Food Insecurity and Mental Disorders in a National Sample of U.S. Adolescents - 29/11/12
, Jennifer Greif Green, Ph.D. d, Margarita Alegría, Ph.D. a, c, E. Jane Costello, Ph.D. e, Michael J. Gruber, M.S. a, Nancy A. Sampson, B.A. a, Ronald C. Kessler, Ph.D. a
Correspondence to Katie A. McLaughlin, Ph.D., Division of General Pediatrics, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115Riassunto |
Objective |
To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents.
Method |
Data were drawn from 6,483 adolescent–parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture’s Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status).
Results |
Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation.
Conclusions |
Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health.
Il testo completo di questo articolo è disponibile in PDF.Key Words : food insecurity, poverty, hunger, adolescence, mental health
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| Drs. McLaughlin, Alegría, and Kessler, and Mr. Gruber, Mrs. Sampson are with Harvard Medical School. Dr. McLaughlin is also with Boston Children's Hospital. Dr. Alegría is also with the Center for Multicultural Mental Health Research and the Cambridge Health Alliance. Dr. Green is with the School of Education, Boston University. Dr. Costello is with the Center for Developmental Epidemiology, Duke University School of Medicine. The National Comorbidity Survey Replication Adolescent Supplement (NCS-A is supported by the National Institute of Mental Health (NIMH; U01-MH60220 and R01-MH66627) with supplemental support from the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044780), and the John W. Alden Trust. Additional support for the preparation of this article was provided by NIMH grants K01-MH092526 (K.A.M.) and K01-MH085710 (J.G.G.). |
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| The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or the U.S. government. A complete list of NCS-A publications can be found at ncs. Send correspondence to hncs@hcp.med.harvard.edu. The NCS-A is carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. The WMH Data Coordination Centers have received support from the NIMH (R01-MH070884, R13-MH066849, R01-MH069864, R01-MH077883), NIDA (R01-DA016558), the Fogarty International Center of the National Institutes of Health (FIRCA R03-TW006481), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, and the Pan American Health Organization. The WMH Data Coordination Centers have also received unrestricted educational grants from Astra Zeneca, Bristol-Myers Squibb, Eli Lilly and Co., GlaxoSmithKline, Ortho-McNeil, Pfizer, Sanofi-Aventis, and Wyeth. A complete list of WMH publications can be found at wmh/. |
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| Mr. Gruber and Dr. Kessler served as the statistical experts for this research. |
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| The authors thank the staff of the WMH Data Collection and Data Analysis Coordination Centers for assistance with instrumentation, fieldwork, and consultation on data analysis. |
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| Disclosure: Dr. Kessler has served as a consultant for AstraZeneca, Analysis Group, Bristol-Myers Squibb, Cerner-Galt Associates, Eli Lilly and Co., GlaxoSmithKline Inc., HealthCore Inc., Health Dialog, Hoffman-LaRoche, Inc., Integrated Benefits Institute, John Snow Inc., Kaiser Permanente, Matria Inc., Mensante, Merck and Co., Inc., Ortho-McNeil Janssen Scientific Affairs, Pfizer Inc., Primary Care Network, Research Triangle Institute, Sanofi-Aventis Groupe, Shire US Inc., SRA International Inc., Takeda Global Research and Development, Transcept Pharmaceuticals Inc., and Wyeth-Ayerst. He has served on advisory boards for Appliance Computing II, Eli Lilly and Co., Mindsite, Ortho-McNeil Janssen Scientific Affairs, Johnson and Johnson, Plus One Health Management, and Wyeth-Ayerst. He has received research support for his epidemiologic studies from Analysis Group Inc., Bristol-Myers Squibb, Eli Lilly and Co., EPI-Q, GlaxoSmithKline, Johnson and Johnson Pharmaceuticals, Ortho-McNeil Janssen Scientific Affairs., Pfizer Inc., Sanofi-Aventis Groupe, Shire US Inc., and Walgreens Co. Dr. Kessler owns shares of DataStat Inc. Drs. McLaughlin, Green, Alegría, and Costello, Mr. Gruber, and Ms. Sampson report no biomedical financial interests or potential conflicts of interest. |
Vol 51 - N° 12
P. 1293-1303 - dicembre 2012 Ritorno al numero
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