The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19-24 March 2020 we fielded a national, web-based survey (53% response rate) among adults with <250% of the federal poverty line in the US (N = 1478). Measures included household food security status and COVID-19-related basic needs challenges. Overall, 36% of low-income adults in the US were food secure, 20% had marginal food security, and 44% were food insecure. Less than one in five (18.8%) of adults with very low food security reported being able to comply with public health recommendations to purchase two weeks of food at a time. For every basic needs challenge, food-insecure adults were significantly more likely to report facing that challenge, with a clear gradient effect based on severity of food security. The short-term effects of the COVID-19 pandemic are magnifying existing disparities and disproportionately affecting low-income, food-insecure households that already struggle to meet basic needs. A robust, comprehensive policy response is needed to mitigate food insecurity as the pandemic progresses.

https://www.mdpi.com/2072-6643/12/6/1648/pdf

Food Insecurity and COVID-19: Disparities in Early Effects for US Adults.

Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. The research databases PubMed, EMBASE, and psycINFO were searched using keywords capturing food insecurity, mental health, and women. Thirty-nine articles (representing 31 unique studies/surveys) were identified. Three-quarters of the articles drew upon data from a version of the United States Department of Agriculture Household Food Security Survey Module. A range of mental health measures were used, most commonly to measure depression and depressive symptoms, but also anxiety and stress. Most research was cross-sectional and showed associations between depression and food insecurity; longitudinal analyses suggested bidirectional relationships (with food insecurity increasing the risk of depressive symptoms or diagnosis, or depression predicting food insecurity). Several articles focused on vulnerable subgroups, such as pregnant women and mothers, women at risk of homelessness, refugees, and those who had been exposed to violence or substance abuse. Overall, this review supports a link between food insecurity and mental health (and other factors, such as housing circumstances and exposure to violence) among women in high-income countries and underscores the need for comprehensive policies and programs that recognize complex links among public health challenges.

https://www.mdpi.com/1660-4601/15/7/1424/pdf

Food Insecurity and Mental Health among Females in High-Income Countries.

Background The current study examines interrelationships between social vulnerability, individual stressors, social and psychological resources, and depressive symptomatology among US adults during the current coronavirus disease 2019 (COVID-19) pandemic. Methods Using an online survey platform, a poststratified (by age, gender, race, income, and geography), representative sample (n = 10,368 adults) is used in the analysis. Results On average, sample respondents report Center for Epidemiological Studies Depression (CES-D) Scale symptomatology nearly a point higher than the often used cutoff score for clinical caseness (16+); one-third of respondents had CES-D scores higher than 25. Multiple regression results show elevated levels of depressive symptomatology among the socially vulnerable (women, Hispanic, unmarried, not working). Those persons expressing heightened COVID-19 fear and moderate to high levels of food insecurity report more depressive symptoms than persons with less fear and low or no food insecurity. All three of the resource variables (mastery of fate, strength of ties, and optimism) are significant and in the negative direction. Conclusions In a snapshot, the data provide an important point prevalence assessment of adult depressive symptoms during the current public health crisis. Results highlight the significance of vulnerability and individual stressors in the wake of the COVID-19 pandemic. In addition, the analysis affirms the importance of access to social and psychological resources to combat heightened fear and anxiety that persons report during the current pandemic.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/da.23080

Living in the midst of fear: Depressive symptomatology among US adults during the COVID-19 pandemic.

Young adults in Appalachia may face poor nutritional status due to low access to healthy food and high mental health symptoms attributed to high stress and the college environment. A cross-sectional design was used to investigate the relationship between diet intake and mental health status of this population via surveys. Participant responses (n = 1956) showed students’ mean number of depressed days over the past 30 days was 9.67 ± 8.80, and of anxious days, 14.1 ± 10.03. The mean fruit and vegetable intake was 1.80 ± 1.27 times per day and the mean added sugars intake was 1.79 ± 1.26 times per day. 36.7% of students were found to be food insecure. One-way ANOVA and Chi-Squared analyses were used to determine relationship between variables. Significant variables were placed into a full logistic regression model. Food insecurity and fruit and vegetable intake remained significant predictors of depression in males (odds ratio (OR) = 2.33 95% CI 1.47–3.71 and OR = 68 95% CI 50–89, respectively) and in females food insecurity remained a significant predictor of depression (OR = 2.26 95% CI 1.67–3.07). Food insecurity and added sugars intake were significant predictor of anxiety in males (OR = 2.33 95% CI 1.47–3.71 and OR = 1.09 95% CI 0.91–1.3, respectively) and for anxiety in females, added sugars intake and food insecurity were significant predictors (OR = 1.18 95% CI 1.05–1.32 and OR = 1.65 95% CI 1.27–2.16, respectively). Improving college student’s diet intake through increased access to healthy foods could improve the mental health and well-being of students.

/pdf/relationship-between-diet-and-mental-health-in-a-young-adult-3vcu9l0x9c.pdf

Relationship between Diet and Mental Health in a Young Adult Appalachian College Population

Objective: To examine associations between sociodemographic and mental health characteristics with household risk for food insecurity during the COVID-19 outbreak. Design:
 Cross-sectional online survey analysed using univariable tests and a multivariable logistic regression model. Setting:
 The United States during the week of 30 March 2020. Participants:
 A convenience sample of 1965 American adults using Amazon’s Mechanical Turk platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. Results:
 One thousand two hundred and fifty participants reported household food security before the COVID-19 outbreak. Among this subset, 41 % were identified as at risk for food insecurity after COVID-19, 55 % were women and 73 % were white. On a multivariable analysis, race, income, relationship status, living situation, anxiety and depression were significantly associated with an incident risk for food insecurity. Black, Asian and Hispanic/Latino respondents, respondents with an annual income <$100 000 and those living with children or others were significantly more likely to be newly at risk for food insecurity. Individuals at risk for food insecurity were 2·60 (95 % CI 1·91, 3·55) times more likely to screen positively for anxiety and 1·71 (95 % CI 1·21, 2·42) times more likely to screen positively for depression. Conclusions:
 An increased risk for food insecurity during the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between being at risk for food insecurity and anxiety/depression. Interventions to increase access to healthful foods, especially among minority and low-income individuals, and ease the socioemotional effects of the outbreak are crucial to relieving the economic stress of this pandemic.

/pdf/predictors-of-households-at-risk-for-food-insecurity-in-the-4ioqzfv2ws.pdf

E. Maddocks

Papers

Food insecurity and mental illness: disproportionate impacts in the context of perceived stress and social isolation