Food Insufficiency, Adverse Childhood Events and Mental Health: Results of the Singapore Mental Health Study 2016.

OBJECTIVE
This study aimed to investigate the prevalence and correlates of food insufficiency and its association with mental disorders and adverse childhood events (ACEs) in Singapore.


DESIGN
This analysis utilized data from the Singapore Mental Health Study (SMHS 2016).


SETTING
SMHS 2016 was a population-based, psychiatric epidemiological study conducted among Singapore residents.


PARTICIPANTS
Interviews were conducted with 6126 respondents. Respondents were included if they were aged 18 years and above, Singapore citizens or permanent residents, and able to speak in English, Chinese, or Malay.


RESULTS
The prevalence of food insufficiency was 2.0% (95% CI: 1.6% - 2.5%) among adult Singapore residents. Relative to respondents who did not endorse any ACE, those with ACEs (OR: 2.9, 95% CI: 1.2 - 6.6) had higher odds of food insufficiency. In addition, there were significant associations between lifetime mental disorders and food insufficiency. Bipolar disorder (OR: 2.7, 95% CI: 1.2 - 6.0), generalized anxiety disorder (OR: 4.5, 95% CI: 1.5 - 13.5), and suicidal behavior (OR: 2.37, 95% CI: 1.04 - 5.41) were shown to be significantly associated with higher odds of food sufficiency.


CONCLUSIONS
The prevalence of food insufficiency is low in Singapore. However, this study identifies a vulnerable group of food insufficient adults that is significantly associated with mental disorders, including suicidality. Government-funded food assistance programs and multi-agency efforts to deal with the social determinants of food insufficiency, such as income sufficiency and early detection and intervention of mental distress, are key to ensuring a sustainable and equitable food system.