Household Food Insecurity Is Positively Associated with Depression among Low-Income Supplemental Nutrition Assistance Program Participants and Income-Eligible Nonparticipants
Household Food Insecurity Is Positively Associated with Depression among Low-Income Supplemental Nutrition Assistance Program Participants and Income-Eligible Nonparticipants
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DOI：
10.3945/jn.114.199414
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发表时间：
2015-03-01
影响因子：
4.2
通讯作者：
Laraia, Barbara A.
中科院分区：
文献类型：
--
作者：
Leung, Cindy W.;Epel, Elissa S.;Laraia, Barbara A.
背景：粮食不安全与不良的心理健康结果有关。鉴于补充营养援助计划（SNAP）等联邦粮食援助计划旨在缓解粮食不安全，因此根据SNAP参与状况，粮食不安全与抑郁症之间的关联可能存在异质性。目的：根据2005-2010年全国家庭健康和营养状况调查的数据，我们研究了家庭食品安全和抑郁症之间的关系，以及这些关系是否因SNAP参与而不同。研究人群仅限于3518名家庭收入= 3的成年人，被认为是粮食不安全。采用9项患者健康问卷对抑郁症进行评估，并将其定义为得分>= 10。多变量logistic回归模型研究了食品不安全和抑郁症之间的关联，调整社会人口和健康characteristics.Results：抑郁症的总体患病率为9.3%，从6.7%之间SNAP nonparticipants到12.8%之间SNAP参与者。对于每一种抑郁症状，都存在剂量反应关系，因此随着粮食不安全状况的恶化，观察到更高的患病率。多变量校正后，食物不安全与抑郁呈正相关（P趋势< 0.0001），但SNAP参与改变了这种关系（P交互= 0.03）。在低收入，合格的非参与者中，非常低的食品安全与抑郁症的高风险显著相关（OR：5.10; 95%CI：3.09，8.41）。在SNAP参与者中，非常低的食品安全也与抑郁症的几率较高，但在较低的幅度（OR：2.21; 95%CI：1.54，3.17）。结论：食品不安全和心理健康之间的复杂关系可能会有所不同的基础上SNAP参与状态。解决其受益人抑郁症风险的方案努力可能会对低收入成年人的心理健康产生积极影响。
Background: Food insecurity is associated with adverse mental health outcomes. Given that federal food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), aim to alleviate food insecurity, there may be heterogeneity in the association between food insecurity and depression by SNAP participation status.Objective: With the use of data from the 2005-2010 NHANES, we examined the associations between household food security and depression and whether these differed by SNAP participation.Methods: The study population was restricted to 3518 adults with household incomes = 3 was considered food insecure. Depression was assessed with the 9-item Patient Health Questionnaire and was defined as a score of >= 10. Multivariate logistic regression models examined the associations between food insecurity and depression, adjusting for sociodemographic and health characteristics.Results: The overall prevalence of depression was 9.3%, ranging from 6.7% among SNAP nonparticipants to 12.8% among SNAP participants. For every depressive symptom, there was a dose-response relation, such that a higher prevalence was observed with worsening food insecurity. After multivariate adjustment, food insecurity was positively associated with depression (P-trend < 0.0001), but SNAP participation modified this relation (P-interaction = 0.03). Among low-income, eligible nonparticipants, very low food security was significantly associated with higher odds of depression (OR: 5.10; 95% CI: 3.09, 8.41). Among SNAP participants, very low food security was also associated with higher odds of depression but at a lower magnitude (OR: 2.21; 95% CI: 1.54, 3.17).Conclusion: The complex relation between food insecurity and mental health may vary on the basis of SNAP participation status. Programmatic efforts to address the risk of depression among their beneficiaries may positively affect the mental health of low-income adults.