1.7, 13.4) and moderate/high affective symptom severity [aORvs no = 8.7, 95% CI 2.8, 27.6) were associated with greater odds of self-injurious thoughts. Interventions to address self-injurious thoughts should consider accompanying psychosocial stressors. Longitudinal research to examine mechanisms through which psychosocial stressors are associated with self-injurious thoughts is warranted.