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There is increasing recognition that common mental disorders are a major contributor to the global burden of disease and that the impact of this burden is substantial in developed and developing countries. 1 Global estimates of the burden of disease suggest that the burden of common mental disorders is similar to, and in many cases greater than, that of many physical health disorders. 1 2 It is also increasingly recognised that common mental disorders may have intergenerational consequences. For example, evidence is emerging that chronic psychosocial stress among pregnant women may have deleterious effects on fetal development, and negatively affects selected parenting and caregiving practices. 3
The recognition of the burden of common mental disorders signals a shift in global public health away from a nearly exclusive focus on infectious diseases and diseases of undernutrition to a broader aim of identifying the causes of poor health. Although there is an abundance of research about the underlying conditions that ultimately lead to common mental disorders in the developed world, far less is known about the determinants of common mental disorders in low-income developing countries. This is a critical gap because identifying the factors that influence common mental disorders and the role that these disorders play in shaping poor overall health may have substantial implications for development of effective interventions in poorer countries. 4 5
Food insecurity, defined as insecure access to sufficient food for an active and healthy life, is a massive, but often neglected, public health and human rights concern in many developing countries. 6 7 In many regions of sub-Saharan Africa (SSA), more than one-third of households are food insecure. 7 It is expected that by 2020 the number of people in SSA who will experience severe food insecurity will double. 8 Public health concern regarding food insecurity often focuses on the nutrition-related consequences of food insecurity, but ethnographic and community-based studies have suggested that the uncertainty and unpredictability that characterise food-insecure households may also promote anxiety and depression. 9 10 These studies either have been qualitative in nature, focused only on women, or have taken place in developed country settings. Furthermore, these conditions may be exacerbated by chronic stressful life events including economic problems and episodic natural and human-made stressors, each of which...