AUTHOR=Beck Jule , Koebach Anke , Abreu Liliana , Regassa Mekdim Dereje , Hoeffler Anke , Stojetz Wolfgang , Brück Tilman 

TITLE=COVID-19 Pandemic and Food Insecurity Fuel the Mental Health Crisis in Africa

JOURNAL=International Journal of Public Health

VOLUME=68

YEAR=2024

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2023.1606369

DOI=10.3389/ijph.2023.1606369

ISSN=1661-8564

ABSTRACT=<p><bold>Objective:</bold> Providing country-level estimates for prevalence rates of Generalized Anxiety Disorder (GAD), COVID-19 exposure and food insecurity (FI) and assessing the role of persistent threats to survival—exemplified by exposure to COVID-19 and FI—for the mental health crisis in Africa.</p><p><bold>Methods:</bold> Original phone-based survey data from Mozambique, Sierra Leone, Tanzania and Uganda (12 consecutive cross-sections in 2021; <italic>n</italic> = 23,943) were analyzed to estimate prevalence rates of GAD. Logistic regression models and mediation analysis using structural equation models identify risk and protective factors.</p><p><bold>Results:</bold> The overall prevalence of GAD in 2021 was 23.3%; 40.2% in Mozambique, 17.0% in Sierra Leone, 18.0% in Tanzania, and 19.1% in Uganda. Both COVID-19 exposure (OR<sub>adj.</sub> 1.4; CI 1.3–1.6) and FI (OR<sub>adj</sub> 3.2; CI 2.7–3.8) are independent and significant predictors of GAD. Thus, the impact of FI on GAD was considerably stronger than that of COVID-19 exposure.</p><p><bold>Conclusion:</bold> Persistent threats to survival play a substantial role for mental health, specifically GAD. High anxiety prevalence in the population requires programs to reduce violence and enhance social support. Even during a pandemic, addressing FI as a key driver of GAD should be prioritized by policymakers.</p>