Mass. doctor on how food insecurity affects mental health

Updated: 5:32 PM EDT Sep 20, 2023

NO INJURIES HAVE BEEN REPORTED ALL DAY TODAY, WE’VE BEEN TELLING YOU ABOUT THE IMPACT OF HUNGER ON LOCAL FAMILIES. EXPERTS TELL US IT’S NOT JUST THEIR PHYSICAL HEALTH THAT’S IMPACTED, BUT, OF COURSE, THEIR MENTAL HEALTH AS WELL. HERE TO TALK ABOUT THAT IS DR. ALICE CONNORS KELLGREN, A CLINICAL PSYCHOLOGY MATT AT TUFTS MEDICAL CENTER. ALWAYS GOOD TO SEE YOU, DOCTOR. HEY, DOCTOR, IT’S GREAT TO SEE YOU. SO THAT BRINGS UP THE QUESTION. LET’S START HERE. I KNOW THAT YOU SPECIALIZE IN TREATING VICTIMS OF TRAUMA. COULD YOU DESCRIBE FOOD INSECURITY AS TRAUMATIC? I WOULD. SO WE DEFINE TRAUMA AS ANY EXPERIENCE THAT OVERWHELMS AN INDIVIDUAL’S CAPACITY TO COPE. WHICH FOOD INSECURITY CERTAINLY DOES. HUNGER ACTIVATES OUR THREAT RESPONSE SYSTEM. WHAT YOU MAY HAVE HEARD CALLED FIGHT, FLIGHT OR FREEZE. WHEN THIS HAPPENS CHRONICALLY, IT CREATES STRESS ON THE NERVOUS SYSTEM, WHICH CAN LEAD TO MANY ADVERSE MENTAL HEALTH OUTCOMES SUCH AS ANXIETY, DEPRESSION, SUBSTANCE ABUSE. NOT ONLY ARE THESE CONDITIONS CAUSED BY THE EXPERIENCE OF DEPRIVATION, OFTEN THEY CAN BE EXACERBATED BY NOT GETTING ENOUGH NUTRITION. OUR BRAINS, LIKE OTHER PARTS OF OUR BODIES, NEED NUTRITION TO FUNCTION ADEQUATELY. SO MALNOURISHED ASIAN, WHICH CAN BE EITHER NOT GETTING ENOUGH CALORIES OR NOT GETTING ENOUGH OF A SPECIFIC VITAMIN, CAN LEAD TO A RANGE OF PSYCHOLOGICAL SYMPTOMS. AS WELL. SO SO, DOCTOR, LET’S JUST HAVE A CONVERSATION ABOUT THIS. THE GREATER BOSTON FOOD BANK SAYS 1 IN 3 FAMILIES HERE IN MASSACHUSETTS, 1 IN 3 OF THOSE FAMILIES ARE STRUGGLING WITH FOOD INSECURITY RIGHT NOW. SO IN YOUR EXPERIENCE, ARE CHILDREN AND THIS IS EVEN THIS IS A HARD QUESTION, BUT ARE THEY MORE RESILIENT OR CAN THIS IMPACT THEIR MENTAL HEALTH, TOO? AND I CAN IMAGINE THE ANSWER IS, OF COURSE IT CAN. YEAH, YOU’RE ABSOLUTELY RIGHT. OF COURSE IT CAN. AND CHILDREN ARE ACTUALLY MORE VULNERABLE TO THE EFFECTS OF FOOD INSECURITY THAN ADULTS ARE, BECAUSE THEIR BRAINS AND BODIES NEED NUTRITION TO GROW AND DEVELOP. THERE ARE ALSO FORMING THEIR UNDERSTANDING OF THE WORLD AND WHETHER IT’S A SAFE PLACE FOR THEM. SO WHEN THEY EXPERIENCE CHRONIC HUNGER OR INCONSISTENT ACCESS TO FOOD, THEIR BODIES ARE REALLY FREQUENTLY IN THAT FIGHT. FLIGHT FREEZE MODE. AND THEY LEARN THAT THE WORLD IS NOT A SAFE PLACE AND THAT THEIR NEEDS ARE NOT NECESSARILY GOING TO BE MET. AND SO, DR. ELLIS, YOU’VE SET THE TABLE REALLY WELL. SO LET’S TALK ABOUT SOLUTIONS. WHAT DO YOU WANT PEOPLE TO KNOW ABOUT GETTING HELP? FORTUNATELY, SHIRLEY RESEARCH HAS SHOWN THAT COMMUNITY BASED PROGRAMS SUCH AS THE GREATER BOSTON FOOD BANK ARE INCREDIBLY HELPFUL TO MANAGING HUNGER AND FOOD INSECURITY. THERE ARE ALSO A LOT OF STATE AND FEDERAL PROGRAMS THAT PROVIDE FOOD ASSISTANCE FOR PEOPLE WHO QUALIFY, AND YOU CAN ACCESS THESE THROUGH YOUR HEALTH CARE PROVIDER. OFTEN, THOUGH, THE BIGGEST BARRIER FOR PEOPLE WHEN IT COMES TO GETTING HELP CAN BE SHAME. SO PLEASE KNOW THAT THERE’S NO SHAME IN PROVIDING FOOD FOR YOU AND YOUR FAMILY. GOOD REMINDER, GOOD REMINDER. VERY GOOD. ALL RIGHT, DR. CONNORS

Mass. doctor on how food insecurity affects mental health

Updated: 5:32 PM EDT Sep 20, 2023

Dr. Alice Connors-Kellgren, a clinical psychologist at Tufts Medical Center, says it’s not just physical health that’s affected, but their mental health too.

Dr. Alice Connors-Kellgren, a clinical psychologist at Tufts Medical Center, says it’s not just physical health that’s affected, but their mental health too.

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Toronto resident Rhonda Miller knows how difficult it can be to afford the basic necessities.

The 52-year-old lives in an apartment with her daughter and two granddaughters, who are nine and six.

Rising rent and food prices mean Miller has to sometimes choose between paying her bills or buying groceries.

“I leave the bills until I can afford it, because I have to get the food,” she told CBC News.

The Millers rely on social assistance and income from some part-time work, but they say it’s not enough to keep pace with the rising cost of living.

“It’s really difficult because sometimes the food, what I want [my grandchildren] to eat, I can’t afford it, because the budget,” said Miller, noting she worries about the impact on their health.

Rhonda Miller, 52, says the family relies on her social assistance paycheque of $900 a month. But with the rising cost of rent and groceries, Miller says they sometimes don’t have enough money left over to afford adequate food. She worries about the health impact on her grandchildren. (Melanie Glanz/CBC)

A new study published Monday in the Canadian Medical Association Journal (CMAJ) highlights the clinical impact a lack of access to affordable, healthy food can have on young people’s mental health.

It found that in food-insecure households, kids could ultimately end up relying more on the health-care system to cope with mental health and substance use disorders. 

In Canada, the number of people facing food insecurity — meaning they can’t afford an adequate diet — has significantly grown in recent years due high inflation and the fiscal constraints brought on by the COVID-19 pandemic.

“The more severe the food insecurity the household was experiencing, the more likely it was that children and adolescents would have a contact with health services,” said Kelly Anderson, the study’s lead author.

Kelly Anderson is the study’s lead author and an associate professor at Western University in London, Ont. (Kimberley McCready/Western University )

Anderson is an associate professor and Canada Research Chair in Public Mental Health Research at Western University in London, Ont. 

Past research on food insecurity has warned of the psychological distress it can cause kids, too. But to Anderson’s knowledge, this study is the first to show how food insecurity can likely lead to clinical disorders that strain the system. 

Last year, 6.9 million Canadians, including 1.8 million children, faced food insecurity. In Ontario, public health data says that one in five children live in a household that struggles to put healthy food on the table. 

Unmet basic needs can cause stress: researcher

To analyze the link between food and mental health, researchers looked at data between 2005 and 2014 that was connected to a community health survey on a lack of access to healthy foods. 

The study looked at information from more than 32,000 children, with more than 5,200 of them living in food insecure households. The children were between the ages of one and 17 years old. 

Results showed that kids living with food insecurity accessed medical services for mental health or substance use disorders 55 per cent more than those who had access to an appropriate diet.

They also recorded a greater prevalence of emergency department visits and hospital admissions — 74 per cent more — compared to those who were food secure.

Most commonly, the study said, health professionals were being contacted to address neurodevelopmental disorders, like autism, attention deficit hyperactivity disorder (ADHD), or a mood or anxiety diagnosis. 

“I think it’s an indicator of living in a state of chronic stress, where you’re unsure whether even your most basic needs will be met,” said Anderson. 

The results say that kids were less likely to have a psychotic disorder, substance use disorder or engage in deliberate self-harm. 

Dr. Gary Bloch is a family doctor at St. Michael’s Hospital in Toronto whose research focuses on the ways that poverty can impact someone’s health. He is also the co-founder of Inner City Health Associates, a group of doctors that work in homeless settings across the Greater Toronto Area. (CBC)

“It’s an especially devastating read,” Dr. Gary Bloch, a family physician at St. Michael’s Hospital in Toronto, said of the study. 

“It is incredibly sad to think about children who are growing up without access to enough food, without access to enough money to live, on a day-to-day basis.” 

Bloch’s career focuses on the health impacts of poverty and the inequities that exist in accessing care. 

While he says the study confirms what is already known, the focus on children creates an urgency to deal with this problem, as kids “have little ability to control the social environments they grow up in.” 

Data more than 10 years old 

A key drawback of the CMAJ study is that the data is more than a decade old.

Since the data was collected, even more Canadians have become food insecure, especially in recent years. Inflation hit a 39-year high last summer.

“We might expect that if we were to repeat the study using more recent data, that we would find even stronger effects and more frequent use of mental health and substance use services among children,” Anderson said. 

The findings also could not be generalized to First Nation communities and people living in remote parts of the province.

Dr. Anna Banerji, a pediatrician and infectious disease specialist in Toronto, says the impacts of food insecurity are far-reaching. (CBC)

Dr. Anna Banerji, a pediatrician and infectious disease specialist in Toronto, studies food insecurity in Indigenous youth. She says this issue impacts them in a “major way,” and often leads kids to lose focus at school and eventually drop out.

“That leads to that cycle of poverty,” she said. “These kids can have mental health issues as a consequence of food insecurity, and food insecurity is a consequence of their mental health issues. So it’s really both ways.” 

Calls for more income supports, food programs

The study’s researchers say their findings emphasize the need for more initiatives to tackle food insecurity as a way to lower strains on the health-care system and prevent poor mental health outcomes that can follow a person throughout their life.

“Many of the risk factors that we think about in the area of mental health are very difficult to change, but [food insecurity] is one where there is something we can do about it,” said Anderson.

WATCH | Why food banks aren’t a long-term solution: 

Why food banks aren’t a long-term solution

Food banks across Canada are reporting record-high numbers of visits. But food insecurity experts say relying on food banks is a Band-Aid solution that detracts from the main issue: inadequate income and a lack of federal policies that would help low-earning families afford food. Here are some solutions they want the federal government to focus on.

There are public policy interventions, like basic-income programs, that can ensure families have adequate resources to support themselves, she said.

Banerji adds that schools can include nutritious breakfast or lunch programs to help kids that might arrive hungry. 

Meanwhile, for Bloch, he says the study shows that resources should be put directly toward dealing with poverty — otherwise its impacts will likely end up costing more in the future. 

“If we don’t want to pay to prevent those visits, we will pay for the visits themselves, and pay for all the ramifications of those visits, through the health system, through increased supports in the education system [and] … in social services systems,” he said. 

“We have real choices to make about where we want to spend our money.”

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