Introduction

Food insecurity is a complex issue and as defined by the FAO (Food and Agriculture Organization), food insecurity is “when a person lacks regular access to enough safe and nutritious food for normal growth and development and an active and healthy life (1). Worldwide more than 3 billion people are food insecure with the highest concentration in Asian countries (418 million) (2). Although there is a lack of data in the Indian context, yet the Government of India is striving hard to reduce food insecurity among affected population groups (3). Additionally, the adverse effects of food insecurity go beyond nutrition and physical health to percolate down on mental health (4), (5). The COVID-19 pandemic further exacerbated the impact of food insecurity on mental health of individuals (6). A recent review associated a positive relationship between FI and risk of depression and stress (5).

“Food Insecurity may be a key contributor to common mental disorders through several different mechanisms”. (7)

Food Insecurity and Mental Health Issues across Lifespan

A global analysis of 149 countries on food insecurity and mental health found that FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa. It demonstrated that FI is associated with poorer mental health and specific psychosocial stressors (7). Food insecurity has been identified as a powerful stressor for families, with significant negative implications for child health and development; these include impacts on physical, social, cognitive, and behavioral development, independent of poverty (8). Study conducted on teenage girls in India found teenage girls from food insecure households were more likely to have high levels of anxiety, depression, loss of behavioral control and psychological distress than those living in food secure households (9). A study conducted on 31,464 older persons 60 years and above found that food insecurity is associated with a lower level of cognition among the elderly in India (10). Likewise, another study reported middle aged and older people experienced high psychological distress due to FI during the pandemic (11). Additionally, high levels of stress were associated with deteriorating FI among women in developing countries (12).

Addressing Food Insecurity and mental health During COVID-19 Pandemic: Indian Context

As a response to the pandemic the Government of India announced a relief package of $22.6 billion (Rs. 1.70 Lakh Crore) on March 26, 2020 which majorly catered to the prevalent food insecurity due to COVID-19 pandemic (13). The public based distribution system (PDS) provided free 5 kgs of rice/wheat along with 1 kg of pulses in three installments under the Pradhan Mantri Garib Kalyan Ann Yojana (13). This was in addition to pre-existing entitlement of 5 kgs low-cost wheat/rice per person per month. The scheme catered to nearly 80 crore individuals accounting for two-thirds of the population of India. Although initially targeted for 3 months only, later the Pradhan Mantri Garib Kalyan Anna Yojana was extended in a total of five phases till March 2022 (14). Additionally, the state governments also announced relief packages for the population. Considering the double burden of pandemic and food insecurity on mental health, the government launched a helpline number and strengthened the telemedicine facilities for the patients (15). Yet, a recent survey by the Indian Psychiatric Society showed a 20% increase in mental illness since the pandemic outbreak (16). Moving forward the government must have a plan with focus on food insecurity and its multidimensional impact on the millions of people in the country.

Way Forward

Long-term and multifaceted interventions studies are needed to positively impact and prevent food insecurity. Moreover, there is a need to understand the complex relationship between well-being and food insecurity. There is paucity of evidence-based tailored interventions that address mental health, well-being, and food insecurity. Funding should be available for advocacy and awareness programs linking food insecurity and poor mental health outcomes. Funding support would help in developing robust monitoring systems and strengthening the research to more comprehensively understand relation between Food Insecurity and Mental Health, Moreover, it may help to design evidence-based interventions that can effectively address insecurity and psychological distress in order to improve nutritional and psychological well-being simultaneously.

References

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  8. Gallegos D, Eivers A, Sondergeld P, Pattinson C. Food Insecurity and Child Development: A State-of-the-Art Review. Int J Environ Res Public Health. 2021 Jan;18(17):8990.
  9. Rani D, Singh JK, Acharya D, Paudel R, Lee K, Singh SP. Household Food Insecurity and Mental Health Among Teenage Girls Living in Urban Slums in Varanasi, India: A Cross-Sectional Study. Int J Environ Res Public Health. 2018 Aug;15(8):1585.
  10. Kumar S, Bansal A, Shri N, Nath NJ, Dosaya D. Effect of food insecurity on the cognitive problems among elderly in India. BMC Geriatr. 2021 Dec 18;21(1):725.
  11. Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al. The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic. Nutrients. 2021 Feb;13(2):353.
  12. Rahman T, Hasnain MDG, Islam A. Food insecurity and mental health of women during COVID-19: Evidence from a developing country. PLOS ONE. 2021 Jul 29;16(7):e0255392.
  13. Finance Minister announces Rs 1.70 Lakh Crore relief package under Pradhan Mantri Garib Kalyan Yojana for the poor to help them fight the battle against Corona Virus [Internet]. [cited 2022 Jan 14]. Available from: https://pib.gov.in/pib.gov.in/Pressreleaseshare.aspx?PRID=1608345
  14. Cabinet approves extension of Pradhan Mantri Garib Kalyan Ann Yojana (PMGKAY) for another four months (December 2021-March 2022) [Internet]. [cited 2022 Jan 14]. Available from: https://pib.gov.in/pib.gov.in/Pressreleaseshare.aspx?PRID=1774586
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  16. 20% increase in patients with mental illness since coronavirus outbreak: Survey – India News [Internet]. [cited 2022 Jan 14]. Available from: https://www.indiatoday.in/india/story/20-per-cent-increase-in-patients-with-mental-illness-since-coronavirus-outbreak-survey-1661584-2020-03-31

Affiliation

  • Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
  • Foundation of Healthcare technologies Society, New Delhi, India