{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T04:19:09Z","timestamp":1785730749508,"version":"3.56.0"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T00:00:00Z","timestamp":1674518400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980023000186_as1\"><jats:title>Objective:<\/jats:title><jats:p>To investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023000186_as2\"><jats:title>Design:<\/jats:title><jats:p>Cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023000186_as3\"><jats:title>Setting:<\/jats:title><jats:p>South Africa during COVID-19, October 2021.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023000186_as4\"><jats:title>Participants:<\/jats:title><jats:p>Nationally representative sample of 3402 adults, weighted to 39,640,674 South African households.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023000186_as5\"><jats:title>Results:<\/jats:title><jats:p>About 20\u00b74 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from \u2018food secure\u2019 to \u2018at risk\u2019 or from \u2018at risk\u2019 to \u2018food insecure\u2019 group was associated with 1\u00b77 times greater odds of being in a higher category of anxiety or depression (<jats:italic>P<\/jats:italic> &lt; 0\u00b7001). All coping strategies were used to some extent in South African households, with 46\u00b70 % relying on less preferred and less expensive foods and 20\u00b79 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all <jats:italic>P<\/jats:italic> &lt; 0\u00b7001), begging for food was associated with the highest odds (OR = 2\u00b73).<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023000186_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980023000186","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T06:59:01Z","timestamp":1674543541000},"page":"705-715","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":49,"title":["Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey"],"prefix":"10.1017","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8383-7866","authenticated-orcid":false,"given":"Siphiwe N","family":"Dlamini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asanda","family":"Mtintsilana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Witness","family":"Mapanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Du Toit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J","family":"Ware","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A","family":"Norris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,1,24]]},"reference":[{"key":"S1368980023000186_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s12571-015-0422-4"},{"key":"S1368980023000186_ref6","unstructured":"6. 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