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Food insecurity, mental distress and suicidal ideation in rural Africa: Evidence from Nigeria, Uganda and Ghana

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Listed:
  • Annika Claire Sweetland
  • Andrea Norcini Pala
  • Jennifer Mootz
  • Jennifer Chien-Wen Kao
  • Catherine Carlson
  • Maria A. Oquendo
  • Bryan Cheng
  • Gary Belkin
  • Milton Wainberg

Abstract

Background: In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries. Aims: To examine the prevalence of and associations between food insecurity, mental distress and suicidal ideation in three rural village clusters in sub-Saharan Africa. Method: Cross-sectional multivariate analysis of sociodemographic variables associated with mental distress and suicidal ideation in three countries. The sample included 1,142 individuals from three rural village clusters in Nigeria ( n  = 380), Uganda ( n  = 380) and Ghana ( n  = 382). Food insecurity was measured based on the number of months in the previous year that the respondent’s family reported being ‘unable to eat two square meals per day’. Mental distress was assessed using the Kessler non-specific psychological distress scale (K6) and suicidal ideation was measured using an item from PRIME-MD. Other sociodemographic variables included gender, age, literacy and occupation. Results: The prevalence of individuals with moderate or severe mental distress in Nigeria, Uganda and Ghana were higher than previously reported in the literature: 35.5%, 30.8% and 30.4%, respectively, and suicidal ideation rates were 29.7%, 21.3% and 10.9%. No differences were observed in mental distress between men and women in any of the sites. Being a farmer (vs student or other) was protective for mental distress in two sites (Uganda and Ghana) but no other social indicators, such as age, gender, literacy and food insecurity, were significantly associated with mental distress. Risk for suicidal ideation differed across sites: it was associated with food insecurity in Nigeria, female gender in Uganda, and older age in Uganda. Conclusions: Mental distress and suicidal ideation were highly prevalent in three settings of extreme poverty across all groups, in ways that were not always consistent with the global literature. These findings suggest that more research is needed in to better understand the social etiology of mental distress in sub-Saharan Africa.

Suggested Citation

  • Annika Claire Sweetland & Andrea Norcini Pala & Jennifer Mootz & Jennifer Chien-Wen Kao & Catherine Carlson & Maria A. Oquendo & Bryan Cheng & Gary Belkin & Milton Wainberg, 2019. "Food insecurity, mental distress and suicidal ideation in rural Africa: Evidence from Nigeria, Uganda and Ghana," International Journal of Social Psychiatry, , vol. 65(1), pages 20-27, February.
    • Handle: RePEc:sae:socpsy:v:65:y:2019:i:1:p:20-27
    DOI: 10.1177/0020764018814274
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    References listed on IDEAS

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    1. Cole, Steven M. & Tembo, Gelson, 2011. "The effect of food insecurity on mental health: Panel evidence from rural Zambia," Social Science & Medicine, Elsevier, vol. 73(7), pages 1071-1079.
    2. Lund, Crick & Breen, Alison & Flisher, Alan J. & Kakuma, Ritsuko & Corrigall, Joanne & Joska, John A. & Swartz, Leslie & Patel, Vikram, 2010. "Poverty and common mental disorders in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 71(3), pages 517-528, August.
    3. Hadley, Craig & Stevenson, Edward Geoffrey Jedediah & Tadesse, Yemesrach & Belachew, Tefera, 2012. "Rapidly rising food prices and the experience of food insecurity in urban Ethiopia: Impacts on health and well-being," Social Science & Medicine, Elsevier, vol. 75(12), pages 2412-2419.
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