To produce national-level figures on the frequency of generalized anxiety disorder (GAD), exposure to COVID-19, and food insecurity (FI), and to investigate the extent to which continued dangers to human survival — particularly COVID-19 exposure and FI — are fueling the growing mental health problems in Africa. Data gathered through telephone interviews in Mozambique, Sierra Leone, Tanzania, and Uganda across 12 sequential survey rounds in 2021 (total n = 23,943) were analyzed to determine the prevalence of GAD. Researchers applied logistic regression and structural equation modeling to conduct a mediation analysis and uncover factors that increase or decrease risk.
In 2021, across all four countries, GAD affected 23.3% of respondents; the rate was highest in Mozambique at 40.2%, followed by 17.0% in Sierra Leone, 18.0% in Tanzania, and 19.1% in Uganda. Both contact with COVID-19 (ORadj. = 1.4; CI = 1.3–1.6) and food insecurity (ORadj = 3.2; CI = 2.7–3.8) independently and strongly predicted higher GAD levels. The link between food insecurity and GAD turned out to be markedly more powerful than the link with COVID-19 exposure. Long-lasting threats to people’s survival play a key part in shaping mental health outcomes, above all for GAD. With such elevated anxiety levels present in the population, there is a clear need for efforts that reduce violence and improve access to social support. Policymakers should continue to treat food insecurity as a central target for action to reduce GAD, even as they address the effects of a pandemic.
