Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Inj Prev. 2021 Aug;27(4):349-355. doi: 10.1136/injuryprev-2020-043905. Epub 2020 Oct 7.
In 2015, the elimination of hunger worldwide by 2030 was declared by the United Nations as a Sustainable Development Goal. However, food insecurity remains pervasive, contributing to socioeconomic health inequalities. The overall objective was to investigate the relationship between food insecurity and intentional injuries among adolescents.
Individual-level data from the Global School-based Student Health Survey from 89 countries were used (370 719 adolescents, aged 12-17 years). Multilevel logistic regressions were used to examine the sex-specific association between the level of food insecurity (none, medium and high) and intentional injuries (interpersonal violence and suicide attempts), accounting for the clustering of observations within surveys. Random-effects meta-analyses were used to analyse dose-response relationships.
Medium and high food insecurity were associated with increased odds of reporting an injury from interpersonal violence among both sexes. A positive dose-response relationship was found, where each level increase in food insecurity was associated with a 30% increase in the odds of an injury due to interpersonal violence among boys (1.30; 95% CI 1.26 to 1.34) and a 50% increase among girls (1.53; 95% CI 1.46-1.62). The odds for suicide attempts increased by 30% for both sexes with each level increase in food insecurity (boys: 1.29; 95% CI 1.25-1.32; girls: 1.29; 95% CI 1.25-1.32).
The findings indicate that socioeconomic inequalities exist in the risk of intentional injuries among adolescents. Although additional studies are needed to establish causality, the present study suggests that the amelioration of food insecurity could have implications beyond the prevention of its direct consequences.
2015 年，联合国宣布到 2030 年在全球范围内消除饥饿，将其作为可持续发展目标之一。然而，粮食不安全仍然普遍存在，导致社会经济健康不平等。本研究的总体目标是调查青少年的粮食不安全与故意伤害之间的关系。
使用了来自 89 个国家的全球学校学生健康调查的个体水平数据（370719 名 12-17 岁的青少年）。采用多水平逻辑回归来检验粮食不安全水平（无、中、高）与故意伤害（人际暴力和自杀未遂）之间的性别特异性关联，同时考虑到调查内观察值的聚类。采用随机效应荟萃分析来分析剂量-反应关系。
中、高度粮食不安全与男女青少年报告人际暴力致伤的几率增加相关。发现了一种正剂量-反应关系，即粮食不安全程度每增加一个等级，男孩因人际暴力致伤的几率增加 30%（1.30；95%置信区间 1.26 至 1.34），女孩增加 50%（1.53；95%置信区间 1.46 至 1.62）。男女两性的自杀未遂几率均随粮食不安全程度每增加一个等级而增加 30%（男孩：1.29；95%置信区间 1.25 至 1.32；女孩：1.29；95%置信区间 1.25 至 1.32）。
研究结果表明，青少年故意伤害的风险存在社会经济不平等。尽管需要进一步的研究来确定因果关系，但本研究表明，改善粮食不安全状况可能不仅可以预防其直接后果，还可能具有更广泛的意义。
