Exploring the Relationship Between Food Security Status and Mental Health Among SNAP-Eligible Virginia Mothers

Food insecurity is associated with increased stress, symptoms of mental illness, and persistent health disparities. Women caregivers (referred to as mothers) may be at an increased risk because they often compensate for food shortages by reducing their own intake and make household food decisions. The current literature on the relationship between food security status and mental health in the U.S. lacks a clear framework for the relationship between these two phenomena. This dissertation describes three studies that aimed to explore the relationship between food security and mental health for mothers with low income in Virginia: (1) understanding differences in mental health outcomes by food security status (n=1,029), (2) a path analysis of a conceptual framework of the relationship (n=1,029), and (3) a thematic analysis of mothers' lived experiences with this relationship (n=29). An explanatory, sequential mixed methods design was employed with a cross-sectional survey informing semi-structured interviews. The survey (administered August-October 2021) was developed with previously validated measures of food security status, physical and mental health, symptoms of mental illness, behavioral food coping strategies, and social support. The interview guide was developed based on the findings of the survey and administered in May and June 2022. Collective findings of this series of studies suggested lower food security status was associated with negative mental health outcomes. However, there were no direct pathways from food security status to mental health outcomes. Social support and behavioral food coping strategies mediated the relationship between food security status and mental health outcomes. Mothers reported experiencing managing a variety of stressors associated with food insecurity. Mothers also indicated that stressors and coping strategies associated with managing food insecurity impacted their mental health. Future research should explore additional factors impacting household resiliency and strategies to reduce stigma associated with resource utilization. These findings can be built upon to develop screening tools and interventions to help improve food security and mental health status mothers with low income.