Interconnected effects of witnessing household violence, food insecurity, and mental health among peri-urban Cape Town youth: A mediation analysis.
Background: In sub-Saharan Africa, young people face high burdens of food insecurity and sexual and gender-based violence (SGBV), both linked to poor mental health. Objective: This study tested whether food insecurity predicts common mental disorders through household SGBV, and conversely, whether S...
| Publicado en: | Journal of Child & Adolescent Mental Health Vol. 37; no. 2; pp. 356 - 371 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Taylor & Francis Ltd
Aug2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195516998&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195516998 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 17280583 1W5X jtl: Journal of Child & Adolescent Mental Health issn: 17280583 maglogo: N pubinfo: dt: Aug2026 vid: 37 iid: 2 pid: 377 pub: Taylor & Francis Ltd artinfo: ui: 195516998 10.2989/17280583.2025.2579960 ppf: 356 ppct: 15 formats: tig: atl: Interconnected effects of witnessing household violence, food insecurity, and mental health among peri-urban Cape Town youth: A mediation analysis. aug: au: Hartmann, Miriam Stoner, Marie C. D. Giovenco, Danielle Ekström, Anna Mia Hatcher, Abigail M Zondi, Yanga Zembe Qwabe, Nontembeko Pettifor, Audrey Bekker, Linda-Gail Kågesten, Anna E affil: Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden Women's Global Health Imperative, Research Triangle Institute International, Berkeley, California Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa Department of Infectious Diseases, South General Hospital, Stockholm, Sweden Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa su: South Africa Mental illness risk factors World Wide Web Sex crimes Food security Families Statistical models Secondary analysis T-test (Statistics) Research funding Probability theory Questionnaires Chi-squared test Descriptive statistics Surveys Factor analysis Application software Data analysis software Gender-based violence Patient aftercare sug: subj: Mental illness risk factors World Wide Web Sex crimes Food security Families South Africa Software publishers (except video game publishers) Software Publishers Custom Computer Programming Services Home Health Care Services Internet Publishing and Broadcasting and Web Search Portals Statistical models Secondary analysis T-test (Statistics) Research funding Probability theory Questionnaires Chi-squared test Descriptive statistics Surveys Factor analysis Application software Data analysis software Gender-based violence Patient aftercare keyword: domestic violence food insecurity mediation analysis mental health sub-Saharan Africa domestic violence food insecurity mediation analysis mental health sub-Saharan Africa ab: Background: In sub-Saharan Africa, young people face high burdens of food insecurity and sexual and gender-based violence (SGBV), both linked to poor mental health. Objective: This study tested whether food insecurity predicts common mental disorders through household SGBV, and conversely, whether SGBV predicts common mental disorders through food insecurity. Method: Data were drawn from 534 participants aged 13 to 25 years in the longitudinal Bidirectional, Upbeat communication and Differentiated Distanced care for Young people (BUDDY) cohort study in Cape Town (2021–2022), surveyed at baseline, three months follow-up, and six months follow-up. Results: At six months follow-up, 24% reported common mental disorder symptoms, 52% had experienced food insecurity, and 33% had witnessed household SGBV. When food insecurity was modelled as the primary exposure, it was not associated with common mental disorders at six months follow-up (OR = 1.00; p = 0.99), and SGBV did not mediate this relationship (Average Direct Effect (ADE) = -0.05; Average Causal Mediated Effect (ACME) = 0.02). In contrast, when witnessing SGBV was the exposure, it was strongly associated with common mental disorders (OR = 2.19; p = 0.006). Food insecurity at three months follow-up was more common among those exposed to SGBV at baseline (OR = 1.55; 95% CI [1.06–2.27]; p = 0.024). Mediation analysis indicated most of SGBV ' s effect on common mental disorders was direct (ADE = 0.17; 95% CI 0.05–0.30), with only a small proportion mediated by food insecurity (5%). Conclusion: Findings were contrary to our primary hypothesis that food insecurity would drive common mental disorders via SGBV. Instead, household SGBV emerged as the stronger predictor of common mental disorders, with food insecurity playing a modest role. Preventing household violence may be critical to improving youth mental health, while research should further examine food insecurity's mental health impacts across contexts and timeframes. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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