Exposure to pollution and climate change-induced food insecurity on depressive symptoms among adolescents in rural areas of Afghanistan.

Background: Research into how pollution and climate change-induced food insecurity affect adolescents' mental health in Afghanistan is still in its infancy. This study analyses the association between pollution exposure, climate change-induced food insecurity and, depressive symptoms among adolescents in Afghanistan.

Methods: A cross-sectional study was conducted among 1416 adolescents and their 1416 parents and/or caregivers in seven provinces of Afghanistan. Exposure to pollution and climate change-induced food insecurity are the explanatory variables of interest. Mental health was measured by the occurrence of depression. Multivariate logistic regression analysis was used for estimation.

Results: The multivariate logistic regression results revealed that adolescents exposed to pollution were 2.66 times more likely to exhibit depressive symptoms (OR = 2.66; $p<0.001$ ), and the effects were significant for both boys and girls. Adolescents experiencing climate change (drought and floods) induced food insecurity were 1.39 times more likely to exhibit depressive symptoms (OR = 1.30; $p<0.05$ ). In addition, the study found that the effects of drought and flood induced food insecurity on mental health were pronounced among girls than boys.

Conclusion: Exposure to pollution and climate change-induced food insecurity were associated with depressive symptoms among adolescents. The public, private sector, and international organizations should promote pollution, drought, and flood mitigation strategies, as these environmental factors may contribute to mental health challenges among adolescents. There is need for interventions that specifically target female adolescents given their vulnerabilities to climate change-induced food insecurity. There is scope to integrate mental health services, with food security, pollution and climate mitigation interventions in Afghanistan. Policymakers should focus on regular community-based mental health screening programs, training local mental health professionals, and educating adolescents about the symptoms of depression.