Association of moderate and severe food insecurity with suicidal ideation in adults: national survey data from three Canadian provinces
- 542 Downloads
Although the important public health issues of food insecurity and suicide may be interconnected, they are rarely studied. Using data from a national survey, we examined whether household food insecurity was associated with suicidal ideation after adjusting for relevant covariates.
We examined cross-sectional data from three Canadian provinces (n = 5,270) that were derived from the 2007 Canadian Community Health Survey and included adults (18+ years). Suicidal ideation was based on affirmative response to the question of whether or not the participant had seriously considered committing suicide in the previous 12 months. The Household Food Security Survey Module provided measures of moderate (indication of compromise in quality and/or quantity of food consumed) and severe (indication of reduced food intake and disrupted eating patterns) food insecurity status. Logistic regression determined associations between food insecurity and suicidal ideation with adjustment for demographics, body mass index, and presence of a mood disorder.
There were differences in the proportion experiencing suicide ideation according to moderate (14.7 vs 10.0 % without suicide ideation) and severe (16.4 vs 7.1 % without suicide ideation) food security (p < 0.001). With covariate adjustment, suicidal ideation was significantly associated with moderate (adjusted OR = 1.32, 95 % CI 1.06–1.64) and severe (adjusted OR = 1.77, 95 % CI 1.42–2.23) food insecurity.
The findings of a robust association between food insecurity and suicidal ideation suggest that interventions targeted at food security may reduce suicide-related morbidity and mortality. Longitudinal investigations that examine various dimensions of food insecurity will advance understanding of etiological pathways involved in food insecurity and suicide.
KeywordsFood insecurity Suicidal ideation Adults Mood disorders
Body mass index
Canadian Community Health Survey
Household Food Security Survey Module
The researchers would like to thank statistician Dr. Jonathan Berkowitz for providing his expertise and assistance with the analysis of the data. Financial support for analysis associated with this project was made available from Public Health Agency of Canada which played no role in carrying out the study, analyzing the results, or influencing publication.
Conflict of interest
Not required for population-based dataset.
- 1.World Health Organization (2012) Public health action for the prevention of suicide: a framework. World Health Organization, Geneva. http://apps.who.int/iris/bitstream/10665/75166/1/9789241503570_eng.pdf Google Scholar
- 8.Tarasuk V, Mitchell A, Dachner N (2014) Household food insecurity in Canada, 2012. Research to identify policy options to reduce food insecurity (PROOF): 2014. Toronto. Retrieved from http://nutritionalsciences.lamp.utoronto.ca/wp-content/uploads/2014/05/Household_Food_Insecurity_in_Canada-2012_ENG.pdf. Accessed 30 Dec 2014
- 9.Power E (2015) Dietitians of Canada—background to position: Individual and Household Food Insecurity in Canada. Dietitians of Canada, Toronto. (in press)Google Scholar
- 14.Health Canada (2012) The Household Food Security Survey Module (HFSSM). Health Canada, OttawaGoogle Scholar
- 15.Health Canada (2007) Canadian Community Health Survey Cycle 2.2, Nutrition -Income-Related Household Food Security in Canada. Health Canada, OttawaGoogle Scholar
- 16.Markwick A, Ansari Z, Sullivan M, McNeil J (2014) Social determinants and lifestyle risk factors only partially explain the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in the Australian state of Victoria: a cross-sectional study. BMC Public Health 14:598. doi: 10.1186/1471-2458-14-598 CrossRefPubMedCentralPubMedGoogle Scholar
- 26.Keys A, Brozek J, Henschel A, Mickelsen O, Longstreet Taylor H (1950) The biology of human starvation, vol 2. University of Minnesota Press, MinneapolisGoogle Scholar
- 33.Statistics Canada (2008) Canadian Community Health Survey—Annual Component (CCHS). Statistics Canada, Ottawa. Available from: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SurvId=50653&InstaId=29539&SDDS=3226 (cited July 15, 2014)
- 34.Bickel G, Nord M, Price C, Hamilton W, Cook J (2010) Measuring Food Security in the United States: Guide to Measuring Household Food Insecurity. Office of Analysis, Nutrition, and Evaluation, Food and Nutrition Service, AlexandriaGoogle Scholar
- 37.Statistics Canada (2008) Low income cut-offs for 2008 and low income measures for 2007. Statistics Canada, Ottawa. Available from: http://www.statcan.gc.ca/pub/75f0002m/75f0002m2009002-eng.pdf (cited July 15, 2014)
- 39.Muldoon KA, Duff PK, Fielden S, Anema A (2013) Food insufficiency is associated with psychiatric morbidity in a nationally representative study of mental illness among food insecure Canadians. Soc Psychiatry Psychiatr Epidemiol 48(5):795–803. doi: 10.1007/s00127-012-0597-3 CrossRefPubMedGoogle Scholar
- 46.Fawcett J (2012) Diagnosis, traits, states, and comorbidity in suicide. In: Dwivedi Y (ed) The neurobiological basis of suicide. CRC Press, Boca RatonGoogle Scholar
- 54.Brown GK (2002) A review of suicide assessment measures for intervention research in adults and older adults. Technical report submitted to NIMH under Contract No. 263-MH914950. National Institute of Mental Health, BethesdaGoogle Scholar