Date of Award

Spring 5-14-2021

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Ike Okosun

Second Advisor

Dr. Therese Pigott

Third Advisor

Dr. Katherine Masyn


Pathways between Food Insecurity and Diabetes, Observing the Mediating Effects of Depression.

(NSCH 2020)


Alpha-Isaac Eferighe


INTRODUCTION: Type 2 diabetes is the seventh leading cause of death in the U.S. and is significantly associated with morbidity, mortality, decreased quality of life, increased health-care utilization, and cost. Studies have shown adults suffering from food insecurity have a greater risk of having diabetes than those that do not. Although 11% of U.S. households suffer from food insecurity, the link between food insecurity and diabetes is not fully understood.

AIM: This study aims to determine the direct and indirect pathways through which food insecurity may lead to diabetes, observing the mediating effects of depression using nationally representative data.

METHODS: The 2005-2006 National Health and Nutrition Examination Survey (NHANES) data were used for this study. The mechanism through which food insecurity influences diabetes was determined using Structural Equation Modeling (SEM). The analysis also included an investigation of the direct and indirect effects of depression on diabetes.

Results: Food insecurity was found to have a negative direct effect on diabetes (β= -.018, p= .497). Depression was directly and significantly related to diabetes (β = 0.09, p = 0.009). Food insecurity was positively and significantly associated with depression (β = 0.329 , p > 0.01).

Conclusion: This study shows that depression is linked to diabetes, and food insecurity is linked to depression. While the total effect of food insecurity on diabetes was positive, the direct impact was negative. Food insecure individuals have heightened chances of being depressed, thus having diabetes, and may benefit from additional income supplements and education in proper food consumption.


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