Household food and water insecurity are positively associated with high
perceived stress during COVID-19 lockdown: Evidence from a low-middle
income country
Abstract
The COVID-19 pandemic has increased the risk of global public health and
has the potential to cause severe food and water insecurity due to
economic recession during lockdown for people living in low-middle
income countries like Bangladesh where capital resources are scarce.
There is growing evidence that household food and water insecurity has
been associated with poor psychological outcomes. The objective of this
study was to determine the association between household food and water
insecurity with mental health and whether these differed among
urban-rural households. A cross-sectional online survey was conducted
with 545 participants immediately after the COVID-19 lockdown period in
Bangladesh (August 1-September 30, 2020). Household food and water
security were determined using a 9-item Household Food Insecurity Access
Scale (HFIAS) (score range 0-27) and a 12-item Household Water
Insecurity Experiences (HWISE) scale (score range 0-36), respectively.
The Perceived Stress Scale (PSS) was used to evaluate mental health.
Multivariable logistic regression examined the association between
household food and water insecurity with perceived stress, adjusting
socioeconomic characteristics. An urban-rural stratified analysis was
also performed. About 72.84% (397) respondents reported high stress and
more than 70% of households suffered from food and water insecurity
during the lockdown period. After adjusting covariates, logistic
regression model results show that food insecurity was associated with a
1.07-point increase in high perceived stress (OR=1.07, 95%
CI=1.01-1.11, p<0.01) while water insecurity was associated
with 1.03 times greater odds of high perceived stress (OR=1.03, 95%
CI=0.93-1.23, p<0.05). In stratified analysis, only food
insecurity was associated with high perceived stress in the urban
household (OR=1.08, 95% CI=1.00-1.11, p<0.05). However, none
of the household insecurity was associated with perceived stress in
rural households. Interventions that promote equal access to resources
for low-income individuals will likely to be more effective to alleviate
economic burden of pandemic.