This week’s PHTwitJC we will be discussing the following paper:
Mental Health Context of Food Insecurity: a Representative Cohort of Families With Young Children, Maria Melchior, Avshalom Caspi, Louise M. Howard, Antony P. Ambler, Heather Bolton, Nicky Mountain and Terrie E. Moffitt
Pediatrics 2009;124;e564; originally published online September 28, 2009
What is Food Insecurity?
The WHO state that food security involves having food available (sufficienct amounts on a consistent basis), food accessible (sufficient resources to obtain food) and food use (based on knowledge of nutrition and care, as well as water and sanitation).
The authors of this study have defined food insecurity as “families that lack access to sufficient, safe and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life” (p.e565)
Why is Food Insecurity a Public Health concern?
Food insecurity has been shown to impact upon children’s behaviour and development. As the authors of this study summarise: “food insecurity… occurs most frequently in families with low socioeconomic position and low income; however, interventions that supplement families’ income or diet have not eradicated food insecurity.” (p.e564)
More widely there is a great deal of debate around food security with some arguing that:
- There is enough food in the world to feed everyone adequately; the problem is distribution.
- Future food needs can – or cannot – be met by current levels of production.
- National food security is paramount – or no longer necessary because of global trade.
- Globalization may – or may not – lead to the persistence of food insecurity and poverty in rural communities. (Source: WHO)
Aim: the study aimed to test the hypothesis that low socio-economic status families are more vulnerable to be food insecure when the mother experiences depression, alcohol and/or drug abuse, psychosis spectrum disorders or domestic violence.
Setting: British cohort “Environmental Risk Logitudinal Study” which had recruited 1116 families in 1999 and were followed until 2006.
Method: a number of validated measures were used to assess family socio-demographic factors (assessed in 1999-2000), maternal mental health and domestic violence (assessed 2001-2002), children behavioural outcomes at age 10 (assessed 2005-2006) and food insecurity (assessed twice: 2001-2002, and 2005-2006). Mothers provided the information to trained interviewers.
Result: 9.7% of families (n=108) were reported to be food insecure. When socio-economic status was controlled (as a known confounder) – multiple regression analyses reported food insecurity was correlated with maternal depression, psychosis and domestic violence.
Discussion Points for Journal Club
- Were the aims of the study clear?
- Were the parameters used clear, relevant and valid?
- Are the findings justifiable considering the information inputted ?
- Could anything else explain the results (chance, bias, confounders?)
- What implications do the findings have for public health practice & policy?