Food insecurity and symptoms of depression and anxiety: the role of resilience

Abstract Food insecurity is a significant public health concern associated with adverse mental health outcomes, including depression and anxiety symptoms, yet the role of resilience in this relationship remains unclear. This cross-sectional study investigated the relationship between food insecurity, resilience, and depression and anxiety symptoms and explored whether resilience moderates or mediates this association. Data were collected using a self-administered online survey distributed from April to May 2022 to a quota-based sample of California adults (n = 1,177). Food security was measured using the United States Department of Agriculture 6-Item Food Security Module, depression and anxiety symptoms using the Patient Health Questionnaire-4, and resilience using the Brief Resilience Scale. Food insecurity was reported by 39.5% of participants and 31.2% reported moderate-to-severe depression and anxiety symptoms. Regression analysis showed an inverse association between resilience and symptoms (beta = −2.01, 95% CI −2.22, −1.79), while food insecurity was positively associated with symptoms (beta = 0.46, 95% CI 0.38, 0.54). Moderation analysis was not significant, while mediation analysis revealed that resilience partially mediated the association between food insecurity and depression and anxiety symptoms (beta = 0.135; 95% CI: 0.095, 0.176). In conclusion, food insecurity and low resilience were independently associated with psychological distress. Resilience showed a partial indirect association in this relationship. These findings suggest that resilience may be a modifiable factor to consider alongside broader efforts to address food insecurity and support mental health. However, longitudinal studies are needed to confirm the directionality of these associations.