Youth in food-insecure homes made more visits to doctors for mental health: study

Hymie Aragones avoids going into the store because just the thought of grocery shopping makes her so anxious that she will come home without food that she can’t feed her children.

Aragones said her husband has taken on more and more responsibility for what he once considered a “me time” vacation for his three- and six-year-old sons. She occasionally helps out, but she “groceries” at least three stores to pick up bargains.

Aragones, who lives in Richmond, British Columbia, where she works as a medical assistant, said “everything just adds up and it’s just really frustrating and unsettling.”

Aragones said that despite the couple’s efforts to stick to a budget, struggling to pay for basic necessities, including rent, has resulted in a constant “feeling of defeat.”

She also worries about how that stress will affect her children, especially her oldest son, who is told to “save it for later” when his favorite snack isn’t in the fridge.

Aragones said he and his wife are both lucky because they have jobs, but he can’t imagine the emotional impact on his family of potentially lower food costs.

Children and adolescents under the age of 18 see a doctor 55% more often for mental health reasons in Ontario’s food-insecure households than those in well-fed households, the Canadian Medical Association Journal (CMAJ) said on Monday.

The study used demographic health data on 32,321 children and adolescents, of whom just over 16 percent were found to be living with food insecurity. 6% were barely food-insecure, 7.3% lived in moderately food-insecure households, and 2.8% were severely food-insecure.

Lead author Kelly Anderson, associate professor of epidemiology and biostatistics at Western University, said the data, which spans the period 2005-2014, is the latest to link Statistics Canada’s findings on food insecurity with health records that show use of specific services, such as emergency room visits and hospitalizations for mental illness.

The study also showed that children and adolescents in food-insecure households had a 74% higher prevalence of hospitalization for mental or substance use disorders. Neurodevelopmental disorders, mood disorders and anxiety disorders were the most common reasons, followed by social problems and other mental health problems.

Anderson said marginal, moderate, and severe food insecurity range from whether people can afford a balanced diet, to whether they worry about food shortages, whether they skip meals or worry about not eating for days.

The time has come to not only quantify these inequalities, but also to do something about them with policies aimed at reducing the chronic stresses associated with food insecurity and mental health problems, said Anderson, the Canadian Research Commissioner for Public Mental Health Studies.

Lynn McIntyre, Ph.D., Emeritus Professor of Community Health Sciences at the University of Calgary Cumming School of Medicine, said in a related commentary that there is no evidence that food banks or other charitable programs, including schools, have reduced food insecurity in households.

In an interview, she said people who can’t afford food are more likely to skip critical medications for their children, which could exacerbate health problems.

He noted that other studies on food insecurity, such as those by Statistics Canada and Public Health Agency of Canada (PHAC), do not link food insecurity to its effects on children’s health.

“While some adults may actually use emergency medical services and outpatient services, some would have expected that they would not be as chronic.”

But the most vulnerable young people do not have easy access to mental health services, McIntyre said.

“These are adverse childhood experiences that really need to be prevented, and it is the duty of society to reduce them,” she said.

“Parents are in such dire straits that mental health services are so hard to reach for their children that they are probably paying at their own expense for alternative services that are not of the highest quality – health care providers outside the reach of the health system.”

Vulnerable families are spending even less money on groceries since the survey period, especially after the pandemic, with significant food price hikes and unprecedented rent increases in many parts of the country.

In other words, doctors should advocate for a basic income for their patients in the same way doctors seek solutions to overcrowded emergency rooms without access to primary care, McIntyre said, adding that it would also reduce overall health care costs.

Income support is one of the most important determinants of health, she said, and Ontario’s findings apply to most parts of the country.

McIntyre said earlier this month a so-called federal grocery rebate aimed at low-income Canadians was an example of a one-time payment that gave people cash they could use to support their families, but that regular support was needed.

As for Aragones, her family was ineligible for the $467 paid to a couple with two children because her and her husband’s income was just a few hundred dollars above the threshold.

“We are surviving,” she said. “That’s what I think about our situation right now.”

This report by the Canadian Press Agency was first published on July 24, 2023.
— Canadian Press’ health coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.