Food Insecurity and Mental Health in a Conflict-Affected Population: A Cross-Sectional Study of Adults in Gaza

Abstract

Background: Gaza has endured military occupation for more than 13 years. This occupation has been accompanied by complete siege (sea, land and air), violence and conflict. The conflict has significantly increased the vulnerability of the Gazan population and there are reports of high burdens of both food insecurity and mental health disorders. Although the magnitude of the burdens of food insecurity and poor mental health have been investigated in the context of Gaza, little is known about the association between food insecurity and the manifestation of mental health disorders in this context. Objectives: This study aims to investigate the dual burden of food insecurity and poor mental health in the adult population of Gaza, and understand the impact of receiving aid on this association. Methods: Data from a representative cross-sectional survey of 4520 adults aged 40 years and above residing in Gaza were used. The survey used the 2017 Population and Housing Census sampling frame and recruited individuals using a multistage stratified cluster sampling approach. Descriptive, bivariate and multivariable logistic regression analyses were conducted to assess the association between food insecurity and poor mental health and determine the moderating effect of receiving assistance on this association. Results: Approximately 55% of the participants have poor mental health, and 57% of them are food insecure. Food insecurity was statistically significantly associated with poor mental health. Receiving in-kind food, and food vouchers as assistance did not modify the association between food insecurity and poor mental health. Cash assistance was found to moderate the association between food insecurity and poor mental health differentially in moderately food insecure as compared to severely food insecure adults. Conclusion: Further studies are needed to understand the role of different types, duration, intensity and amounts of assistance in moderating the association between food insecurity and poor mental health in the context of Gaza, as well as, consider other social determinants of both food insecurity and poor mental health to design appropriate interventions to alleviate these in Gaza.