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  • These findings can also inform


    These findings can also inform existing typologies of coping by suggesting a path to move beyond avoidant vs. approach strategies to explore three additional dimensions: (a) motivations and perceived effectiveness, (b) kinetics (i.e., the timeliness and A-443654 of perceived relief from distress), and (c) consequences of coping in terms of short-term emotional relief vs. long-term health. We could only address the first of these in the present study, but future work should explore the utility of these other aspects. Doing so requires drawing on ideas of human behavior from disciplines like neuroscience, psychology, and sociology but applying these in epidemiologic research on health disparities. For example, the results for perceived effectiveness demonstrate that not all health behaviors are equal in terms of reducing psychological distress, and that there is variation in this metric even across the crude proxies of context examined here. This variation may be informative in efforts to “personalize” public health efforts to reduce disparities along these dimensions of context (Bayer & Galea, 2015).
    Acknowledgements The Health and Retirement Study is supported by the National Institute on Aging (NIA U01AG009740) and the Social Security Administration. B. Mezuk, S. Ratliff, J.A. Rafferty, and J.S. Jackson are supported by the University of Michigan Center for Integrative Approaches to Health Disparities (P60-MD002249). B. Mezuk is also supported by grant 1-16-ICTS-082 from the American Diabetes Association and grant K01-MH093642 from the National Institute of Mental Health. The sponsors had no role in the design, analysis, or decision to publish these findings.
    Introduction Untreated mental health problems account for 13% of the total global burden of disease and depressive disorders are the third leading cause of disease burden worldwide (World Health Assembly, 2012). It has been estimated that by 2030 depressive disorders could represent the highest disease burden in the world (World Health Assembly, 2012). In Canada, mental health problems pose substantial direct and indirect costs on the lives of individuals and society (Deraspe, 2013). An estimated 20% of Canadians will experience a mental illness throughout the course of their lives (Smetanin et al., 2011), which can lead to short- and long-term productivity losses with serious consequences on public finances and lower government tax revenues. In addition, the costs associated with governmental financial assistance, public spending on health care and community support to address mental illness can place a major strain on the resources of the government. For example, approximately one third of hospital stays are due to mental disorders (Government of Canada, 2006) and it is estimated that the direct cost of mental ill health was $42 billion in Canada in 2011 (Smetanin et al., 2011). Therefore, strategic spending on mental illness prevention and mental health promotion will promote population health, reduce the need for hospital admissions due to mental illness, and limit productivity declines, all of which would result in cost savings and a reduction in human suffering (Roberts & Grimes, 2011). Poverty has long been associated with poor health outcomes including mental health outcomes. In Canada, individuals in the lowest income group are three to four times more likely to report their mental health as fair or poor compared with the highest income group (Statistics Canada, 2013). In addition, many cross-national and cross-sectional studies have shown that individuals with low-income or low socioeconomic status are at increased odds of reporting major depression (Lorant et al., 2003), mood disorders, anxiety disorder and substance abuse (Fryers, Melzer & Jenkins, 2003). Recently Burns (2015), stressed the need to disaggregate poverty into specific indicators such as, “income, expenditure, assets, education, employment and food security…” (p.108), in order to examine their distinct impact on mental health outcomes. This paper contributes to the literature by examining one of these indicators in greater detail—household food insecurity (HFI).