Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey

Abstract Objective: To investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression. Design: Cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identific...

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Bibliographic Details
Main Authors: Siphiwe N Dlamini (Author), Ashleigh Craig (Author), Asanda Mtintsilana (Author), Witness Mapanga (Author), Justin Du Toit (Author), Lisa J Ware (Author), Shane A Norris (Author)
Format: Book
Published: Cambridge University Press, 2023-04-01T00:00:00Z.
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Summary:Abstract Objective: To investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression. Design: Cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression. Setting: South Africa during COVID-19, October 2021. Participants: Nationally representative sample of 3402 adults, weighted to 39,640,674 South African households. Results: About 20·4 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from 'food secure' to 'at risk' or from 'at risk' to 'food insecure' group was associated with 1·7 times greater odds of being in a higher category of anxiety or depression (P < 0·001). All coping strategies were used to some extent in South African households, with 46·0 % relying on less preferred and less expensive foods and 20·9 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all P < 0·001), begging for food was associated with the highest odds (OR = 2·3). Conclusions: Food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.
Item Description:10.1017/S1368980023000186
1368-9800
1475-2727