Dladla-Jaca Philile, Ncama Busisiwe P, Moodley Yoshan, Sobratee-Fajurally Nafiisa, Davids Rashieda, Ngidi Mjabuliseni Simon C, Sutherland Catherine, Siwela Muthulisi, Mabhaudhi Tafadzwanashe, Modi Albert T, Slotow Rob, Burns Jonathan K, Tomita Andrew
Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Food Secur. 2024;16(4):1009-1018. doi: 10.1007/s12571-024-01448-x. Epub 2024 Jul 1.
We investigated the trajectory of depressive symptoms ("depression") from the start of the COVID-19 pandemic in South Africa (March 2020) until 2021, between individuals with and without pre-pandemic depression, specifically regarding the role of food security. Our investigation used publicly available panel data (N = 6,930) from the South African National Income Dynamics Study Coronavirus Rapid Mobile Survey (SA-NIDS-CRAM from 2020-2021) on those who had also participated in the pre-pandemic South African National Income Dynamics Study (SA-NIDS, 2017) depression interview. We investigated trends in depressive symptomatology (based on a 2-item Patient Health Questionnaire) at SA-NIDS-CRAM Wave 2 (July 2020), Wave 3 (February 2021) and Wave 5 (May 2021). Generalized estimating equations (GEE) with post-estimation linear combinations of estimators were fitted to investigate the roles of pre-pandemic depression (based on 2017 SA-NIDS data) and food insecurity during the pandemic on depressive symptomatology. During the pandemic, the highest levels of depression were observed consistently among those with pre-pandemic depression and food insecurity; and were lowest among those without pre-pandemic depression and food security. Depressive symptomatology rose in nearly equal magnitude during the early phases of the pandemic in two groups: those without pre-pandemic depression but food insecure during the pandemic; as well as those with pre-pandemic depression but food secure during the pandemic. However, this dynamic changed later in the pandemic, when higher depressive symptomatology was observed in the group with both pre-pandemic depression and food insecurity, widening the gap between them from Wave 3 (adj β = 0.63, p < 0.01) to Wave 5 (adj β = 0.79, p < 0.01). Our results highlight the importance of addressing both population mental health and food insecurity, particularly at the early stages of a crisis/disaster. As we showed that mental health impact is linked to food insecurity during a pandemic, strengthening social protection measures, especially around food and nutrition, would help build resilience to crises in the long term.
我们调查了从南非新冠疫情开始（2020年3月）到2021年期间，有和没有疫情前抑郁症的个体的抑郁症状（“抑郁症”）轨迹，特别关注粮食安全的作用。我们的调查使用了来自南非国民收入动态研究冠状病毒快速移动调查（2020 - 2021年的SA - NIDS - CRAM）的公开可用面板数据（N = 6,930），这些数据来自那些也参加了疫情前南非国民收入动态研究（SA - NIDS，2017年）抑郁症访谈的人。我们调查了SA - NIDS - CRAM第2波（2020年7月）、第3波（2021年2月）和第5波（2021年5月）时的抑郁症状学趋势（基于一个2项患者健康问卷）。采用带有估计量后估计线性组合的广义估计方程（GEE）来研究疫情前抑郁症（基于2017年SA - NIDS数据）和疫情期间粮食不安全对抑郁症状学的作用。在疫情期间，在有疫情前抑郁症和粮食不安全的人群中始终观察到最高水平的抑郁症；而在没有疫情前抑郁症且粮食安全的人群中抑郁症水平最低。在疫情早期，两组人群的抑郁症状学上升幅度几乎相同：一组是没有疫情前抑郁症但在疫情期间粮食不安全的人；另一组是有疫情前抑郁症但在疫情期间粮食安全的人。然而，这种动态在疫情后期发生了变化，此时在既有疫情前抑郁症又有粮食不安全的人群中观察到更高的抑郁症状学，从第3波到第5波，他们之间的差距不断扩大（调整后的β = 0.63，p < 0.01到调整后的β = 0.79，p < 0.01）。我们的结果强调了应对人群心理健康和粮食不安全问题的重要性，特别是在危机/灾难的早期阶段。正如我们所表明的，心理健康影响与疫情期间的粮食不安全有关，加强社会保护措施，特别是围绕粮食和营养的措施，将有助于长期增强应对危机的能力。
