Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 4/2018

Open Access 01-04-2018 | Original Paper

Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study

Authors: Zulfa Abrahams, Crick Lund, Sally Field, Simone Honikman

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 4/2018

Login to get access

Abstract

Purpose

Food insecurity has been linked with maternal depression in low-income settings. Few studies have looked at factors associated with both food insecurity and maternal depression as outcomes. This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women.

Methods

We conducted a cross-sectional study at a Midwife Obstetric Unit in a low-income suburb in Cape Town. Pregnant women attending the clinic for their first antenatal visit were invited to participate. The shortened form of the US Household Food Security Survey Module was used to measure food insecurity. The Expanded Mini-International Neuropsychiatric Interview was used to diagnose depression, anxiety, alcohol and drug dependence, and assess for suicidal ideation and behaviour. Logistic regression modelling was conducted to explore factors associated with food insecurity and depression in separate models.

Results

We found that 42% of households were food insecure and that 21% of participants were depressed (N = 376). The odds of being food insecure were increased in women with suicidal behaviour (OR = 5.34; 95% CI 1.26–22.57), with depression (4.27; 1.43–12.70) and in those with three or more children (3.79; 1.25–11.55). The odds of depression was greater in women who were food insecure (5.30; 1.63–17.30), substance dependent (15.83; 1.31–191.48) or diagnosed with an anxiety disorder (5.04; 1.71–14.82).

Conclusions

Food insecurity and depression are strongly associated in pregnant women. The relationship between food insecurity and depression is complex and requires further investigation. Interventions that improve both food security and mental health during the perinatal period are likely to benefit the physical and mental well-being of mothers and children.
Literature
4.
go back to reference Blumberg SJ, Bialostosky K, Hamilton WL, Briefel RR (1999) The effectiveness of a short form of the Household Food Security Scale. Am J Public Health 89(8):1231–1234CrossRefPubMedPubMedCentral Blumberg SJ, Bialostosky K, Hamilton WL, Briefel RR (1999) The effectiveness of a short form of the Household Food Security Scale. Am J Public Health 89(8):1231–1234CrossRefPubMedPubMedCentral
5.
go back to reference Chersich M, Blaauw D, Scorgie F et al (2016) Safeguarding maternal and child health in South Africa by starting the Child Support Grant before birth: design lessons from pregnancy support programmes in 27 countries. SA Med J 106(12):1192–1210 Chersich M, Blaauw D, Scorgie F et al (2016) Safeguarding maternal and child health in South Africa by starting the Child Support Grant before birth: design lessons from pregnancy support programmes in 27 countries. SA Med J 106(12):1192–1210
6.
go back to reference Tomlinson M, Swartz L, Kruger L, Gureje O (2007) Manifestations of affective disturbance in sub-Saharan Africa: key themes. J Affect Disord 102(1):191–198CrossRefPubMed Tomlinson M, Swartz L, Kruger L, Gureje O (2007) Manifestations of affective disturbance in sub-Saharan Africa: key themes. J Affect Disord 102(1):191–198CrossRefPubMed
7.
go back to reference Hamad R, Fernald LC, Karlan DS, Zinman J (2008) Social and economic correlates of depressive symptoms and perceived stress in South African adults. J Epidemiol Community Health 62(6):538–544CrossRefPubMed Hamad R, Fernald LC, Karlan DS, Zinman J (2008) Social and economic correlates of depressive symptoms and perceived stress in South African adults. J Epidemiol Community Health 62(6):538–544CrossRefPubMed
8.
go back to reference Fisher J, de Mello M, Patel V et al (2012) Prevalence and determinants of common perinatal mental disorders in women in low-and lower-middle-income countries: a systematic review. Bull World Health Organ 90(2):139–149CrossRef Fisher J, de Mello M, Patel V et al (2012) Prevalence and determinants of common perinatal mental disorders in women in low-and lower-middle-income countries: a systematic review. Bull World Health Organ 90(2):139–149CrossRef
9.
go back to reference Rochat TJ, Richter LM, Doll HA et al (2006) Depression among pregnant rural South African women undergoing HIV testing. J Am Med Assoc 295(12):1373–1378CrossRef Rochat TJ, Richter LM, Doll HA et al (2006) Depression among pregnant rural South African women undergoing HIV testing. J Am Med Assoc 295(12):1373–1378CrossRef
10.
go back to reference Rochat TJ, Tomlinson M, Bärnighausen T, Newell M, Stein A (2011) The prevalence and clinical presentation of antenatal depression in rural South Africa. J Affect Disord 135(1):362–373CrossRefPubMedPubMedCentral Rochat TJ, Tomlinson M, Bärnighausen T, Newell M, Stein A (2011) The prevalence and clinical presentation of antenatal depression in rural South Africa. J Affect Disord 135(1):362–373CrossRefPubMedPubMedCentral
11.
go back to reference Hanlon C, Medhin G, Alem A et al (2009) Impact of antenatal common mental disorders upon perinatal outcomes in Ethiopia: the P-MaMiE population-based cohort study. Trop Med Int Health 14(2):156–166CrossRefPubMed Hanlon C, Medhin G, Alem A et al (2009) Impact of antenatal common mental disorders upon perinatal outcomes in Ethiopia: the P-MaMiE population-based cohort study. Trop Med Int Health 14(2):156–166CrossRefPubMed
12.
go back to reference Pryor L, Lioret S, van der Waerden J et al (2016) Food insecurity and mental health problems among a community sample of young adults. Soc Psychiatry Psychiatr Epidemiol 51(8):1073–1081CrossRefPubMed Pryor L, Lioret S, van der Waerden J et al (2016) Food insecurity and mental health problems among a community sample of young adults. Soc Psychiatry Psychiatr Epidemiol 51(8):1073–1081CrossRefPubMed
13.
go back to reference Garcia J, Hromi-Fiedler A, Mazur RE et al (2013) Persistent household food insecurity, HIV, and maternal stress in peri-urban Ghana. BMC Public Health 13(1):215CrossRefPubMedPubMedCentral Garcia J, Hromi-Fiedler A, Mazur RE et al (2013) Persistent household food insecurity, HIV, and maternal stress in peri-urban Ghana. BMC Public Health 13(1):215CrossRefPubMedPubMedCentral
14.
go back to reference Jebena MG, Taha M, Nakajima M et al (2015) Household food insecurity and mental distress among pregnant women in Southwestern Ethiopia: a cross sectional study design. BMC Pregnancy Childbirth 15(1):250CrossRefPubMedPubMedCentral Jebena MG, Taha M, Nakajima M et al (2015) Household food insecurity and mental distress among pregnant women in Southwestern Ethiopia: a cross sectional study design. BMC Pregnancy Childbirth 15(1):250CrossRefPubMedPubMedCentral
15.
go back to reference Tsai AC, Tomlinson M, Comulada WS, Rotheram-Borus MJ (2016) Food insufficiency, depression, and the modifying role of social support: Evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa. Soc Sci Med 151:69–77CrossRefPubMedPubMedCentral Tsai AC, Tomlinson M, Comulada WS, Rotheram-Borus MJ (2016) Food insufficiency, depression, and the modifying role of social support: Evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa. Soc Sci Med 151:69–77CrossRefPubMedPubMedCentral
16.
go back to reference Melchior M, Caspi A, Howard LM et al (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatr 124(4):e564–e572CrossRef Melchior M, Caspi A, Howard LM et al (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatr 124(4):e564–e572CrossRef
17.
go back to reference Patel V (2001) Poverty, inequality, and mental health in developing countries. In: Leon D, Walt G (eds) Poverty, inequality, and health: an international perspective. Oxford University Press, England, 247–262 Patel V (2001) Poverty, inequality, and mental health in developing countries. In: Leon D, Walt G (eds) Poverty, inequality, and health: an international perspective. Oxford University Press, England, 247–262
18.
go back to reference Patel V, Kleinman A (2003) Poverty and common mental disorders in developing countries. Bull World Health Organ 81(8):609–615PubMedPubMedCentral Patel V, Kleinman A (2003) Poverty and common mental disorders in developing countries. Bull World Health Organ 81(8):609–615PubMedPubMedCentral
19.
go back to reference Dibaba Y, Fantahun M, Hindin MJ (2013) The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth 13(1):135CrossRefPubMedPubMedCentral Dibaba Y, Fantahun M, Hindin MJ (2013) The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth 13(1):135CrossRefPubMedPubMedCentral
20.
go back to reference Hromi-Fiedler A, Bermúdez-Millán A, Segura-Pérez S, Pérez-Escamilla R (2011) Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas. Matern Child Nutr 7(4):421–430CrossRefPubMed Hromi-Fiedler A, Bermúdez-Millán A, Segura-Pérez S, Pérez-Escamilla R (2011) Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas. Matern Child Nutr 7(4):421–430CrossRefPubMed
21.
go back to reference Huddleston-Casas C, Charnigo R, Simmons LA (2009) Food insecurity and maternal depression in rural, low-income families: a longitudinal investigation. Public Health Nutr 12(8):1133–1140CrossRefPubMed Huddleston-Casas C, Charnigo R, Simmons LA (2009) Food insecurity and maternal depression in rural, low-income families: a longitudinal investigation. Public Health Nutr 12(8):1133–1140CrossRefPubMed
22.
go back to reference Du Toit NFB (2014) Gangsterism on the Cape Flats: a challenge to ‘engage the powers’. HTS Theol Stud 70(3):01–07 Du Toit NFB (2014) Gangsterism on the Cape Flats: a challenge to ‘engage the powers’. HTS Theol Stud 70(3):01–07
24.
go back to reference Zimet GD, Dahlem NW, Zimet SG, Farley GK (1988) The multidimensional scale of perceived social support. J Pers Assess 52(1):30–41CrossRef Zimet GD, Dahlem NW, Zimet SG, Farley GK (1988) The multidimensional scale of perceived social support. J Pers Assess 52(1):30–41CrossRef
25.
go back to reference Brugha TS, Cragg D (1990) The list of threatening experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatr Scand 82(1):77–81CrossRefPubMed Brugha TS, Cragg D (1990) The list of threatening experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatr Scand 82(1):77–81CrossRefPubMed
26.
go back to reference Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB (1996) The revised conflict tactics scales (CTS2) development and preliminary psychometric data. J Fam Issues 17(3):283–316CrossRef Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB (1996) The revised conflict tactics scales (CTS2) development and preliminary psychometric data. J Fam Issues 17(3):283–316CrossRef
27.
go back to reference Sheehan D, Lecrubier Y, Sheehan KH et al (1998) Diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatr 59:22–33 Sheehan D, Lecrubier Y, Sheehan KH et al (1998) Diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatr 59:22–33
28.
go back to reference Lecrubier Y, Sheehan DV, Weiller E et al (1997) The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 12(5):224–231CrossRef Lecrubier Y, Sheehan DV, Weiller E et al (1997) The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 12(5):224–231CrossRef
29.
go back to reference Dewing S, Tomlinson M, le Roux IM, Chopra M, Tsai AC (2013) Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa. J Affect Disord 150(2):460–465CrossRefPubMedPubMedCentral Dewing S, Tomlinson M, le Roux IM, Chopra M, Tsai AC (2013) Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa. J Affect Disord 150(2):460–465CrossRefPubMedPubMedCentral
30.
go back to reference Myer L, Smit J, Roux LL, Parker S, Stein DJ, Seedat S (2008) Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDS 22(2):147–158CrossRefPubMed Myer L, Smit J, Roux LL, Parker S, Stein DJ, Seedat S (2008) Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDS 22(2):147–158CrossRefPubMed
31.
go back to reference Lecrubier Y, Sheehan D, Hergueta T, Weiller E (1998) The mini international neuropsychiatric interview. Eur Psychiatry 13(1004):198CrossRefPubMed Lecrubier Y, Sheehan D, Hergueta T, Weiller E (1998) The mini international neuropsychiatric interview. Eur Psychiatry 13(1004):198CrossRefPubMed
32.
go back to reference Baron EC, Davies T, Lund C (2017) Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry 17(1):6CrossRefPubMedPubMedCentral Baron EC, Davies T, Lund C (2017) Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry 17(1):6CrossRefPubMedPubMedCentral
33.
go back to reference Van Heyningen T, Myer L, Onah M, Tomlinson M, Field S, Honikman S (2016) Antenatal depression and adversity in urban South Africa. J Affect Disord 203:121–129CrossRefPubMedPubMedCentral Van Heyningen T, Myer L, Onah M, Tomlinson M, Field S, Honikman S (2016) Antenatal depression and adversity in urban South Africa. J Affect Disord 203:121–129CrossRefPubMedPubMedCentral
35.
go back to reference Booysen F, Van Der Berg S, Burger R, Von Maltitz M, Du Rand G (2008) Using an asset index to assess trends in poverty in seven Sub-Saharan African countries. World Dev 36(6):1113–1130CrossRef Booysen F, Van Der Berg S, Burger R, Von Maltitz M, Du Rand G (2008) Using an asset index to assess trends in poverty in seven Sub-Saharan African countries. World Dev 36(6):1113–1130CrossRef
36.
go back to reference Harttgen K, Klasen S, Vollmer S (2013) An African growth miracle? Or: what do asset indices tell us about trends in economic performance? Rev Income Wealth 59:S1CrossRef Harttgen K, Klasen S, Vollmer S (2013) An African growth miracle? Or: what do asset indices tell us about trends in economic performance? Rev Income Wealth 59:S1CrossRef
39.
go back to reference Wight V, Kaushal N, Waldfogel J, Garfinkel I (2014) Understanding the link between poverty and food insecurity among children: Does the definition of poverty matter? J Child Poverty 20(1):1–20CrossRefPubMedPubMedCentral Wight V, Kaushal N, Waldfogel J, Garfinkel I (2014) Understanding the link between poverty and food insecurity among children: Does the definition of poverty matter? J Child Poverty 20(1):1–20CrossRefPubMedPubMedCentral
41.
go back to reference Lund C, Breen A, Flisher AJ et al (2010) Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med 71(3):517–528CrossRefPubMedPubMedCentral Lund C, Breen A, Flisher AJ et al (2010) Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med 71(3):517–528CrossRefPubMedPubMedCentral
42.
43.
go back to reference Chung H, Kim OY, Kwak SY, Cho Y, Lee KW, Shin M (2016) Household food insecurity is associated with adverse mental health indicators and lower quality of life among Koreans: results from the Korea National Health and Nutrition Examination Survey 2012–2013. Nutrients 8(12):819CrossRefPubMedCentral Chung H, Kim OY, Kwak SY, Cho Y, Lee KW, Shin M (2016) Household food insecurity is associated with adverse mental health indicators and lower quality of life among Koreans: results from the Korea National Health and Nutrition Examination Survey 2012–2013. Nutrients 8(12):819CrossRefPubMedCentral
44.
go back to reference Pellowski JA, Barnett W, Kuo CC, Koen N, Zar HJ, Stein DJ (2017) Investigating tangible and mental resources as predictors of perceived household food insecurity during pregnancy among women in a South African birth cohort study. Soc Sci Med 187:76–84CrossRefPubMed Pellowski JA, Barnett W, Kuo CC, Koen N, Zar HJ, Stein DJ (2017) Investigating tangible and mental resources as predictors of perceived household food insecurity during pregnancy among women in a South African birth cohort study. Soc Sci Med 187:76–84CrossRefPubMed
45.
go back to reference Maselko J, Patel V (2008) Why women attempt suicide: the role of mental illness and social disadvantage in a community cohort study in India. J Epidemiol Community Health 62(9):817–822CrossRefPubMed Maselko J, Patel V (2008) Why women attempt suicide: the role of mental illness and social disadvantage in a community cohort study in India. J Epidemiol Community Health 62(9):817–822CrossRefPubMed
46.
go back to reference Kinyanda E, Hoskins S, Nakku J, Nawaz S, Patel V (2012) The prevalence and characteristics of suicidality in HIV/AIDS as seen in an African population in Entebbe district, Uganda. BMC Psychiatry 12(1):63CrossRefPubMedPubMedCentral Kinyanda E, Hoskins S, Nakku J, Nawaz S, Patel V (2012) The prevalence and characteristics of suicidality in HIV/AIDS as seen in an African population in Entebbe district, Uganda. BMC Psychiatry 12(1):63CrossRefPubMedPubMedCentral
47.
go back to reference Davison KM, Marshall-Fabien GL, Tecson A (2015) Association of moderate and severe food insecurity with suicidal ideation in adults: national survey data from three Canadian provinces. Soc Psychiatry Psychiatr Epidemiol 50(6):963–972CrossRefPubMed Davison KM, Marshall-Fabien GL, Tecson A (2015) Association of moderate and severe food insecurity with suicidal ideation in adults: national survey data from three Canadian provinces. Soc Psychiatry Psychiatr Epidemiol 50(6):963–972CrossRefPubMed
48.
go back to reference Weaver LJ, Hadley C (2009) Moving beyond hunger and nutrition: a systematic review of the evidence linking food insecurity and mental health in developing countries. Ecol Food Nutr 48(4):263–284CrossRefPubMed Weaver LJ, Hadley C (2009) Moving beyond hunger and nutrition: a systematic review of the evidence linking food insecurity and mental health in developing countries. Ecol Food Nutr 48(4):263–284CrossRefPubMed
50.
go back to reference Lund C, De Silva M, Plagerson S et al (2011) Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378(9801):1502–1514CrossRefPubMed Lund C, De Silva M, Plagerson S et al (2011) Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378(9801):1502–1514CrossRefPubMed
51.
go back to reference Hamelin A, Beaudry M, Habicht J (2002) Characterization of household food insecurity in Quebec: food and feelings. Soc Sci Med 54(1):119–132CrossRefPubMed Hamelin A, Beaudry M, Habicht J (2002) Characterization of household food insecurity in Quebec: food and feelings. Soc Sci Med 54(1):119–132CrossRefPubMed
52.
go back to reference Hamelin AM, Habicht JP, Beaudry M (1999) Food insecurity: consequences for the household and broader social implications. J Nutr 129(2S):525S–528SCrossRefPubMed Hamelin AM, Habicht JP, Beaudry M (1999) Food insecurity: consequences for the household and broader social implications. J Nutr 129(2S):525S–528SCrossRefPubMed
53.
go back to reference Tarasuk VS (2001) Household food insecurity with hunger is associated with women’s food intakes, health and household circumstances. J Nutr 131(10):2670–2676CrossRefPubMed Tarasuk VS (2001) Household food insecurity with hunger is associated with women’s food intakes, health and household circumstances. J Nutr 131(10):2670–2676CrossRefPubMed
55.
go back to reference Pyne JM, Kuc EJ, Schroeder PJ, Fortney JC, Edlund M, Sullivan G (2004) Relationship between perceived stigma and depression severity. J Nerv Ment Dis 192(4):278–283CrossRefPubMed Pyne JM, Kuc EJ, Schroeder PJ, Fortney JC, Edlund M, Sullivan G (2004) Relationship between perceived stigma and depression severity. J Nerv Ment Dis 192(4):278–283CrossRefPubMed
56.
go back to reference Haushofer J, Fehr E (2014) On the psychology of poverty. Sci 344(6186):862–867CrossRef Haushofer J, Fehr E (2014) On the psychology of poverty. Sci 344(6186):862–867CrossRef
57.
go back to reference Lai HM, Cleary M, Sitharthan T, Hunt GE (2015) Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: a systematic review and meta-analysis. Drug Alcohol Depend 154:1–13CrossRefPubMed Lai HM, Cleary M, Sitharthan T, Hunt GE (2015) Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: a systematic review and meta-analysis. Drug Alcohol Depend 154:1–13CrossRefPubMed
58.
go back to reference Vythilingum B, Roos A, Faure SC, Geerts L, Stein DJ (2012) Risk factors for substance use in pregnant women in South Africa. SA Med J 102(11):853–854 Vythilingum B, Roos A, Faure SC, Geerts L, Stein DJ (2012) Risk factors for substance use in pregnant women in South Africa. SA Med J 102(11):853–854
Metadata
Title
Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study
Authors
Zulfa Abrahams
Crick Lund
Sally Field
Simone Honikman
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 4/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1497-y

Other articles of this Issue 4/2018

Social Psychiatry and Psychiatric Epidemiology 4/2018 Go to the issue