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Abstract
Background Food insecurity poses a substantial threat to mental health. However, there is limited understanding of how food-insecure adults experience mental health challenges and access necessary health services. We examined the association of food insecurity with mental health status, mental health service utilisation and general healthcare utilisation among US adults.
Methods A retrospective longitudinal cohort study was conducted to analyse data from 9906 US adults participating in the 2016–2017 Medical Expenditure Panel Survey. Outcomes included mental health status, mental health service utilisation and general healthcare utilisation. The primary independent variable was food insecurity measured using the 10-item Food Security Survey Module. Two separate models were used: A lagged-dependent model and a fixed-effect model.
Results The lagged dependent model showed that food insecurity in 1 year was associated with a higher likelihood of reporting mental health symptoms based on the Patient Health Questionnaire and the Kessler 6 Psychological Distress Scale (3.5 percentage points (95% CI: 1.3 to 5.8)) and self-reported poor mental health (5.8 percentage points (2.9 to 8.7)) in the subsequent year. However, compared with food-secure adults, food-insecure adults were no more likely to have outpatient mental health visits, specialty mental health visits or psychotropic medication fills. Moreover, food-insecure adults were 4.1 (1.2 to 7.0) percentage points more likely to have an emergency room visit than food-secure adults. These findings were consistent with the fixed-effect model.
Conclusion Food insecurity is associated with worse mental health. However, food-insecure adults may not access adequate mental health services and instead rely on emergency room visits.
- MENTAL HEALTH
- FOOD INSECURITY
- Health inequalities
- HEALTH SERVICES
Data availability statement
Data are available in a public, open access repository.
Statistics from Altmetric.com
Data availability statement
Data are available in a public, open access repository.
Footnotes
Contributors SP and SAB conceptualised and acquired funding for the study. SP carried out statistical analyses. SP and SAB drafted the manuscript. All authors contributed to the article and approved the submitted version. As the guarantor, SP had access to the data, controlled the decision to publish and accepts full responsibility for the work and the conduct of the study.
Funding This work was partly supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. RS-2023-00219289) and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK125831).
Competing interests One of the authors reports research grants from the National Institutes of Health, North Carolina Department of Health and Human Services, Blue Cross Blue Shield of North Carolina and Feeding America and personal fees from the Aspen Institute, Rockefeller Foundation, Gretchen Swanson Center for Nutrition and Kaiser Permanente, outside of the submitted work.
Provenance and peer review Not commissioned; externally peer reviewed.
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