Davison Karen M, Marshall-Fabien Gillian L, Tecson Angela
School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada,
Soc Psychiatry Psychiatr Epidemiol. 2015 Jun;50(6):963-72. doi: 10.1007/s00127-015-1018-1. Epub 2015 Feb 5.
Although the important public health issues of food insecurity and suicide may be interconnected, they are rarely studied. Using data from a national survey, we examined whether household food insecurity was associated with suicidal ideation after adjusting for relevant covariates.
We examined cross-sectional data from three Canadian provinces (n = 5,270) that were derived from the 2007 Canadian Community Health Survey and included adults (18+ years). Suicidal ideation was based on affirmative response to the question of whether or not the participant had seriously considered committing suicide in the previous 12 months. The Household Food Security Survey Module provided measures of moderate (indication of compromise in quality and/or quantity of food consumed) and severe (indication of reduced food intake and disrupted eating patterns) food insecurity status. Logistic regression determined associations between food insecurity and suicidal ideation with adjustment for demographics, body mass index, and presence of a mood disorder.
There were differences in the proportion experiencing suicide ideation according to moderate (14.7 vs 10.0 % without suicide ideation) and severe (16.4 vs 7.1 % without suicide ideation) food security (p < 0.001). With covariate adjustment, suicidal ideation was significantly associated with moderate (adjusted OR = 1.32, 95 % CI 1.06-1.64) and severe (adjusted OR = 1.77, 95 % CI 1.42-2.23) food insecurity.
The findings of a robust association between food insecurity and suicidal ideation suggest that interventions targeted at food security may reduce suicide-related morbidity and mortality. Longitudinal investigations that examine various dimensions of food insecurity will advance understanding of etiological pathways involved in food insecurity and suicide.
尽管粮食不安全和自杀这两个重要的公共卫生问题可能相互关联,但它们很少被研究。利用一项全国性调查的数据,我们在调整了相关协变量后,研究了家庭粮食不安全与自杀意念之间是否存在关联。
我们研究了来自加拿大三个省份(n = 5270)的横断面数据,这些数据源自2007年加拿大社区健康调查,涵盖成年人(18岁及以上)。自杀意念基于参与者对在过去12个月内是否曾认真考虑过自杀这一问题的肯定回答。家庭粮食安全调查模块提供了中度(表明所消费食物的质量和/或数量受到影响)和重度(表明食物摄入量减少且饮食模式紊乱)粮食不安全状况的测量指标。逻辑回归确定了在调整人口统计学、体重指数和情绪障碍存在情况后,粮食不安全与自杀意念之间的关联。
根据中度(有自杀意念的比例为14.7%,无自杀意念的比例为10.0%)和重度(有自杀意念的比例为16.4%,无自杀意念的比例为7.1%)粮食安全状况,经历自杀意念的比例存在差异(p < 0.001)。经过协变量调整后,自杀意念与中度(调整后的比值比 = 1.32,95%置信区间1.06 - 1.64)和重度(调整后的比值比 = 1.77,95%置信区间1.42 - 2.23)粮食不安全显著相关。
粮食不安全与自杀意念之间存在强烈关联的研究结果表明,针对粮食安全的干预措施可能会降低与自杀相关的发病率和死亡率。对粮食不安全的各个维度进行研究的纵向调查将增进对粮食不安全和自杀所涉及病因途径的理解。