Association between socioeconomic position of the household head, food insecurity and psychological health: an application of propensity score matching.

Autor: Militao EMA; Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, Sundsvall, SE-851 70, Sweden. elias.militao@miun.se.; Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, Gävle, 80176, Sweden. elias.militao@miun.se.; Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Maputo, 257, Mozambique. elias.militao@miun.se., Uthman OA; Warwick Centre for Global Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.; Department of Global Health, Division of Epidemiology and Biostatistics, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Cape Town, 7505, South Africa., Salvador EM; Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Maputo, 257, Mozambique., Vinberg S; Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, Sundsvall, SE-851 70, Sweden., Macassa G; Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, Gävle, 80176, Sweden. gloria.macassa@hig.se.; Department of Public Health, School of Health Sciences, University of Skövde, Skövde, 541 28, Sweden. gloria.macassa@hig.se.; EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal. gloria.macassa@hig.se.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Sep 27; Vol. 24 (1), pp. 2590. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1186/s12889-024-20153-0
Abstrakt: Background: Mental health outcomes can be influenced by various factors, one of which has recently gained attention, namely food security. Food security is paramount to maintaining not only physical, but also mental health. There is an increasing need to understand the interplay between food insecurity (FI) and mental health outcomes, especially among vulnerable populations. The objective of this study was to investigate the effect of FI on psychological health (anxiety and depression) as well as to examine the modifying effect of socioeconomic position on this relationship.
Methods: A cross-sectional study was conducted in Maputo City, Mozambique, in 1,842 participants. Data were collected through structured interviews using a modified version of the US Department of Agriculture Household Food Security Module to measure FI, and the Hospital Anxiety and Depression Scale to measure anxiety and depression. A composite variable for psychological health was created. Propensity score matching and interaction effect analyses were employed to examine the effects of FI on psychological health and the moderating role of socioeconomic position.
Results: Of the 1,174 participants randomly assigned to propensity score matching, 787 were exposed to FI while 387 were unexposed. The analysis revealed stark disparities in psychological health outcomes associated with FI. The risk of poor psychological health among those exposed to FI was 25.79%, which was significantly higher than the 0.26% in unexposed individuals. The risk difference was 25.54% points (95% CI: 22.44-28.63), with a risk ratio of 99.82. Our assessment of population attributable fractions indicated that nearly all the risk for poor psychological health in the exposed group could be ascribed to FI. The interaction effects analysis revealed that socioeconomic status modifies this relationship. Specifically, heads of food-insecure households with a lower socioeconomic position tended to report poor mental health compared to their food-secure counterparts with a higher position.
Conclusions: The findings underscore the profound impact of FI on the mental health of household heads in Maputo City, socioeconomic position being a significant modifier. Addressing household FI along with the socioeconomic position of household heads could be pivotal to mental health promotion, especially among vulnerable populations.
(© 2024. The Author(s).)
Databáze: MEDLINE
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