The mediating role of food insecurity in the relationship between income poverty and depressive symptoms and suicidal ideation: A nationwide study of Korean adults

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-03-18 DOI:10.1016/j.socscimed.2025.117972

Seong-Uk Baek , Jin-Ha Yoon

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引用次数: 0

Abstract

Background

Income poverty has been linked to poor mental health. Food insecurity, a consequence of poverty, has been identified as a determinant of mental health. We explored the mediating role of food insecurity in the relationship between income poverty and mental health problems.

Methods

This study utilized a nationally representative sample of 12,918 adults from the 2019–2021 Korea National Health and Nutrition Examination Survey, among whom 3,896 were included in the depressive symptom analysis and 9,022 in the suicidal ideation analysis. Income poverty was defined as having a household income below 50 % of the median. Food insecurity was assessed using the Korean version of the 18-item Household Food Security Survey Module and was dichotomized as the presence of food insecurity if three or more items received affirmative responses. Logistic regression and mediation analyses were conducted, with odds ratios (ORs) and 95 % confidence intervals (CIs) computed. Models were adjusted for gender, region, education, employment status, marital status, presence of a child, smoking, physical exercise, and alcohol use.

Results

Among the sample, the prevalence was 15.1 % for income poverty, 3.8 % for food insecurity, 3.9 % for depressive symptoms, and 3.2 % for suicidal ideation. Poverty was associated with a 1.5 % (95 % CI: 1.3 %–1.6 %) increase in the likelihood of depressive symptoms compared to non-poverty conditions, with food insecurity accounting for 52.7 % (95 % CI: 46.8–58.2 %) of this effect (average causal mediating effect [ACME]: 0.008, 95 % CI: 0.006–0.009). Additionally, income poverty was associated with a 2.0 % (95 % CI: 1.9 %–2.1 %) increase in the likelihood of suicidal ideation compared to non-poverty conditions, with food insecurity accounting for 17.7 % (95 % CI: 15.7–19.8 %) of this effect (ACME: 0.004, 95 % CI: 0.003–0.004).

Conclusion

Food insecurity can mediate a meaningful portion of the relationship between poverty and mental health problems, highlighting the importance of targeted public health to address food access.

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粮食不安全在收入贫困与抑郁症状和自杀意念之间的关系中的中介作用：一项针对韩国成年人的全国性研究

背景收入贫困与心理健康状况不佳有关。粮食不安全是贫困的后果之一，也被认为是心理健康的决定因素。我们探讨了粮食不安全在收入贫困与心理健康问题之间关系中的中介作用。方法本研究利用了 2019-2021 年韩国全国健康与营养调查中具有全国代表性的 12,918 名成年人样本，其中 3,896 人被纳入抑郁症状分析，9,022 人被纳入自杀意念分析。收入贫困的定义是家庭收入低于中位数的 50%。粮食不安全状况采用韩国版的 18 项家庭粮食安全调查模块进行评估，如果有三项或三项以上得到肯定回答，则被二分为存在粮食不安全状况。我们进行了逻辑回归和中介分析，并计算了几率比（OR）和 95 % 的置信区间（CI）。根据性别、地区、教育程度、就业状况、婚姻状况、有无子女、吸烟、体育锻炼和饮酒情况对模型进行了调整。与非贫困状况相比，贫困导致抑郁症状发生率增加 1.5%（95% CI：1.3%-1.6%），其中粮食不安全占 52.7%（95% CI：46.8%-58.2%）（平均因果中介效应 [ACME]：0.008，95% CI：0.006-0.009）。此外，与非贫困条件相比，收入贫困与自杀意念可能性增加 2.0 %（95 % CI：1.9 %-2.1 %）相关，而粮食不安全占这一效应的 17.7 %（95 % CI：15.7-19.8 %）（ACME：0.008-0.009）。结论粮食不安全可以在贫困与心理健康问题之间的关系中起到重要的中介作用，突出了有针对性地解决粮食获取问题的公共卫生的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.