Abstract
Objective
Adults in food-insecure households will often sacrifice their own nutritional needs so that children are fed first. This shielding may protect children from malnutrition, but its links to mental health and well-being have not been closely examined. The aim of this study is to explore these links.
Methods
We used data from three cycles of the Canadian Community Health Survey (n = 28,871 youth, 74,416 adults) to identify shielded children (those who reported not being food insecure but lived in food-insecure households). Using Poisson regression, we examined youth and adult mental health and well-being (mood disorder, anxiety disorder, fair/poor mental health, fair/poor health, and low life satisfaction) in shielding households compared to food-secure households and food-insecure households where children were not shielded.
Results
About one in six (15.3%) households with children was food insecure. One third of these (6.3%) included children who were shielded from experiencing food insecurity. Shielded youth did not differ significantly from food-secure youth in three of the five outcomes examined. However, unshielded youth, compared to food-secure youth, showed increased risks of every health outcome we investigated. Adults in food-insecure households also reported worse mental health than food-secure adults but better mental health if children were shielded.
Conclusion
Shielding is associated with reduced risk of common psychiatric outcomes and poor mental health in youth and adults, possibly because it is associated with milder forms of food insecurity. The inability to protect children from having inadequate access to food may compound the psychological strain of food insecurity on mental health and well-being among adults.
Résumé
Objectif
Les adultes d’un ménage en insécurité alimentaire sacrifient souvent leurs propres besoins nutritionnels afin que les enfants soient nourris en priorité. Cette protection peut préserver les enfants de la malnutrition, mais ses liens avec la santé mentale et le bien-être n’ont pas été spécifiquement examinés. L’objectif de cette étude est d’explorer ces liens.
Méthode
Nous avons utilisé les données de trois cycles de l’Enquête sur la santé dans les collectivités canadiennes (n = 28 871 jeunes, 74 416 adultes) dans le but d’identifier les ménages en insécurité alimentaire dans lesquels les enfants ne se trouvaient pas en insécurité alimentaire ( « protégés »). Afin de comparer la santé mentale et le bien-être des jeunes et adultes vivant au sein d’un ménage en insécurité alimentaire « protégé » par rapport aux individus vivant au sein d’un ménage en sécurité alimentaire et d’un ménage en insécurité alimentaire où les enfants n’étaient pas protégés de cette insécurité, nous avons utilisé la régression de Poisson.
Résultats
Environ un ménage avec des enfants sur six (15,3 %) était en insécurité alimentaire. Un tiers de ces enfants (6,3 %) étaient protégés de l’insécurité alimentaire. Les enfants « protégés » ne différaient pas significativement des enfants vivant au sein d’un ménage en sécurité alimentaire pour la plupart des résultats concernant la santé mentale. Les enfants « non protégés » ont montré des risques accrus pour chaque indicateur étudié (trouble de l’humeur, trouble de l’anxiété, santé mentale moyenne/ mauvaise, santé moyenne/ mauvaise, faible satisfaction de la vie). Les adultes vivant dans un ménage en insécurité alimentaire ont également déclaré une plus mauvaise santé mentale que les adultes vivant dans un ménage en sécurité alimentaire, mais une meilleure santé mentale lorsque les enfants du ménage étaient protégés de l’insécurité alimentaire.
Conclusion
La protection des enfants au sein d’un ménage en insécurité alimentaire est associé à une réduction du risque de problèmes psychiatriques communs et de mauvaise santé mentale chez les jeunes et les adultes, possiblement parce que les ménages dans lesquels les enfants sont protégés font face à des formes plus légères d’insécurité alimentaire. L’incapacité de protéger les enfants et l’accès inadéquat à la nourriture peut aggraver la pression psychologique de l’insécurité alimentaire sur la santé mentale et le bien-être des adultes.
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Availability of data and material
Public Use Microdata Files for the Canadian Community Health Survey are publicly available through the Data Liberation Initiative of Statistics Canada.
Code availability
Available upon request.
References
Ashiabi, G. S., & O’Neal, K. K. (2007). Food insecurity and adjustment problems in a national sample of adolescents. Journal of Children and Poverty, 13(2), 111–132. https://doi.org/10.1080/10796120701520226
Bernard, R., Hammarlund, R., Bouquet, M., et al. (2018). Parent and child reports of food insecurity and mental health: Divergent perspectives. The Ochsner Journal, 18(4), 318–325. https://doi.org/10.31486/toj.18.0037
Bickel, G., Nord, M., Price, C., et al. (2000). Guide to measuring household food security. United States Department of Agriculture. https://naldc.nal.usda.gov/download/38369/PDF. Accessed July 29, 2021.
Bøe, T., Øverland, S., Lundervold, A. J., & Hysing, M. (2012). Socioeconomic status and children’s mental health: Results from the Bergen Child Study. Social Psychiatry and Psychiatric Epidemiology, 47(10), 1557–1566. https://doi.org/10.1007/s00127-011-0462-9
Brisebois, F., & Thivierge, S. (2001). The weighting strategy of the Canadian Community Health Survey. American Statistical Association.
Chiu, M., Amartey, A., Wang, X., & Kurdyak, P. (2018). Ethnic differences in mental health status and service utilization: A population-based study in Ontario, Canada. Canadian Journal of Psychiatry, 63(7), 481–491. https://doi.org/10.1177/0706743717741061
Coleman-Jensen, A., McFall, W., & Nord, M. (2013). Food insecurity in households with children: Prevalence, severity, and household characteristics, 2010-11, EIB-113, U.S. Department of Agriculture, Economic Research Service. https://www.ers.usda.gov/webdocs/publications/43763/37672_eib-113.pdf.
Dhunna, S., & Tarasuk, V. (2021). Black–white racial disparities in household food insecurity from 2005 to 2014, Canada. Canadian Journal of Public Health, 112, 888–902. https://doi.org/10.17269/s41997-021-00539-y.
Elgar, F. J., Craig, W., & Trites, S. J. (2013). Family dinners, communication, and mental health in Canadian adolescents. Journal of Adolescent Health, 52(4), 433–438. https://doi.org/10.1016/j.jadohealth.2012.07.012
Firth, J., Gangwisch, J. E., Borisini, A., et al. (2020). Food and mood: How do diet and nutrition affect mental wellbeing? BMJ, 369, m2382. https://doi.org/10.1136/bmj.m2382
Food and Agricultural Organisation. (2020). The state of food security and nutrition in the world 2019: Transforming food systems for affordable healthy diets. Safeguarding against economic slowdowns and downturns. FAO, Rome. https://doi.org/10.4060/ca9692en. Accessed 20 Nov 2021.
Fram, M. S., Frongillo, E. A., Jones, S. J., et al. (2011). Children are aware of food insecurity and take responsibility for managing food resources. Journal of Nutrition, 141(6), 1114–1119. https://doi.org/10.3945/jn.110.135988
Hamelin, A. M., Beaudry, M., & Habicht, J. P. (2002). Characterization of household food insecurity in Québec: Food and feelings. Social Science and Medicine, 54(1), 119–132. https://doi.org/10.1016/s0277-9536(01)00013-2
Health Canada. (n.d.). Determining food security status. https://www.canada.ca/en/health-canada/services/food-nutrition/food-nutrition-surveillance/health-nutrition-surveys/canadian-community-health-survey-cchs/household-food-insecurity-canada-overview/determining-food-security-status-food-nutrition-surveillance-health-canada.html. Accessed July 29, 2021.
Jenkins, T. A., Nguyen, J. C., Polglaze, K. E., & Bertrand, P. P. (2016). Influence of tryptophan and serotonin on mood and cognition with a possible role of the gut-brain axis. Nutrients, 8(1), 56. https://doi.org/10.3390/nu8010056
Kirkpatrick, S. I., Dodd, K. W., Parsons, R., et al. (2015). Household food insecurity is a stronger marker of adequacy of nutrient intakes among Canadian compared to American youth and adults. Journal of Nutrition, 145, 1596–1603. https://doi.org/10.3945/jn.114.208579
Madigan, S., Oatley, H., Racine, N., et al. (2018). A meta-analysis of maternal prenatal depression and anxiety on child socioemotional development. Journal of the American Academy of Child and Adolescent Psychiatry, 57(9), 645–657.e8. https://doi.org/10.1016/j.jaac.2018.06.012
Martin, M. S., Maddocks, E., Chen, Y., Gilman, S. E., & Colman, I. (2016). Food insecurity and mental illness: Disproportionate impacts in the context of perceived stress and social isolation. Public Health, 132, 86–91. https://doi.org/10.1016/j.puhe.2015.11.014
Maynard, M. S., Perlman, C. M., & Kirkpatrick, S. I. (2019). Food insecurity and perceived anxiety among adolescents: An analysis of data from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). Journal of Hunger & Environmental Nutrition, 14, 339–351. https://doi.org/10.1080/19320248.2017.1393363
McLaughlin, K. A., Green, J. G., Alegría, M., et al. (2012). Food insecurity and mental disorders in a national sample of U.S. adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1293–1303. https://doi.org/10.1016/j.jaac.2012.09.009
Melchior, M., Chastang, J. F., Falissard, B., et al. (2012). Food insecurity and children’s mental health: A prospective birth cohort study. PLoS ONE, 7(12), e52615. https://doi.org/10.1371/journal.pone.0052615
Men, F., Elgar, F. J., & Tarasuk, V. (2021). Food insecurity is associated with mental health problems among Canadian youth. Journal of Epidemiology and Community Health, 75(8), 741–748. https://doi.org/10.1136/jech-2020-216149
Nagata, J. M., Palar, K., Gooding, H. C., et al. (2019). Food insecurity is associated with poorer mental health and sleep outcomes in young adults. Journal of Adolescent Health, 65(6), 805–811. https://doi.org/10.1016/j.jadohealth.2019.08.010
O’Donnell, S., Vanderloo, S., McRae, L., et al. (2016). Comparison of the estimated prevalence of mood and/or anxiety disorders in Canada between self-report and administrative data. Epidemiology and Psychiatric Sciences, 25, 360–369. https://doi.org/10.1017/S2045796015000463
Owen, L., & Corfe, B. (2017). The role of diet and nutrition on mental health and wellbeing. The Proceedings of the Nutrition Society, 76, 425–426. https://doi.org/10.1017/S0029665117001057
Porter, R. J., & Gallagher, P. (2006). Abnormalities of the HPA axis in affective disorders: Clinical subtypes and potential treatments. Acta Neuropsychiatrica, 18(5), 193–209. https://doi.org/10.1111/j.1601-5215.2006.00152.x
Pryor, L., Lioret, S., van der Waerden, J., Fombonne, É., Falissard, B., & Melchior, M. (2016). Food insecurity and mental health problems among a community sample of young adults. Social Psychiatry and Psychiatric Epidemiology, 51(8), 1073–1081. https://doi.org/10.1007/s00127-016-1249-9
Sentenac, M., Gariepy, G., McKinnon, B., & Elgar, F. J. (2016). Hunger and overweight in Canadian school-aged children: A propensity score matching analysis. Canadian Journal of Public Health, 107(4–5), e447–e452. https://doi.org/10.17269/cjph.107.5526
StataCorp. (2011). Multiple-imputation reference manual. Stata Press.
Statistics Canada. (n.d.) Canadian Community Health Survey - Annual Component (CCHS). Available online at: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&Id=1314175. Accessed 10 Nov 2021.
Tarasuk, V., Li, N., Dachner, N., & Mitchell, A. (2019). Household food insecurity in Ontario during a period of poverty reduction, 2005–2014. Canadian Public Policy, 45(1), 93–104. https://doi.org/10.3138/cpp.2018-054
Tarasuk, V., & Mitchell, A. (2020). Household food insecurity in Canada, 2017-18. Toronto ON. https://proof.utoronto.ca/resources/proof-annual-reports/household-food-insecurity-in-canada-2017-2018/. Accessed 20 Nov 2021.
Vanzella-Yang, A, & Veenstra, G. (2021). Socio-economic resources and adult mental health in Canada: Controlling for time-invariant confounders and investigating causal directionality. Canadian Journal of Public Health, 112, 1042–1049. https://doi.org/10.17269/s41997-021-00547-y
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Supported by grants from the Canadian Institutes of Health Research (PJT-162463, PJT-165971), Social Sciences and Humanities Research Council (435-2019-1083), and Canada Research Chairs Program.
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All the authors contributed to the study conception and design. Literature review and data cleaning and analysis were performed by MO and FE. The first draft of the manuscript was written by MO. MADS assisted with data analysis and editing of the manuscript. All the authors commented on previous versions of the manuscript and read and approved the final manuscript.
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Ovenell, M., Azevedo Da Silva, M. & Elgar, F.J. Shielding children from food insecurity and its association with mental health and well-being in Canadian households. Can J Public Health 113, 250–259 (2022). https://doi.org/10.17269/s41997-021-00597-2
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DOI: https://doi.org/10.17269/s41997-021-00597-2