IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v21y2024i10p1296-d1487995.html

The Association between Food Insecurity and Insomnia Symptoms among Young Adults in Puerto Rico and the Mediating Role of Psychological Distress Symptoms

Author

Listed:
  • Natalia Vázquez-Colón

    (Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA)

  • Andrea López-Cepero

    (Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA)

  • Claudia Amaya

    (Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA)

  • Katherine L. Tucker

    (Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, and Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA)

  • Catarina I. Kiefe

    (Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA)

  • Sharina D. Person

    (Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA)

  • Milagros C. Rosal

    (Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA)

  • Cynthia M. Pérez

    (Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA)

Abstract

Residents of Puerto Rico face a high burden of food insecurity (FI), which has been associated with insomnia symptoms (IS). However, this association remains understudied in Puerto Rican young adults, a vulnerable group experiencing an elevated prevalence of FI and poor sleep. We evaluated the association between FI and IS and the mediating role of psychological distress symptoms among young adults in Puerto Rico. Data are derived from the PR-OUTLOOK cohort (2020–2023) of adults aged 18–29 y. We assessed FI with the six-item USDA Household Food Security Scale and IS with the 5-item Women’s Health Initiative Insomnia Rating Scale. Psychological distress symptoms included depressive symptoms (CES-D-10), anxiety (STAI-10), and perceived stress (PSS-4). Poisson’s regression models estimated prevalence ratios (PRs) with 95% confidence intervals (CIs). The Karlson–Holm–Breen method estimated the mediation percentage of each psychological distress symptom on the association between FI and IS. Notably, 24.8% of participants experienced FI, and 30.4% reported elevated IS. FI was associated with IS (PR = 1.41, 95% CI = 1.24, 1.60), an association partially mediated by depressive (31.6%), perceived stress (17.6%), and anxiety symptoms (17.2%), accounting for 35.8% of the mediation percentage. Future research should confirm these findings using objective assessments of sleep and psychosocial stress.

Suggested Citation

  • Natalia Vázquez-Colón & Andrea López-Cepero & Claudia Amaya & Katherine L. Tucker & Catarina I. Kiefe & Sharina D. Person & Milagros C. Rosal & Cynthia M. Pérez, 2024. "The Association between Food Insecurity and Insomnia Symptoms among Young Adults in Puerto Rico and the Mediating Role of Psychological Distress Symptoms," IJERPH, MDPI, vol. 21(10), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:10:p:1296-:d:1487995
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/21/10/1296/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/21/10/1296/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Richard Breen & Kristian Bernt Karlson & Anders Holm, 2013. "Total, Direct, and Indirect Effects in Logit and Probit Models," Sociological Methods & Research, , vol. 42(2), pages 164-191, May.
    2. Blumberg, S.J. & Bialostosky, K. & Hamilton, W.L. & Briefel, R.R., 1999. "The effectiveness of a short form of the household food security scale," American Journal of Public Health, American Public Health Association, vol. 89(8), pages 1231-1234.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Evans-Polce, Rebecca J. & Staff, Jeremy & Maggs, Jennifer L., 2016. "Alcohol abstention in early adulthood and premature mortality: Do early life factors, social support, and health explain this association?," Social Science & Medicine, Elsevier, vol. 163(C), pages 71-79.
    2. Alexandra K. Murphy & Natasha V. Pilkauskas & Nicole Kovski & Alix Gould-Werth, 2025. "How Does Transportation Insecurity Compare and Relate to Other Indicators of Material Hardship in the U.S.?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 178(1), pages 435-463, May.
    3. Joseph S Lightner & Serena Rajabiun & Howard J Cabral & Jessica Flaherty & Jamie Shank & Ronald Brooks, 2021. "Associations of internalized and anticipated HIV stigma with returning to work for persons living with HIV," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-10, June.
    4. repec:mpr:mprres:3679 is not listed on IDEAS
    5. Robert G. Wood & Anu Rangarajan & John Deke, "undated". "WFNJ Clients Under Welfare Reform: How Is an Early Group Faring Over Time?," Mathematica Policy Research Reports 32fc33e1160a4682b83019769, Mathematica Policy Research.
    6. Sunjin Ahn & Travis A. Smith & F. Bailey Norwood, 2020. "Can Internet Surveys Mimic Food Insecurity Rates Published by the US Government?," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 42(2), pages 187-204, June.
    7. Montserrat Vilalta-Bufi & Roberto Dopeso-Fernández & Aleksander Kucel, 2024. "Parental education and the transition to master and PhD studies in Spain," UB School of Economics Working Papers 2024/482, University of Barcelona School of Economics.
    8. Samson, Frank L., 2015. "Racial resentment and smoking," Social Science & Medicine, Elsevier, vol. 126(C), pages 164-168.
    9. Hyo Sun Jung & Yu Hyun Hwang & Hye Hyun Yoon, 2025. "Is the Impact of Food Insecurity on Food-Related Behavior Moderated by Generation in South Korea?," IJERPH, MDPI, vol. 22(5), pages 1-15, May.
    10. Samuel H. Fishman & S. Philip Morgan & Robert A. Hummer, 2018. "Smoking and Variation in the Hispanic Paradox: A Comparison of Low Birthweight Across 33 US States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(5), pages 795-824, October.
    11. Zhong, Danruo & Gunnar, Megan R. & Kelly, Aaron S. & French, Simone & Sherwood, Nancy E. & Berge, Jerica M. & Kunin-Batson, Alicia, 2022. "Household food insecurity and obesity risk in preschool-aged children: A three-year prospective study," Social Science & Medicine, Elsevier, vol. 307(C).
    12. Kathryn M. Cardarelli & Emily DeWitt & Rachel Gillespie & Rachel H. Graham & Heather Norman-Burgdolf & Janet T. Mullins, 2021. "Policy Implications of the COVID-19 Pandemic on Food Insecurity in Rural America: Evidence from Appalachia," IJERPH, MDPI, vol. 18(23), pages 1-13, December.
    13. Duxbury, Scott W, 2019. "Mediation and Moderation in Statistical Network Models," SocArXiv 9bs4u, Center for Open Science.
    14. Zajacova, Anna & Montez, Jennifer Karas, 2018. "Explaining the increasing disability prevalence among mid-life US adults, 2002 to 2016," Social Science & Medicine, Elsevier, vol. 211(C), pages 1-8.
    15. Felter, Elizabeth M. & Smith, Morgan & Cheyne, Kate & Orozco, Martha Y. & Steiner, Eric A. & Park, Yuae & Gary-Webb, Tiffany L., 2025. "Applying the RE-AIM framework to evaluate a diabetes prevention intervention delivered through a food bank," Evaluation and Program Planning, Elsevier, vol. 112(C).
    16. Amy Saxe-Custack & Richard Sadler & Jenny LaChance & Mona Hanna-Attisha & Tiffany Ceja, 2020. "Participation in a Fruit and Vegetable Prescription Program for Pediatric Patients is Positively Associated with Farmers’ Market Shopping," IJERPH, MDPI, vol. 17(12), pages 1-11, June.
    17. Walters, Glenn D. & Mandracchia, Jon T., 2017. "Testing criminological theory through causal mediation analysis: Current status and future directions," Journal of Criminal Justice, Elsevier, vol. 49(C), pages 53-64.
    18. Lyk-Jensen, Stéphanie Vincent & Weatherall, Cecilie Dohlmann & Jepsen, Peter Winning, 2016. "The effect of military deployment on mental health," Economics & Human Biology, Elsevier, vol. 23(C), pages 193-208.
    19. repec:osf:socarx:vykkz_v1 is not listed on IDEAS
    20. Joshua Choper & Daniel Schneider & Kristen Harknett, 2022. "Uncertain Time: Precarious Schedules and Job Turnover in the US Service Sector," ILR Review, Cornell University, ILR School, vol. 75(5), pages 1099-1132, October.
    21. Pellowski, Jennifer A. & Barnett, Whitney & Kuo, Caroline C. & Koen, Nastassja & Zar, Heather J. & Stein, Dan J., 2017. "Investigating tangible and mental resources as predictors of perceived household food insecurity during pregnancy among women in a South African birth cohort study," Social Science & Medicine, Elsevier, vol. 187(C), pages 76-84.
    22. Myrskylä, Mikko & Elo, Irma T. & Kohler, Iliana V. & Martikainen, Pekka, 2014. "The association between advanced maternal and paternal ages and increased adult mortality is explained by early parental loss," Social Science & Medicine, Elsevier, vol. 119(C), pages 215-223.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:21:y:2024:i:10:p:1296-:d:1487995. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager The email address of this maintainer does not seem to be valid anymore. Please ask MDPI Indexing Manager to update the entry or send us the correct address (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.