title: Food insecurity and mental illness: disproportionate impacts in the context of perceived stress and social isolation.
abstract: OBJECTIVE
  Food insecurity is associated with elevated risk of mental illness. This risk may be further compounded by stressful life events and by social isolation. This study investigated whether the risk of mental illness is higher among individuals experiencing food insecurity along with greater stress and social isolation.
  
  
  METHODS
  Cross-sectional self-report survey data from the 2009-10 Canadian Community Health Survey (N = 100,401).
  
  
  METHODS
  We estimated prevalence differences of the risk of self-reported mental illness associated with food insecurity alone and in combination with stressful life events and social isolation. Sensitivity analyses were conducted on a sub-sample who completed a structured diagnostic interview.
  
  
  RESULTS
  Overall, the prevalence of mental illness was 18.4% [95% CI 16.7-20.1] higher for women and 13.5% higher [95% CI 11.9, 15.2] for men in severely food insecure households compared to those reporting food security. The increased risk of mental illness associated with food insecurity was more pronounced among females and those reporting higher stress and social isolation.
  
  
  CONCLUSIONS
  Individuals reporting food insecurity are at increased risk of mental illness. This increased risk is further exacerbated in high stress and socially isolated environments. Policies, clinical and public health interventions must address broader constellations of risks that exist when food insecurity is present.
authors.affiliation: School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada. Electronic address: mmart007@uottawa.ca.
authors.forename: M S
authors.initials: MS
authors.lastname: Martin
authors.affiliation: School of Information Studies, McGill University, Montreal, QC, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Maddocks
authors.affiliation: School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Social and Behavioral Sciences and Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Gilman
authors.affiliation: School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Colman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012934:Social Isolation / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology; D055815:Young Adult
keywords: Anxiety; Depression; Food supply; Life stress; Psychological; Social support; Stress