Children in food-insecure homes visit doctors, ER more than peers, study says

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Children and teens living in households without adequate access to food make more doctor and emergency department visits and are admitted to hospital for mental-health issues more often than their peers with a reliable source of food, according to a new study whose lead author warns that their needs are likely growing amid worsening food insecurity in Canada.

The study, published Monday in the Canadian Medical Association Journal (CMAJ), found that children and teens in food-insecure homes had a 55-per-cent higher prevalence of doctors’ visits and were 74 per cent more likely to end up in hospital for mental or substance-use disorders. The findings were based on health administrative data and survey data from 2005 to 2014.

Since then, the prevalence of food insecurity has only gotten worse, particularly since the pandemic, said Kelly Anderson, a Canada research chair in public mental-health research at Western University and an adjunct scientist at ICES (formerly known as the Institute for Clinical Evaluative Sciences).

“And so we might expect to see stronger effects if we were to repeat the study using more current data,” Dr. Anderson said.

The researchers defined food insecurity as the inability to acquire adequate food because of financial constraints. The most recent Statistics Canada data show that more than 18 per cent of Canadians said they were food insecure in 2021, up from 15.7 per cent in 2020. Among single-parent families, almost 39 per cent were food insecure in 2021, compared with 33.7 per cent the previous year.

The study builds on research showing that, for both adults and children, food insecurity is strongly tied to experiences of poor mental health. It analyzed data for more than 32,300 children and teens in Ontario, including more than 5,200 living in food-insecure households.

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The researchers found a disproportionately higher use of health care services for mental and substance-use disorders among the food insecure, driven mainly by visits for neurodevelopmental and mood and anxiety disorders. They also found that the frequency of health care use increased as the severity of the food insecurity worsened.

Dr. Anderson said the data did not capture visits to private psychologists, school counsellors or other mental health care providers. Nor did it include First Nations communities.

In a separate commentary in the CMAJ, Lynn McIntyre, a professor emerita at the University of Calgary and an expert on health equity and food insecurity, said the adverse effects of food insecurity on children’s and teens’ mental health are more likely related to the distress of living in difficult circumstances rather than the lack of specific nutrients or poor diet.

“Household food insecurity is modifiable, and reducing it would surely reduce its related strain on children’s mental health,” Dr. McIntyre wrote, explaining that the only interventions shown to curb household food insecurity are related to income, such as seniors’ pensions and, to some extent, the Canada Child Benefit, not charitable food programs. She added that a universal basic income merits examination.

Jennifer Black, an associate professor of food, nutrition and health at the University of British Columbia, who was not involved in the study, said policy makers should pay attention to the latest findings.

Her own research in the early months of the pandemic found that adults who were worried about having enough food to meet their household needs were more likely to experience worse mental-health outcomes, including anxiety and suicidal thoughts.

The toll food insecurity takes on families is clear, Dr. Black said.