Food insecurity and depression: a cross‐sectional study of a multi‐site urban youth cohort in Durban and Soweto, South Africa

Abstract

objective To assess the prevalence of food insecurity and the independent association between depression and food insecurity among youth living in two urban settings in South Africa.methods Baseline cross-sectional survey data was analysed from a prospective cohort study conducted between 2014 and 2016 among youth (aged 16-24 years) in Soweto and Durban. Intervieweradministered questionnaires collecting socio-demographic, sexual and reproductive health and mental health data were conducted. Household food insecurity was measured using the 3-item Household Hunger Scale, with food insecure participants defined as having 'moderate' or 'severe hunger' compared to 'no hunger'. Depression was assessed using the 10-item Center for Epidemiological Studies Depression (CES-D 10) Scale (range 0-30, probable depression ≥ 10). Multivariable logistic regression models were used to estimate the association between depression and food insecurity. results There were 422 participants. Median age was 19 years (interquartile range [IQR] 18-21) and 60% were women. Overall, 18% were food insecure and 42% had probable depression. After adjustment for socio-demographic variables (age, gender, female-headed household, household size and school enrolment), participants with probable depression had higher odds of being food insecure than non-depressed participants (2.79, 95%CI 1.57-4.94).conclusion Nearly one-fifth of youth in this study were food insecure. Those with probable depression had increased odds of food insecurity. Interventions are needed to address food insecurity among urban youth in South Africa, combining nutritional support and better access to quality food with mental health support. keywords adolescent, young adult, youth, south africa, food insecurity, depression Sustainable Development Goals (SDGs): No poverty; Zero hunger; Good health and well-being; Gender equality.

Assessing longitudinal patterns of depressive symptoms and the influence of symptom trajectories on HIV pre‐exposure prophylaxis adherence among adolescent girls in the HPTN 082 randomized controlled trial

“…Ours is one of the first studies to focus on depressive symptom prevalence and patterns in a population of African AGYW seeking PrEP. Other studies with African AGYW engaged in HIV treatment, other types of prevention services, or those in nationally representative cohorts report depressive symptom prevalence estimates around 40% to 50% [17,53,54]. Consistent with our findings, analyses of depressive symptom patterns among populations living with or at‐risk of HIV in the United States and South Africa also found distinct trajectories characterized by severe or persistent symptoms, declining symptoms and low or no symptoms [28‐31].…”

“…depressive symptom prevalence estimates around 40% to 50% [17,53,54]. Consistent with our findings, analyses of depressive symptom patterns among populations living with or at-risk of HIV in the United States and South Africa also found distinct trajectories characterized by severe or persistent symptoms, declining symptoms and low or no symptoms [28][29][30][31].…”

High cellphone use associated with greater risk of depression among young women aged 15–24 years in Soweto and Durban, South Africa

“…Soweto and Durban are densely populated South African cities in which most youth have access to cellphones [ 39 , 46 ], but experience high rates of unemployment and poor socio-economic status, including high food insecurity [ 21 , 49 ]. Previous work in Soweto indicates a high incidence of depression [ 4 , 5 , 7 , 50 ].…”

“…However, cellphone use among youth in South Africa depends on their resources, including socio-economic status, cellphone ownership, and access to data or Wi-Fi [ 20 ]. Youth living in lower socio-economic settings may be more vulnerable to crime, including home and street robberies (having their phone stolen), and poorer overall access to basic needs [ 21 , 22 ].…”

Food insecurity, depressive symptoms, and the salience of gendered family roles during the COVID-19 pandemic in South Africa

“…A growing empirical literature in both developed and developing country contexts has demonstrated FI to be a factor associated with greater depressive symptomology, independent of other well-documented risk factors such as poverty and low socioeconomic status ( Wu and Schimmele, 2005 ; Weaver and Hadley, 2009 ; Jones, 2017 ; Joseph et al, 2021 ). This association has been established in adult populations ( Sorsdahl et al, 2011 ; Martin et al, 2016 ; Allen et al, 2018 ; Perkins et al, 2018a ), adolescent populations ( Jebena et al, 2016 ; Rani et al, 2018 ; Fertig, 2019 ; Jesson et al, 2021 ), as well as amongst vulnerable groups ( Normen et al, 2005 ; Maharaj et al, 2017 ).…”