School of Public Health, University of California Berkeley, Berkeley, California, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
BMJ Open. 2021 Sep 7;11(9):e054263. doi: 10.1136/bmjopen-2021-054263.
Household food insufficiency (HFIS) is a major public health threat to children. Children may be particularly vulnerable to HFIS as a psychological stressor due to their rapid growth and accelerated behavioural and cognitive states, whereas data focusing on HFIS and childhood mental disorders are as-yet sparse. We aimed to examine the associations of HFIS with depression and anxiety in US children.
Cross-sectional study.
The 2016-2018 National Survey of Children's Health, a nationally-representative study.
Primary caregivers of 102 341 children in the USA.
Physician diagnosed depression and anxiety were assessed by questionnaires administered to primary caregivers of 102 341 children. Multivariable logistic regression models estimated adjusted OR (aOR) for current depression or anxiety associated with HFIS measured through a validated single-item instrument.
Among children aged 3-17 years, 3.2% and 7.4% had parent-reported physician-diagnosed current depression and anxiety, respectively. Compared with children without HFIS, children with HFIS had approximately twofold higher weighted prevalence of anxiety or depression. After adjusting for covariates, children with versus without HFIS had a 1.53-fold (95% CI 1.15 to 2.03) and 1.48-fold (95% CI 1.20 to 1.82) increased odds of current depression and anxiety, respectively. Associations were slightly more pronounced among girls (aOR (95% CI): depression 1.69 (1.16 to 2.48); anxiety 1.78 (1.33 to 2.38)) than boys (1.42 (0.98 to 2.08); 1.32 (1.00 to 1.73); both P-for-interaction <0.01). The associations did not vary by children's age or race/ethnicity.
HFIS was independently associated with depression and anxiety among US children. Girls presented slightly greater vulnerability to HFIS in terms of impaired mental health. Children identified as food-insufficient may warrant mental health assessment and possible intervention. Assessment of HFIS among children with impaired mental health is also warranted. Our findings also highlight the importance of promptly addressing HFIS with referral to appropriate resources and inform its potential to alleviate childhood mental health issues.
家庭食物不足（HFIS）是儿童面临的主要公共卫生威胁。由于儿童生长迅速，行为和认知状态加速，他们可能特别容易受到 HFIS 的心理压力，而关注 HFIS 和儿童精神障碍的数据仍然很少。我们旨在研究 HFIS 与美国儿童抑郁和焦虑的关系。
横断面研究。
具有全国代表性的 2016-2018 年全国儿童健康调查。
美国 102341 名儿童的主要照顾者。
通过向 102341 名儿童的主要照顾者发放问卷，评估医生诊断的抑郁和焦虑。多变量逻辑回归模型估计了通过经过验证的单项仪器测量的当前 HFIS 与当前抑郁或焦虑相关的调整后比值比（aOR）。
在 3-17 岁的儿童中，分别有 3.2%和 7.4%的儿童有父母报告的医生诊断的当前抑郁和焦虑。与没有 HFIS 的儿童相比，有 HFIS 的儿童焦虑或抑郁的加权患病率约高两倍。在调整了协变量后，与没有 HFIS 的儿童相比，有 HFIS 的儿童当前抑郁和焦虑的几率分别增加了 1.53 倍（95%CI 1.15 至 2.03）和 1.48 倍（95%CI 1.20 至 1.82）。在女孩（aOR（95%CI）：抑郁 1.69（1.16 至 2.48）；焦虑 1.78（1.33 至 2.38））中，相关性比男孩（1.42（0.98 至 2.08）；1.32（1.00 至 1.73）；两者 P 交互作用均<0.01）中稍高。这些关联不因儿童年龄或种族/民族而异。
HFIS 与美国儿童的抑郁和焦虑独立相关。女孩在心理健康受损方面对 HFIS 的敏感性略高。被确定为食物不足的儿童可能需要进行心理健康评估和可能的干预。评估有心理健康受损的儿童的 HFIS 也是必要的。我们的研究结果还强调了及时解决 HFIS 问题的重要性，包括向适当资源转介，并为缓解儿童心理健康问题提供信息。
