TY - JOUR
T1 - A syndemic perspective on food insecurity, gestational diabetes, and mental health disorders during pregnancy
AU - Oresnik, Sarah
AU - Moffat, Tina
AU - McKerracher, Luseadra
AU - Sloboda, Deborah M.
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/5
Y1 - 2025/5
N2 - Pregnancy brings numerous physiological and psychosocial changes and conditions that may include gestational diabetes mellitus (GDM) and anxiety and mood disorders. Household food insecurity (HFI)—not having access to food that meets dietary needs and preferences—may put pregnant people at risk for developing pregnancy complications like GDM. This study used qualitative and quantitative methods to understand, from a syndemic perspective, the intersections among these conditions in Canada. Using the Canadian Community Health Survey cycles from 2009 to 2018, we fit multivariable and multivariate logistic regressions to these data to understand interactions among food insecurity, anxiety and mood disorders, and GDM. We also conducted four focus group discussions (FGDs) and six one-on-one interviews with pregnant and postpartum people living in Hamilton, Ontario. Analyses of the survey data show that pregnant individuals who reported an anxiety and/or mood disorder were more likely to experience HFI. Those who experienced HFI were also more likely to be diagnosed with GDM during pregnancy or report an anxiety and/or mood disorder. Major themes identified from interviews and FGDs revealed that structural variables impact access to food, that a GDM diagnosis increased anxiety, and that experiencing HFI exacerbates the management of these conditions during pregnancy. The potential interactions among HFI, GDM, and anxiety and/or mood disorders indicate that addressing rising HFI alongside prevention and treatment of GDM and anxiety and mood disorders are critical to improving the health and well-being of pregnant people in Canada.
AB - Pregnancy brings numerous physiological and psychosocial changes and conditions that may include gestational diabetes mellitus (GDM) and anxiety and mood disorders. Household food insecurity (HFI)—not having access to food that meets dietary needs and preferences—may put pregnant people at risk for developing pregnancy complications like GDM. This study used qualitative and quantitative methods to understand, from a syndemic perspective, the intersections among these conditions in Canada. Using the Canadian Community Health Survey cycles from 2009 to 2018, we fit multivariable and multivariate logistic regressions to these data to understand interactions among food insecurity, anxiety and mood disorders, and GDM. We also conducted four focus group discussions (FGDs) and six one-on-one interviews with pregnant and postpartum people living in Hamilton, Ontario. Analyses of the survey data show that pregnant individuals who reported an anxiety and/or mood disorder were more likely to experience HFI. Those who experienced HFI were also more likely to be diagnosed with GDM during pregnancy or report an anxiety and/or mood disorder. Major themes identified from interviews and FGDs revealed that structural variables impact access to food, that a GDM diagnosis increased anxiety, and that experiencing HFI exacerbates the management of these conditions during pregnancy. The potential interactions among HFI, GDM, and anxiety and/or mood disorders indicate that addressing rising HFI alongside prevention and treatment of GDM and anxiety and mood disorders are critical to improving the health and well-being of pregnant people in Canada.
KW - Anxiety and mood disorders
KW - Food insecurity
KW - Gestational diabetes
KW - Pregnancy
KW - Syndemics
UR - http://www.scopus.com/inward/record.url?scp=105001137958&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2025.117994
DO - 10.1016/j.socscimed.2025.117994
M3 - Journal article
C2 - 40158449
AN - SCOPUS:105001137958
SN - 0277-9536
VL - 373
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 117994
ER -