A limited number of studies have shown that homeless populations are affected by higher levels of food insecurity, but little is known about food insecurity among homeless adults living with mental illness. Understanding the extent to which food insecurity affects homeless mentally ill adults is crucial to informing relevant policies, intervention and reducing related health consequences. This study is the first to address the question of what is the prevalence and potential factors associated with food insecurity among homeless adults with mental disorders.
A cross-sectional study design was used to analyse baseline data from participants of the Vancouver At Home Study. Participants were homeless or unstably housed adults with mental illness (n = 421) and were recruited by referral from community agencies in Vancouver, BC, Canada. Univariate and multivariable logistic regression models were conducted to identify food insecurity correlates. Stepwise backwards elimination was employed to determine the final adjusted model.
Of 421 participants, 64% were food insecure. Significant variables in the final adjusted model included: self-reported mental health (aOR = 0.97; 95% CI, 0.95-0.98); >$500 spent on substances in the previous month (aOR = 1.85; 95% CI, 1.01-3.39); HIV/AIDS (aOR = 3.08; 95% CI, 1.11-8.54); and having visited a drop-in centre/meal program (aOR = 1.70, 95% CI, 1.08-2.69).
The exceptionally high prevalence of food insecurity in this sample of homeless adults living with mental illness indicates the need for consideration and intervention. Screening for the aforementioned correlates may help identify those who are food insecure. The present study supports the notion that current food provision systems to food insecure individuals are insufficient, with a better systematic response needed. Additional implications of covariates are discussed.
Food insecurity interventions are needed immediately to reduce an already high prevalence of food insecurity among homeless mentally ill adults
Several correlates were identified and may be used for screening/future research