Objectives: To assess the prevalence and trend of food insecurity (FI), mental wellbeing and their associations in the understudied immigrants living in high-income countries between
2014–2017.
Methods: Using nationally representative Gallup World Poll data
from 2014 to 2017, a total of 15,343 immigrants from 48 World Bank
defined high-income countries were included. Individual FI status
was measured by the Food Insecurity Experience Scale (FIES) and
categorized into food secure and mild, moderate and severe FI groups.
Mental wellbeing was assessed by the Negative Experience Index (NEI,
the greater the worse) and the Positive Experience Index (PEI, the
greater the better). Multiple linear regression models were used to
examine the association between FI and NEI/PEI, adjusting for age,
gender, marital status, education, employment status, annual household
income, residency, household size, and the number of children younger
than 15 y in the household.
Results: The prevalence of FI in immigrants decreased from 38.4%
in 2014 to 28.9% in 2017 globally (p-trend <0.001). During 2014–2017,
the overall mental wellbeing in immigrants improved as the mean (SD)
NEI decreased from 32.8 (1.1) to 27.8 (0.5) and PEI increased from
63.1 (1.1) to 73.2 (0.5), respectively (both p-trend <0.001). In the pooled
adjusted model, FI was dose-responsively associated with greater NEI
in mild (12.8 [11.7, 14.1]), moderate (20.5 [18.7,22.3]), and severe FI
groups (28.3 [26.1, 30.5]) as compared to the food secure referent.
By year analyses revealed that the gap in NEI between immigrants
in the severe FI and food secure group widened by ∼10 points from
22.7 [14.7, 30.8] in 2014 to 32.3 [28.24, 36.38] in 2017. The doseresponsive association and its trend over time was less clear in PEI.
Conclusions: Progressive FI is significantly associated with poor
mental wellbeing among immigrants in high income countries. Despite the improvement in food security and mental health status in
immigrants, severely food insecure immigrants have had worsened
mental wellbeing in recent years. Future policies are required to address
disparities in food access and mental health in vulnerable immigrants.
Funding Sources: FAO’s Voices of the Hungry Project for having
granted access to the full GWP data set and supporting materials, which
allowed the present study to be conducted.