Park Sungchul, Berkowitz Seth A
Department of Health Policy and Management, Korea University - Seoul Campus, Seoul, Korea (the Republic of)
Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
J Epidemiol Community Health. 2025 Apr 10;79(5):332-339. doi: 10.1136/jech-2024-221900.
Food insecurity poses a substantial threat to mental health. However, there is limited understanding of how food-insecure adults experience mental health challenges and access necessary health services. We examined the association of food insecurity with mental health status, mental health service utilisation and general healthcare utilisation among US adults.
A retrospective longitudinal cohort study was conducted to analyse data from 9906 US adults participating in the 2016-2017 Medical Expenditure Panel Survey. Outcomes included mental health status, mental health service utilisation and general healthcare utilisation. The primary independent variable was food insecurity measured using the 10-item Food Security Survey Module. Two separate models were used: A lagged-dependent model and a fixed-effect model.
The lagged dependent model showed that food insecurity in 1 year was associated with a higher likelihood of reporting mental health symptoms based on the Patient Health Questionnaire and the Kessler 6 Psychological Distress Scale (3.5 percentage points (95% CI: 1.3 to 5.8)) and self-reported poor mental health (5.8 percentage points (2.9 to 8.7)) in the subsequent year. However, compared with food-secure adults, food-insecure adults were no more likely to have outpatient mental health visits, specialty mental health visits or psychotropic medication fills. Moreover, food-insecure adults were 4.1 (1.2 to 7.0) percentage points more likely to have an emergency room visit than food-secure adults. These findings were consistent with the fixed-effect model.
Food insecurity is associated with worse mental health. However, food-insecure adults may not access adequate mental health services and instead rely on emergency room visits.
粮食不安全对心理健康构成重大威胁。然而，对于粮食不安全的成年人如何经历心理健康挑战以及获得必要的医疗服务，人们的了解有限。我们研究了美国成年人中粮食不安全与心理健康状况、心理健康服务利用情况和一般医疗服务利用情况之间的关联。
进行了一项回顾性纵向队列研究，以分析参与2016 - 2017年医疗支出小组调查的9906名美国成年人的数据。结果包括心理健康状况、心理健康服务利用情况和一般医疗服务利用情况。主要自变量是使用10项粮食安全调查模块测量的粮食不安全状况。使用了两个单独的模型：滞后依存模型和固定效应模型。
滞后依存模型显示，基于患者健康问卷和凯斯勒6项心理困扰量表，前一年的粮食不安全与次年报告心理健康症状的可能性更高相关（3.5个百分点（95%置信区间：1.3至5.8）），以及自我报告的心理健康状况不佳（5.8个百分点（2.9至8.7））。然而，与粮食安全的成年人相比，粮食不安全的成年人进行门诊心理健康就诊、专科心理健康就诊或使用精神药物的可能性并没有更高。此外，粮食不安全的成年人进行急诊室就诊的可能性比粮食安全的成年人高4.1（1.2至7.0）个百分点。这些发现与固定效应模型一致。
粮食不安全与更差的心理健康状况相关。然而，粮食不安全的成年人可能无法获得足够的心理健康服务，而是依赖急诊室就诊。
