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A new study published in the Canadian Medical Association Journal looked at household food insecurity and health service use for mental and substance use disorders among children and adolescents in Ontario, Canada.

“There have been other studies that have shown that food insecurity can lead to behavioural issues among children and adolescents, as well as symptoms of mental health problems,” study author Kelly Anderson told us. “We wanted to examine whether these behaviours and symptoms are translating to clinically significant mental health problems that require contact with the health care system.”

The researchers expected that children and adolescents who were living in food insecure household would have more frequent contacts with the health care system for mental health reasons. With the rising price of food and other costs of living, as well as increasing requests to food banks and other charitable organizations, they thought this was a very important and timely topic.

“However, the data we used in the study were quite old, as this was the most recent linked data available to us to be able to answer this question,” Anderson told us. “The most recent data on food insecurity in Canada suggests that the frequency of household food insecurity has increased in the years since the period we looked at in our study. We also have data showing that use of mental health services have also been increasing in recent years. We might expect to see even stronger effects for the association between household food insecurity and use of mental health services among children and adolescents if we were to use more recent data.”

The researchers used data from a population health survey that asked families about their experiences of food insecurity across a number of years. Food insecurity includes things like worrying about running out of food, an inability to afford balanced meals, and missing meals or going days without eating. They linked the survey data to records from the health care system, and identified children and teens who were living in households experiencing food insecurity.

“When we analyzed the data, we found that kids and teens who were living in households experiencing food insecurity were more 55% more likely to have contact with a doctor for mental health issues, and 74% more likely to have an emergency department visit or hospitalization for a mental health reason,” Anderson told us. “This association between household food insecurity and health service use persisted even after we accounted for things like low household income, single parent family, or number of children in the household.”

The research team also found that as the severity of food insecurity increased, so did the likelihood of having contact with health services for mental health problems.

“I don’t think it would be surprising to anyone that experiences of food insecurity could lead to symptoms of anxiety or depression among children and adolescents,” Anderson told us. “However, we found and association of food insecurity across a wide range of mental health problems – ranging from autism and ADHD to depression, anxiety, and substance use issues. This tells us that our findings are unlikely to be due to a nutrient deficiency, as we would expect to see more specific effects if that were this case. It is more likely that our findings are the result of living in a state of chronic stress due to not having your basic needs met.”

Anderson believes the findings might also suggest that mental health problems may be poorly managed for kids and teens who are living in food-insecure households. Other research from Ontario has found that people experiencing food insecurity are often unable to afford their medications, so families may be forced to make a difficult choice between paying for mental health treatment for their kids or putting dinner on the table.

“Many of the known risk factors for mental health problems are very difficult to change, but food insecurity is a marker of risk that is modifiable and completely preventable,” Anderson told us. “We have evidence of effective public policy interventions, like basic income programs, to make sure that families have the resources they need to meet their basic needs.”