Food insufficiency is associated with psychiatric morbidity in a nationally representative study of mental illness among food insecure Canadians

  • Katherine A. MuldoonEmail author
  • Putu K. Duff
  • Sarah Fielden
  • Aranka Anema
Original Paper



Studies suggest that people who are food insecure are more likely to experience mental illness. However, little is known about which aspects of food insecurity place individuals most at risk of mental illness. The purpose of this study was to establish the prevalence of mental illness among food insecure Canadians, and examine whether mental illness differs between those who are consuming insufficient amounts of food versus poor quality foods.


This analysis utilized the publically available dataset from the Canadian Community Health Survey cycle 4.1. Bivariable and multivariable logistic regression were used to examine the associations between food insecurity and mental health disorder diagnosis, while adjusting for potential confounders. Stratified analyses were used to identify vulnerable sub-groups.


Among 5,588 Canadian adults (18–64 years) reporting food insecurity, 58 % reported poor food quality and 42 % reported food insufficiency. The prevalence of mental health diagnosis was 24 % among participants with poor food quality, and 35 % among individuals who were food insufficient (hunger). After adjusting for confounders, adults experiencing food insufficiency had 1.69 adjusted-odds [95 % confidence interval (CI): 1.49–1.91] of having a mental health diagnosis. Stratified analyses revealed increased odds among women (a-OR 1.89, 95 % CI 1.62–2.20), single parent households (a-OR 2.05, 95 % CI 1.51–2.78), and non-immigrants (a-OR 1.88, 95 % CI 1.64–2.16).


The prevalence of mental illness is alarmingly high in this population-based sample of food insecure Canadians. These findings suggest that government and community-based programming aimed at strengthening food security should integrate supports for mental illness in this population.


Food insecurity Food insufficiency Hunger Mental illness Canada 



The authors wish to greatly acknowledge Dr. Mieke Koehoorn for her ongoing support and helpful comments on this manuscript which was written as part of a graduate course at UBC; KAM designed the research, analyzed the data; KAM wrote the first draft, PD, SF and AA supported the final manuscript; AA had primary responsibility for the final content. All authors read and approved the final manuscript. KAM is funded through a doctoral fellowship through the Canadian Association for HIV/AIDS Research administered by the Canadian Institute for Health Research (CIHR). PD is funded through the Population Health Intervention Research Network. SF is funded through a CIHR post-doctoral award. AA is funded through the Vanier Canada Graduate Scholarships of CIHR.


  1. 1.
    Health Canada (2004) Income-Related Household Food Security in CanadaGoogle Scholar
  2. 2.
    Levin BW, Browner CH (2005) The social production of health: critical contributions from evolutionary, biological, and cultural anthropology. Soc Sci Med 61(4):745–750PubMedCrossRefGoogle Scholar
  3. 3.
    Collins L (2005) The impact of food insecurity on women’s mental health. J Assoc Res Mothering 11(1):251–262Google Scholar
  4. 4.
    Webb P, Coates J, Frongillo EA, Rogers BL, Swindale A, Bilinsky P (2006) Measuring household food insecurity: why it’s so important and yet so difficult to do. J Nutr 136(5):1404S–1408SPubMedGoogle Scholar
  5. 5.
    United Nations Subcommittee on Nutrition (2001) United Nations Subcommittee on Nutrition: Nutrition and HIV/AIDS. Nairobi, KenyaGoogle Scholar
  6. 6.
    Guerrant RL, Oriá RB, Moore SR, Oriá MOB, Lima AAM (2008) Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev 66(9):487–505PubMedCrossRefGoogle Scholar
  7. 7.
    Gucciardi E, Vogt JA, DeMelo M, Stewart DE (2009) Exploration of the relationship between household food insecurity and diabetes in Canada. Diabetes Care 32(12):2218–2224PubMedCrossRefGoogle Scholar
  8. 8.
    Thompson B, Amoroso L (2010) Combating micronutrient deficiencies: food-based approaches. Food and Agriculture Organization of the United NationsGoogle Scholar
  9. 9.
    Stuff JE, Casey PH, Szeto KL, Gossett JM, Robbins JM, Simpson PM, Connell C, Bogle ML (2004) Household food insecurity is associated with adult health status. J Nutr 134(9):2330–2335PubMedGoogle Scholar
  10. 10.
    Siefert K, Heflin CM, Corcoran M, Williams DR (2004) Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients. J Health Soc Behav 45:171–186PubMedCrossRefGoogle Scholar
  11. 11.
    Chilton M, Booth S (2007) Hunger of the body and hunger of the mind: African American women’s perceptions of food insecurity, health and violence. J Nutr Educ Behav 39(3):116–125PubMedCrossRefGoogle Scholar
  12. 12.
    Melchior M, Caspi A, Howard LM, Ambler AP, Bolton H, Mountain N, Moffitt TE (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatrics 124(4):e564–e572PubMedCrossRefGoogle Scholar
  13. 13.
    Anema A, Wood E, Weiser SD, Qi J, Montaner JS, Kerr T (2010) Hunger and associated harms among injection drug users in an urban Canadian setting. Subst Abus Treat Prev Policy 5:20CrossRefGoogle Scholar
  14. 14.
    Che J, Chen J (2001) Food insecurity in Canadian households. Health rep/Stat Can Can Cent Health Inf 12(4):11–22Google Scholar
  15. 15.
    Vozoris NT, Tarasuk VS (2003) Household food insufficiency is associated with poorer health. J Nutr 133(1):120–126PubMedGoogle Scholar
  16. 16.
    Statistics Canada (2009) Canadian Community Health Survey (CCHS)—Annual component user guideGoogle Scholar
  17. 17.
    Frongillo EA (1999) Validation of measures of food insecurity and hunger. J Nutr 129(2S Suppl):506S–509SPubMedGoogle Scholar
  18. 18.
    American Psychological Association. Diagnostic and statistical manual of mental health disorders, 4th edn Washington, DCGoogle Scholar
  19. 19.
    Wade TJ, Veldhuizen S, Cairney J (2011) Prevalence of psychiatric disorder in lone fathers and mothers: examining the intersection of gender and family structure on mental health. Can J Psychiatry 56(9):567–573PubMedGoogle Scholar
  20. 20.
    Sim SM, Glanville NT, McIntyre L (2011) Food management behaviours in food-insecure, lone mother-led families. Can J Diet Pract Res: Publ Diet of Can 72(3):123–129CrossRefGoogle Scholar
  21. 21.
    Pahwa P, Karunanayake CP, McCrosky J, Thorpe L (2012) Longitudinal trends in mental health among ethnic groups in Canada. Chronic Dis Inj Can 32(3):164–176PubMedGoogle Scholar
  22. 22.
    Kirkpatrick SI, Tarasuk V (2011) Housing circumstances are associated with household food access among low-income urban families. J Urban Health: bull NY Acad Med 88(2):284–296CrossRefGoogle Scholar
  23. 23.
    Kirkpatrick SI, Tarasuk V (2008) Food insecurity in Canada: considerations for monitoring. Can J Public Health 99(4):324–327PubMedGoogle Scholar
  24. 24.
    Heflin CM, Siefert K, Williams DR (2005) Food insufficiency and women’s mental health: findings from a 3-year panel of welfare recipients. Soc Sci Med 61(9):1971–1982PubMedCrossRefGoogle Scholar
  25. 25.
    Crosier T, Butterworth P, Rodgers B (2007) Mental health problems among single and partnered mothers. The role of financial hardship and social support. Soc Psychiatry Psychiatr Epidemiol 42(2):6–13PubMedCrossRefGoogle Scholar
  26. 26.
    Vahabi M, Damba C, Rocha C, Montoya EC (2011) Food insecurity among latin American recent immigrants in Toronto. J Immigr Minor Health/Cent Minor Public Health 13(5):929–939CrossRefGoogle Scholar
  27. 27.
    Tiwari SK, Wang J (2008) Ethnic differences in mental health service use among White, Chinese, South Asian and South East Asian populations living in Canada. Soc Psychiatry Psychiatr Epidemiol 43(11):866–871PubMedCrossRefGoogle Scholar
  28. 28.
    O’Mahony J, Donnelly T (2010) Immigrant and refugee women’s post-partum depression help-seeking experiences and access to care: a review and analysis of the literature. J Psychiatr Ment Health Nurs 17(10):917–928PubMedCrossRefGoogle Scholar
  29. 29.
    Donnelly TT, Hwang JJ, Este D, Ewashen C, Adair C, Clinton M (2011) If I was going to kill myself, I wouldn’t be calling you. I am asking for help: challenges influencing immigrant and refugee women’s mental health. Issues Mental Health Nurs 32(5):279–290CrossRefGoogle Scholar
  30. 30.
    Willows N, Veugelers P, Raine K, Kuhle S (2011) Associations between household food insecurity and health outcomes in the Aboriginal population (excluding reserves). Health Rep/Stat Can, Can Cent Health Inf 22(2):15–20Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Katherine A. Muldoon
    • 1
    • 2
    Email author
  • Putu K. Duff
    • 1
    • 2
  • Sarah Fielden
    • 1
    • 3
  • Aranka Anema
    • 1
    • 4
  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.BC Centre for Excellence in HIV/AIDSVancouverCanada
  3. 3.University of Quebec in MontrealMontrealCanada
  4. 4.Experimental MedicineUniversity of British ColumbiaVancouverCanada

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