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Food insecurity and mental health: new answers and remaining questions
  1. Miriam Evensen
  1. Centre for Disease Burden/ Department of Health and Inequality, Norwegian Institute of Public Health, Oslo 0213, Norway
  1. Correspondence to Dr Miriam Evensen, Norwegian Institute of Public Health, Oslo 0213, Norway; Miriam.Evensen{at}

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Food insecurity—the economic and social condition of limited or uncertain access to adequate food—is high on the agenda.1 In Europe, estimates from Eurostat in 2020 show that 7% of households with children are food insecure.2 There is a worry that the corresponding figures for 2021 may be even higher as the COVID-19 pandemic has led to increased unemployment and economic uncertainty, processes that likely exacerbate food insecurity.3 4 The fact that so many children experience insecure access to food is important in its own right, but food insecurity is also associated with long-term adverse outcomes related to, for example, education and nutrition.5 6

In a timely new study, Men et al 7 examine the association between food insecurity and mental health problems among children and young adults. Using large-scale Canadian survey data on more than 55 000 individuals, they document that food insecurity is associated with worse mental health, and that the association is graded with more severe food insecurity associated with progressively worse health. The study includes overall measures of mental health, but also more specific measures related to depression, anxiety and suicidal ideation.

Beyond the immediate relevance of the topic, Men et al 7 address dimensions of disadvantage that go beyond standard measures of socioeconomic status such as income and poverty, and it is also interesting to see such patterns in a country with universal healthcare and a safety net meant to buffer some of the disadvantages of poor income. Men et al 7 also found a strong association between food insecurity and risk of mental health problems, net of household income and other socioeconomic factors. This highlights an additional point: even though childhood food insecurity is closely linked to poverty, food insecurity may be high even among families above poverty thresholds.

Men and colleagues mention social disorganisation within the family as a potential explanation of why the relationship between household insecurity and mental health exists even after controlling for income. Other factors, such as high cost of living in certain areas (ie, large cities), may make it difficult to get by even with a decent income. As such geography may be a relevant factor. Parental unemployment and other abrupt changes such as divorce, or disability among family members, are additional factors that could contribute to food insecurity. Importantly, these risk factors are much more likely to affect low-income families.8 Even among those entitled to benefits, there might be delays in receiving these, with consequences for a family’s food security. Typically, family poverty is often measured annually, but such aggregated measures might not capture the income volatility experienced by many low-income families.

A key limitation of the study is the cross-sectional nature of the data, which makes the interpretation open to reverse causation. For example, prior research has revealed a plethora of factors that predict food insecurity, such as mother’s health, substance abuse, family instability and immigrant background.5 Thus, the path from food insecurity to mental health might not be as straightforward as we might expect, as there could be other factors—often less easily measured—that account for part of the association. However, the authors acknowledge this, and one study can only do so much. Instead, future research should also apply (quasi)experimental approaches to get closer to causal estimates.

Future research could also benefit from a comparative perspective. The rate of food insecurity varies considerably across countries, but we know less about whether the consequences of food insecurity for children and youth also differ across countries. Previous research has shown that the relationship between parental income and children’s adult attainments and intergenerational mobility varies across countries, with less adverse consequences in more egalitarian and universal welfare states.9 For the current topic, the primary goal of welfare states should be to limit the prevalence of food insecurity among children. However, it is important to know whether welfare states also cushion the negative repercussions among those children who still face insecure access to food while growing up.

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  • Twitter @miriamevensen

  • Contributors ME is the sole author of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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