在 COVID-19 大流行期间，印度尼西亚马卡萨市城市非正规住区的妇女，粮食和用水不安全问题对其抑郁有多重影响。
Joint Food and Water Insecurity Had a Multiplicative Effect on Women's Depression in Urban Informal Settlements in Makassar, Indonesia during the COVID-19 Pandemic.
机构信息
Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA, USA.
Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA, USA.
出版信息
J Nutr. 2023 Apr;153(4):1244-1252. doi: 10.1016/j.tjnut.2023.01.010. Epub 2023 Mar 21.
BACKGROUND
Women living in urban informal settlements may be particularly vulnerable to the detrimental effects of the COVID-19 pandemic because of increased economic and psychosocial stressors in resource-limited environments.
OBJECTIVES
The objective of this study was to assess the associations between food and water insecurity during the pandemic and depression among women living in the urban informal settlements in Makassar, Indonesia.
METHODS
We implemented surveys at 3 time points among women enrolled in the Revitalizing Informal Settlements and their Environments trial. Depression was measured using the Center for Epidemiologic Studies Depression Scale-10 (CESD-10) between November and December 2019 and again between February and March 2021. Food insecurity was measured using questions from the Innovation for Poverty Action's Research for Effective COVID-19 Reponses survey and water insecurity was measured using the Household Water Insecurity Experiences Short Form. Both were measured between August and September 2020. We built 3 multivariate quantile linear regression models to assess the effects of water insecurity, food insecurity, and joint food and water insecurity during the COVID-19 pandemic on CESD-10 score.
RESULTS
In models with the full sample (n = 323), food insecurity (β: 1.48; 95% CI: 0.79, 2.17), water insecurity (β: 0.13; 95% CI: -0.01, 0.26), and joint food and water insecurity (β: 2.40; 95% CI: 1.43, 3.38) were positively associated with CESD-10 score. In subgroup analyses of respondents for whom we had prepandemic CESD-10 scores (n = 221), joint food and water insecurity (β: 1.96; 95% CI: 0.78, 3.15) maintained the strongest relationship with CESD-10 score. A limitation of this study is that inconsistency in respondents from households across the survey waves reduced the sample size used for this study.
CONCLUSIONS
Our results find a larger association between depression and joint resource insecurity than with water or food insecurity alone, underlining the importance of addressing food and water insecurity together, particularly as they relate to women's mental health and well-being.
背景
由于资源有限环境中经济和心理社会压力的增加，居住在城市非正规住区的妇女可能特别容易受到 COVID-19 大流行的不利影响。
目的
本研究的目的是评估在印度尼西亚望加锡城市非正规住区中，大流行期间食物和水不安全与妇女抑郁之间的关联。
方法
我们在望加锡城市非正规住区和环境振兴试验（Revitalizing Informal Settlements and their Environments trial）中，在 3 个时间点实施了调查。抑郁通过中心流行病学研究抑郁量表-10（Center for Epidemiologic Studies Depression Scale-10，CESD-10）在 2019 年 11 月至 12 月和 2021 年 2 月至 3 月之间进行测量。食物不安全通过创新扶贫行动的研究有效应对 COVID-19 反应调查中的问题进行测量，而水不安全则通过家庭用水不安全体验简短形式进行测量。这些测量都在 2020 年 8 月至 9 月之间进行。我们构建了 3 个多元分位数线性回归模型，以评估 COVID-19 大流行期间水不安全、食物不安全和食物与水联合不安全对 CESD-10 评分的影响。
结果
在全样本模型中（n = 323），食物不安全（β：1.48；95%置信区间：0.79，2.17）、水不安全（β：0.13；95%置信区间：-0.01，0.26）和食物与水联合不安全（β：2.40；95%置信区间：1.43，3.38）与 CESD-10 评分呈正相关。在我们有大流行前 CESD-10 评分的受访者（n = 221）的亚组分析中，食物与水联合不安全（β：1.96；95%置信区间：0.78，3.15）与 CESD-10 评分的关系最强。本研究的一个局限性是，调查各轮次来自家庭的受访者的不一致性减少了本研究使用的样本量。
结论
我们的研究结果发现，与单独的水不安全或食物不安全相比，抑郁与联合资源不安全之间存在更大的关联，这突显了共同解决食物和水不安全问题的重要性，尤其是在它们与妇女的心理健康和幸福感有关时。
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