Joshua D Miller1, Edward A Frongillo2, Elly Weke3, Rachel Burger4, Pauline Wekesa3, Lila A Sheira5, A Rain Mocello4, Elizabeth A Bukusi3,4, Phelgona Otieno6, Craig R Cohen4, Sheri D Weiser5, Sera L Young1,7. 1. Department of Anthropology, Northwestern University, Evanston, IL, USA. 2. Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA. 3. Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya. 4. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. 5. Department of Medicine, University of California San Francisco, San Francisco, CA, USA. 6. Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. 7. Institute for Policy Research, Northwestern University, Evanston, IL, USA.
Abstract
BACKGROUND: Household food insecurity (FI) and water insecurity (WI) are prevalent public health issues that can co-occur. Few studies have concurrently assessed their associations with health outcomes, particularly among people living with HIV. OBJECTIVES: We aimed to investigate the associations between FI and WI and how they relate to physical and mental health. METHODS: Food-insecure adult smallholder farmers living with HIV in western Kenya were recruited to participate in a cluster-randomized controlled trial of a multisectoral agricultural and asset loan intervention. We used baseline data on experiences of FI (using the Household Food Insecurity Access Scale, range: 0-27) and WI (using a modified scale developed for this region, range: 0-51) in the prior month (n = 716). Outcomes included probable depression (using the Hopkins Symptom Checklist), fatigue and diarrhea in the prior month, and overall mental and physical health (using the Medical Outcomes Study HIV Health Survey, range: 0-100). We first assessed Pearson correlations between FI, WI, and sociodemographic characteristics. We then developed 3 regressions for each health outcome (control variables and FI; control variables and WI; control variables, FI, and WI) and compared model fit indexes. RESULTS: Correlations between household FI, WI, and wealth were low, meaning they measure distinct constructs. FI and WI were associated with numerous physical and mental health outcomes; accounting for both resource insecurities typically provided the best model fit. For instance, when controlling for FI, each 10-point higher WI score was associated with a 6.42-point lower physical health score (P < 0.001) and 2.92 times greater odds of probable depression (P < 0.001). CONCLUSIONS: Assessing both FI and WI is important for correctly estimating their relation with health outcomes. Interventions that address food- and water-related issues among persons living with HIV concurrently will likely be more effective at improving health than those addressing a single resource insecurity. This trial was registered at clinicaltrials.gov as NCT02815579.
BACKGROUND: Household food insecurity (FI) and water insecurity (WI) are prevalent public health issues that can co-occur. Few studies have concurrently assessed their associations with health outcomes, particularly among people living with HIV. OBJECTIVES: We aimed to investigate the associations between FI and WI and how they relate to physical and mental health. METHODS: Food-insecure adult smallholder farmers living with HIV in western Kenya were recruited to participate in a cluster-randomized controlled trial of a multisectoral agricultural and asset loan intervention. We used baseline data on experiences of FI (using the Household Food Insecurity Access Scale, range: 0-27) and WI (using a modified scale developed for this region, range: 0-51) in the prior month (n = 716). Outcomes included probable depression (using the Hopkins Symptom Checklist), fatigue and diarrhea in the prior month, and overall mental and physical health (using the Medical Outcomes Study HIV Health Survey, range: 0-100). We first assessed Pearson correlations between FI, WI, and sociodemographic characteristics. We then developed 3 regressions for each health outcome (control variables and FI; control variables and WI; control variables, FI, and WI) and compared model fit indexes. RESULTS: Correlations between household FI, WI, and wealth were low, meaning they measure distinct constructs. FI and WI were associated with numerous physical and mental health outcomes; accounting for both resource insecurities typically provided the best model fit. For instance, when controlling for FI, each 10-point higher WI score was associated with a 6.42-point lower physical health score (P < 0.001) and 2.92 times greater odds of probable depression (P < 0.001). CONCLUSIONS: Assessing both FI and WI is important for correctly estimating their relation with health outcomes. Interventions that address food- and water-related issues among persons living with HIV concurrently will likely be more effective at improving health than those addressing a single resource insecurity. This trial was registered at clinicaltrials.gov as NCT02815579.
Authors: Janice E Stuff; Patrick H Casey; Kitty L Szeto; Jeffrey M Gossett; James M Robbins; Pippa M Simpson; Carol Connell; Margaret L Bogle Journal: J Nutr Date: 2004-09 Impact factor: 4.798
Authors: Walelegn W Yallew; Mamo W Terefe; Thomas E Herchline; Hardeep R Sharma; Bikes D Bitew; Manay W Kifle; Desalegn M Tetemke; Mekuriaw A Tefera; Mesafint M Adane Journal: BMC Public Health Date: 2012-12-07 Impact factor: 3.295
Authors: Thuy Ngoc Vuong; Chinh Van Dang; Simon Toze; Paul Jagals; Danielle Gallegos; Michelle L Gatton Journal: PLoS One Date: 2022-05-05 Impact factor: 3.752
Authors: Joshua D Miller; Cassandra L Workman; Sarita V Panchang; Gretchen Sneegas; Ellis A Adams; Sera L Young; Amanda L Thompson Journal: Adv Nutr Date: 2021-12-01 Impact factor: 8.701
Authors: Jason M Nagata; Joshua D Miller; Craig R Cohen; Edward A Frongillo; Elly Weke; Rachel Burger; Pauline Wekesa; Lila A Sheira; A Rain Mocello; Phelgona Otieno; Lisa M Butler; Elizabeth A Bukusi; Sheri D Weiser; Sera L Young Journal: AIDS Behav Date: 2021-08-09