The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19
Abstract
:1. Introduction
Food (In)security and Mental Health
2. Materials and Methods
2.1. Study Design
2.2. Participant Recruitment
2.2.1. Household Survey
2.2.2. Researcher Interviews
2.3. Materials
2.3.1. Household Survey
2.3.2. Researcher Interviews
2.4. Data Analysis
2.4.1. Household Survey
2.4.2. Researcher Interviews
3. Results
3.1. Quantitative Analysis (Household Survey)
3.1.1. Correlation Analysis
3.1.2. Regression Analyses
3.2. Qualitative Analysis (Researcher Interviews)
3.2.1. SSR Responses and Experiences of Mental Health
- Indications of positive emotion/well-being: Many SSRs expressed MH in positive terms, often linked to religious beliefs and a sense of resilience. However, there was a noted loss of trust in the future.
- Indications of negative emotion/well-being: Despite the general positive outlook, there were concerns about the future, especially regarding children’s well-being, reflecting the broader societal situations impacting the MH of SSRs. Similar sentiments were reported by long-term displaced Syrian refugees in Lebanon, who experienced anxiety, depression, hopelessness, sadness, and diminished self-worth.
- Influence of culture and community: Cultural and religious beliefs shaped how SSR participants expressed their mental health. A notable influence was the role of religious faith, which fostered a generally positive outlook despite challenges. Many participants emphasised gratitude towards God as a coping mechanism when faced with adversity, exemplified by expressions such as “thank God for what we have” (Interview 1). This perspective reflects the protective role of faith in providing comfort, hope, and meaning during times of hardship.
3.2.2. SSR Experiences and Responses Towards Food and Basic Necessities
- Emotional responses to FI/food: SSRs often expressed emotions an emotion-based approach when discussing food habits such as shame or distress. Nevertheless, others expressed pride in the nature of their cooking.
- SSR feed for food and other basics: This sub-theme highlighted the lack of availability of resources and SSR reliance on external bodies for support.
- Community and cultural responses: A sense of solidarity and camaraderie within the community. SSRs relied on community-based food distribution practices, and extended networks to mitigate food insecurity (such as relying on neighbours).
3.2.3. The Impact of COVID-19 and Other Social Issues on SSRs
- COVID-19 and additional economic issues: The impact of the pandemic was often overshadowed by pre-existing economic challenges, such as inflation. The pandemic merely exacerbated these difficulties.
- Work and financial changes: The impact of COVID-19 and the existing economic challenges that COVID-19 exacerbated were keenly observed through changes in work available to SSRs. Many Syrian refugees lost their jobs due to disruptions in agricultural supply chains and pandemic-related restrictions, exacerbating already precarious working conditions shaped by limited labour rights and legal ambiguity. While work was disrupted for many, some displaced people continued working as the beginning of the pandemic coincided with the start of the agricultural season in the Middle East.
- Debt: SSR communities were able to exhibit coping mechanisms, including resource-sharing, informal debt networks or getting a loan from an NGO to counteract the impact of the current economic issue. However, many respondents reported having nothing left to sell and no one to borrow from, indicating that their communities’ ability to cope with shocks had already been eroded before the pandemic.
- Regional differences: Some interviews referred to the current economic crisis in Lebanon as playing a significant role in impacting the lives of SSRs.
4. Discussion
5. Conclusions
Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CARA | Council for At-Risk Academics |
CSI | Coping Strategy Index |
FI | Food Insecurity |
LMICs | Lower-/Middle-Income Countries |
MH | Mental Health |
MPCA | Multi-Purpose Cash Assistance |
NGO | Non-Governmental Organisation |
PPE | Personal Protective Equipment |
SRs | Syrian Refugees |
SSRs | Syrians and Syrian Refugees |
SWEMWBS | Warwick–Edinburgh Mental Wellbeing Scale |
UNHCR | United Nations High Commissioner for Refugees |
USDA | The United States Department of Agriculture |
WHO | World Health Organization |
Appendix A
Variable | n | M | SD | 1 | 2 | 3 | 4 |
---|---|---|---|---|---|---|---|
6. MH | 100 | 25.58 | 4.25 | - | |||
7. C19p | 100 | 2.44 | 0.69 | −0.16 | - | ||
8. C19a | 100 | 8.76 | 2.81 | 0.09 | −0.09 | - | |
9. FI | 100 | 18.85 | 4.06 | −0.24 * | 0.29 ** | 0.15 | - |
Variables | n | M | SD | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1. MH | 100 | 24.58 | 4.25 | - | ||||||||
2. C19p | 100 | 2.44 | 0.69 | −0.158 | - | |||||||
3. C19a | 100 | 8.76 | 2.81 | 0.086 | −0.092 | - | ||||||
4. FI | 100 | 18.85 | 4.06 | −0.237 * | 0.287 ** | 0.146 | - | |||||
5. No change | 100 | 1.96 | 0.20 | 0.004 | −0.116 | 0.031 | 0.086 | - | ||||
6. Storage of food | 100 | 1.45 | 0.50 | −0.206 * | 0.198 * | 0.028 | 0.208 * | −0.226 * | - | |||
7. Having smallerportions | 100 | 1.40 | 0.49 | 0.364 ** | −0.191 | 0.096 | −0.352 ** | −0.250 * | −0.123 | - | ||
8. Cleaning more than normal | 100 | 1.18 | 0.39 | −0.077 | 0.213 * | 0.124 | 0.099 | −0.436 ** | 0.361 ** | 0.043 | - | |
9. No visiting with family/ friends | 100 | 1.03 | 0.17 | −0.079 | 0.175 | −0.035 | −0.042 | −0.862 ** | 0.194 | 0.215 * | 0.375 ** | - |
Variables | n | M | SD | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. MH | 100 | 24.58 | 4.25 | - | |||||||||
2. C19p | 100 | 2.44 | 0.69 | −0.158 | - | ||||||||
3. C19a | 100 | 8.76 | 2.81 | 0.086 | −0.092 | - | |||||||
4. FI | 100 | 18.85 | 4.06 | −0.237 * | 0.287 ** | 0.146 | - | ||||||
5. No change | 100 | 1.97 | 0.17 | −0.088 | 0.015 | 0.046 | 0.152 | - | |||||
6. Information distribution | 100 | 1.57 | 0.50 | −0.074 | 0.077 | −0.258 ** | 0.027 | 0.084 | - | ||||
7. Organisation of food items | 100 | 1.54 | 0.50 | −0.086 | 0.150 | 0.012 | 0.017 | −0.045 | 0.049 | - | |||
8. Staying home | 100 | 1.11 | 0.31 | 0.084 | −0.047 | 0.143 | −0.094 | −0.313 ** | −0.017 | 0.068 | - | ||
9. No social gatherings | 100 | 1.08 | 0.27 | 0.066 | −0.070 | 0.024 | −0.070 | −0.164 | 0.033 | 0.198 * | 0.485 ** | - | |
10. Mosque announcements | 100 | 1.70 | 0.46 | 0.055 | 0.005 | −0.326 ** | −0.126 | 0.013 | 0.181 | −0.079 | 0.091 | 0.032 | - |
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Variable | B | 95% CI for B | SE B | β | R2 | ∆R2 | |
---|---|---|---|---|---|---|---|
LL | UL | ||||||
Step 1 | 0.09 | 0.092 * | |||||
Constant | 29.25 *** | 24.38 | 34.12 | 2.45 | |||
C19p | −1.09 | −2.35 | 0.17 | 0.64 | −0.18 | ||
C19a | 0.18 | −0.12 | 0.47 | 0.15 | 0.12 | ||
FI | −0.19 | −0.40 | 0.03 | 0.11 | −0.18 | ||
Step 2 | 0.09 | 0.001 | |||||
Constant | 29.39 *** | 24.39 | 34.39 | 2.52 | |||
C19p | −1.12 | −2.41 | 0.17 | 0.65 | −0.18 | ||
C19a | 0.17 | −0.13 | 0.47 | 0.15 | 0.11 | ||
FI | −0.19 | −0.41 | 0.03 | 0.11 | −0.18 | ||
FI × C19a | 0.11 | −0.71 | 0.93 | 0.42 | 0.03 | ||
Step 3 | 0.09 | 0.000 | |||||
Constant | 29.32 *** | 24.14 | 34.49 | 2.61 | |||
C19p | −1.10 | −2.44 | 0.23 | 0.67 | −0.18 | ||
C19a | 0.17 | −0.14 | 0.48 | 0.16 | 0.11 | ||
FI | −0.19 | −0.41 | 0.03 | 0.11 | −0.18 | ||
FI × C19a | 0.13 | −0.74 | 0.99 | 0.44 | 0.03 | ||
FI × C19p | −0.05 | −0.91 | 0.81 | 0.43 | −0.01 | ||
Step 4 | 0.09 | 0.000 | |||||
Constant | 29.29 *** | 24.07 | 34.51 | 2.63 | |||
C19p | −1.09 | −2.46 | 0.29 | 0.69 | −0.18 | ||
C19a | 0.18 | −0.14 | 0.50 | 0.16 | 0.12 | ||
FI | −0.19 | −0.41 | 0.03 | 0.11 | −0.18 | ||
FI × C19a | 0.10 | −0.89 | 1.08 | 0.49 | 0.02 | ||
FI × C19p | −0.07 | −1.02 | 0.88 | 0.48 | −0.02 | ||
C19a × C19p | 0.06 | −1.01 | 1.13 | 0.54 | 0.01 | ||
Step 5 | 0.09 | 0.001 | |||||
Constant | 29.73 *** | 23.74 | 35.72 | 3.02 | |||
C19p | −1.16 | −2.64 | 0.31 | 0.74 | −0.19 | ||
C19a | 0.15 | −0.21 | 0.51 | 0.18 | 0.10 | ||
FI | −0.19 | −0.42 | 0.032 | 0.11 | −0.19 | ||
FI × C19a | 0.09 | −0.90 | 1.01 | 0.50 | 0.02 | ||
FI × C19p | −0.10 | −1.08 | 0.88 | 0.49 | −0.03 | ||
C19a × C19p | −0.03 | −1.25 | 1.19 | 0.62 | −0.01 | ||
FI × C19a × C19p | 0.14 | −0.77 | 1.05 | 0.46 | 0.05 |
Variable | B | 95% CI for B | SE B | β | R2 | ∆R2 | |
---|---|---|---|---|---|---|---|
LL | UL | ||||||
Step 1 | 0.13 | 0.131 ** | |||||
Constant | 24.80 *** | 19.08 | 30.51 | 2.88 | |||
FI | −0.10 | −0.31 | 0.12 | 0.11 | −0.09 | ||
SP | 2.33 ** | 0.58 | 4.08 | 0.88 | 0.27 | ||
SF | −1.14 | −2.78 | 0.50 | 0.83 | −0.13 | ||
Step 2 | 0.14 | 0.009 | |||||
Constant | 25.44 *** | 19.58 | 31.29 | 2.95 | |||
FI | −0.12 | −0.34 | 0.10 | 0.11 | −0.11 | ||
SP | 2.12 * | 0.32 | 3.91 | 0.90 | 0.25 | ||
SF | −1.21 | −2.86 | 0.44 | 0.83 | −0.14 | ||
FI × SP | −0.47 | −1.40 | 0.46 | 0.47 | −0.10 | ||
Step 3 | 0.14 | 0.001 | |||||
Constant | 25.43 *** | 19.55 | 31.31 | 2.96 | |||
FI | −0.12 | −0.34 | 0.10 | 0.11 | −0.12 | ||
SP | 2.13 * | 0.32 | 3.93 | 0.91 | 0.25 | ||
SF | −1.22 | −2.88 | 0.44 | 0.84 | −0.14 | ||
FI × SP | −0.49 | −1.43 | 0.45 | 0.47 | −0.10 | ||
FI × SF | 0.13 | −0.71 | 0.97 | 0.42 | 0.3 | ||
Step 4 | 0.14 | 0.000 | |||||
Constant | 25.45 *** | 19.52 | 31.39 | 3.00 | |||
FI | −0.12 | −0.34 | 0.10 | 0.11 | −0.12 | ||
SP | 2.12 * | 0.30 | 3.94 | 0.917 | 0.25 | ||
SF | −1.22 | −2.88 | 0.45 | 0.84 | −0.14 | ||
FI × SP | −0.48 | −1.45 | 0.48 | 0.49 | −0.10 | ||
FI × SF | 0.11 | −0.80 | 1.03 | 0.46 | 0.03 | ||
SP × SF | −0.04 | −0.95 | 8.71 | 0.46 | −0.01 | ||
Step 5 | 0.14 | 0.001 | |||||
Constant | 25.53 *** | 19.54 | 31.51 | 3.01 | |||
FI | −0.13 | −0.36 | 0.10 | 0.12 | −0.12 | ||
SP | 2.06 * | 0.19 | 3.94 | 0.94 | 0.24 | ||
SF | −1.11 | −2.94 | 0.72 | 0.92 | −0.13 | ||
FI × SP | −0.50 | −1.48 | 0.47 | 0.49 | −0.10 | ||
FI × SF | 0.14 | −0.80 | 1.07 | 0.47 | 0.03 | ||
SP × SF | −0.01 | −0.94 | 0.92 | 0.47 | −0.00 | ||
FI × SP × SF | 0.14 | −0.82 | 1.11 | 4.9 | 0.03 |
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Calia, C.; El-Gayar, A.; Zuntz, A.-C.; Abdullateef, S.; Almashhor, E.; Grant, L.; Boden, L. The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19. Int. J. Environ. Res. Public Health 2025, 22, 549. https://doi.org/10.3390/ijerph22040549
Calia C, El-Gayar A, Zuntz A-C, Abdullateef S, Almashhor E, Grant L, Boden L. The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19. International Journal of Environmental Research and Public Health. 2025; 22(4):549. https://doi.org/10.3390/ijerph22040549
Chicago/Turabian StyleCalia, Clara, Afnan El-Gayar, Ann-Christin Zuntz, Shaher Abdullateef, Esraa Almashhor, Liz Grant, and Lisa Boden. 2025. "The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19" International Journal of Environmental Research and Public Health 22, no. 4: 549. https://doi.org/10.3390/ijerph22040549
APA StyleCalia, C., El-Gayar, A., Zuntz, A.-C., Abdullateef, S., Almashhor, E., Grant, L., & Boden, L. (2025). The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19. International Journal of Environmental Research and Public Health, 22(4), 549. https://doi.org/10.3390/ijerph22040549