Fear of COVID-19 Higher among Food-Insecure Households: A Model-Based Study, Mediated by Perceived Stress among Iranian Populations
,
Abstract
Objective: The COVID-19 pandemic is a crisis accompanied by multiple psychological consequences (including fear of COVID-19) and threatens the food security status of millions of people. This study aimed to examine the association between fear of COVID-19 and food insecurity, mediated by perceived stress.
Method: This cross-sectional study was conducted among 2871 Iranian participants (18-80 years), recruited through the Social Media during the COVID-19 epidemic. The demographic and socio-economic information questionnaire, Household Food Insecurity Access Scale (HFIAS), COVID-19 fear scale (FCV-19S), Cohen's Perceived Stress Scale (PSS-14) and Perceived Social Support Questionnaire (MSPSS) were used in data gathering. Descriptive and analytical analyses were done using SPSS 22.0 and Amos 22.0 was used for structural equation modeling (SES).
Results: Food insecurity has significant positive direct and indirect (mediated by perceived stress) correlations with fear of COVID-19 (P < 0.05). It was also shown that perceived social support could negatively relate to fear of COVID-19 through the pathways of food security status or perceived stress (P < 0.05). Among women, the presence of a child under 5 had a significant direct association with fear of COVID-19 (P < 0.05).
Conclusion: Food insecurity was associated with more perceived fear of COVID-19 among the studied population. The crisis caused by COVID-19 highlights the need to increase social resilience through developing and implementing appropriate strategies to prevent and mitigate social costs (whether physical, psychological, or nutritional).
1. Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health. 2020;16(1):57.
2. Worldometer. Coronavirus Statistics: 28 Jan 2022. Available from: https://www.worldometers.info/coronavirus/
3. Mamun MA, Bhuiyan A, Manzar MD. The first COVID-19 infanticide-suicide case: Financial crisis and fear of COVID-19 infection are the causative factors. Asian J Psychiatr. 2020;54:102365.
4. Pakpour A, Griffiths M. The fear of COVID-19 and its role in preventive behaviors. Journal of Concurrent Disorders. 2020;2(1):58–63.
5. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict. 2022;20(3):1537-45.
6. Satici B, Gocet-Tekin E, Deniz ME, Satici SA. Adaptation of the Fear of COVID-19 Scale: Its Association with Psychological Distress and Life Satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6):1980-8.
7. Mamun MA, Griffiths MD. First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: Possible suicide prevention strategies. Asian J Psychiatr. 2020;51:102073.
8. Dsouza DD, Quadros S, Hyderabadwala ZJ, Mamun MA. Aggregated COVID-19 suicide incidences in India: Fear of COVID-19 infection is the prominent causative factor. Psychiatry Res. 2020;290:113145.
9. Varasteh S, Esmaeili M, Mazaheri M. Factors affecting Iranian nurses' intention to leave or stay in the profession during the COVID-19 pandemic. Int Nurs Rev. 2022;69(2):139-49.
10. Ramezani N, Ashtari F, Bastami EA, Ghaderi K, Hosseini SM, Naeini MK, et al. Fear and anxiety in patients with multiple sclerosis during COVID-19 pandemic; report of an Iranian population. Mult Scler Relat Disord. 2021;50:102798.
11. Ahorsu DK, Imani V, Lin CY, Timpka T, Broström A, Updegraff JA, et al. Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling. Int J Ment Health Addict. 2022;20(1):68-82.
12. Policy Brief: The Impact of COVID-19 on Food Security and Nutrition. United Nations; 2020 Jun.
13. Rad AK, Shamshiri RR, Azarm H, Balasundram SK, Sultan M. Effects of the COVID-19 Pandemic on Food Security and Agriculture in Iran: A Survey. Sustainability. 2021;13(18):10103.
14. Mosadeghrad AM, Gebru AA, Sari AA, Tafesse TB. Impact of food insecurity and malnutrition on the burden of Non-communicable diseases and death in Ethiopia: A situational analysis. Hum Antibodies. 2019;27(4):213-20.
15. Kluge HHP, Wickramasinghe K, Rippin HL, Mendes R, Peters DH, Kontsevaya A, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020;395(10238):1678-80.
16. Azarpazhooh MR, Morovatdar N, Avan A, Phan TG, Divani AA, Yassi N, et al. COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries. J Stroke Cerebrovasc Dis. 2020;29(9):105089.
17. Martin MS, Maddocks E, Chen Y, Gilman SE, Colman I. Food insecurity and mental illness: disproportionate impacts in the context of perceived stress and social isolation. Public Health. 2016;132:86-91.
18. Rodríguez-Hidalgo AJ, Pantaleón Y, Dios I, Falla D. Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression. Front Psychol. 2020;11:591797.
19. Byrd K, Her E, Fan A, Almanza B, Liu Y, Leitch S. Restaurants and COVID-19: What are consumers' risk perceptions about restaurant food and its packaging during the pandemic? Int J Hosp Manag. 2021;94:102821.
20. Rabiei S, Ghodsi D, Amini M, Nikooyeh B, Rasekhi H, Doustmohammadian A, et al. Changes in fast food intake in Iranian households during the lockdown period caused by COVID-19 virus emergency, National Food and Nutrition Surveillance. Food Sci Nutr. 2022;10(1):39-48.
21. Gómez-Corona C, Ramaroson Rakotosamimanana V, Sáenz-Navajas MP, Rodrigues H, Franco-Luesma E, Saldaña E, et al. To fear the unknown: Covid-19 confinement, fear, and food choice. Food Qual Prefer. 2021;92:104251.
22. Mohammadi F, Omidvar N, Houshiar-Rad A, Khoshfetrat MR, Abdollahi M, Mehrabi Y. Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran. Public Health Nutr. 2012;15(1):149-57.
23. Lin CY, Hou WL, Mamun MA, Aparecido da Silva J, Broche-Pérez Y, Ullah I, et al. Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues. Nurs Open. 2021;8(4):1892-908.
24. L. Mohammadi-Yeganeh, F. Bastani, Z. Feizi, M. Agilar-Vafaie, H. Haghani. Effect of Stress Management Education on Mood and Perceived Stress among Oral Contraceptive Pill Users. Iran. J. Nurs. 2008;21(53):63–73.
25. Ghasedi Qazvini S, Kiani Q. The Relationship Between Body Mass Index, Perceived Stress and Health-Related Quality of Life Among Male and Female Adolescents. Iran. J. Nutr. Sci. Food Technol. 2018;13(1):31–9.
26. A.r S, Bahram J, Roushanak N. Internet and communication: Perceived social support and loneliness as antecedent variables. Psychol Stud. 2009;5(3):81–102.
27. Tribble AG, Maxfield A, Hadley C, Goodman M. Food Insecurity and Mental Health: A Meta-Analysis. The lancet. 2020 Jan. Report No.: ID 3520061.
28. Ezzeddin N, Jahanihashemi H, Zavoshy R, Noroozi M. The Prevalence of Postpartum Depression and Its Association with Food Insecurity among Mothers Referring to Community Health Centers. Iran J Psychiatry. 2018;13(4):280-7.
29. Davison KM, Gondara L, Kaplan BJ. Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults. Nutrients. 2017;9(3):274.
30. Hromi-Fiedler A, Bermúdez-Millán A, Segura-Pérez S, Damio G, Pérez-Escamilla R. Adaptation of the U.S. Food Security Survey Module for Low-Income Pregnant Latinas: Qualitative Phase. J Hunger Environ Nutr. 2009;4(1):62-80.
31. Alkhamees AA, Alrashed SA, Alzunaydi AA, Almohimeed AS, Aljohani MS. The psychological impact of COVID-19 pandemic on the general population of Saudi Arabia. Compr Psychiatry. 2020;102:152192.
32. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety. 2020;37(8):706-14.
33. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2021;57(1):42-8.
34. Hirvonen K, de Brauw A, Abate GT. Food Consumption and Food Security during the COVID-19 Pandemic in Addis Ababa. Am J Agric Econ. 2021;103(3):772-89.
35. Ruszczyk HA, Rahman MF, Bracken LJ, Sudha S. Contextualizing the COVID-19 pandemic's impact on food security in two small cities in Bangladesh. Environ Urban. 2021;33(1):239-54.
36. Kelly JD, Richardson ET, Drasher M, Barrie MB, Karku S, Kamara M, et al. Food Insecurity as a Risk Factor for Outcomes Related to Ebola Virus Disease in Kono District, Sierra Leone: A Cross-Sectional Study. Am J Trop Med Hyg. 2018;98(5):1484-8.
37. 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.
38. Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562.
39. Wimalawansa SJ. Fighting against COVID-19: Boosting the immunity with micronutrients, stress reduction, physical activity, and vitamin D. Nutr. Food Sci. 2020;3:1–4.
40. Liu QW, Zhao GZ, Ji B, Liu YT, Zhang JY, Mou QJ, et al. Analysis of the influence of the psychology changes of fear induced by the COVID-19 epidemic on the body: COVID-19. World J Acupunct Moxibustion. 2020;30(2):85-9.
41. Ye Z, Yang X, Zeng C, Wang Y, Shen Z, Li X, et al. Resilience, Social Support, and Coping as Mediators between COVID-19-related Stressful Experiences and Acute Stress Disorder among College Students in China. Appl Psychol Health Well Being. 2020;12(4):1074-94.
42. Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549.
43. Labrague LJ, De Los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag. 2020;28(7):1653-61.
44. El-Zoghby SM, Soltan EM, Salama HM. Impact of the COVID-19 Pandemic on Mental Health and Social Support among Adult Egyptians. J Community Health. 2020;45(4):689-95.
45. Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychol Trauma. 2020;12(S1):S55-s7.
46. Ashe KM, Lapane KL. Food Insecurity and Obesity: Exploring the Role of Social Support. J Womens Health (Larchmt). 2018;27(5):651-8.
47. Santos IND, Damião JJ, Fonseca M, Cople-Rodrigues CDS, Aguiar OB. Food insecurity and social support in families of children with sickle-cell disease. J Pediatr (Rio J). 2019;95(3):306-13.
48. Hadley C, Mulder MB, Fitzherbert E. Seasonal food insecurity and perceived social support in rural Tanzania. Public Health Nutr. 2007;10(6):544-51.
2. Worldometer. Coronavirus Statistics: 28 Jan 2022. Available from: https://www.worldometers.info/coronavirus/
3. Mamun MA, Bhuiyan A, Manzar MD. The first COVID-19 infanticide-suicide case: Financial crisis and fear of COVID-19 infection are the causative factors. Asian J Psychiatr. 2020;54:102365.
4. Pakpour A, Griffiths M. The fear of COVID-19 and its role in preventive behaviors. Journal of Concurrent Disorders. 2020;2(1):58–63.
5. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict. 2022;20(3):1537-45.
6. Satici B, Gocet-Tekin E, Deniz ME, Satici SA. Adaptation of the Fear of COVID-19 Scale: Its Association with Psychological Distress and Life Satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6):1980-8.
7. Mamun MA, Griffiths MD. First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: Possible suicide prevention strategies. Asian J Psychiatr. 2020;51:102073.
8. Dsouza DD, Quadros S, Hyderabadwala ZJ, Mamun MA. Aggregated COVID-19 suicide incidences in India: Fear of COVID-19 infection is the prominent causative factor. Psychiatry Res. 2020;290:113145.
9. Varasteh S, Esmaeili M, Mazaheri M. Factors affecting Iranian nurses' intention to leave or stay in the profession during the COVID-19 pandemic. Int Nurs Rev. 2022;69(2):139-49.
10. Ramezani N, Ashtari F, Bastami EA, Ghaderi K, Hosseini SM, Naeini MK, et al. Fear and anxiety in patients with multiple sclerosis during COVID-19 pandemic; report of an Iranian population. Mult Scler Relat Disord. 2021;50:102798.
11. Ahorsu DK, Imani V, Lin CY, Timpka T, Broström A, Updegraff JA, et al. Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling. Int J Ment Health Addict. 2022;20(1):68-82.
12. Policy Brief: The Impact of COVID-19 on Food Security and Nutrition. United Nations; 2020 Jun.
13. Rad AK, Shamshiri RR, Azarm H, Balasundram SK, Sultan M. Effects of the COVID-19 Pandemic on Food Security and Agriculture in Iran: A Survey. Sustainability. 2021;13(18):10103.
14. Mosadeghrad AM, Gebru AA, Sari AA, Tafesse TB. Impact of food insecurity and malnutrition on the burden of Non-communicable diseases and death in Ethiopia: A situational analysis. Hum Antibodies. 2019;27(4):213-20.
15. Kluge HHP, Wickramasinghe K, Rippin HL, Mendes R, Peters DH, Kontsevaya A, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020;395(10238):1678-80.
16. Azarpazhooh MR, Morovatdar N, Avan A, Phan TG, Divani AA, Yassi N, et al. COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries. J Stroke Cerebrovasc Dis. 2020;29(9):105089.
17. Martin MS, Maddocks E, Chen Y, Gilman SE, Colman I. Food insecurity and mental illness: disproportionate impacts in the context of perceived stress and social isolation. Public Health. 2016;132:86-91.
18. Rodríguez-Hidalgo AJ, Pantaleón Y, Dios I, Falla D. Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression. Front Psychol. 2020;11:591797.
19. Byrd K, Her E, Fan A, Almanza B, Liu Y, Leitch S. Restaurants and COVID-19: What are consumers' risk perceptions about restaurant food and its packaging during the pandemic? Int J Hosp Manag. 2021;94:102821.
20. Rabiei S, Ghodsi D, Amini M, Nikooyeh B, Rasekhi H, Doustmohammadian A, et al. Changes in fast food intake in Iranian households during the lockdown period caused by COVID-19 virus emergency, National Food and Nutrition Surveillance. Food Sci Nutr. 2022;10(1):39-48.
21. Gómez-Corona C, Ramaroson Rakotosamimanana V, Sáenz-Navajas MP, Rodrigues H, Franco-Luesma E, Saldaña E, et al. To fear the unknown: Covid-19 confinement, fear, and food choice. Food Qual Prefer. 2021;92:104251.
22. Mohammadi F, Omidvar N, Houshiar-Rad A, Khoshfetrat MR, Abdollahi M, Mehrabi Y. Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran. Public Health Nutr. 2012;15(1):149-57.
23. Lin CY, Hou WL, Mamun MA, Aparecido da Silva J, Broche-Pérez Y, Ullah I, et al. Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues. Nurs Open. 2021;8(4):1892-908.
24. L. Mohammadi-Yeganeh, F. Bastani, Z. Feizi, M. Agilar-Vafaie, H. Haghani. Effect of Stress Management Education on Mood and Perceived Stress among Oral Contraceptive Pill Users. Iran. J. Nurs. 2008;21(53):63–73.
25. Ghasedi Qazvini S, Kiani Q. The Relationship Between Body Mass Index, Perceived Stress and Health-Related Quality of Life Among Male and Female Adolescents. Iran. J. Nutr. Sci. Food Technol. 2018;13(1):31–9.
26. A.r S, Bahram J, Roushanak N. Internet and communication: Perceived social support and loneliness as antecedent variables. Psychol Stud. 2009;5(3):81–102.
27. Tribble AG, Maxfield A, Hadley C, Goodman M. Food Insecurity and Mental Health: A Meta-Analysis. The lancet. 2020 Jan. Report No.: ID 3520061.
28. Ezzeddin N, Jahanihashemi H, Zavoshy R, Noroozi M. The Prevalence of Postpartum Depression and Its Association with Food Insecurity among Mothers Referring to Community Health Centers. Iran J Psychiatry. 2018;13(4):280-7.
29. Davison KM, Gondara L, Kaplan BJ. Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults. Nutrients. 2017;9(3):274.
30. Hromi-Fiedler A, Bermúdez-Millán A, Segura-Pérez S, Damio G, Pérez-Escamilla R. Adaptation of the U.S. Food Security Survey Module for Low-Income Pregnant Latinas: Qualitative Phase. J Hunger Environ Nutr. 2009;4(1):62-80.
31. Alkhamees AA, Alrashed SA, Alzunaydi AA, Almohimeed AS, Aljohani MS. The psychological impact of COVID-19 pandemic on the general population of Saudi Arabia. Compr Psychiatry. 2020;102:152192.
32. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety. 2020;37(8):706-14.
33. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2021;57(1):42-8.
34. Hirvonen K, de Brauw A, Abate GT. Food Consumption and Food Security during the COVID-19 Pandemic in Addis Ababa. Am J Agric Econ. 2021;103(3):772-89.
35. Ruszczyk HA, Rahman MF, Bracken LJ, Sudha S. Contextualizing the COVID-19 pandemic's impact on food security in two small cities in Bangladesh. Environ Urban. 2021;33(1):239-54.
36. Kelly JD, Richardson ET, Drasher M, Barrie MB, Karku S, Kamara M, et al. Food Insecurity as a Risk Factor for Outcomes Related to Ebola Virus Disease in Kono District, Sierra Leone: A Cross-Sectional Study. Am J Trop Med Hyg. 2018;98(5):1484-8.
37. 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.
38. Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562.
39. Wimalawansa SJ. Fighting against COVID-19: Boosting the immunity with micronutrients, stress reduction, physical activity, and vitamin D. Nutr. Food Sci. 2020;3:1–4.
40. Liu QW, Zhao GZ, Ji B, Liu YT, Zhang JY, Mou QJ, et al. Analysis of the influence of the psychology changes of fear induced by the COVID-19 epidemic on the body: COVID-19. World J Acupunct Moxibustion. 2020;30(2):85-9.
41. Ye Z, Yang X, Zeng C, Wang Y, Shen Z, Li X, et al. Resilience, Social Support, and Coping as Mediators between COVID-19-related Stressful Experiences and Acute Stress Disorder among College Students in China. Appl Psychol Health Well Being. 2020;12(4):1074-94.
42. Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549.
43. Labrague LJ, De Los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag. 2020;28(7):1653-61.
44. El-Zoghby SM, Soltan EM, Salama HM. Impact of the COVID-19 Pandemic on Mental Health and Social Support among Adult Egyptians. J Community Health. 2020;45(4):689-95.
45. Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychol Trauma. 2020;12(S1):S55-s7.
46. Ashe KM, Lapane KL. Food Insecurity and Obesity: Exploring the Role of Social Support. J Womens Health (Larchmt). 2018;27(5):651-8.
47. Santos IND, Damião JJ, Fonseca M, Cople-Rodrigues CDS, Aguiar OB. Food insecurity and social support in families of children with sickle-cell disease. J Pediatr (Rio J). 2019;95(3):306-13.
48. Hadley C, Mulder MB, Fitzherbert E. Seasonal food insecurity and perceived social support in rural Tanzania. Public Health Nutr. 2007;10(6):544-51.
| Files | ||
| Issue | Vol 17 No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v17i4.10689 | |
| Keywords | ||
| COVID-19 Fear Food Security Perceived Social Support Stress | ||
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How to Cite
1.
Ezzeddin N, Eini-Zinab H, Kalantari N, Ahmadi M, Beheshti Z. Fear of COVID-19 Higher among Food-Insecure Households: A Model-Based Study, Mediated by Perceived Stress among Iranian Populations. Iran J Psychiatry. 2022;17(4):401-410.
