Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.
Food Insecurity Is Associated with Depression, Anxiety, and Stress: Evidence from the Early Days of the COVID-19 Pandemic in the United States.
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DOI：
10.1089/heq.2020.0059
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发表时间：
2021
期刊：
影响因子：
2.7
通讯作者：
Leung CW
中科院分区：
文献类型：
--
作者：
Wolfson JA;Garcia T;Leung CW
目的：了解美国低收入成年人在COVID-19大流行期间粮食不安全与抑郁、焦虑和压力之间的关系。研究方法：在2020年3月19日至24日期间，我们在美国（N= 1，476）的低收入成年人（<联邦贫困线的250%）中进行了一项全国性的基于网络的调查（53%的回复率）。粮食安全状况是使用18个问题的美国农业部家庭粮食安全模块衡量的。多变量调整逻辑回归模型研究了粮食不安全和心理困扰结果与COVID-19特定担忧之间的关系。还分析了来自开放式回答问题的定性数据。结果：超过三分之一的低收入成年人在抑郁（33%）、焦虑（39%）和高压力（39%）方面表现出阳性。更严重的粮食不安全与所有心理困扰结果（所有结果p趋势<0.001）和COVID-19特定担忧（所有结果p趋势<0.001）的剂量反应关系相关。与食物安全的成年人相比，食物安全非常低的成年人更容易筛查出抑郁症（比值比[OR] 7.72; 95%置信区间[CI]：5.52-10.80），焦虑症（OR 6.19; 95% CI：4.51-8.51）和高感知压力（OR 10.91; 95% CI：7.78-15.30）。极低的粮食安全也与对COVID-19对个人健康（OR 2.56; 95% CI：1.90-3.45）、收入（OR 5.18; 95% CI：3.78-7.06）和养家糊口能力（OR 9.24; 95% CI：6.61-12.92）的影响的担忧增加有关。结论：COVID-19大流行与美国低收入成年人的心理健康呈负相关，在经历粮食不安全的成年人中，这种相关性不成比例。这些差异有可能在长期内增加心理健康方面的差异。
Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19–24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=1,476). Food security status was measured using the 18-question USDA Household Food Security Module. Multivariable-adjusted logistic regression models examined the association between food insecurity and psychological distress outcomes and COVID-19-specific worries. Qualitative data from an open-response question were also analyzed. Results: More than one-third of low-income adults screened positive for depression (33%), anxiety (39%), and high stress (39%). Greater food insecurity was associated with a dose–response relationship with all psychological distress outcomes (all outcomes p-trend <0.001) and COVID-19-specific worries (all outcomes p-trend <0.001). Compared to food-secure adults, adults with very low food security were more likely to screen positive for depression (odds ratio [OR] 7.72; 95% confidence interval [CI]: 5.52–10.80), anxiety (OR 6.19; 95% CI: 4.51–8.51), and high perceived stress (OR 10.91; 95% CI: 7.78–15.30). Very low food security was also associated with increased worries about the effect of COVID-19 on one's health (OR 2.56; 95% CI: 1.90–3.45), income (OR 5.18; 95% CI: 3.78–7.06), and ability to feed one's family (OR 9.24; 95% CI: 6.61–12.92). Conclusions: The COVID-19 pandemic is negatively associated with the mental health of low-income adults in the United States, with disproportionate associations among adults experiencing food insecurity. These disparities have the potential to increase mental health disparities over the long term.