Defining food security and examining its association with mental health among Black adolescents

An estimated six million households with children in the US experience food insecurity annually. Food insecurity, defined as inadequate access to safe and nutritious food required for maintaining a healthy life, can be detrimental to mental health. This three-paper dissertation examines minoritized youths’ experience of food insecurity and its effects on mental health. Paper 1 (P1) examined measurement invariance (MI) of a commonly used measure of food insecurity. MI evaluated whether the 10-item household food security scale (HFSSM) could be validly used to compare food insecurity scores across racial and ethnic identities. After establishing MI of HFSSM, paper 2 (P2) tested the association of food insecurity and mental health outcomes and the moderating role of racial and ethnic identity using multiple-group structural equation modeling. Paper 3 (P3) dyadically analyzed semi-structured interviews with Black mothers and their adolescents to explore how parent and youth reports of experiences of food insecurity converge and diverge; and whether experiences of Black youth align with domains of a widely-used conceptual framework for food security measures. P1 results established invariance of the HFSSM across racial and ethnic identities of adolescents, confirming valid cross-group comparisons of scores. P2 results identified higher levels of emotional, conduct, hyperactivity, and peer problems among youth in food-insecure homes than youth in non-food insecure homes. Racial and ethnic identity only moderated the relationship between food insecurity and conduct problems. P3 findings indicated that Black mothers were aware of their children’s understanding of the socioeconomic realities of the home, while unaware of the emotional aspects. Similarly, youth’s physical experiences of food insecurity aligned with the Radimer framework, whereas youth’s description of their emotional experiences related to food insecurity were unaligned with the Radimer framework. This dissertation addresses critical gaps in food insecurity research by establishing measurement invariance across youth’s racial and ethnic identities, identifying a negative association of food insecurity on mental health, and characterizing the food insecurity experiences of Black youth. This dissertation also underscores the importance of establishing invariance prior to testing association across diverse groups and using qualitative methods to better understand food insecurity experiences of underrepresented populations.