Abstract
Food insecurity is increasingly recognized as a public health issue with social and psychological dimensions. However, evidence on its association with mental health and social isolation in regional Australia remains limited. A cross-sectional online survey among adults (≥18 years) living in the Illawarra and Shoalhaven regions of Australia assessed food insecurity using the 18-item USDA Household Food Security Survey Module, categorized into 'food secure' (score = 0) or 'food insecure' (score = 1+). Self-rated mental health and physical health (excellent/good vs. fair/poor) and reported diagnosis of a mental health condition was determined. Social isolation was assessed using six individual indicators and a composite social isolation score dichotomized participants into high versus low isolation. Multivariate logistic regression models examined associations between mental health, social isolation, and food insecurity, adjusting for relevant sociodemographic characteristics. Of participants (n = 666; 80% female; 57.1% university education), 38.3% experienced food insecurity. Poor self-rated mental health (22%) was associated with increased odds of food insecurity (AOR = 2.41, 95% CI: 1.47-3.96), as was diagnosed mental illness (AOR = 2.33, 95% CI: 1.46-3.71) and poor self-rated physical health (AOR = 2.06, 95% CI: 1.23-3.44). Participants with high social isolation on the composite score (15.5%) had two times higher odds of food insecurity compared with those with low isolation (AOR = 2.16, 95% CI: 1.09-4.26). Strong associations were also observed for individual indicators. Findings demonstrate strong links between food insecurity, mental health, and social isolation in regional Australia. Addressing food insecurity requires integrated strategies that combine material assistance with initiatives to strengthen social connectedness.