A Systematic Review and Meta-analysis of Depression, Anxiety, and Sleep Disorders in US Adults with Food Insecurity

  • Daniel J. Arenas
  • Arthur Thomas
  • JiCi Wang
  • Horace M. DeLisserEmail author
Systematic Review



A large number of peer-reviewed studies, with various methodologies and populations, have addressed the effects of food insecurity (FIS) on mental health conditions such as depression, anxiety, and sleep disorders. There are currently, however, no published systematic assessments or meta-analyses of this literature.


A systematic search of the literature was conducted in PubMed, PsycInfo, Embase, Scopus, and Web of Science. Cross-sectional studies assessing the association between food insecurity and depression, anxiety, or sleep disorders were identified. For each of the three health outcomes, we extracted (or calculated when possible) the following effect sizes: odds ratio (OR), Hedges’ g, Pearson correlation coefficients r, or bivariate coefficients. Then, for each mental health-outcome/effect-size pair, the available studies were combined using the random effect model. Heterogeneity, publication bias, and subgroup dependence, for each meta-analysis, were also assessed.


Fifty-seven studies provided cross-sectional data on the relationship between FIS and depression (n = 169,433), 13 on anxiety and psychological distress (n = 91,957), and 8 studies provided data on sleep disorders (n = 85,788). Meta-analysis showed that FIS is associated with an increased risk of testing positive for depression OR = 2.74 [95% CI 2.52–2.97, n = 135,500, Q(df = 41) = 69, I2 = 40%], anxiety OR = 2.41 [95% CI 1.81–3.22, n = 51,541, Q(df = 3) = 8, I2 = 63%], and sleep disorders OR = 1.80 [95% CI 1.51–2.15, n = 84,800, Q(df = 5) = 13, I2 = 62%]. The highest risks were found for depression and anxiety which had statistically similar values. The results were robust to covariates and population groups.


This systematic review and meta-analysis demonstrates a strong association between FIS and depression, anxiety, and sleep disorders, for which more longitudinal studies addressing effect sizes are warranted to further study causation.


food insecurity health disparities social determinants of health depression anxiety sleep disorders systematic review meta-analysis 



We would like to thank Lanair Lett, Gilberto Vila Arroyo, and Sara Zhou for their very helpful comments.

Funding Information

The authors are grateful for the support provided by the Program for Diversity and Inclusion at the Perelman School of Medicine at the University of Pennsylvania. DJA and AT would like to thank the Gamble Scholarship and the Perelman Scholarship for support.

Compliance with Ethical Standards

Conflict of Interest

All authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_5202_MOESM1_ESM.pdf (90 kb)
ESM 1 (PDF 90 kb)
11606_2019_5202_MOESM2_ESM.pdf (758 kb)
ESM 2 (PDF 758 kb)
11606_2019_5202_MOESM3_ESM.pdf (382 kb)
ESM 3 (PDF 382 kb)


  1. 1.
    Stunkard, A. J., Faith, M. S. & Allison, K. C. Depression and obesity. Biol. Psychiatry 54, 330–337 (2003).CrossRefPubMedGoogle Scholar
  2. 2.
    Suls, J. & Bunde, J. Anger, anxiety, and depression as risk factors for cardiovascular disease: the problems and implications of overlapping affective dispositions. Psychol. Bull. 131, 260 (2005).CrossRefPubMedGoogle Scholar
  3. 3.
    Nichols, C. E. Time Ni Hota Hai: time poverty and food security in the Kumaon hills, India. Gend. Place Cult. 23, 1404–1419 (2016).CrossRefGoogle Scholar
  4. 4.
    Wallander, M.-A., Johansson, S., Ruigómez, A., Rodríguez, L. A. G. & Jones, R. Morbidity associated with sleep disorders in primary care: a longitudinal cohort study. Prim. Care Companion J. Clin. Psychiatry 9, 338 (2007).CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Adler, N. E. & Ostrove, J. M. Socioeconomic status and health: what we know and what we don’t. Ann. N. Y. Acad. Sci. 896, 3–15 (1999).CrossRefPubMedGoogle Scholar
  6. 6.
    Adler, N. E. et al. Socioeconomic status and health: the challenge of the gradient. Am. Psychol. 49, 15 (1994).CrossRefPubMedGoogle Scholar
  7. 7.
    Williams, D. R., Priest, N. & Anderson, N. B. Understanding associations among race, socioeconomic status, and health: patterns and prospects. Health Psychol. 35, 407 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Fitzpatrick, T. et al. Looking beyond income and education: socioeconomic status gradients among future high-cost users of health care. Am. J. Prev. Med. 49, 161–171 (2015).CrossRefPubMedGoogle Scholar
  9. 9.
    Maxwell, S. & Smith, M. Household food security: a conceptual review. Househ. Food Secur. Concepts Indic. Meas. 1–72 (1992).Google Scholar
  10. 10.
    Frongillo Jr, E. A. Validation of measures of food insecurity and hunger. J. Nutr. 129, 506S–509S (1999).CrossRefPubMedGoogle Scholar
  11. 11.
    Pinstrup-Andersen, P. Food security: definition and measurement. Food Secur. 1, 5–7 (2009).CrossRefGoogle Scholar
  12. 12.
    Kendall, A., Olson, C. M. & Frongillo Jr., E. A. Validation of the Radimer/Cornell measures of hunger and food insecurity. J. Nutr. 125, 2793–2801 (1995).PubMedGoogle Scholar
  13. 13.
    Webb, P. et al. Measuring household food insecurity: why it’s so important and yet so difficult to do. J. Nutr. 136, 1404S–1408S (2006).CrossRefPubMedGoogle Scholar
  14. 14.
    Chilton, M. & Rose, D. A rights-based approach to food insecurity in the United States. Am. J. Public Health 99, 1203–1211 (2009).CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Gundersen, C. & Ziliak, J. P. Food insecurity and health outcomes. Health Aff. (Millwood) 34, 1830–1839 (2015).CrossRefGoogle Scholar
  16. 16.
    Compton, M. T. Food insecurity as a social determinant of mental health. Psychiatr. Ann. 44, 46–51 (2014).CrossRefGoogle Scholar
  17. 17.
    Weaver, L. J. & Fasel, C. B. A systematic review of the literature on the relationships between chronic diseases and food insecurity. Food Nutr. Sci. 9, 519 (2018).Google Scholar
  18. 18.
    De Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E. & Lustman, P. J. Association of depression and diabetes complications: a meta-analysis. Psychosom. Med. 63, 619–630 (2001).CrossRefPubMedGoogle Scholar
  19. 19.
    Howren, M. B., Lamkin, D. M. & Suls, J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom. Med. 71, 171–186 (2009).CrossRefPubMedGoogle Scholar
  20. 20.
    Black, C. N., Bot, M., Scheffer, P. G., Cuijpers, P. & Penninx, B. W. Is depression associated with increased oxidative stress? A systematic review and meta-analysis. Psychoneuroendocrinology 51, 164–175 (2015).CrossRefPubMedGoogle Scholar
  21. 21.
    Passos, I. C. et al. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. Lancet Psychiatry 2, 1002–1012 (2015).CrossRefPubMedGoogle Scholar
  22. 22.
    Arenas, D. J. Inter-Rater Software for analysis of inter-rater reliability by permutating pairs of multiple users. ArXiv Prepr. ArXiv180905731 (2018).Google Scholar
  23. 23.
    Brunoni, A. R. & Vanderhasselt, M.-A. Working memory improvement with non-invasive brain stimulation of the dorsolateral prefrontal cortex: a systematic review and meta-analysis. Brain Cogn. 86, 1–9 (2014).CrossRefPubMedGoogle Scholar
  24. 24.
    Hedges, L. V. Distribution theory for Glass’s estimator of effect size and related estimators. J. Educ. Stat. 6, 107–128 (1981).CrossRefGoogle Scholar
  25. 25.
    Peterson, R. A. & Brown, S. P. On the use of beta coefficients in meta-analysis. J. Appl. Psychol. 90, 175 (2005).CrossRefPubMedGoogle Scholar
  26. 26.
    Morris, S. B. & DeShon, R. P. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychol. Methods 7, 105 (2002).CrossRefPubMedGoogle Scholar
  27. 27.
    Roth, P. L., Le, H., Oh, I-S., Van Iddekinge, C-H., Bobko, P. Using beta coefficients to impute missing correlations in meta-analysis research: Reasons for caution. J. Appl. Psychol. 103, 644–658 (2018).Google Scholar
  28. 28.
    Downes, M. J., Brennan, M. L., Williams, H. C. & Dean, R. S. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open 6, e011458 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    IntHout, J., Ioannidis, J. P. & Borm, G. F. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method. BMC Med. Res. Methodol. 14, 25 (2014).CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Silver, N. C. & Dunlap, W. P. Averaging correlation coefficients: should Fisher’s z transformation be used? J. Appl. Psychol. 72, 146 (1987).CrossRefGoogle Scholar
  31. 31.
    Higgins, J. P. & Thompson, S. G. Quantifying heterogeneity in a meta-analysis. Stat. Med. 21, 1539–1558 (2002).CrossRefPubMedGoogle Scholar
  32. 32.
    Anglin, R. E., Samaan, Z., Walter, S. D. & McDonald, S. D. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br. J. Psychiatry 202, 100–107 (2013).CrossRefPubMedGoogle Scholar
  33. 33.
    Bohlmeijer, E., Prenger, R., Taal, E. & Cuijpers, P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J. Psychosom. Res. 68, 539–544 (2010).CrossRefPubMedGoogle Scholar
  34. 34.
    Demnitz, N. et al. A systematic review and meta-analysis of cross-sectional studies examining the relationship between mobility and cognition in healthy older adults. Gait Posture 50, 164–174 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Begg, C. B. & Mazumdar, M. Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101 (1994).CrossRefPubMedGoogle Scholar
  36. 36.
    Gariepy, G., Nitka, D. & Schmitz, N. The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int. J. Obes. 34, 407 (2010).CrossRefGoogle Scholar
  37. 37.
    Viechtbauer, W. Conducting meta-analyses in R with the metafor package. J. Stat. Softw. 36, (2010).Google Scholar
  38. 38.
    Fleiss, J. L., Nee, J. C. & Landis, J. R. Large sample variance of kappa in the case of different sets of raters. Psychol. Bull. 86, 974 (1979).CrossRefGoogle Scholar
  39. 39.
    Siefert, K., Heflin, C. M., Corcoran, M. E. & Williams, D. R. Food insufficiency and the physical and mental health of low-income women. Women Health 32, 159–177 (2001).CrossRefPubMedGoogle Scholar
  40. 40.
    Siefert, K., Heflin, C. M., Corcoran, M. E. & Williams, D. R. Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients. J. Health Soc. Behav. 45, 171–186 (2004).CrossRefPubMedGoogle Scholar
  41. 41.
    Dong, K. R., Tang, A. M., Stopka, T. J., Beckwith, C. G. & Must, A. Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island. PloS One 13, e0198598 (2018).CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Dong, K. R., Must, A., Tang, A. M., Stopka, T. J. & Beckwith, C. G. Food insecurity, morbidities, and substance use in adults on probation in Rhode Island. J. Urban Health Bull. N. Y. Acad. Med. 95, 564–575 (2018).CrossRefGoogle Scholar
  43. 43.
    Widome, R., Jensen, A., Bangerter, A. & Fu, S. S. Food insecurity among veterans of the US wars in Iraq and Afghanistan. Public Health Nutr. 18, 844–849 (2014).CrossRefPubMedGoogle Scholar
  44. 44.
    Widome, R., Jensen, A. & Fu, S. S. Socioeconomic disparities in sleep duration among veterans of the US wars in Iraq and Afghanistan. Am. J. Public Health 105, e70–e74 (2015).CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Weinreb, L. et al. Hunger: its impact on children’s health and mental health. Pediatrics 110, e41–e41 (2002).CrossRefPubMedGoogle Scholar
  46. 46.
    Sharkey, J. R. Risk and presence of food insufficiency are associated with low nutrient intakes and multimorbidity among homebound older women who receive home-delivered meals. J. Nutr. 133, 3485–3491 (2003).CrossRefPubMedGoogle Scholar
  47. 47.
    Laraia, B. A., Siega-Riz, A. M., Gundersen, C. & Dole, N. Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. J. Nutr. 136, 177–182 (2006).CrossRefPubMedGoogle Scholar
  48. 48.
    Whitaker, R. C. & Orzol, S. M. Obesity among US urban preschool children: relationships to race, ethnicity, and socioeconomic status. Arch. Pediatr. Adolesc. Med. 160, 578–584 (2006).CrossRefPubMedGoogle Scholar
  49. 49.
    Siefert, K., Finlayson, T. L., Williams, D. R., Delva, J. & Ismail, A. I. Modifiable risk and protective factors for depressive symptoms in low-income African American mothers. Am. J. Orthopsychiatry 77, 113–123 (2007).CrossRefPubMedGoogle Scholar
  50. 50.
    Weigel, M. M., Armijos, R. X., Hall, Y. P., Ramirez, Y. & Orozco, R. The household food insecurity and health outcomes of US–Mexico border migrant and seasonal farmworkers. J. Immigr. Minor. Health 9, 157–169 (2007).CrossRefPubMedGoogle Scholar
  51. 51.
    Weiser, S. D. et al. Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. J. Gen. Intern. Med. 24, 14–20 (2009).CrossRefPubMedGoogle Scholar
  52. 52.
    Sullivan, A. F., Clark, S., Pallin, D. J. & Camargo, C. A. Food security, health, and medication expenditures of emergency department patients. J. Emerg. Med. 38, 524–528 (2010).CrossRefPubMedGoogle Scholar
  53. 53.
    Fitzgerald, N., Hromi-Fiedler, A., Segura-Pérez, S. & Pérez-Escamilla, R. Food insecurity is related to increased risk of type 2 diabetes among Latinas. Ethn. Dis. 21, 328 (2011).PubMedPubMedCentralGoogle Scholar
  54. 54.
    Hromi-Fiedler, A., Bermúdez-Millán, A., Segura-Pérez, S. & Pérez-Escamilla, R. Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas. Matern. Child. Nutr. 7, 421–430 (2011).CrossRefPubMedGoogle Scholar
  55. 55.
    Johnson, C. M., Sharkey, J. R. & Dean, W. R. Indicators of material hardship and depressive symptoms among homebound older adults living in North Carolina. J. Nutr. Gerontol. Geriatr. 30, 154–168 (2011).CrossRefPubMedGoogle Scholar
  56. 56.
    Vogenthaler, N. S. et al. Depressive symptoms and food insufficiency among HIV-infected crack users in Atlanta and Miami. AIDS Behav. 15, 1520–1526 (2011).CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Wang, E. A. et al. Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications. J. Gen. Intern. Med. 26, 1012–1018 (2011).CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Waitzkin, H. et al. Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression. J. Community Health 36, 316–331 (2011).CrossRefPubMedGoogle Scholar
  59. 59.
    Okechukwu, C. A., El Ayadi, A. M., Tamers, S. L., Sabbath, E. L. & Berkman, L. Household food insufficiency, financial strain, work-family spillover, and depressive symptoms in the working class: the Work, Family, and Health Network study. Am. J. Public Health 102, 126–133 (2012).CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Cook, J. T. et al. Are food insecurity’s health impacts underestimated in the US population? Marginal food security also predicts adverse health outcomes in young US children and mothers Adv. Nutr. 4, 51–61 (2013).CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Daveyâ-Rothwell, M. A., Flamm, L. J., Kassa, H. T. & Latkin, C. A. Food insecurity and depressive symptoms: comparison of drug using and nondrug-using women at risk for HIV. J. Community Psychol. 42, 469–478 (2014).CrossRefGoogle Scholar
  62. 62.
    Leung, C. W., Epel, E. S., Willett, W. C., Rimm, E. B. & Laraia, B. A. Household food insecurity is positively associated with depression among low-income supplemental nutrition assistance program participants and income-eligible nonparticipants. J. Nutr. 145, 622–627 (2014).CrossRefPubMedGoogle Scholar
  63. 63.
    Sidebottom, A. C., Hellerstedt, W. L., Harrison, P. A. & Hennrikus, D. An examination of prenatal and postpartum depressive symptoms among women served by urban community health centers. Arch. Womens Ment. Health 17, 27–40 (2014).CrossRefPubMedGoogle Scholar
  64. 64.
    Goldberg, S. L. & Mawn, B. E. Predictors of food insecurity among older adults in the United States. Public Health Nurs. Boston Mass 32, 397–407 (2015).CrossRefGoogle Scholar
  65. 65.
    Kapulsky, L., Tang, A. M. & Forrester, J. E. Food insecurity, depression, and social support in HIV-infected Hispanic individuals. J. Immigr. Minor. Health 17, 408–413 (2015).CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Pinard, C. A., Calloway, E. E., Fricke, H. E. & Yaroch, A. L. A cross-sectional exploration of food security, depression, and CHAOS in low-income households with children. J. Appl. Res. Child. 6, 1–12 (2015).Google Scholar
  67. 67.
    Silverman, J. et al. The relationship between food insecurity and depression, diabetes distress and medication adherence among low-income patients with poorly-controlled diabetes. J. Gen. Intern. Med. 30, 1476–1480 (2015).CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Vaudin, A. & Sahyoun, N. R. Food anxiety is associated with poor health status among recently hospital-discharged older adults. J. Nutr. Gerontol. Geriatr. 34, 245–262 (2015).CrossRefPubMedGoogle Scholar
  69. 69.
    Wang, E. A. et al. Food insecurity and health: data from the Veterans Aging Cohort Study. Public Health Rep. Wash. DC 1974 130, 261–268 (2015).CrossRefGoogle Scholar
  70. 70.
    Bruening, M., Brennhofer, S., van Woerden, I., Todd, M. & Laska, M. Factors related to the high rates of food insecurity among diverse, urban college freshmen. J. Acad. Nutr. Diet. 116, 1450–1457 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Ippolito, M. M. et al. Food insecurity and diabetes self-management among food pantry clients. Public Health Nutr. 20, 183–189 (2017).CrossRefPubMedGoogle Scholar
  72. 72.
    Pulgar, C. A. et al. Economic hardship and depression among women in Latino farmworker families. J. Immigr. Minor. Health 18, 497–504 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Shiue, I. People with diabetes, respiratory, liver or mental disorders, higher urinary antimony, bisphenol A, or pesticides had higher food insecurity: USA NHANES, 2005-2006. Environ. Sci. Pollut. Res. Int. 23, 198–205 (2016).CrossRefPubMedGoogle Scholar
  74. 74.
    Sun, J. et al. Childhood adversity and adult reports of food insecurity among households with children. Am. J. Prev. Med. 50, 561–572 (2016).CrossRefPubMedGoogle Scholar
  75. 75.
    Brostow D.P., Gunzburger E. & Thomas K.S. Food insecurity among veterans: findings from the health and retirement study. J. Nutr. Health Aging 21, 1358–1364 (2017).CrossRefPubMedGoogle Scholar
  76. 76.
    Montgomery, J., Lu, J., Ratliff, S. & Mezuk, B. Food insecurity and depression among adults with diabetes: results from the National Health and Nutrition Examination Survey (NHANES). Diabetes Educ. 43, 260–271 (2017).CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Hessol, N. A., Zepf, R., Zobell, E., Weiser, S. D. & John, M. D. Food insecurity and aging outcomes in older adults living with HIV. AIDS Behav. 21, 3506–3514 (2017).CrossRefPubMedGoogle Scholar
  78. 78.
    Payne-Sturges, D. C., Tjaden, A., Caldeira, K. M., Vincent, K. B. & Arria, A. M. Student hunger on campus: food insecurity among college students and implications for academic institutions. Am. J. Health Promot. 32, 349–354 (2017).Google Scholar
  79. 79.
    Bruening, M., van Woerden, I., Todd, M. & Laska, M. N. Hungry to learn: the prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen. Int. J. Behav. Nutr. Phys. Act. 15, 9 (2018).Google Scholar
  80. 80.
    Palar, K. et al. Food insecurity, internalized stigma, and depressive symptoms among women living with HIV in the United States. AIDS Behav. 22, 3869–3878 (2018).CrossRefPubMedGoogle Scholar
  81. 81.
    Scanlon, F. A. et al. Depression, executive dysfunction, and prior economic and social vulnerability associations in incarcerated African American men. J. Correct. Health Care Off. J. Natl. Comm. Correct. Health Care 24, 295–308 (2018).CrossRefGoogle Scholar
  82. 82.
    Steiner, J. F. et al. Food insecurity in older adults in an integrated health care system. J. Am. Geriatr. Soc. 66, 1017–1024 (2018).CrossRefPubMedGoogle Scholar
  83. 83.
    Tong, M. et al. Factors associated with food insecurity among older homeless adults: results from the HOPE HOME study. J. Public Health Oxf. Engl. 41, 240–249 (2018).Google Scholar
  84. 84.
    Wattick, R. A., Hagedorn, R. L. & Olfert, M. D. Relationship between diet and mental health in a young adult Appalachian college population. Nutrients. 10(8), (2018).Google Scholar
  85. 85.
    Stuff, J. E. et al. Household food insecurity is associated with adult health status. J. Nutr. 134, 2330–2335 (2004).CrossRefPubMedGoogle Scholar
  86. 86.
    Simmons, L. A., Modesitt, S. C., Brody, A. C. & Leggin, A. B. Food insecurity among cancer patients in Kentucky: a pilot study. J. Oncol. Pract. 2, 274–279 (2006).CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Laraia, B. A., Borja, J. B. & Bentley, M. E. Grandmothers, fathers, and depressive symptoms are associated with food insecurity among low-income first-time African-American mothers in North Carolina. J. Am. Diet. Assoc. 109, 1042–1047 (2009).CrossRefPubMedPubMedCentralGoogle Scholar
  88. 88.
    Kalichman, S. C. et al. Health and treatment implications of food insufficiency among people living with HIV/AIDS, Atlanta, Georgia. J. Urban Health Bull. N. Y. Acad. Med. 87, 631–641 (2010).CrossRefGoogle Scholar
  89. 89.
    Kalichman, S. C. et al. Food insecurity and antiretroviral adherence among HIV positive adults who drink alcohol. J. Behav. Med. 37, 1009–1018 (2014).CrossRefPubMedPubMedCentralGoogle Scholar
  90. 90.
    Gao, X., Scott, T., Falcon, L. M., Wilde, P. E. & Tucker, K. L. Food insecurity and cognitive function in Puerto Rican adults. Am. J. Clin. Nutr. 89, 1197–1203 (2009).CrossRefPubMedPubMedCentralGoogle Scholar
  91. 91.
    Bermudez-Millan, A. et al. Psychological distress mediates the association between food insecurity and suboptimal sleep quality in Latinos with type 2 diabetes mellitus. J. Nutr. 146, 2051–2057 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  92. 92.
    Sharpe, P. A., Whitaker, K., Alia, K. A., Wilcox, S. & Hutto, B. Dietary intake, behaviors and psychosocial factors among women from food-secure and food-insecure households in the United States. Ethn. Dis. 26, 139–146 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Wong, J. C. et al. Food insecurity is associated with subsequent cognitive decline in the Boston Puerto Rican Health Study–3. J. Nutr. 146, 1740–1745 (2016).CrossRefPubMedPubMedCentralGoogle Scholar
  94. 94.
    Austin, A. E. & Smith, M. V. Examining material hardship in mothers: associations of diaper need and food insufficiency with maternal depressive symptoms. Health Equity 1, 127–133 (2017).CrossRefPubMedPubMedCentralGoogle Scholar
  95. 95.
    Darling, K. E., Fahrenkamp, A. J., Wilson, S. M., D’Auria, A. L. & Sato, A. F. Physical and mental health outcomes associated with prior food insecurity among young adults. J. Health Psychol. 22, 572–581 (2017).CrossRefPubMedGoogle Scholar
  96. 96.
    Harrison, P. A. & Sidebottom, A. C. Systematic prenatal screening for psychosocial risks. J. Health Care Poor Underserved 19, 258–276 (2008).CrossRefPubMedGoogle Scholar
  97. 97.
    Black, M. M. et al. WIC participation and attenuation of stress-related child health risks of household food insecurity and caregiver depressive symptoms. Arch. Pediatr. Adolesc. Med. 166, 444–451 (2012).CrossRefPubMedGoogle Scholar
  98. 98.
    Jung, S. E., Kim, S., Bishop, A. & Hermann, J. Poor nutritional status among low-income older adults: examining the interconnection between self-care capacity, food insecurity, and depression. J. Acad. Nutr. Diet. Jun 16. pii: S2212–2672(18)30513–6 (2018).Google Scholar
  99. 99.
    Sharkey, J. R., Johnson, C. M. & Dean, W. R. Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women. Women Health 51, 442–460 (2011).CrossRefPubMedPubMedCentralGoogle Scholar
  100. 100.
    Brucker, D. L. Food security among young adults with disabilities in the United States: findings from the National Health Interview Survey. Disabil. Health J. 9, 298–305 (2016).CrossRefPubMedGoogle Scholar
  101. 101.
    Allen, N. L., Becerra, B. J. & Becerra, M. B. Associations between food insecurity and the severity of psychological distress among African-Americans. Ethn. Health 23, 511–520 (2018).CrossRefPubMedGoogle Scholar
  102. 102.
    Tseng, K. K., Park, S. H., Shearston, J. A., Lee, L. & Weitzman, M. Parental psychological distress and family food insecurity: sad dads in hungry homes. J. Dev. Behav. Pediatr. JDBP 38, 611–618 (2017).CrossRefPubMedGoogle Scholar
  103. 103.
    Clay, L. A., Papas, M. A., Gill, K. B. & Abramson, D. M. Factors associated with continued food insecurity among households recovering from Hurricane Katrina. Int. J. Environ. Res. Public. Health 15, (2018).
  104. 104.
    Grandner, M. A. et al. Sleep symptoms, race/ethnicity, and socioeconomic position. J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med. 9, 897 (2013).Google Scholar
  105. 105.
    Liu, Y., Njai, R. S., Greenlund, K. J., Chapman, D. P. & Croft, J. B. Relationships between housing and food insecurity, frequent mental distress, and insufficient sleep among adults in 12 US States, 2009. Prev. Chronic. Dis. 11, E37 (2014).CrossRefPubMedPubMedCentralGoogle Scholar
  106. 106.
    Whinnery, J., Jackson, N., Rattanaumpawan, P. & Grandner, M. A. Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position. Sleep 37, 601–611 (2014).CrossRefPubMedPubMedCentralGoogle Scholar
  107. 107.
    Ding M., Keiley M.K., Garza K.B., Duffy P.A. & Zizza C.A. Food insecurity is associated with poor sleep outcomes among US adults. J. Nutr. 145, 615–621 (2015).CrossRefPubMedGoogle Scholar
  108. 108.
    Becerra, M. B., Bol, B. S., Granados, R. & Hassija, C. Sleepless in school: the role of social determinants of sleep health among college students. J. Am. Coll. Health. 29, 1–7 (2018).Google Scholar
  109. 109.
    Sterne, J. A., Gavaghan, D. & Egger, M. Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J. Clin. Epidemiol. 53, 1119–1129 (2000).CrossRefPubMedGoogle Scholar
  110. 110.
    Deeks, J. J., Macaskill, P. & Irwig, L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J. Clin. Epidemiol. 58, 882–893 (2005).CrossRefPubMedGoogle Scholar
  111. 111.
    Nelson, J. M. & Harwood, H. Learning disabilities and anxiety: a meta-analysis. J. Learn. Disabil. 44, 3–17 (2011).CrossRefPubMedGoogle Scholar
  112. 112.
    Rock, P. L., Roiser, J. P., Riedel, W. J. & Blackwell, A. D. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol. Med. 44, 2029–2040 (2014).CrossRefPubMedGoogle Scholar
  113. 113.
    Cohen, J. Statistical Power Analysis for the Behavioural Sciences. (Hillsdale: Erlbaum, 1988).Google Scholar
  114. 114.
    Sullivan, G. M. & Feinn, R. Using effect size—or why the P value is not enough. J. Grad. Med. Educ. 4, 279–282 (2012).CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.United Community ClinicPhiladelphiaUSA
  3. 3.College of Arts and SciencesUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations