The sticker shock Hawaiʻi residents regularly experience at the grocery store has serious mental health implications for working adults struggling to get by, according to a new study from the University of Hawaiʻi Mānoa. 

Researchers, who used in-depth health surveys to measure the impact of more than a dozen socioeconomic factors on mental health, found that food insecurity is the single biggest predictor of poor mental health in the islands.

“Individuals who are affected by food insecurity are significantly more likely to have depressive symptoms, as well as low self esteem and suicidal ideation,” said Ruben Juarez, a UH professor and one of the lead researchers.

Even residents who can afford their grocery bills are not immune to mental and emotional fallout from the state’s high cost of living.

Residents who spend a high percentage of their income on housing — even if they are well above the poverty line — are also more likely to experience mental health issues, Juarez said.

Nearly 40% of working-age adults in the study reported symptoms of depression — a higher rate than the state as a whole.

Food Insecurity On The Rise Again

The report comes at a time of elevated concern about the state’s high cost of living and the potential economic impacts of federal cutbacks and layoffs initiated by the Trump administration. 

Nearly a third of working households in the state — and almost half of households with children — are struggling financially. A family of four would need to earn $107,795 this year to pay for basic necessities, according to Aloha United Way.

In the last few months, workers at The Food Basket have noticed a sharp increase in the number of dual-income families seeking food assistance, said Kristin Frost Albrecht, executive director of the Hawaiʻi island-based food bank. 

The nonprofit is getting as many requests for help as it was during the peak of the Covid-19 pandemic, Frost Albrecht said.

“It seems to be really impacting families where both parents are working and they have kids in school,” Frost Albrecht said. “And that is heartbreaking. Absolutely heartbreaking.”

In addition to the socioeconomic issues that contribute to poor mental health, researchers identified a number of “protective factors” that can reduce the prevalence of mental health issues.

People who were married or had a long-term partner reported better mental health. Employment was also identified as a protective factor, improving self esteem and reducing depression rates. How safe people feel in their neighborhood also plays a big role.

A big takeaway from the UH study, Juarez said, is that there’s plenty policymakers can do to address the risk factors the researchers identified.

Improving public safety, programs to address job security and efforts to reduce food insecurity can all serve as mental health interventions, Juarez said.

But Juarez said, “the big takeaway from all of this is that addressing food insecurity is critical.”

Civil Beat’s community health coverage is supported by the Atherton Family Foundation, Swayne Family Fund of Hawai‘i Community Foundation, the Cooke Foundation and Papa Ola Lōkahi.