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Study reveals link between food insecurity and children’s mental health services use


London, ON, July 24, 2023 – Children and adolescents from food-insecure households had a 55 per cent higher prevalence of past-year outpatient visits for mental or substance use disorders compared to those from food-secure households, according to a new study from ICES and Western University.

Children and adolescents also had a 74 per cent higher prevalence of past-year acute care visits, defined as an emergency department visit or hospitalization for a mental or substance use disorder.

“Over one million children in Canada face food insecurity, and there is evidence that inadequate access to food may contribute to mental health issues,” says lead author Kelly Anderson, associate professor of epidemiology and biostatistics at Western’s Schulich School of Medicine & Dentistry, Canada Research Chair in public mental health research, and adjunct scientist at ICES Western. “This is the first study to explore the relationship between children’s mental health and food insecurity by examining linked health record and survey data, which gives us an accurate snapshot of how food-insecure children are using mental health services.”

The study was published in CMAJ and included 32,321 Ontario children and adolescents (1-17 years), of whom 5,216 (16 per cent) were living in food-insecure households. Food insecurity was measured using a validated community health survey and responses were categorized as: food-secure, marginally food-insecure, moderately food-insecure, or severely food-insecure. Any level of food insecurity was compared to food-secure households.

Study findings show:

  • In the year prior to the survey, 9 per cent of children and adolescents had an outpatient physician visit for a mental or substance use disorder, and 0.6 per cent of children and adolescents received acute care. There was also evidence of higher contact with the healthcare system as the severity of food insecurity increased.
  • The most common health visits were for neurodevelopmental disorders and mood or anxiety disorders; followed by social problems and other mental disorders.
  • Health service use for psychotic disorders, substance use disorders, and deliberate self-harm were rare.

“Taken together, these findings are concerning, and we need strong public policy to support families who face food insecurity,” says senior author Salimah Shariff, staff scientist at ICES Western. “As well, public mental health strategies must be improved and targeted to youth specifically to help reduce the strain on the public mental health system.”

One limitation of the study is that the findings may not be generalizable to First Nations groups and individuals living in remote areas, where food insecurity is particularly prevalent. Additionally, there is missing data for mental health services used outside the public healthcare sector, such as community-based mental health programs, school-based psychologists, and private therapists.

Nevertheless, this is the first study to examine the link between food insecurity and mental health among children and adolescents in Ontario and is consistent with findings that show a higher prevalence of psychiatric symptoms and self-reported diagnoses among Canadian youth experiencing food insecurity.

The study, “Household food insecurity and health service use for mental and substance use disorders among children and adolescents in Ontario, Canada” was published in CMAJ.

Author block: Anderson KK, Clemens KK, Le B, Zhang L, Comeau J, Tarasuk V, Shariff SZ.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

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Misty Pratt
Senior Communications Associate, ICES
[email protected] 613-882-7065

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