Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, Sundsvall, SE-851 70, Sweden.
Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, Gävle, 80176, Sweden.
BMC Public Health. 2024 Sep 27;24(1):2590. doi: 10.1186/s12889-024-20153-0.
Mental health outcomes can be influenced by various factors, one of which has recently gained attention, namely food security. Food security is paramount to maintaining not only physical, but also mental health. There is an increasing need to understand the interplay between food insecurity (FI) and mental health outcomes, especially among vulnerable populations. The objective of this study was to investigate the effect of FI on psychological health (anxiety and depression) as well as to examine the modifying effect of socioeconomic position on this relationship.
A cross-sectional study was conducted in Maputo City, Mozambique, in 1,842 participants. Data were collected through structured interviews using a modified version of the US Department of Agriculture Household Food Security Module to measure FI, and the Hospital Anxiety and Depression Scale to measure anxiety and depression. A composite variable for psychological health was created. Propensity score matching and interaction effect analyses were employed to examine the effects of FI on psychological health and the moderating role of socioeconomic position.
Of the 1,174 participants randomly assigned to propensity score matching, 787 were exposed to FI while 387 were unexposed. The analysis revealed stark disparities in psychological health outcomes associated with FI. The risk of poor psychological health among those exposed to FI was 25.79%, which was significantly higher than the 0.26% in unexposed individuals. The risk difference was 25.54% points (95% CI: 22.44-28.63), with a risk ratio of 99.82. Our assessment of population attributable fractions indicated that nearly all the risk for poor psychological health in the exposed group could be ascribed to FI. The interaction effects analysis revealed that socioeconomic status modifies this relationship. Specifically, heads of food-insecure households with a lower socioeconomic position tended to report poor mental health compared to their food-secure counterparts with a higher position.
The findings underscore the profound impact of FI on the mental health of household heads in Maputo City, socioeconomic position being a significant modifier. Addressing household FI along with the socioeconomic position of household heads could be pivotal to mental health promotion, especially among vulnerable populations.
心理健康结果可能受到多种因素的影响，其中最近引起关注的一个因素是食品安全。食品安全不仅对维持身体健康至关重要，对维持心理健康也同样重要。越来越有必要了解粮食不安全（FI）与心理健康结果之间的相互作用，特别是在弱势群体中。本研究的目的是调查 FI 对心理健康（焦虑和抑郁）的影响，并研究社会经济地位对这种关系的调节作用。
在莫桑比克马普托市进行了一项横断面研究，共纳入 1842 名参与者。使用经过修改的美国农业部家庭粮食安全模块的结构访谈收集数据，以测量粮食不安全，使用医院焦虑和抑郁量表测量焦虑和抑郁。创建了一个心理健康综合变量。使用倾向评分匹配和交互效应分析来检验 FI 对心理健康的影响以及社会经济地位的调节作用。
在随机分配到倾向评分匹配的 1174 名参与者中，787 名暴露于 FI，387 名未暴露于 FI。分析显示，与 FI 相关的心理健康结果存在明显差异。暴露于 FI 的个体发生不良心理健康的风险为 25.79%，明显高于未暴露个体的 0.26%。风险差异为 25.54%点（95%CI：22.44-28.63），风险比为 99.82。我们对人群归因分数的评估表明，暴露组中几乎所有不良心理健康的风险都可以归因于 FI。交互效应分析表明，社会经济地位调节了这种关系。具体来说，社会经济地位较低的粮食不安全家庭户主比粮食安全家庭户主更有可能报告心理健康不良。
这些发现强调了 FI 对马普托市家庭户主心理健康的深远影响，社会经济地位是一个重要的调节因素。解决家庭 FI 以及家庭户主的社会经济地位可能对促进心理健康至关重要，特别是在弱势群体中。
