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Food insecurity and mental health: an analysis of routine primary care data of pregnant women in the Born in Bradford cohort
  1. Madeleine Power1,
  2. Eleonora Uphoff1,
  3. Brian Kelly2,
  4. Kate E Pickett1
  1. 1Department of Health Sciences, University of York, York, UK
  2. 2Bradford Institute For Health Research, Bradford Royal Infirmary, Bradford, UK
  1. Correspondence to Dr Madeleine Power, University of York, Research Centre for the Social Sciences, 6 Innovation Close, Heslington, York YO10 5ZF, UK; msp517{at}


Background Since 2008, use of food banks has risen sharply in the UK; however, evidence on the epidemiology of UK food insecurity is sparse. The aim of this study was to describe the trajectory of common mental disorder across the pre-pregnancy, pregnancy and postnatal period for food secure compared with food insecure women.

Methods Data from the Born in Bradford (BiB) cohort, the nested BiB1000 study and primary care records were linked based on National Health Service (NHS) numbers. Data linkage was completed for 1297, and primary care records were available from 18 months prior to 40 months after birth of the cohort child. Incidence rates of common mental disorders per 1000 patient years at risk were compared between food secure and insecure women, and for Pakistani compared with white British women, in 10 6-month periods around pregnancy. Poisson regression was used to calculate incidence rate ratios, adjusted for ethnicity and exposure.

Results Food insecurity was significantly associated with an increased risk of common mental disorder before and during pregnancy (incidence rate ratio 1.9, 95% confidence interval 1.3 to 2.8, p=0.001) and after giving birth (incidence rate ratio 1.3, 95% confidence interval 1.0 to 1.7, p=0.029).

Conclusions Our study shows that food insecure women have worse mental health than food secure women, and that this difference is most pronounced for white British pregnant women. These findings provide evidence for concerns expressed by public health experts that food insecurity may become the next public health emergency.

  • Cohort studies

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  • Twitter Follow Eleonora Uphoff at @NoortjeUphoff

  • Contributors MP, EU and KEP contributed to the design and planning of the study; BK was responsible for the acquisition of the data; BK, MP and EU contributed to the analysis and interpretation of the data; all authors contributed to the drafting and revision of the study; all authors gave final approval for the study to be published.

  • Competing interests None declared.

  • Ethics approval Ethics approval for the data collection was granted by Bradford Research Ethics Committee (reference number 07/H1302/112).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional information is available on request from the corresponding author (