Food insecurity and psychological stress among migrants and refugees in high-income countries: Protocol for a systematic review and meta-analysis

Abstract

Background: Numerous studies have established a correlation between Food Insecurity (FI) and diminished physical and psychological well-being. However, there is a lack of knowledge regarding this association among migrant and refugee populations. Migrants and refugees face difficulties, such as a lack of legal clarity and employment opportunities, which can exacerbate FI and psychological well-being issues. Therefore, the main goal of this study is to conduct a systematic review of the existing body of literature, followed by a meta-analysis of the results, where appropriate, to examine how common food insecurity is among migrants and refugees living in high-income countries and whether it might be linked to mental distress.

Methods: The inclusion of studies will be contingent upon providing quantitative data on migrants and refugees in developed countries. This criterion encompasses all pertinent observational study designs and has been published in English. The review will specifically include cross-sectional, case-control, and cohort studies that utilize standardized and validated measurement tools for food insecurity (e.g., Food Insecurity Experience Scale) and psychological stress (e.g., 21-item Depression Anxiety and Stress Scale (DASS-21)), excluding non-standard or non-validated measures. A systematic search will be conducted across electronic databases such as Ovid Medline, Embase, SCOPUS, and Web of Science, containing peer-reviewed journal papers in health, psychology, and social sciences from January 1, 2008, to the present for relevant studies. Prevalence estimates will be generated using meta-analysis with a 95% CI, 95% prediction intervals, and I2 statistics for heterogeneity. The studies incorporated in the review will be analysed using meta-analysis, as deemed suitable for the characteristics of the data obtained.

Discussion: This study has practical implications for policies and interventions, offering insights for evidence-based initiatives targeting food security and mental health among migrants and refugees, thus improving resource allocation. PROSPERO registration number: CRD42024525690.