Associations between Hunger and Mental Health among Adolescents in Bangladeshi Slums Amid COVID-19
Keywords:
Hunger, Food insecurity, Covid-19, Mental health, Poverty, AdolescentsAbstract
Objective: Identify the prevalence of hunger, anxiety, and depression, while also exploring the association between hunger, sociodemographic factors, and the presence of anxiety and depression among adolescents in Dhaka's urban slums during the Covid-19 pandemic
Methods: This cross-sectional study was conducted during April to May 2022 among 324 adolescents living in slums in Dhaka division, Bangladesh. Data collection was done onsite using a structured questionnaire. Anxiety and depression were assessed using pre-validated and reliable Bangla translated versions of Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Hunger was measured using the Household Hunger Scale (HHS). Binary logistic regression was used to find associations.
Results: 61.7% of the adolescents suffered from moderate – severe hunger. The prevalence of moderate to severe levels of anxiety and depression were high at 46.3% and 63.3% respectively. In logistic regression, hunger showed significant association with both anxiety (AOR= 2.345, 95% CI= 1.474- 3.731) and depression (AOR= 1.852, 95% CI= 1.166- 2.941). Additionally, early adolescence was associated with anxiety, and adolescents who were school going and lived in a household with >5 family members had more likelihood of both anxiety and depression.
Conclusion: Hunger during the Covid-19 pandemic was associated with increased risk of anxiety and depression. In crisis situations, public health measures should ensure that poor communities have access to at least basic meals to minimize impact on mental health of adolescents. Apart from this, they should also focus on living situations in slums and enhance their efforts in the national school feeding program.
References
Practical G. An Introduction to the Basic Concepts of Food Security. FAO. Available from: https://www. fao. org/3/al936e/al936e.pdf; 2008. accessed 17 June, 2023.
Fram MS, Nguyen HT, Frongillo EA. Food insecurity among adolescent students from 95 countries is associated with diet, behavior, and health, and associations differ by student age and sex. Current Developments in Nutrition. 2022; 6(3): nzac024. DOI: 10.1093/cdn/nzac024
Romo ML, Abril-Ulloa V, Kelvin EA. The relationship between hunger and mental health outcomes among school-going Ecuadorian adolescents. Social Psychiatry and Psychiatric Epidemiology. 2016; 51: 827-37. DOI: 10.1007/s00127-016-1204-9
Fang D, Thomsen MR, Nayga RM. The association between food insecurity and mental health during the COVID-19 pandemic. BMC Public Health. 2021; 21(1): 607. DOI: 10.1186/s12889-021-10631-0
Rahman MT, Akter S, Rana MR, Sabuz AA, Jubayer MF. How COVID-19 pandemic is affecting achieved food security in Bangladesh: A perspective with required policy interventions. Journal of Agriculture and Food Research. 2022; 7: 100258. DOI: 10.1016/j.jafr.2021.100258
Rahman HZ, Matin I. Livelihoods, coping, and support during COVID-19 crisis. Dhaka, BRAC Institute of Governance and Development. 2020.
Seager J, Baird S, Kalow J, Tauseef S. Locking down adolescent hunger: COVID‐19 and food security in Bangladesh. Applied Economic Perspectives and Policy. 2023. DOI: 10.1002/aepp.13360
Ria AF, Raha SA, Rana S, Roy P, Aktar T, Al Mamun S, et al. Exploring the impact of covid-19 on adolescents in urban slums in Dhaka, Bangladesh. Dhaka; 2020.
Kumar MM, Karpaga PP, Panigrahi SK, Raj U, Pathak VK. Impact of COVID-19 pandemic on adolescent health in India. J Family Med Prim Care. 2020; 9(11): 5484-9. DOI: 10.4103/jfmpc.jfmpc_1266_20
Sama BK, Kaur P, Thind PS, Verma MK, Kaur M, Singh DD. Implications of COVID‐19‐induced nationwide lockdown on children's behaviour in Punjab, India. Child: Care, Health and Development. 2021; 47(1): 128-35. DOI: 10.1111/cch.12816
Hasan MT, Anwar T, Christopher E, Hossain S, Hossain MM, Koly KN, et al. The current state of mental healthcare in Bangladesh: part 1 – an updated country profile. BJPsych International. 2021; 18(4): 78-82. DOI: 10.1192/bji.2021.41
Mullick MS, Goodman R. The prevalence of psychiatric disorders among 5-10 year olds in rural, urban and slum areas in Bangladesh: an exploratory study. Soc Psychiatry Psychiatr Epidemiol. 2005; 40(8): 663-71. DOI: 10.1007/s00127-005-0939-5
SMY A. Integrating mental health into primary health care in Bangladesh: problems and prospects. Ment Health Addict Res 3. 2018.
Gruebner O, Khan MMH, Lautenbach S, Müller D, Krämer A, Lakes T, Hostert P. Mental health in the slums of Dhaka - a geoepidemiological study. BMC Public Health. 2012; 12(1): 177. DOI: 10.1186/1471-2458-12-177
Rahaman MA, Kalam A, Al-Mamun M. Unplanned urbanization and health risks of Dhaka City in Bangladesh: uncovering the associations between urban environment and public health. Frontiers in public health. 2023; 11. DOI: 10.3389/fpubh.2023.1269362
Anjum A HS, Hasan MT, Uddin M.E, Sikder M.T. Anxiety among urban, semiurban and rural school adolescents in Dhaka, Bangladesh: Investigating prevalence and associated factors. PLoS ONE. 2022; 17(1). DOI: 10.1371/journal.pone.0262716
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Internal Medicine. 2006; 166(10):1 092-7. DOI: 10.1001/archinte.166.10.1092
Segura-Jiménez V, Carbonell-Baeza A, Keating XD, Ruiz JR, Castro-Piñero J. Association of sleep patterns with psychological positive health and health complaints in children and adolescents. Quality of Life Research. 2015; 24(4): 885-95. DOI: 10.1007/s11136-014-0827-0
Sheikh S, Iqbal R, Qureshi R, Azam I, Barolia R. Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey. BMC nutrition. 2020; 6(1): 1-9. DOI: 10.1186/s40795-020-00343-w
Sclar ED, Garau P, Carolini G. The 21st century health challenge of slums and cities. The Lancet. 2005; 365(9462): 901-3. DOI: 10.1016/S0140-6736(05)71049-7
Räder C. Fighting food insecurity and undernutrition in urban slums. The Daily Star. 2016.
Napier-Raman S, Rattani A, Qaiyum Y, Bose V, Seth R, Raman S. Impact of COVID-19 on the lives of vulnerable young people in New Delhi, India: a mixed method study. BMJ Paediatr Open. 2021; 5(1): e001171. DOI: 10.1136/bmjpo-2021-001171
Anjum A, Hossain S, Sikder T, Uddin ME, Rahim DA. Investigating the prevalence of and factors associated with depressive symptoms among urban and semi-urban school adolescents in Bangladesh: a pilot study. International health. 2022; 14(4): 354-62. DOI: 10.1093/inthealth/ihz092
Rani D, Singh JK, Acharya D, Paudel R, Lee K, Singh SP. Household Food Insecurity and Mental Health Among Teenage Girls Living in Urban Slums in Varanasi, India: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2018; 15(8): 1585. DOI: 10.3390/ijerph15081585
Swahn M, Bossarte R, Gaylor E, Elimam DM, Walingo M. Hunger and risk for emotional and behavioral problems: a comparison between students in Botswana, Kenya, Uganda and Zambia. Int Public Health J. 2010; 2: 185-94.
Hungry Teens and Mental Health Internet: Food Lifeline; 2016 Available from: https://foodlifeline.org/hungry-teens-and-mental-health/. accessed 23 April, 2024.
Mridha MK, Hossain MM, Khan MSA, Hanif AAM, Hasan M, Mitra D, et al. Prevalence and associated factors of depression among adolescent boys and girls in Bangladesh: findings from a nationwide survey. BMJ Open. 2021; 11(1): e038954. DOI: 10.1136/bmjopen-2020-038954
Lee J. Mental health effects of school closures during COVID-19. The Lancet Child & Adolescent Health. 2020; 4(6): 421. DOI: 10.1016/S2352-4642(20)30109-7
Hawrilenko M, Kroshus E, Tandon P, Christakis D. The association between school closures and child mental health during COVID-19. JAMA network open. 2021; 4(9): e2124092-e. DOI: 10.1001/jamanetworkopen.2021.24092
Rahman HZR, Atiya; Islam, Md. Saiful; Faruk, Avinno; Kabir, Eradul; Matin, Imran; Wazed, Mohammad Abdul; Zillur, Umama; Hossain, Md. Billal; Haque, Md. Masudul. Education Life of Children During COVID-19: Trends in Learning Loss, Digital Inclusion, Mental Health, and Child Labour. Internet: Brac institute of governance and development; 2022.
Jones C. Student anxiety, depression increasing during school closures, survey finds Internet: edsource.org; 2020. Available from: https://edsource.org/2020/student-anxiety-depression-increasing-during-school-closures-survey-finds/631224. accessed 23 April, 2024.
Corburn J, Vlahov D, Mberu B, Riley L, Caiaffa WT, Rashid SF, et al. Slum health: arresting COVID-19 and improving well-being in urban informal settlements. Journal of urban health. 2020; 97: 348-57. DOI: 10.1007/s11524-020-00438-6
Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan journal of medical sciences. 2020; 36(COVID19-S4): S67. DOI: 10.12669/pjms.36.COVID19-S4.2759
Dharmaraju N, Mauleshbhai SS, Arulappan N, Thomas B, Marconi DS, Paul SS, Mohan VR. Household food security in an urban slum: Determinants and trends. J Family Med Prim Care. 2018; 7(4): 819-22. DOI: 10.4103/jfmpc.jfmpc_185_17
Adegboye D, Williams F, Collishaw S, Shelton K, Langley K, Hobson C, et al. Understanding why the COVID‐19 pandemic‐related lockdown increases mental health difficulties in vulnerable young children. JCPP advances. 2021; 1(1) :e12005. DOI: 10.1111/jcv2.12005
Gunawardhana N, Ginigaddara G. Household food security of urban slum dwellers: a case study in Colombo municipality, Sri Lanka. Journal of Food Chemistry & Nanotechnology. 2021; 7(2): 34-40. DOI: 10.17756/jfcn.2021-0110
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons License CC-BY-ND