Food insecurity and mental health among migrants and refugees in high-income countries: Systematic review and meta-analyses.

Food insecurity was significantly associated with higher odds of depression among migrants and refugees in high-income countries.

• Adjusted odds ratio for depression: aOR = 1.44; 95% CI: 1.32–1.57
• Analysis based on 17 eligible studies totalling more than 4.3 million participants
• Random-effects models were used due to substantial heterogeneity (I² > 50%)
• Studies were observational, mostly cross-sectional, published between January 1, 2008, and December 16, 2025

Food insecurity was significantly associated with higher odds of anxiety among migrants and refugees in high-income countries.

• Adjusted odds ratio for anxiety: aOR = 2.43; 95% CI: 1.82–3.23
• The association was stronger for anxiety than for depression
• Five databases were searched: Medline, Scopus, Web of Science, PsycINFO, and Embase
• Inclusion required studies to use standard, validated measures for both food insecurity and mental health outcomes

Food insecurity was significantly associated with higher odds of stress among migrants and refugees in high-income countries.

• Adjusted odds ratio for stress: aOR = 5.9; 95% CI: 2.95–11.94
• The association between food insecurity and stress was the strongest of the three mental health outcomes examined
• Funnel plots and Begg's test were used to assess potential publication bias
• Three independent reviewers screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute checklist

Being a woman was significantly associated with higher odds of depression among migrants and refugees in high-income countries.

• Adjusted odds ratio for women: aOR = 1.44; 95% CI: 1.32–1.57
• This effect size was identical to that observed for food insecurity and depression
• The finding was derived from the same pool of 17 eligible studies with more than 4.3 million participants

Being unmarried was significantly associated with higher odds of depression among migrants and refugees in high-income countries.

• Adjusted odds ratio for unmarried individuals: aOR = 1.7; 95% CI: 1.49–1.83
• This association was stronger than that observed for female sex or food insecurity and depression

Poor self-rated health was significantly associated with higher odds of depression among migrants and refugees in high-income countries.

• Adjusted odds ratio for poor self-rated health: aOR = 3.6; 95% CI: 2.97–4.36
• Poor self-rated health had the largest association with depression among the sociodemographic factors examined, excluding stress

Higher household income was significantly associated with lower odds of depression among migrants and refugees in high-income countries.

• Adjusted odds ratio for higher household income: aOR = 0.90; 95% CI: 0.84–0.98; P = 0.007
• This was the only factor identified as protective against depression in the meta-analysis
• The finding suggests an inverse relationship between household income and depression risk in this population

The systematic review identified 17 eligible observational studies with a combined sample of more than 4.3 million migrants and refugees in high-income countries.

• Systematic search covered five databases: Medline, Scopus, Web of Science, PsycINFO, and Embase
• Search period was January 1, 2008 to December 16, 2025
• Most included studies were cross-sectional in design
• The review was prospectively registered with PROSPERO (CRD42024525690)