Public Health Nutrition Editorial Highlight ‘Food insufficiency is associated with depression among street-involved youth in a Canadian setting’ Authors Julia Goldman-Hasbun, Ekaterina Nosova, Kora DeBeck, Lucia Dahlby and Thomas Kerr discuss their research below.

Youth who live or work on the street often struggle to obtain nutritious and reliable food supplies. Food insecurity has been associated with many health issues such as nutritional deficiencies, kidney disease, obesity, and diabetes. Some studies have shown food insecurity to be associated with mental illness, including depression, among adults. To our knowledge, our study was the first to examine the association between food insufficiency – a form of food insecurity defined by hunger – and symptoms of depression among a population of street youth. We drew on survey data from a cohort of street-involved youth who use illicit drugs in Vancouver, Canada, to examine whether the likelihood of depression increased as the level of food insufficiency increased.

We used data collected from 1066 participants aged 14 to 26 between April 2006 and November 2013. Food insufficiency was measured through responses to the survey question “I am often hungry but I don’t eat because I can’t afford enough food”. Depression was measured using the Centre for Epidemiological Studies Depression (CES-D) scale. We also considered several other factors that might explain the relationship between food insufficiency and depression, including homelessness, gender and ethnicity, employment, and education.

Our study found a high rate of both depression and food insufficiency, with more than 5 out of 10 youth reporting depression, and nearly 7 out of 10 youth reporting some level of food insufficiency. We also observed that the likelihood of depression increased as the level of food insufficiency increased. Stress, anxiety, nutritional deficiencies, shame, trauma, and hopelessness triggered by food insufficiency may help explain this association. These findings are consistent with other studies that have found the rates of mental illness and food insufficiency to be high among vulnerable populations of youth. Previous studies have also found that street youth experience many barriers to mental health care and that food banks and other food security interventions are often unable to meet demands.

Our findings suggest that there is an urgent need to increase access to quality mental health and food security interventions among this population of youth, and increase linkages between the two. It is also critical that policies and programs focus on the social and environmental determinants of food access, such as formal employment and stable housing.

The full article ‘Food insufficiency is associated with depression among street-involved youth in a Canadian setting’ published in Public Health Nutrition is available to download for free until 30th April 2019.

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