Food Insecurity and Depression Among Older Adults: The Mediating Role of Health Literacy and Perceived Health Status

IntroductionThis study investigated the effects of food insecurity on depression among older adults living in Maryland, United States, focusing on the roles of health literacy and perceived health status.

Data from 211 hypertensive older adults in a community-based hypertension management project were analyzed. A hypothesized path model was tested to examine direct and indirect relationships among the variables.

Of the participants, 12.4% reported food insecurity, and 13.8% had depressive symptoms. Food insecurity demonstrated a strong direct effect on depression and significant indirect effects through health literacy and perceived health status, indicating a double mediating effect.

Food-insecure older adults are more vulnerable to depression, with low health literacy and poor perceived health contributing to this risk. Health literacy acted as a buffer. Transcultural nursing interventions should enhance intrapersonal reserve capacities like health literacy and adapt to cultural and behavioral contexts to boost engagement, reduce stigma, and improve well-being.