title: Food insecurity and mental health: an analysis of routine primary care data of pregnant women in the Born in Bradford cohort.
abstract: Since 2008, use of food banks has risen sharply in the UK; however, evidence on the epidemiology of UK food insecurity is sparse. The aim of this study was to describe the trajectory of common mental disorder across the pre-pregnancy, pregnancy and postnatal period for food secure compared with food insecure women.
  
  
  
  Data from the Born in Bradford (BiB) cohort, the nested BiB1000 study and primary care records were linked based on National Health Service (NHS) numbers. Data linkage was completed for 1297, and primary care records were available from 18 months prior to 40 months after birth of the cohort child. Incidence rates of common mental disorders per 1000 patient years at risk were compared between food secure and insecure women, and for Pakistani compared with white British women, in 10 6-month periods around pregnancy. Poisson regression was used to calculate incidence rate ratios, adjusted for ethnicity and exposure.
  
  
  
  Food insecurity was significantly associated with an increased risk of common mental disorder before and during pregnancy (incidence rate ratio 1.9, 95% confidence interval 1.3 to 2.8, p=0.001) and after giving birth (incidence rate ratio 1.3, 95% confidence interval 1.0 to 1.7, p=0.029).
  
  
  
  Our study shows that food insecure women have worse mental health than food secure women, and that this difference is most pronounced for white British pregnant women. These findings provide evidence for concerns expressed by public health experts that food insecurity may become the next public health emergency.
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Power
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Eleonora
authors.identifier: 0000-0002-9759-2502
authors.initials: E
authors.lastname: Uphoff
authors.affiliation: Bradford Institute For Health Research, Bradford Royal Infirmary, Bradford, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Kelly
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Pickett
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D063105:Food Assistance / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D008603:Mental Health / Q000706:statistics & numerical data*; D009035:Mothers / Q000706:statistics & numerical data; D009752:Nutritional Status; D011203:Poverty; D011247:Pregnancy; D006113:United Kingdom; D055815:Young Adult
keywords: Cohort studies; ETHNICITY; MENTAL HEALTH; NUTRITION; PRIMARY CARE