'Energy Insecurity' Tied to Anxiety, Depression Risk

TOPLINE:

Energy insecurity, the inability to meet household energy needs, was associated with more than twice the odds of having depression and anxiety symptoms than energy security in US adults, a new cross-sectional study showed.

METHODOLOGY:

• Using data from the US Census Bureau's online Household Pulse Survey, administered between 2022 and 2024, researchers conducted a cross-sectional study with a weighted population of > 187 million US adults (51% women; 64% White, 16% Hispanic, 10% Black, and 5% Asian). About a quarter of the population was in each of 4 age groups: 18-34 years, 35-49 years, 50-64 years, and ≥ 65 years.
• Three indicators of energy insecurity—inability to pay energy bills, maintaining unsafe/unhealthy home temperatures, and forgoing expenses on basic necessities to pay energy bills—were assessed individually and as a composite measure.
• Mental health was assessed using modified versions of the 2-item Patient Health Questionnaire for depression and the 2-item Generalized Anxiety Disorder scale for anxiety.
• The analysis was adjusted for other social determinants of health, including unemployment, housing instability, and food insecurity. Covariates included a wide range of factors, such as age, educational level, sex, and annual household income.

TAKEAWAY:

• In all, > 43% of the population reported having ≥ 1 form of energy security; around 22% reported being unable to pay energy bills, 22% maintained unsafe home temperatures, and nearly 34% forewent spending on basic necessities to pay energy bills.
• Individuals who gave up spending on basic necessities to pay energy bills had higher odds of anxiety (adjusted odds ratio [aOR], 1.79) and depression (aOR, 1.74) than those who did not.
• Adults with energy insecurity on the composite measure had higher odds for anxiety (aOR, 2.29) and depression (aOR, 2.31) than those with energy security.
• Food insecurity was also associated with poorer mental health, with higher odds for symptoms of depression (aOR, 2.05) and anxiety (aOR, 2.07).

IN PRACTICE:

"Despite its high prevalence, energy insecurity remains underrecognized in public health and policy intervention strategies," the investigators wrote.

"These findings suggest that energy insecurity is a widespread and important factor associated with mental health symptoms and may warrant consideration in efforts to reduce adverse mental health outcomes," they added.

SOURCE:

This study was led by Michelle Graf, PhD, Carter School of Public Policy, Georgia Institute of Technology, Atlanta. It was published online on October 27 in JAMA Network Open.

LIMITATIONS:

The cross-sectional nature of the data limited causal interference and increased the possibility of reverse causality. The questionnaire captured subjective interpretations of unsafe and unhealthy indoor temperatures, which may have varied among respondents. Additionally, the recall periods for energy insecurity and mental health outcomes were different.

DISCLOSURES:

The investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.