Associations between food insecurity and common mental health problems: a systematic review and meta-analyses of observational studies

This study aimed to systematically review the literature on the association between food insecurity (FI) and common mental health problems (CMHPs). We conducted a systematic review and meta-analysis to investigate the existing evidence on the relationship between FI and CMHPs. We searched Web of Science, Scopus, and PubMed for relevant articles published through December 2020. We reported associations between FI with CMHPs using odd ratios (ORs) and 95% confidence intervals (CIs). ORs were pooled using a random-effects model. Eighteen articles were identified resulting in 113,614 pooled individuals. FI was associated with the risk of depression and stress (OR = 2.01; CI: 1.64-2.46; OR = 2.07: CI; 1.64-2.61, respectively). Sub-group analyses based on gender showed that depression risk was higher among FI males (OR = 2.63; CI:1.74-3.98, I2 = 72.2, P < 0.001). Participants with moderate and severe FI were more likely to be depressed (OR = 2.14; CI: 1.86-2.46, I2 = 0.0, P < 0.001 for moderate; OR = 2.08; CI: 1.24-3.46, I2 = 86.9, P < 0.001 for severe). Cross-sectional studies showed FI was associated with a higher risk of depression (OR = 2.32; CI: 1.86-2.88, I2 = 95.4, P < 0.001) than cohort/longitudinal studies (OR = 1.24; CI:1.12-1.37, I2 = 86.0, P < 0.001). The estimated risk of depression was higher among people with FI in Australia (OR = 5.77; CI: 2.88-11.55, P < 0.001) compared to other continents. FI Asians were at higher risk of stress (OR = 2.23; CI: 1.51-3.28, I2 = 82.4, P < 0.001) than people in the US (OR = 1.88; CI: 1.58-2.39, I2 = 5.7, P < 0.001). To alleviate the burden on CMHPs, the management of FI should be prioritized in the highest-risk regions including Australia, Asia, and Europe.