Association of food insecurity with physical and mental health in primary care: a cross-sectional study in Ankara, Turkey

BACKGROUND: Food insecurity (FI) is the inability to consume adequate diets for a healthy and active life, mainly due to structural causes. It aimed to examine the association between FI with physical and mental health-related quality of life (HRQoL). METHODS: It was implemented through face-to-face interviews with individuals selected by convenience sampling who applied to selected Family Health Centers in Sincan/Ankara. A logistic regression model was created to examine factors related to FI. Linear regression models of Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) scores of SF-12 (Short Form 12) were created. Independent factors of models include socioeconomic factors and the presence of non-communicable diseases (NCDs). RESULTS: The prevalence of mild, moderate, and severe FI was 14.3%, 14.7%, and 9.3%, respectively. The risk of FI is higher in the lowest-income group (aOR: 12.416) and the income group immediately above it (aOR: 6.573) than in the highest-income group. In the fully adjusted linear regression model including socioeconomic variables and the presence of non-communicable diseases (NCDs), severe FI was associated with lower PCS-12 scores compared with food security (β = -0.079, p < 0.01). Mild (β = -0.174, p < 0.001), moderate (β = -0.217, p < 0.001), and severe FI (β = -0.233, p < 0.001) were associated with lower MCS-12 scores, showing a graded association across FI severity categories. CONCLUSION: FI was common among primary healthcare users in this study and was most strongly associated with low income. The persistence of the association between severe FI and physical HRQoL after adjustment for NCDs underscores FI's relevance to physical HRQoL in primary care populations. Its negative association with mental HRQoL was stronger and more consistent than that observed for physical HRQoL, underlining its importance for community mental health. Integrating FI screening and developing primary care-based interventions may help mitigate its adverse effects.