Department of Pediatrics (Pound), Children's Hospital of Eastern Ontario; School of Epidemiology and Public Health (Chen), Faculty of Medicine, University of Ottawa, Ottawa, Ont.
CMAJ Open. 2021 Jan 29;9(1):E71-E78. doi: 10.9778/cmajo.20200112. Print 2021 Jan-Mar.
Women with food insecurity are at higher risk for mental health disorders. This study examined the joint effect of female sex and food insecurity on self-reported poor or fair mental health in Canadian adults.
The analysis was based on data from adults (age ≥ 18 yr) who participated in the Canadian Community Health Survey (CCHS) 2015-2016. We determined past-year food security level (secure, moderately insecure or severely insecure) based on 18 questions. We used log-binomial regression to explore associations of sex and food insecurity with self-reported poor or fair mental health. We measured additive interaction between female sex and food insecurity using relative excess risk due to interaction (RERI).
The overall response rate for the CCHS was 59.5%. Data for 61 446 respondents were analyzed. Poor or fair mental health was reported by 4107 participants (6.1% when weighted to the Canadian population). Increased risk of poor or fair mental health was associated with female sex (prevalence ratio [PR] 1.22, 95% confidence interval [CI] 1.12 to 1.31), and moderate (PR 2.50, 95% CI 2.21 to 2.82) and severe (PR 4.03, 95% CI 3.59 to 4.52) food insecurity. Significant additive interaction between female sex and severe food insecurity was found for those aged 40-64 years (RERI 1.38, 95% CI 0.29 to 2.47), and the PR for poor or fair mental health for severely food-insecure women was 5.55 (95% CI 4.48 to 6.89) compared to food-secure men of the same age group.
Poor or fair mental health is common in the food-insecure population, and there exists synergism between female sex and severe food insecurity among middle-aged people. This suggests the need to develop targeted mental health support strategies for food-insecure people, specifically middle-aged women.
食物无保障的女性面临更高的心理健康障碍风险。本研究调查了女性性别和食物无保障对加拿大成年人自我报告的较差或一般心理健康的共同影响。
该分析基于参加 2015-2016 年加拿大社区健康调查（CCHS）的成年人（年龄≥18 岁）的数据。我们根据 18 个问题确定过去一年的食物保障水平（有保障、中等无保障或严重无保障）。我们使用对数二项式回归来探讨性别和食物无保障与自我报告的较差或一般心理健康之间的关联。我们使用交互超额相对风险（RERI）来衡量女性性别和食物无保障之间的附加交互作用。
CCHS 的总体回复率为 59.5%。分析了 61446 名受访者的数据。6.1%（加权至加拿大人口时）的参与者报告了较差或一般心理健康状况。较差或一般心理健康状况的风险增加与女性性别相关（流行率比[PR]1.22，95%置信区间[CI]1.12 至 1.31），与中度（PR 2.50，95%CI 2.21 至 2.82）和严重（PR 4.03，95%CI 3.59 至 4.52）食物无保障相关。对于 40-64 岁的人群，发现女性性别和严重食物无保障之间存在显著的附加交互作用（RERI 1.38，95%CI 0.29 至 2.47），严重食物无保障的女性的较差或一般心理健康的 PR 为 5.55（95%CI 4.48 至 6.89），而同龄的食物有保障的男性为 1.00。
较差或一般心理健康在食物无保障人群中很常见，女性性别和中年人群中严重食物无保障之间存在协同作用。这表明需要为食物无保障人群，特别是中年妇女制定有针对性的心理健康支持策略。
