Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey
Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey
Objective: to investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression.
Design: cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression.
Setting: South Africa during COVID-19, October 2021.
Participants: nationally representative sample of 3402 adults, weighted to 39,640,674 South African households.
Results: about 20·4 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from ‘food secure’ to ‘at risk’ or from ‘at risk’ to ‘food insecure’ group was associated with 1·7 times greater odds of being in a higher category of anxiety or depression (P < 0·001). All coping strategies were used to some extent in South African households, with 46·0 % relying on less preferred and less expensive foods and 20·9 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all P < 0·001), begging for food was associated with the highest odds (OR = 2·3).
Conclusions: food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.
Food insecurity, Coping strategies, South African survey, Anxiety, Depression
705-715
Dlamini, Siphiwe N.
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Craig, Ashleigh
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Mtintsilana, Asanda
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Mapanga, Witness
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Du Toit, Justin
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Ware, Lisa J.
763b80c2-743c-400e-8306-acfbd9701261
Norris, Shane A.
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24 January 2023
Dlamini, Siphiwe N.
af5d00d3-f69d-47ab-84a8-27b535a9bfd4
Craig, Ashleigh
0b01368b-7592-4bd0-8820-cf120a8c6dc3
Mtintsilana, Asanda
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Mapanga, Witness
75389e09-7cde-4cfe-89ef-ee2e456b7b1a
Du Toit, Justin
667369d3-e76e-4425-8aaa-9da386b3e3a8
Ware, Lisa J.
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Norris, Shane A.
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Dlamini, Siphiwe N., Craig, Ashleigh, Mtintsilana, Asanda, Mapanga, Witness, Du Toit, Justin, Ware, Lisa J. and Norris, Shane A.
(2023)
Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey.
Public Health Nutrition, 26 (4), .
(doi:10.1017/S1368980023000186).
Abstract
Objective: to investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression.
Design: cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression.
Setting: South Africa during COVID-19, October 2021.
Participants: nationally representative sample of 3402 adults, weighted to 39,640,674 South African households.
Results: about 20·4 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from ‘food secure’ to ‘at risk’ or from ‘at risk’ to ‘food insecure’ group was associated with 1·7 times greater odds of being in a higher category of anxiety or depression (P < 0·001). All coping strategies were used to some extent in South African households, with 46·0 % relying on less preferred and less expensive foods and 20·9 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all P < 0·001), begging for food was associated with the highest odds (OR = 2·3).
Conclusions: food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.
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food-insecurity-and-coping-strategies-and-their-association-with-anxiety-and-depression-a-nationally-representative-south-african-survey
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e-pub ahead of print date: 23 January 2023
Published date: 24 January 2023
Keywords:
Food insecurity, Coping strategies, South African survey, Anxiety, Depression
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Local EPrints ID: 505578
URI: http://eprints.soton.ac.uk/id/eprint/505578
ISSN: 1368-9800
PURE UUID: bb46716c-fe3f-458e-a2ff-40361b57188b
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Date deposited: 14 Oct 2025 16:42
Last modified: 15 Oct 2025 02:01
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Contributors
Author:
Siphiwe N. Dlamini
Author:
Ashleigh Craig
Author:
Asanda Mtintsilana
Author:
Witness Mapanga
Author:
Justin Du Toit
Author:
Lisa J. Ware
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