Maxwell, Daniel; Russo, Luca; Alinovi, Luca
A substantial portion of the world's people have not made adequate progress toward overcoming hunger or achieving sustainable livelihoods. The classic approach to addressing chronic food insecurity has been a strategy of agricultural development, supplemented by humanitarian assistance in the event of a shock or crisis—an approach predicated on assumptions that do not fit the context of protracted crises. This article describes protracted crises and argues that they are sufficiently different to warrant special consideration, but there are unique constraints to engagement in protracted crises. The article explores the constraints promoting sustainable livelihoods in these contexts and proposes elements of an alternative approach. It evaluates the limited evidence available about such an approach and outlines important questions for further research. PMID:21646522
Power, Elaine M; Little, Margaret H; Collins, Patricia A
Food insecurity is an urgent public health problem in Canada, affecting 4 million Canadians in 2012, including 1.15 million children, and associated with significant health concerns. With little political will to address this significant policy issue, it has been suggested that perhaps it is time for Canada to try a food stamp-style program. Such a program could reduce rates of food insecurity and improve the nutritional health of low-income Canadians. In this article, we explore the history of the US food stamp program; the key impetus of which was to support farmers and agricultural interests, not to look after the needs of people living in poverty. Though the US program has moved away from its roots, its history has had a lasting legacy, cementing an understanding of the problem as one of lack of food, not lack of income. While the contemporary food stamp program, now called Supplemental Nutrition Assistance Program (SNAP), reduces rates of poverty and food insecurity, food insecurity rates in the USA are significantly higher than those in Canada, suggesting a food stamp-style program per se will not eliminate the problem of food insecurity. Moreover, a food stamp-style program is inherently paternalistic and would create harm by reducing the autonomy of participants and generating stigma, which in itself has adverse health effects. Consequently, it is ethically problematic for health promoters to advocate for such a program, even if it could improve diet quality.
Roncarolo, Federico; Bisset, Sherri; Potvin, Louise
offer short term reprise from the effects of food insecurity, the question as to whether food banks are the most appropriate solution to food insecurity still needs to be addressed. PMID:26974826
POSITION STATEMENT It is the position of Dietitians of Canada that household food insecurity is a serious public health issue with profound effects on physical and mental health and social well-being. All households in Canada must have sufficient income for secure access to nutritious food after paying for other basic necessities. Given the alarming prevalence, severity and impact of household food insecurity in Canada, Dietitians of Canada calls for a pan-Canadian, government-led strategy to specifically reduce food insecurity at the household level, including policies that address the unique challenges of household food insecurity among Indigenous Peoples. Regular monitoring of the prevalence and severity of household food insecurity across all of Canada is required. Research must continue to address gaps in knowledge about household vulnerability to food insecurity and to evaluate the impact of policies developed to eliminate household food insecurity in Canada. Dietitians of Canada recommends: Development and implementation of a pan-Canadian government-led strategy that includes coordinated policies and programs, to ensure all households have consistent and sufficient income to be able to pay for basic needs, including food. Implementation of a federally-supported strategy to comprehensively address the additional and unique challenges related to household food insecurity among Indigenous Peoples, including assurance of food sovereignty, with access to lands and resources, for acquiring traditional/country foods, as well as improved access to more affordable and healthy store-bought/market foods in First Nation reserves and northern and remote communities. Commitment to mandatory, annual monitoring and reporting of the prevalence of marginal, moderate and severe household food insecurity in each province and territory across Canada, including among vulnerable populations, as well as regular evaluation of the impact of poverty reduction and protocols for
Berman, Judit; Zhu, Changfu; Pérez-Massot, Eduard; Arjó, Gemma; Zorrilla-López, Uxue; Masip, Gemma; Banakar, Raviraj; Sanahuja, Georgina; Farré, Gemma; Miralpeix, Bruna; Bai, Chao; Vamvaka, Evangelia; Sabalza, Maite; Twyman, Richard M; Bassié, Ludovic; Capell, Teresa; Christou, Paul
Genetically engineered (GE) crops can be used as part of a combined strategy to address food insecurity, which is defined as a lack of sustainable access to safe and nutritious food. In this article, we discuss the causes and consequences of food insecurity in the developing world, and the indirect economic impact on industrialized countries. We dissect the healthcare costs and lost productivity caused by food insecurity, and evaluate the relative merits of different intervention programs including supplementation, fortification and the deployment of GE crops with higher yields and enhanced nutritional properties. We provide clear evidence for the numerous potential benefits of GE crops, particularly for small-scale and subsistence farmers. GE crops with enhanced yields and nutritional properties constitute a vital component of any comprehensive strategy to tackle poverty, hunger and malnutrition in developing countries and thus reduce the global negative economic effects of food insecurity.
Dowler, Elizabeth A; O'Connor, Deirdre
Food poverty is an important contributing factor to health inequalities in industrialised countries; it refers to the inability to acquire or eat an adequate quality or sufficient quantity of food in socially acceptable ways (or the uncertainty of being able to do so). Synonymous with household food insecurity, the issue needs to be located within a social justice framework. Recognising the clear interdependence between the right to food and the right to health, this paper explores how international human rights obligations could inform approaches to addressing food poverty and insecurity with specific reference to Ireland and the UK. Little attention has been paid to how countries should meet their obligations to respect, protect and fulfil the right to food in developed countries. The paper contributes by examining the social and policy circumstances which inhibit poor households from obtaining sufficient food to eat healthily, along with strategies and interventions from State and civil society actors in the two countries. In practice, problems and potential solutions have largely been directed towards the individual rather than at social determinants, particularly as research on environmental factors such as distance to shops has produced equivocal results. Other key structural aspects such as income sufficiency for food are broadly ignored by the State, and anti-poverty strategies are often implemented without monitoring for effects on food outcomes. Thus scant evidence exists for either Ireland or the UK meeting its rights to food obligations to date, in terms of roles and responsibilities in ensuring access to affordable, available and appropriate food for all.
Jernigan, Valarie Blue Bird; Salvatore, Alicia L; Styne, Dennis M; Winkleby, Marilyn
The food insecurity faced by many Native American communities has numerous implications for the health and welfare of families. To identify and address upstream causes of food insecurity in a rural California reservation, we conducted a community assessment using the Tool for Health and Resilience in Vulnerable Environments (THRIVE). Guided by a community-based participatory research orientation, the THRIVE tool was adapted using digital storytelling and implemented in a series of focus groups. As a result of the THRIVE assessment, community members identified racial injustice and physical and financial barriers to accessing healthy and culturally appropriate foods as areas of greatest importance. Subsequently, the project partnership developed policies to reduce identified barriers which included an integrated community supported agriculture and commodity food program, the introduction of Electronic Benefits Transfer and culturally appropriate foods at the local farmers' market and reallocation of shelf space at the grocery store to include vegetables and fruits as well as special foods for diabetics. Results suggest that a participatory research orientation coupled with the use of a culturally adapted THRIVE tool may be an effective means for identifying structural determinants of food insecurity and initiating novel policy interventions to reduce health disparities experienced by Native American communities.
Blue Bird Jernigan, Valarie; Salvatore, Alicia L.; Styne, Dennis M.; Winkleby, Marilyn
The food insecurity faced by many Native American communities has numerous implications for the health and welfare of families. To identify and address upstream causes of food insecurity in a rural California reservation, we conducted a community assessment using the Tool for Health and Resilience in Vulnerable Environments (THRIVE). Guided by a community-based participatory research orientation, the THRIVE tool was adapted using digital storytelling and implemented in a series of focus groups. As a result of the THRIVE assessment, community members identified racial injustice and physical and financial barriers to accessing healthy and culturally appropriate foods as areas of greatest importance. Subsequently, the project partnership developed policies to reduce identified barriers which included an integrated community supported agriculture and commodity food program, the introduction of Electronic Benefits Transfer and culturally appropriate foods at the local farmers’ market and reallocation of shelf space at the grocery store to include vegetables and fruits as well as special foods for diabetics. Results suggest that a participatory research orientation coupled with the use of a culturally adapted THRIVE tool may be an effective means for identifying structural determinants of food insecurity and initiating novel policy interventions to reduce health disparities experienced by Native American communities. PMID:21994709
Okamoto, Kristen E
Health communication scholars are uniquely positioned to examine the ways in which individuals organize to address current and future exigencies related to social ills. In particular, organizations are key sites in understanding our health decisions related to food choice. From a young age, children develop habits of eating that stay with them throughout their life. More specifically, food insecurity impacts childhood nutrition. Children from low-income homes experience disproportional negative health outcomes. Appalachian Ohio is an area within the United States that experiences severe poverty. In 2013, community members in a small public school district in Appalachian Ohio formed the Appalachian Nutrition Advisory Council to address the nutritional needs of students in schools. This project stories the ways in which community members creatively organized to supplement existing structures in place designed to address school nutrition and food security.
Struble, Marie Boyle; Aomari, Laurie Lindsay
It is the position of the American Dietetic Association (ADA) that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable. The Association is aware that hunger exists in a world of plenty and that poverty, gender inequity, ethnocentrism, racism, and the lack of political will are key constraints to solving the problems of global hunger and malnutrition. Recognizing that simplistic approaches are inadequate, the ADA identifies sustainable development as the long-term strategy to ending world hunger and achieving food security. Sustainable development requires political, economic, and social changes that include empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature. Additionally, because the health status of future generations is related to the well-being of their mothers, achieving food security will also require increased access for women to education, adequate health care and sanitation, and economic opportunities. This position paper reviews the complex issues of global food insecurity and discusses long-term solutions for achieving world food security. Achieving the end of world hunger has been and is now within our grasp. There is sufficient food to feed everyone, and solutions can be realized now that will benefit all of humanity. As noted in the paper, most people who examine the costs of ending versus not ending world hunger are bewildered by the question of why humanity did not solve the problem a long time ago. The Association supports programs and encourages practices that combat
Food insecurity, hunger, and undernutrition are often viewed as a continuum, with food insecurity resulting in hunger and, ultimately, if sufficiently severe and/or of sufficient duration, in undernutrition. According to this view, food insecurity indicates inadequate access to food for whatever rea...
Food insecurity, hunger, and undernutrition are viewed as a continuum, with food insecurity resulting in hunger and ultimately, if sufficiently severe and/or of sufficient duration, in undernutrition. Food insecurity indicates inadequate access to food for whatever reason, hunger is the immediate ph...
Schroeder, Krista; Smaldone, Arlene
Aim To report an analysis of the concept of food insecurity, in order to 1) propose a theoretical model of food insecurity useful to nursing and 2) discuss its implications for nursing practice, nursing research, and health promotion. Background Forty eight million Americans are food insecure. As food insecurity is associated with multiple negative health effects, nursing intervention is warranted. Design Concept Analysis Data sources A literature search was conducted in May 2014 in Scopus and MEDLINE using the exploded term “food insecur*.” No year limit was placed. Government websites and popular media were searched to ensure a full understanding of the concept. Review Methods Iterative analysis, using the Walker and Avant method Results Food insecurity is defined by uncertain ability or inability to procure food, inability to procure enough food, being unable to live a healthy life, and feeling unsatisfied. A proposed theoretical model of food insecurity, adapted from the Socio-Ecological Model, identifies three layers of food insecurity (individual, community, society), with potential for nursing impact at each level. Conclusion Nurses must work to fight food insecurity. There exists a potential for nursing impact that is currently unrealized. Nursing impact can be guided by a new conceptual model, Food Insecurity within the Nursing Paradigm. PMID:25612146
Gundersen, Craig; Ziliak, James P
Almost fifty million people are food insecure in the United States, which makes food insecurity one of the nation's leading health and nutrition issues. We examine recent research evidence of the health consequences of food insecurity for children, nonsenior adults, and seniors in the United States. For context, we first provide an overview of how food insecurity is measured in the country, followed by a presentation of recent trends in the prevalence of food insecurity. Then we present a survey of selected recent research that examined the association between food insecurity and health outcomes. We show that the literature has consistently found food insecurity to be negatively associated with health. For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. The Supplemental Nutrition Assistance Program (SNAP) substantially reduces the prevalence of food insecurity and thus is critical to reducing negative health outcomes.
Food insecurity is a leading public health challenge in the United States today. This is primarily due to the magnitude of the problem, ∼50 million persons are food insecure (i.e., they were uncertain of having, or unable to acquire, enough food because they had insufficient money or other resources), and the serious negative health and other outcomes associated with being food insecure. This paper defines the measure used to delineate whether a household is food insecure. The measure, the Core Food Security Module, is based on 18 questions about a household’s food situation. From the responses, a household is defined as food secure, low food secure, or very low food secure, with the latter 2 categories defined as “food insecure.” I next discuss the extent of food insecurity in the US across various dimensions and the key determinants of food insecurity. The key policy tool used to address food insecurity is the Supplemental Nutrition Assistance Program (SNAP; formerly known as the Food Stamp Program). During the current economic downturn, >40 million persons are enrolled in SNAP, with total benefits of >$70 billion. This makes it the largest food assistance program and the largest near-cash assistance program in the US. After defining the eligibility criteria, I review the literature, which has demonstrated the effectiveness of SNAP in addressing its key goal, namely the alleviation of food insecurity in the US. I conclude with 4 suggestions for how SNAP can maintain and even improve its effectiveness in alleviating food insecurity. PMID:23319121
Broberg, Danielle M.; Broberg, Katharine A.; McGuire, Jenifer K.
Policies originally designed to address food insecurity are in need of revision due to rising rates of obesity among those they serve. Within the context of national policies, this article uses an ecological perspective to consider the links between food insecurity and obesity. The recommendations include adjusting the nutritional standards of the…
Lee, Jung Sun; Gundersen, Craig; Cook, John; Laraia, Barbara; Johnson, Mary Ann
Our symposium entitled, "Food Insecurity and Health across the Lifespan" explored the latest research from the economic, medical, pediatric, geriatric, and nutrition literature concerning the measurement, prevalence, predictors, and consequences of food insecurity across the lifespan, with a focus on chronic disease, chronic disease management, and healthcare costs. Consideration of the health impacts of food insecurity is a new and timely area of research, with a considerable potential for translation of the findings into public policy surrounding alleviation of food insecurity. Although it is widely acknowledged that food insecurity and hunger are morally unacceptable, strategies to develop national policies to alleviate hunger must also approach this problem by considering the economic impact of food insecurity on health and well-being. The goals of this symposium were to: 1) learn about the prevalence and severity of food insecurity in the US across the lifespan and how this is increasing with the continued economic downturn; 2) understand the growing body of research that documents the impact of varying degrees of food insecurity on physical and mental health across the lifespan; 3) examine how food insecurity is related to chronic disease; and 4) explore research methodology to determine the impact of food insecurity on healthcare costs and utilization. Our symposium provided new and novel understandings and research initiatives directed toward alleviating food insecurity in America.
Salvador Castell, Gemma; Pérez Rodrigo, Carmen; Ngo de la Cruz, Joy; Aranceta Bartrina, Javier
In 1996, the World Food Summit reaffirmed the inalienable right that each person across the globe has to access safe, adequate and nutritious food. At that time a goal was established to reduce by half the number of undernourished persons worldwide by 2015, in other words the year that we are now commencing. Different countries and organisations considered the necessity of reaching consensus and developing indicators for measuring household food insecurity. The availability of a simple but evidence-based measurement method to identify nutritionally at-risk population groups constitutes an essential instrument for implementing strategies that effectively address relevant key issues.
Shariff, Zalilah Mohd; Sulaiman, Norhasmah; Jalil, Rohana Abdul; Yen, Wong Chee; Yaw, Yong Heng; Taib, Mohd Nasir Mohd; Kandiah, Mirnalini; Lin, Khor Geok
This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.
Schmeer, Kammi K; Piperata, Barbara A
Food insecurity, the lack of consistent access to sufficient quality and quantity of food, affects an estimated 800 million people around the world. Although household food insecurity is generally associated with poor child nutrition and health in the USA, we know less about household food insecurity and child health in developing countries. Particularly lacking is research assessing how associations between household food insecurity and children's health outcomes may differ by child age and among children beyond age 5 years in low-income settings. We use data from a population-based sample of households with children ages 3-11 years (N = 431) in León, Nicaragua to consider how household food insecurity is associated with three measures of child health: illness, anaemia and low height-for-age. Our results provide new evidence that even mild household food insecurity is detrimental to children's health; and that child age conditions the associations between household food insecurity and child health. We find that food insecurity is especially harmful to health during early childhood, but continues to have significant associations with health into middle childhood (up to ages 7-8 years). We discuss the potential implications of these results for future child health research and policies in low-income countries. © 2016 John Wiley & Sons Ltd.
Cady, Clare L.
Food insecurity is a threat to student success on college campuses in the United States. It has the potential to impact academics, wellness, and behavior--all factors that have bearing on student retention and graduation rates. This article reviews the literature on food insecurity among college students, utilizing research on hunger and…
Food and fuel production are intricately interconnected. In a carbon-smart society, it is imperative to produce both food and fuel sustainably. Integration of the emerging biorefinery concept with other industries can bring many environmental deliverables while mitigating several sustainability-related issues with respect to greenhouse gas emissions, fossil fuel usage, land use change for fuel production and future food insufficiency. A new biorefinery-based integrated industrial ecology encompasses the different value chain of products, coproducts, and services from the biorefinery industries. This paper discusses a framework to integrate the algal biofuel-based biorefinery, a booming biofuel sector, with other industries such as livestock, lignocellulosic and aquaculture. Using the USA as an example, this paper also illustrates the benefits associated with sustainable production of fuel and food. Policy and regulatory initiatives for synergistic development of the algal biofuel sector with other industries can bring many sustainable solutions for the future existence of mankind.
Mayer, Victoria L; Hillier, Amy; Bachhuber, Marcus A; Long, Judith A
An estimated 17.6 million American households were food insecure in 2012, meaning they were unable to obtain enough food for an active and healthy life. Programs to augment local access to healthy foods are increasingly widespread, with unclear effects on food security. At the same time, the US government has recently enacted major cuts to federal food assistance programs. In this study, we examined the association between food insecurity (skipping or reducing meal size because of budget), neighborhood food access (self-reported access to fruits and vegetables and quality of grocery stores), and receipt of food assistance using the 2008, 2010, and 2012 waves of the Southeastern Pennsylvania Household Health Survey. Of 11,599 respondents, 16.7% reported food insecurity; 79.4% of the food insecure found it easy or very easy to find fruits and vegetables, and 60.6% reported excellent or good quality neighborhood grocery stores. In our regression models adjusting for individual- and neighborhood-level covariates, compared to those who reported very difficult access to fruits and vegetables, those who reported difficult, easy or very easy access were less likely to report food insecurity (OR 0.62: 95% CI 0.43-0.90, 0.33: 95% CI 0.23-0.47, and 0.28: 95% CI 0.20-0.40). Compared to those who reported poor stores, those who reported fair, good, and excellent quality stores were also less likely to report food insecurity (OR 0.81: 95% CI 0.60-1.08, 0.58: 95% CI 0.43-0.78, and 0.43: 95% CI 0.31-0.59). Compared to individuals not receiving food assistance, those receiving Supplemental Nutrition Assistance Program (SNAP) benefits were significantly more likely to be food insecure (OR 1.36: 95% CI 1.11-1.67), while those receiving benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (OR 1.17: 95% CI 0.77-1.78) and those receiving both SNAP and WIC (OR 0.84: 95% CI 0.61-1.17) did not have significantly different odds of food insecurity
Canales, Mary K; Coffey, Nancy; Moore, Emily
A focus group process, conducted by a community-academic partnership, qualitatively assessed food insecurity perspectives of parents and community staff assisting families with food assistance. Food insecurity was reported to affect all aspects of their life, increasing stress and reducing coping abilities. The Agency for Healthcare Research and Quality encourages research with priority populations, including low-income populations. This research supports the body of knowledge correlating relationships between poverty, food insecurity, and chronic health conditions. Perspectives of food-insecure people are often missing from policy and advocacy interventions. Nurses can use lessons learned and recommendations from this research to address food-insecurity-related health disparities.
The US Food Security Scale (USFSS) measures household and child food insecurity (CFI) separately. Our goal was to determine whether CFI increases risks posed by household food insecurity (HFI) to child health and whether the Food Stamp Program (FSP) modifies these effects. From 1998 to 2004, 17,158 ...
Background Food insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs). Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk. Methods A cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use. Results In the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else’s injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals. Conclusions Findings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed. PMID:23216869
Coleman-Jensen, Alisha Judith
United States Department of Agriculture defines food insecure as answering affirmatively to three or more food insecurity questions describing a household's ability to acquire enough food. Households indicating low levels of food insecurity (one or two affirmative responses) are considered food secure. This paper compares the characteristics of…
Laraia, Barbara A.
Household food insecurity has been previously hypothesized to promote dependence on inexpensive, highly palatable foods that are energy dense. Such dependence, and the cyclical nature of having enough food in the beginning of the month followed by food scarcity at the end of the month, could lead to weight gain over a short period of time. Such dependence on energy-dense foods and weight gain may play a direct role in the development of chronic conditions. Other compounding factors that result from exposure to household food insecurity have been well described, including pathways by which stress promotes visceral fat accumulation and chronic disease. This symposium review paper summarizes the literature on the link between food insecurity and the following: 1) diet, 2) weight gain, and 3) chronic disease, especially among women. This paper also proposes a framework for considering how the lived experience of household food insecurity may potentiate the development of chronic disease by activating the stress response among individuals at critical developmental periods in a food-impoverished environment. PMID:23493536
Freedman, Darcy A; Bell, Bethany A
The influence of local food environments on the risk for obesity is important overall, but may be particularly important for food insecure populations in urban settings. Access to healthful foods is most limited among racial and ethnic minorities and low-income populations; these same populations experience the highest rates of obesity and food insecurity. Few valid and reliable measures have been developed to assess the quality of local food environments. This research addresses this gap by introducing an inventory for measuring self-reported perceptions of food access and then compares the perceptions measure to objective assessments of local food environments. Data are focused on an urban population experiencing disproportionate rates of food insecurity. The four-item perceptions of food access inventory had high internal consistency (Cronbach's alpha = 0.80). Participants' perceptions of access to healthful foods mirrored the reality of their food environment; however, perceptions of access to alcohol and tobacco were less accurate. Findings suggest that people living in low-income, urban, minority, and food insecure communities can validly assess (in)access to healthful foods. Future research is needed to further validate the perceptions of food access measure introduced and, more importantly, to develop strategies for increasing access to healthful foods in food insecure contexts.
Background Food insecurity is associated with detrimental physical, psychological, behavioral, social, and educational functioning in children and adults. Greater than one-quarter of all Hispanic households in the U.S. are food insecure. Hispanic families in the U.S. comprise 30% of households with food insecurity at the child level, the most severe form of the condition. Methods Food security discordance was evaluated among 50 Mexican-origin children ages 6–11 and their mothers living in Texas border colonias from March to June 2010. Mothers and children were interviewed separately using promotora-researcher administered Spanish versions of the Household Food Security Survey Module and the Food Security Survey Module for Youth. Cohen’s kappa statistic (κ) was used to analyze dyadic agreement of food security constructs and level of food security. Results Eighty percent of mothers reported household food insecurity while 64% of children identified food insecurity at the child level. There was slight inter-rater agreement in food security status (κ = 0.13, p = 0.15). Poor agreement was observed on the child hunger construct (κ = −0.06, p = 0.66) with fair agreement in children not eating for a full day (κ = 0.26, p < 0.01) and relying on low-cost foods (κ = 0.23, p = 0.05). Conclusions Mother and child-reported household and child-level food insecurity among this sample of limited-resource Mexican-origin colonias residents far surpass national estimates. While the level of dyadic agreement was poor, discordance may be attributable to parental buffering, social desirability in responses, and/or the age of children included in the present analysis. Future research should continue to explore how food security is understood from the perspectives and experiences of children and adolescents. PMID:23356877
Borch, Anita; Kjærnes, Unni
In this paper we address the academic discourse on food insecurity and food security in Europe as expressed in articles published in scientific journals in the period 1975 to 2013. The analysis indicates that little knowledge has been produced on this subject, and that the limited research that has been produced tends to focus on the production of food rather than on people's access to food. The lack of knowledge about European food insecurity is particularly alarming in these times, which are characterised by increasing social inequalities and poverty, as well as shifting policy regimes. More empirical, comparative and longitudinal research is needed to survey the extent of food security problems across European countries over time. There is also a need to identify groups at risk of food insecurity as well as legal, economic, practical, social, and psychological constraints hindering access to appropriate and sufficient food.
Barnidge, Ellen; LaBarge, Gene; Krupsky, Kathryn; Arthur, Joshua
Food insecurity is a serious health concern among children in the United States with 15.3 million children living in food insecure households. The American Academy of Pediatrics recommends that pediatricians screen for food insecurity at health maintenance visits as identifying children at risk is a crucial step in the amelioration of food insecurity. Two surveys were administered in a Midwest pediatric clinic. A cross-sectional survey was electronically distributed to pediatric providers to assess perceptions of food insecurity among patients, provider readiness to conduct food security screenings, and barriers to conducting those screenings. A cross-sectional caregiver survey was administered to assess demographics, household food security status, participation in nutrition assistance programs, and barriers to getting enough food to eat. Descriptive statistics and odds ratios were calculated. Eighty-eight percent of physicians believe that food insecurity is a challenge for some of their patients. Only 15 % of providers reported screening for food insecurity, while 80 % were willing to screen. Physicians were most concerned with knowing how to handle a positive screen. Among caregivers, 57 % screened positive for food insecurity. Those experiencing food insecurity were more likely to be non-white, participate in SNAP and to feel discomfort towards the idea of talking to a doctor or nurse about food needs. Caregivers reporting food insecurity were significantly less likely to have a personal vehicle. Effective food insecurity screening requires addressing caregiver and health provider barriers in order to increase the likelihood of identifying households most at risk.
Dobbertin, Konrad; Kulkarni-Rajasekhara, Sheetal; Beilstein-Wedel, Erin; Andresen, Elena M.
Introduction Increasing numbers of US residents rely on informal caregiving from friends and family members. Caregiving can have substantial health and financial impacts on caregivers. This study addressed whether those impacts include adverse nutritional states. Specifically, we examined household food insecurity, individual hunger, and obesity among caregivers compared with noncaregivers. Methods We analyzed 2012 Behavioral Risk Factor Surveillance System data from Oregon. The Caregiving Module was administered to a random subset of 2,872 respondents. Module respondents included 2,278 noncaregivers and 594 caregivers providing care or assistance to a friend or family member with a health problem or disability. We used multivariable logistic regression to assess associations between caregiving status and each of our dependent variables. Results Caregivers had significantly greater odds of reporting household food insecurity (odds ratio [OR] = 2.10, P = .003) and personal hunger (OR = 2.89, P = .002), even after controlling for income and other correlates of food insecurity. There were no significant differences in obesity between caregivers and noncaregivers. Conclusion Caregiving is associated with increased risk of food insecurity and hunger in Oregon, suggesting that careful attention to the nutritional profile of households with family caregivers is needed in this population. PMID:26447547
Hadley, Craig; Lindstrom, David; Tessema, Fasil; Belachew, Tefara
Food insecurity is a pressing public health concern in many developing countries. Despite widespread interest in the sociocultural determinants of food insecurity, little is known about whether youths living in food insecure households experience food insecurity. The buffering hypothesis reviewed here assumes that, to the extent possible, adult members of households will buffer younger household members from the ill effects of food insecurity. A variant of the buffering hypothesis argues that only certain members of the households will enjoy the benefits of buffering. We hypothesize that within the context of Ethiopia, where girls have historically experienced discrimination, buffering is preferentially aimed at boys, especially as the household experiences greater levels of food stress. These hypotheses are tested using data from a population-based study of 2084 adolescents living in southwestern Ethiopia. Results indicate that boys and girls were equally likely to be living in severely food insecure households. Despite no differences in their households' food insecurity status, girls were more likely than boys to report being food insecure themselves. This gender difference was the largest in severely food insecure households. This same pattern was observed when comparing male-female sibling pairs living in the same household. These results are among the first to show that household level measures of food insecurity predict adolescent experiences of food insecurity, and that in the Ethiopian socio-cultural context, the relationship between household level food insecurity and adolescent food insecurity varies by gender. We also show that adolescent food insecurity is strongly associated with measures of general health and well-being.
Save the Children Foundation (SCF), a nongovernmental organization (NGO), developed the "household food economy analysis" to assess the needs of an area or population facing acute food insecurity. This method considers all of the ways people secure access to food and illustrates the distribution of various food supplies in pie charts that allow comparison of the percentage contribution of each option during a normal year and a "bad" year. Data are gathered through the use of key informants, and the analysis permits identification of ways to support local initiatives and to target assistance. As a result of this work, SCF and another NGO, Helen Keller International, attended a March 1997 expert consultation organized by the UN Food and Agriculture Organization (FAO) to create a workplan for the Food Insecurity and Vulnerability Information and Mapping System (FIVIMS) called for in the World Food Summit Plan of Action. The consultation adopted use of the FAO's food and balance sheet approach, despite its limitations, and determined that indicators should be location- and time-specific as well as 1) simple and reliable, 2) readily available, 3) social and anthropometric, and 4) found at all levels. The consultation also recommended combination of the key informant and the indicator approach to data collection. Finally, the consultation identified appropriate actions that should be accomplished before the 1998 meeting of the FAO's Committee on World Food Security.
Hackett, Michelle; Zubieta, Ana Claudia; Hernandez, Kattya; Melgar-Quiñonez, Hugo
The objective of this research is to assess the validity of a modified US Household Food Security Survey Module (HFSSM) through its correlation with food supply and demographic factors, and its fitness using Rasch model analysis in rural Ecuador. This study examines the relationship between household food insecurity and household food supplies in 52 Ecuadorian households. The sample was drawn from four rural communities participating in the project PLAN in Cantón Quijos. Questionnaires included a modified HFSSM, a household food shelf-inventory and demographic characteristics. Multiple ANOVA analysis resulted in statistically significant inverse relationships between household food insecurity and total food supply, as well as the supply of meat, vegetables, legumes, oils, and other food products (p=0.05). Rasch model measure values on the HFSSM illustrated food insecurity at different levels of severity. The majority of the items (>75%) presented adequate infit values. This study affirms that the proposed modified HFSSM may be useful to measure food insecurity and thus be used as a tool to monitor and evaluate programs aimed at improving quantity and variety of food items in rural Ecuador.
Rosas, Lisa G; Harley, Kim; Fernald, Lia CH; Guendelman, Sylvia; Mejia, Fabiola; Neufeld, Lynnette M
Background/objective Children of Mexican descent frequently experience household food insecurity both in the United States (US) and Mexico, however, little is known about the associations of food insecurity with dietary intake. This study aimed to understand the level of perceived food insecurity and its association with dietary intake among children of Mexican descent residing in the US and Mexico. Design This cross-sectional study utilized data from a 2006 binational study of five-year-old children of Mexican descent living in migrant communities in California (CA) and Mexico (MX). Methods In CA, children were 301 participants from the CHAMACOS study, a longitudinal birth cohort in a Mexican immigrant community. MX children (n=301) were participants in the Proyecto Mariposa study, which was designed to capture a sample of women and their children living in Mexico who closely resembled the CA sample, yet who never migrated to the US. Household food insecurity was measured using the US Department of Agriculture Food Security Scale and dietary intake was assessed with food frequency questionnaires. Analysis of variance was used to examine unadjusted and adjusted differences in total energy, nutrient intake, and consumption of food groups by household food security status. Results Approximately 39% of the CA mothers and 75% of the MX mothers reported low or very low food security in the last 12 months (p<0.01). Children in the US, experiencing food insecurity consumed more fat, saturated fat, sweets and fried snacks than children not experiencing food insecurity. In contrast, in Mexico food insecurity was associated with lower intake of total carbohydrates, dairy and vitamin B6. Conclusions Programs and policies addressing food insecurity in the US and Mexico may need to take steps to address dietary intake among children in households experiencing food insecurity, possibly through education and programs to increase resources to obtain healthy foods. PMID:19942017
Dutta, Mohan Jyoti; Hingson, LaReina; Anaele, Agaptus; Sen, Soumitro; Jones, Kyle
Food insecurity and its most extreme form, hunger, have increased exponentially in the United States since 2006. This essay seeks to contribute to our understanding of hunger by attending to the context of the financial crisis as an organizing frame for understanding local meanings of hunger. Within a broader framework of the culture-centered approach (CCA) that works to identify and develop locally rooted solutions to food insecurity, we describe through locally grounded stories of food insecurity the financial climate where large percentages of U.S. households have been cast into poverty because of the crash of an unregulated economy. These local understandings of hunger in the context of the economy offer entry points for organizing a food-insecure coalition that seeks to address the stigma around food insecurity.
Gundersen, Craig G; Garasky, Steven B
Food insecurity is one of the leading public health challenges facing children in the United States today. Reducing food insecurity and its attendant consequences requires an understanding of the determinants of food insecurity. Although previous work has greatly advanced our understanding of these determinants, the role of one of the oft-speculated important determinants of food insecurity, household financial management skills, has not been considered. To address this research lacuna, we use a recently conducted survey, the Survey of Household Finances and Childhood Obesity, that has information on specific financial management practices, impressions of financial management skills, and households' food insecurity. The sample included 904 households with children. Within this sample, 19.3% were food insecure and, for our central financial management skill variable, the mean value was 3.55 on a 5-point scale. Probit regression models estimated the probability of a household being food insecure as conditional on financial management skills and other covariates. We found a large and significant inverse relationship between a respondent's use of specific financial management practices and food insecurity and between a respondent's confidence in his or her financial management skills and food insecurity. That is, households with greater financial management abilities are less likely to be food insecure. This finding also holds when the sample is restricted to households with incomes <200% of the poverty line. These results suggest that improving households' financial management skills has the potential to reduce food insecurity in the United States.
Tarasuk, Valerie; Cheng, Joyce; de Oliveira, Claire; Dachner, Naomi; Gundersen, Craig; Kurdyak, Paul
Background: Household food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs. Methods: We obtained data for 67 033 people aged 18–64 years in Ontario who participated in the Canadian Community Health Survey in 2005, 2007/08 or 2009/10 to assess their household food insecurity status in the 12 months before the survey interview. We linked these data with administrative health care data to determine individuals’ direct health care costs during the same 12-month period. Results: Total health care costs and mean costs for inpatient hospital care, emergency department visits, physician services, same-day surgeries, home care services and prescription drugs covered by the Ontario Drug Benefit Program rose systematically with increasing severity of household food insecurity. Compared with total annual health care costs in food-secure households, adjusted annual costs were 16% ($235) higher in households with marginal food insecurity (95% confidence interval [CI] 10%–23% [$141–$334]), 32% ($455) higher in households with moderate food insecurity (95% CI 25%–39% [$361–$553]) and 76% ($1092) higher in households with severe food insecurity (95% CI 65%–88% [$934–$1260]). When costs of prescription drugs covered by the Ontario Drug Benefit Program were included, the adjusted annual costs were 23% higher in households with marginal food insecurity (95% CI 16%–31%), 49% higher in those with moderate food insecurity (95% CI 41%–57%) and 121% higher in those with severe food insecurity (95% CI 107%–136%). Interpretation: Household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food
Smith, Sunny; Malinak, David; Chang, Jinnie; Perez, Maria; Perez, Sandra; Settlecowski, Erica; Rodriggs, Timothy; Hsu, Ming; Abrew, Alexandra; Aedo, Sofia
Food insecurity is associated with many poor health outcomes yet is not routinely addressed in clinical settings. The purpose of this study was to implement a food insecurity screening and referral program in Student-run Free Clinics (SRFC) and to document the prevalence of food insecurity screening in this low-income patient population. All patients seen in three SRFC sites affiliated with one institution in San Diego, California were screened for food insecurity using the 6-item United States Department of Agriculture (USDA) Food Security Survey between January and July 2015 and referred to appropriate resources. The percentage of patients who were food insecure was calculated. The screening rate was 92.5% (430/463 patients), 74.0% (318/430) were food insecure, including 30.7% (132/430) with very low food security. A food insecurity registry and referral tracking system revealed that by January 2016, 201 participants were receiving monthly boxes of food onsite, 66 used an off-site food pantry, and 64 were enrolled in the Supplemental Nutrition Assistance Program (SNAP). It is possible to implement a food insecurity screening and referral program into SRFCs. The prevalence of food insecurity in this population was remarkably high yet remained largely unknown until this program was implemented. Other health care settings, particularly those with underserved patient populations, should consider implementing food insecurity screening and referral programs.
Chilton, Mariana; Chyatte, Michelle; Breaux, Jennifer
This paper addresses the importance of the first three years of life to the developing child, examines the importance of early childhood nutrition and the detrimental effects on child health and development due to poverty and food insecurity. As development experts learn more about the importance of the first three years of life, there is growing recognition that investments in early education, maternal-child attachment and nurturance, and more creative nutrition initiatives are critical to help break the cycle of poverty. Even the slightest forms of food insecurity can affect a young child's development and learning potential. The result is the perpetuation of another generation in poverty. Conceptualizing the poorly developed child as an embodiment of injustice helps ground the two essential frameworks needed to address food insecurity and child development: the capability approach and the human rights framework. The capability approach illuminates the dynamics that exist between poverty and child development through depicting poverty as capability deprivation and hunger as failure in the system of entitlements. The human rights framework frames undernutrition and poor development of young children as intolerable for moral and legal reasons, and provides a structure through which governments and other agencies of the State and others can be held accountable for redressing such injustices. Merging the development approach with human rights can improve and shape the planning, approach, monitoring and evaluation of child development while establishing international accountability in order to enhance the potential of the world's youngest children.
Weiser, Sheri D.; Fernandes, Kimberly A.; Brandson, Eirikka K.; Lima, Viviane D.; Anema, Aranka; Bangsberg, David R.; Montaner, Julio S.; Hogg, Robert S.
Background Food insecurity is increasingly recognized as a barrier to optimal treatment outcomes but there is little data on this issue. We assessed associations between food insecurity and mortality in HIV-infected antiretroviral therapy (ART)-treated individuals in Vancouver, British Columbia (BC), and whether body max index (BMI) modified associations. Methods Individuals were recruited from the BC HIV/AIDS drug treatment program in 1998 and 1999, and were followed until June 2007 for outcomes. Food insecurity was measured with the Radimer/Cornell questionnaire. Cox proportional hazard models were used to determine associations between food insecurity, BMI and non-accidental deaths when controlling for confounders. Results Among 1119 participants, 536 (48%) were categorized as food insecure and 160 (14%) were categorized as underweight (BMI <18.5). After a median follow-up time of 8.2 years, 153 individuals (14%) had died from non-accidental deaths. After controlling for adherence, CD4 counts, and socioeconomic variables, people who were food insecure and underweight were nearly two times more likely to die (Adjusted hazard ratio [AHR]=1.94, 95% Confidence interval [CI]=1.10-3.40) compared with people who were not food insecure or underweight. There was also a trend towards increased risk of mortality among people who were food insecure and not underweight (AHR= 1.40, 95% CI=0.91-2.05). In contrast, people who were underweight but food secure were not more likely to die. Conclusions Food insecurity is a risk factor for mortality among ART-treated individuals in BC, particularly among individuals who are underweight. Innovative approaches to address food insecurity should be incorporated into HIV treatment programs. PMID:19675463
Food insecurity is a leading nutrition-related health care issue in the USA due to the magnitude of the problem (almost 50 million Americans are food insecure) and its association with a wide array of negative health and other outcomes. Alongside this interest in the USA, there has also been growing interest in Canada. In contrast, food insecurity has received less attention in Europe. Nevertheless, there is both direct and indirect evidence that food insecurity and its attendant consequences are present in Europe. Given the similarities between the USA, Canada, and Europe, previous research can offer numerous insights into the causes and consequences of food insecurity in Europe and possible directions to address these through measurement and public policies. I first cover the methods used to measure food insecurity in the USA and Canada. In both countries, a series of 18 questions in the Core Food Security Module are used to identify whether a household is food insecure. I then briefly cover the current extent of food insecurity in each country along with some discussion of the recent history of food insecurity. A central advantage to using the Core Food Security Module in Europe is that the measure has been proven useful in other high-income countries, and using a standardized measure would allow for cross-country comparisons. I next cover two large-scale food assistance programs from the USA, the Supplemental Nutrition Assistance Program (formerly known as the Food Stamp Program) and the National School Lunch Program. For each, I summarize how the program is structured, how eligibility is established, and how participation proceeds. Europe has generally used income-based assistance programs to improve the well-being of low-income households; I consider a couple of reasons for why food assistance programs may also be worth considering.
Hadley, Craig; Linzer, Drew A; Belachew, Tefera; Mariam, Abebe Gebre; Tessema, Fasil; Lindstrom, David
The global food crisis of 2008 led to renewed interest in global food insecurity and how macro-level food prices impact household and individual level wellbeing. There is debate over the extent to which food price increases in 2008 eroded food security, the extent to which this effect was distributed across rural and urban locales, and the extent to which rural farmers might have benefited. Ethiopia's food prices increased particularly dramatically between 2005 and 2008 and here we ask whether there was a concomitant increase in household food insecurity, whether this decline was distributed equally across rural, urban, and semi-urban locales, and to what extent pre-crisis household capacities and vulnerabilities impacted 2008 household food insecurity levels. Data are drawn from a random sample of 2610 households in Southwest Ethiopia surveyed 2005/6 and again in mid to late 2008. Results show broad deterioration of household food insecurity relative to baseline but declines were most pronounced in the rural areas. Wealthier households and those that were relatively more food secure in 2005/6 tended to be more food secure in 2008, net of other factors, and these effects were most pronounced in urban areas. External shocks, such as a job loss or loss of crops, experienced by households were also associated with worse food insecurity in 2008 but few other household variables were associated with 2008 food insecurity. Our results also showed that rural farmers tended to produce small amounts for sale on markets, and thus were not able to enjoy the potential benefits that come from greater crop prices. We conclude that poverty, and not urban/rural difference, is the important variable for understanding the risk of food insecurity during a food crisis and that many rural farmers are too poor to take advantage of rapid rises in food prices.
Food insecurity is associated with nutrient inadequacy and a variety of unfavorable health outcomes. However, little is known about whether food security is associated with lower cognitive function in the elderly. We investigated the prevalence of food insecurity in a representative sample of 1358 P...
Guo, Yang; Berrang-Ford, Lea; Ford, James; Lardeau, Marie-Pierre; Edge, Victoria; Patterson, Kaitlin; Harper, Sherilee L.
Background Food insecurity is an ongoing problem in the Canadian Arctic. Although most studies have focused on smaller communities, little is known about food insecurity in larger centres. Objectives This study aimed to estimate the prevalence of food insecurity during 2 different seasons in Iqaluit, the territorial capital of Nunavut, as well as identify associated risk factors. Designs A modified United States Department of Agriculture Food Security Survey was applied to 532 randomly selected households in September 2012 and 523 in May 2013. Chi-square tests and multivariable logistic regression were used to examine potential associations between food security and 9 risk factors identified in the literature. Results In September 2012, 28.7% of surveyed households in Iqaluit were food insecure, a rate 3 times higher than the national average, but lower than smaller Inuit communities in Nunavut. Prevalence of food insecurity in September 2012 was not significantly different in May 2013 (27.2%). When aggregating results from Inuit households from both seasons (May and September), food insecurity was associated with poor quality housing and reliance on income support (p<0.01). Unemployment and younger age of the person in charge of food preparation were also significantly associated with food insecurity. In contrast to previous research among Arctic communities, gender and consumption of country food were not positively associated with food security. These results are consistent with research describing high food insecurity across the Canadian Arctic. Conclusion The factors associated with food insecurity in Iqaluit differed from those identified in smaller communities, suggesting that experiences with, and processes of, food insecurity may differ between small communities and larger commercial centres. These results suggest that country food consumption, traditional knowledge and sharing networks may play a less important role in larger Inuit communities. PMID
Pérez-Escamilla, Rafael; Dessalines, Michael; Finnigan, Mousson; Pachón, Helena; Hromi-Fiedler, Amber; Gupta, Nishang
Haiti is the poorest country in the Western Hemisphere and is heavily affected by food insecurity and malaria. To find out if these 2 conditions are associated with each other, we studied a convenience sample of 153 women with children 1-5 y old in Camp Perrin, South Haiti. Household food insecurity was assessed with the 16-item Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale previously validated in the target communities. ELCSA's reference time period was the 3 mo preceding the survey and it was answered by the mother. Households were categorized as either food secure (2%; ELCSA score = 0), food insecure/very food insecure (42.7%; ELCSA score range: 1-10), or severely food insecure (57.3%; ELCSA score range: 11-16). A total of 34.0% of women reported that their children had malaria during the 2 mo preceding the survey. Multivariate analyses showed that severe food insecure was a risk factor for perceived clinical malaria (odds ratio: 5.97; 95% CI: 2.06-17.28). Additional risk factors for perceived clinical malaria were as follows: not receiving colostrum, poor child health (via maternal self-report), a child BMI <17 kg/m(2), and child vitamin A supplementation more than once since birth. Findings suggest that policies and programs that address food insecurity are also likely to reduce the risk of malaria in Haiti.
Kamimura, Akiko; Jess, Allison; Trinh, Ha N; Aguilera, Guadalupe; Nourian, Maziar M; Assasnik, Nushean; Ashby, Jeanie
Food insecurity is a significant public health issue that affects the physical and mental health of people of all ages. Higher levels of self-efficacy may reduce levels of food insecurity. In addition, acculturation is potentially an important factor for food insecurity among immigrant populations. The purpose of this study is to examine food insecurity associated with self-efficacy and acculturation among low-income primary care patients in the United States. A self-administered survey was administered in May and June 2015 to uninsured primary care patients (N = 551) utilizing a free clinic that provides free primary care services to low-income uninsured individuals and families in the United States. On average, participants reported low food security. Higher levels of self-efficacy were associated with lower levels of food insecurity. Higher levels of heritage language proficiency were related to lower levels of food insecurity. US-born English speakers, women, and unmarried individuals potentially have higher risks of food insecurity and may need interventions to meet their specific needs. Self-efficacy should be included in nutrition education programs to reduce the levels of food insecurity. Future studies should further examine why these groups have a high risk to better understand needs for interventions.
Jackson, Dylan B; Vaughn, Michael G
A large body of research has found that household food insecurity can interfere with the healthy development of children. The link between household food insecurity during childhood and misbehaviors during adolescence, however, is not commonly explored. The objective of the current study is to assess whether household food insecurity across childhood predicts four different forms of misconduct during early adolescence. Data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K), a nationally representative sample of U.S. children, were employed in the present study. Associations between household food insecurity during childhood and adolescent misconduct were examined using Logistic and Negative Binomial Regression. Analyses were performed separately for males and females. The results revealed that household food insecurity and food insecurity persistence were predictive of most forms of misconduct for males, and were consistently predictive of engagement in multiple forms of misconduct and a greater variety of forms of misconduct for males. For females, however, household food insecurity generally failed to predict adolescent misconduct. The behavioral development of males during adolescence appears to be sensitive to the presence and persistence of household food insecurity during childhood. Future research should seek to replicate and extend the present findings to late adolescence and adulthood.
Black, Maureen M.; Berkowitz, Carol; Casey, Patrick H.; Cook, John; Cutts, Diana; Jacobs, Ruth Rose; Heeren, Timothy; de Cuba, Stephanie Ettinger; Coleman, Sharon; Meyers, Alan; Frank, Deborah A.
Objectives. We investigated the risk of household food insecurity and reported fair or poor health among very young children who were US citizens and whose mothers were immigrants compared with those whose mothers had been born in the United States. Methods. Data were obtained from 19 275 mothers (7216 of whom were immigrants) who were interviewed in hospital-based settings between 1998 and 2005 as part of the Children's Sentinel Nutrition Assessment Program. We examined whether food insecurity mediated the association between immigrant status and child health in relation to length of stay in the United States. Results. The risk of fair or poor health was higher among children of recent immigrants than among children of US-born mothers (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.02, 1.55; P < .03). Immigrant households were at higher risk of food insecurity than were households with US-born mothers. Newly arrived immigrants were at the highest risk of food insecurity (OR = 2.45; 95% CI = 2.16, 2.77; P < .001). Overall, household food insecurity increased the risk of fair or poor child health (OR = 1.74; 95% CI = 1.57, 1.93; P < .001) and mediated the association between immigrant status and poor child health. Conclusions. Children of immigrant mothers are at increased risk of fair or poor health and household food insecurity. Policy interventions addressing food insecurity in immigrant households may promote child health. PMID:19106417
Tsai, Alexander C; Bangsberg, David R; Emenyonu, Nneka; Senkungu, Jude K; Martin, Jeffrey N; Weiser, Sheri D
HIV/AIDS and food insecurity are two of the leading causes of morbidity and mortality in sub-Saharan Africa, with each heightening the vulnerability to, and worsening the severity of, the other. Less research has focused on the social determinants of food insecurity in resource-limited settings, including social support and HIV-related stigma. In this study, we analyzed data from a cohort of 456 persons from the Uganda AIDS Rural Treatment Outcomes study, an ongoing prospective cohort of persons living with HIV/AIDS (PLWHA) initiating HIV antiretroviral therapy in Mbarara, Uganda. Quarterly data were collected by structured interviews. The primary outcome, food insecurity, was measured with the Household Food Insecurity Access Scale. Key covariates of interest included social support, internalized HIV-related stigma, HIV-related enacted stigma, and disclosure of HIV serostatus. Severe food insecurity was highly prevalent overall (38%) and more prevalent among women than among men. Social support, HIV disclosure, and internalized HIV-related stigma were associated with food insecurity; these associations persisted after adjusting for household wealth, employment status, and other previously identified correlates of food insecurity. The adverse effects of internalized stigma persisted in a lagged specification, and the beneficial effect of social support further persisted after the inclusion of fixed effects. International organizations have increasingly advocated for addressing food insecurity as part of HIV/AIDS programming to improve morbidity and mortality. This study provides quantitative evidence on social determinants of food insecurity among PLWHA in resource-limited settings and suggests points of intervention. These findings also indicate that structural interventions to improve social support and/or decrease HIV-related stigma may also improve the food security of PLWHA.
Roberts, Christopher B.; Johnson, Erin E.
Objective We assessed findings from a food-insecurity screening of a national sample of Veterans Administration clinics for homeless and formerly homeless veterans. Methods We reviewed results from initial screenings administered at 6 Veterans Administration primary care clinics for the homeless and responses from clinic staff members interviewed about the screening program. Results A total of 270 patients were screened. The average age was 53 years, and most were male (93.1%). Screening showed a high prevalence of food insecurity. Of the 270, 48.5% reported they experienced food insecurity in the previous 3 months, 55.0% reported averaging 2 meals a day, and 27.3% averaged 1 meal a day. Eighty-seven percent prepared their own meals, relying on food they bought (54.2%), help from friends and family (19.1%), and soup kitchens and food pantries (22%); 47.3% received Supplemental Nutrition Assistance Program benefits (food stamps). Additionally, of those who screened positive for food insecurity 19.8% had diabetes or prediabetes, and 43.5% reported hypoglycemia symptoms when without food. Clinic staff members responded positively to the screening program and described it as a good rapport builder with patients. Conclusions Integrating screening for food insecurity among patients in clinical settings was well received by both patients and health care providers. Addressing these positive findings of food insecurity requires a multidisciplinary health care approach. PMID:28084988
Ivers, Louise C; Cullen, Kimberly A; Freedberg, Kenneth A; Block, Steven; Coates, Jennifer; Webb, Patrick
Despite tremendous advances in HIV care and increased funding for treatment, morbidity and mortality from HIV/AIDS in developing countries remains unacceptably high. A major contributing factor is that globally over 800 million people remain chronically undernourished and the HIV epidemic largely overlaps with populations already suffering from low diet quality and quantity. We present an updated review of the relationship between HIV, nutritional deficiencies and food insecurity, and consider efforts to interrupt this cycle at a programmatic level. As HIV infection progresses, it causes a catabolic state and increased susceptibility to infection which are compounded by lack of caloric and other nutrient intake, leading to progressive worsening of malnutrition. Despite calls from national and international organizations to integrate HIV and nutrition programs, data are lacking on how such programs can be effectively implemented in resource-poor settings, on the optimum content and duration of nutrition support and on ideal target recipients. PMID:19725790
Kimani-Murage, E W; Schofield, L; Wekesah, F; Mohamed, S; Mberu, B; Ettarh, R; Egondi, T; Kyobutungi, C; Ezeh, A
purchasing power was eroded due to worsened unemployment situation. The use of negative coping strategies to address food insecurity such as reducing the number of meals, reducing food variety and quality, scavenging, and eating street foods was prevalent. In conclusion, this study describes the deeply intertwined nature of chronic poverty and acute crisis, and the subsequent high levels of food insecurity in urban slum settings. Households are extremely vulnerable to food insecurity; the situation worsening during periods of crisis in the perception of slum residents, engendering frequent use of negative coping strategies. Effective response to addressing vulnerability to household food insecurity among the urban poor should focus on both the underlying vulnerabilities of households due to chronic poverty and added impacts of acute crises.
Metallinos-Katsaras, Elizabeth; Gorman, Kathleen S; Wilde, Parke; Kallio, Jan
We examined the association between women's/children's duration of WIC participation and household food security status. For mothers (n = 21,863) and their children (n = 57,377) participating in WIC (2001-2006), longitudinal measures of household food security status were collected using a subscale of the USDA Food Security Module. Using logistic regression, household food security status at the last WIC visit was associated with measures of WIC duration (number of trimesters on WIC for pregnant women, and number of WIC visits for children). Among women with prenatal household food insecurity with hunger, odds of any post-partum household food insecurity was reduced with first (AOR = 0.67, 95% CI = 0.48-0.94) or second trimester of entry (AOR= 0.64, 95% CI = 0.45-0.90) versus third. Among children with initial household food insecurity without hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.92, 95% CI = 0.90-0.94) and of household food insecurity with hunger (AOR = 0.94, 95% CI = 0.89-0.98) at the last visit. Among those with initial household food insecurity with hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.96, 95% CI = 0.92-0.99) and of household food insecurity with hunger (AOR = 0.88, 95% CI = 0.83-0.94) at the last visit. Earlier and longer WIC participation may improve household food security status, particularly of vulnerable groups.
Miller, Cari L; Bangsberg, David R; Tuller, David M; Senkungu, Jude; Kawuma, Annet; Frongillo, Edward A; Weiser, Sheri D
Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged from the interview data: the relationship between food insecurity and transactional sex for women; the impact of a husband's death from HIV on worsening food insecurity among women and children; the impact of food insecurity on control over condom use, and the relationship between food insecurity and staying in violent/abusive relationships. Food insecurity led to increased sexual vulnerability among women. Women were often compelled to engage in transactional sex or remain in violent or abusive relationships due to their reliance on men in their communities to provide food for themselves and their children. There is an urgent need to prioritize food security programs for women living with HIV/AIDS and address broader gender-based inequities that are propelling women to engage in risky sexual behaviors based on hunger. Such interventions will play an important role in improving the health and well-being of people living with HIV/AIDS, and preventing HIV transmission.
Benzekri, Noelle A.; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Guèye, Ndèye Fatou; Diallo, Mouhamadou Baïla; Hawes, Stephen E.; Seydi, Moussa; Gottlieb, Geoffrey S.
Background Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes. Methods We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. Results One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01). Conclusions Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population. PMID:26529509
Tsoh, Janice Y.
Introduction Low socioeconomic status is associated with high rates of cigarette smoking, and socioeconomic differences in cigarette smoking tend to emerge during young adulthood. To further our understanding of socioeconomic differences in smoking among young adults, we examined correlates of smoking, with attention to multiple socioeconomic indicators that have not been examined in this population. Methods We analyzed data from the 2011–2012 California Health Interview Survey. The analytic sample consisted of young adults aged 18–30 years who were considered socioeconomically disadvantaged as measured by education and poverty. Logistic regression analyses were conducted to examine factors associated with smoking status in this group, and multinomial logistic regression analyses were conducted to examine correlates of smoking frequency. Results In this sample (N = 1,511; 48% female, 66% Hispanic/Latino, 18% non-Hispanic white), 39.7% reported experiencing food insecurity in the past year. Smoking prevalence was significantly higher among young adults who reported being food insecure (26.9%) than among those who reported being food secure (16.4%). Past-year food insecurity was significantly associated with current smoking, independent of sociodemographic characteristics and alcohol use. Specifically, food insecurity was significantly associated with daily but not nondaily smoking. Conclusion Socioeconomically disadvantaged young adults with food insecurity may be considered a high-risk group with respect to cigarette smoking. Efforts to reduce tobacco-related health disparities should address diverse sources of socioeconomic influences, including experiences of food insecurity. PMID:26766849
Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; Jean, Jessica St; Goldenberg, Shira M; Duff, Putu; Deering, Kathleen N
This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010-2013). We examined the independent relationship between YSWs' food insecurity and being pressured into sex without a condom by clients ("client condom refusal"). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23-3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs' particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.
Parpouchi, Milad; Moniruzzaman, Akm; Russolillo, Angela; Somers, Julian M.
Background The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada. Methods Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture’s Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity. Results The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95–0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35–0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00–2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96–0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16–4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36–12.96), heart disease (aOR = 0.39; 95% CI: 0.16–0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01–2.68). Conclusions The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed. PMID:27437937
Melchior, Maria; Chastang, Jean-François; Falissard, Bruno; Galéra, Cédric; Tremblay, Richard E; Côté, Sylvana M; Boivin, Michel
Food insecurity (which can be defined as inadequate access to sufficient, safe, and nutritious food that meets individuals' dietary needs) is concurrently associated with children's psychological difficulties. However, the predictive role of food insecurity with regard to specific types of children's mental health symptoms has not previously been studied. We used data from the Longitudinal Study of Child Development in Québec, LSCDQ, a representative birth cohort study of children born in the Québec region, in Canada, in 1997-1998 (n = 2120). Family food insecurity was ascertained when children were 1½ and 4½ years old. Children's mental health symptoms were assessed longitudinally using validated measures of behaviour at ages 4½, 5, 6 and 8 years. Symptom trajectory groups were estimated to identify children with persistently high levels of depression/anxiety (21.0%), aggression (26.2%), and hyperactivity/inattention (6.0%). The prevalence of food insecurity in the study was 5.9%. In sex-adjusted analyses, children from food-insecure families were disproportionately likely to experience persistent symptoms of depression/anxiety (OR: 1.79, 95% CI 1.15-2.79) and hyperactivity/inattention (OR: 3.06, 95% CI 1.68-5.55). After controlling for immigrant status, family structure, maternal age at child's birth, family income, maternal and paternal education, prenatal tobacco exposure, maternal and paternal depression and negative parenting, only persistent hyperactivity/inattention remained associated with food insecurity (fully adjusted OR: 2.65, 95% CI 1.16-6.06). Family food insecurity predicts high levels of children's mental health symptoms, particularly hyperactivity/inattention. Addressing food insecurity and associated problems in families could help reduce the burden of mental health problems in children and reduce social inequalities in development.
Shen, Xiuhua; Gao, Xiang; Tang, Wenjing; Mao, Xuanxia; Huang, Jingyan; Cai, Wei
It has been shown that food insecurity is associated with poor diet quality and unfavourable health outcomes. However, little is known about the potential effects of food insecurity on the overall malnutrition status among children. In this study, we investigated the prevalence of food insecurity among 1583 elementary school students, aged 6-14 years, living in Chinese rural areas and examined its association with four malnutrition signs, including rickets sequelae, anaemia, stunting and wasting. Information on food security was collected via questionnaires. Rickets sequelae were assessed by an experienced paediatrician during the interview. Anaemia was determined by the WHO Hb thresholds adjusted by the local altitude. Weight and height were measured during the interview. Stunting and wasting were then evaluated according to WHO child growth standards (2007). We examined the association between food insecurity and the number of malnutrition signs (total number = 4), and the likelihood of having severe malnutrition (presence of 3+ signs), after adjusting for potential confounders, such as age, social-economic status and dietary intakes. During the previous 12 months, the overall prevalence of food insecurity was 6.1% in the entire studied population and 16.3% in participants with severe malnutrition. Participants with food insecurity had a slightly higher number of malnutrition signs (1.14 v. 0.96; P=0.043) relative to those who were food secure, after adjusting for potential confounders. Food insecurity was also associated with increased likelihood of having severe malnutrition (adjusted OR 3.08; 95% CI 1.47, 6.46; P=0.003). In conclusion, food insecurity is significantly associated with malnutrition among Chinese children in this community.
Castillo, Darleen C.; Ramsey, Natalie LM; Yu, Sophia SK; Ricks, Madia; Courville, Amber B.; Sumner, Anne E.
Food insecurity is defined as limited or uncertain ability to acquire nutritionally adequate and safe foods in socially acceptable ways. The United States Department of Agriculture (USDA) has divided food insecurity into two categories: low food security and very low food security. Low food security is characterized by irregular access to food, binge eating when food is available, overconsumption of energy-dense foods, obesity, and even type 2 diabetes. This type of food insecurity occurs in impoverished urban areas of high-income countries such as the United States. In contrast, very low food security is distinctly different from low food security and can lead to undernutrition and frank starvation. Very low food security is found in developing countries in both rural areas and urban slums. In these countries, food insecurity is often exacerbated by natural disasters and climate changes that compromise food availability. With a focus on the social, economic, and behavioral factors that promote obesity and cardiometabolic disease in food insecure households in the United States, this review will first define the key terms and concepts associated with food insecurity. Then, the characteristics of food insecure households and the relationship to cardiometabolic disease will be discussed. Finally, the cardiac consequences of food insecurity in developing countries will be briefly described. PMID:22629473
Dachner, Naomi; Tarasuk, Valerie
Current knowledge about food insecurity in North America is largely based on research with low-income households. Much less is known about the food experiences of homeless people, a group who are particularly vulnerable to food insecurity. This study explored the food experiences of street youth, one of the fastest growing segments of the homeless population in Canada. To gain an in-depth understanding of food insecurity within the context of daily life, ethnographic research was undertaken with street youth at one inner-city drop-in centre in Toronto, Canada. Results of this study reveal that street youth's access to food was precarious amidst the instability and chaos of street life. The day-to-day lives of the street youth encountered in this study were characterized by a constant struggle to find safe, secure shelter, generate income, and obtain sufficient food. In this context, food was a precious commodity. Food access was inextricably linked to and contingent upon conditions of health, shelter, and income. Food access was precarious since everyday food sources purchased food and charitable food assistance were ultimately insecure. "Squeegeeing" (washing car windows), the primary source of income for youth in the study, was dependent on the weather, political and public will, and youth's physical health, and thus did not generate enough money to continuously meet basic food needs. Charitable food assistance was considered poor quality and was associated with food sickness. The often unsavoury atmosphere of charitable food programmes, their locations, capacity, and idiosyncratic rules, policies, and hours of operation also affected access. Findings from this study extend the current understanding of food insecurity to homeless youth and offer insight into current responses to hunger and homelessness.
Cook, John T; Frank, Deborah A; Levenson, Suzette M; Neault, Nicole B; Heeren, Tim C; Black, Maurine M; Berkowitz, Carol; Casey, Patrick H; Meyers, Alan F; Cutts, Diana B; Chilton, Mariana
The US Food Security Scale (USFSS) measures household and child food insecurity (CFI) separately. Our goal was to determine whether CFI increases risks posed by household food insecurity (HFI) to child health and whether the Food Stamp Program (FSP) modifies these effects. From 1998 to 2004, 17,158 caregivers of children ages 36 mo were interviewed in six urban medical centers. Interviews included demographics, the USFSS, child health status, and hospitalization history. Ten percent reported HFI, 12% HFI and CFI (H&CFI). Compared with food-secure children, those with HFI had significantly greater adjusted odds of fair/poor health and being hospitalized since birth, and those with H&CFI had even greater adverse effects. Participation in the FSP modified the effects of FI on child health status and hospitalizations, reducing, but not eliminating, them. Children in FSP-participating households that were HFI had lower adjusted odds of fair/poor health [1.37 (95% CI, 1.06-1.77)] than children in similar non-FSP households [1.61 (95% CI, 1.31-1.98)]. Children in FSP-participating households that were H&CFI also had lower adjusted odds of fair/poor health [1.72 (95% CI, 1.34-2.21)] than in similar non-FSP households [2.14 (95% CI, 1.81-2.54)]. HFI is positively associated with fair/poor health and hospitalizations in young children. With H&CFI, odds of fair/poor health and hospitalizations are even greater. Participation in FSP reduces, but does not eliminate, effects of FI on fair/poor health.
Sattler, Elisabeth Lilian Pia; Lee, Jung Sun; Bhargava, Vibha
Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.
Gundersen, Craig; Kreider, Brent
Policymakers have been puzzled to observe that food stamp households appear more likely to be food insecure than observationally similar eligible nonparticipating households. We reexamine this issue allowing for nonclassical reporting errors in food stamp participation and food insecurity. Extending the literature on partially identified…
Wilde, Parke E
The federal government has estimated the prevalence of household "food insecurity" and "food insecurity with hunger" since 1995. Early observers believed that the new measure could be used to assess and improve the Food Stamp Program (FSP). Ten years of research have tempered the initial optimism. The prevalence of food insecurity with hunger (12.3% of all low-income households in 2004) is much higher among food stamp participant households (18.6% in 2004) than among low-income nonparticipant households (10.1% in 2004), due to strong self-selection effects. Households facing greater hardship are more likely to join the program. This article reviews 6 types of nonexperimental research designs that have been used to address the self-selection problem. The results have been inconclusive and the authors have warned against drawing causal inferences from their research. Ethical random-assignment research designs may be required to satisfy the intense policy interest in measuring the antihunger impact of the FSP. The most promising ethical research designs would test the effects of offering eligibility to households that are currently ineligible or offering increased benefits to households that are currently eligible for small benefit amounts.
Patel, Shivani A; Surkan, Pamela J
Household food insecurity is a population health concern disproportionately affecting families with children in the United States. Unwanted childbearing may place unanticipated strain on families to meet basic needs, heightening the risk for household food insecurity. We investigated the association between mother's and father's report of unwanted childbearing and exposure to household food insecurity among children residing in two-parent households in the United States. Data from the Early Childhood Longitudinal Study - Birth Cohort, a nationally representative cohort of US children (n ∼ 6150), were used to estimate the odds of household food insecurity when children were aged 9 months and 2 years, separately, based on parental report of unwanted childbearing. The majority of children were reported as wanted by both parents (74.4%). Of the sample, report of unwanted childbearing by father-only was 20.0%, mother-only was 3.4% and joint mother and father was 2.2%. Household food insecurity was higher when children were 9 months compared with 2 years. In adjusted models accounting for confounders, children born to mothers and fathers who jointly reported unwanted childbearing were at higher odds of exposure to household food insecurity at 9 months [adjusted odds ratio (AOR) = 3.31; 95% confidence interval (CI): 1.97, 5.57] and 2 years (AOR = 2.52; 95% CI: 1.12, 5.68). In two-parent households, we found that children raised by parents reporting unwanted childbearing were more likely to be exposed to food insecurity and potentially related stressors. Further studies that prospectively measure wantedness before the child's birth will aid in confirming the direction of this association.
Chun, In-Ae; Park, Jong; Ro, Hee-Kyung; Han, Mi-Ah
BACKGROUND/OBJECTIVES Food insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults. SUBJECTS/METHODS The data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors. RESULTS The prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight. CONCLUSIONS Food insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population. PMID:26244083
DeMartini, Tori L; Beck, Andrew F; Kahn, Robert S; Klein, Melissa D
Despite evidence that food insecurity negatively impacts child health, health care providers play little role in addressing the issue. To inform potential primary care interventions, we sought to assess a range of challenges faced by food insecure (FI) families coming to an urban, pediatric primary care setting. A cross-sectional study was performed at a hospital-based, urban, academic pediatric primary care clinic that serves as a medical home for approximately 15,000 patients with 35,000 annual visits. Subjects included a convenience sample of caregivers of children presenting for either well child or ill care over a 4 months period in 2012. A self-administered survey assessed household food security status, shopping habits, transportation access, budgeting priorities, and perceptions about nutrition access in one's community. Bivariate analyses between food security status and these characteristics were performed using Chi square statistics or Fisher's exact test. The survey was completed by 199 caregivers. Approximately 33% of families were FI; 93% received food-related governmental assistance. FI families were more likely to obtain food from a corner/convenience store, utilize food banks, require transportation other than a household car, and prioritize paying bills before purchasing food. FI families perceived less access to healthy, affordable foods within their community. Thus, FI families may face unique barriers to accessing food. Knowledge of these barriers could allow clinicians to tailor in-clinic screening and create family-centered interventions.
Kalichman, Seth C; Hernandez, Dominica; Cherry, Chauncey; Kalichman, Moira O; Washington, Christopher; Grebler, Tamar
Health disparities in access to antiretroviral therapy (ART) as well as the demands of long-term medication adherence have meant the full benefits of HIV treatment are often not realized. In particular, food insecurity has emerged as a robust predictor of ART non-adherence. However, research is limited in determining whether food insecurity uniquely impedes HIV treatment or if food insecurity is merely a marker for poverty that interferes more broadly with treatment. This study examined indicators of poverty at multiple levels in a sample of 364 men and 157 women living with HIV recruited through an offering of a free holiday food basket. Results showed that 61 % (N = 321) of participants had experienced at least one indicator of food insecurity in the previous month. Multivariate analyses showed that food insecurity was closely tied to lack of transportation. In addition, food insecurity was associated with lacking access to ART and poor ART adherence after adjusting for neighbourhood poverty, living in an area without a supermarket (food desert), education, stable housing, and reliable transportation. Results therefore affirm previous research that has suggested food insecurity is uniquely associated with poor ART adherence and calls for structural interventions that address basic survival needs among people living with HIV, especially food security.
Epstein, Leonard H; Jankowiak, Noelle; Lin, Henry; Paluch, Rocco; Koffarnus, Mikhail N; Bickel, Warren K
Background: Low income is related to food insecurity, and research has suggested that a scarcity of resources associated with low income can shift attention to the present, thereby discounting the future. Objective: We tested whether attending to the present and discounting the future may moderate the influence of income on food insecurity. Design: Delay discounting and measures of future time perspective (Zimbardo Time Perspective Inventory, Consideration of Future Consequences Scale, time period of financial planning, and subjective probability of living to age 75 y) were studied as moderators of the relation between income and food insecurity in a diverse sample of 975 adults, 31.8% of whom experienced some degree of food insecurity. Results: Income, financial planning, subjective probability of living to age 75 y, and delay discounting predicted food insecurity as well as individuals who were high in food insecurity. Three-way interactions showed that delay discounting interacted with financial planning and income to predict food insecurity (P = 0.003). At lower levels of income, food insecurity was lowest for subjects who had good financial planning skills and did not discount the future, whereas having good financial skills and discounting the future had minimal influence on food insecurity. The same 3-way interaction was observed when high food insecurity was predicted (P = 0.008). Conclusion: Because of the role of scarce resources on narrowing attention and reducing prospective thinking, research should address whether modifying future orientation may reduce food insecurity even in the face of diminishing financial resources. This trial was registered at clinicaltrials.gov as NCT02099812. PMID:25008855
Gao, Xiang; Scott, Tammy; Falcon, Luis M; Wilde, Parke E; Tucker, Katherine L
Background: Food insecurity is associated with nutrient inadequacy and a variety of unfavorable health outcomes. However, little is known about whether food security is associated with lower cognitive function in the elderly. Objective: We investigated the prevalence of food insecurity in a representative sample of 1358 Puerto Ricans aged 45–75 y living in Massachusetts in relation to cognitive function performances. Design: Food security was assessed with the US Household Food Security Scale. Cognitive function was measured to capture general cognition with a battery of 7 tests: Mini-Mental State Examination (MMSE), word list learning (verbal memory), digit span (attention), clock drawing and figure copying (visual-spatial ability), and Stroop and verbal fluency tests (fluency executive functioning). Results: The overall prevalence of food insecurity during the past 12 mo was 12.1%; 6.1% of the subjects reported very low food security. Food insecurity was inversely associated with global cognitive performance, as assessed by the MMSE score. The adjusted difference in the MMSE score was −0.90 (95% CI: −1.6, −0.19; P for trend = 0.003) for a comparison of participants with very low food security with those who were food secure, after adjustment for age, smoking, education, poverty status, income, acculturation, plasma homocysteine, alcohol, diabetes, and hypertension. Food insecurity was significantly associated with lower scores for word-list learning, percentage retention, letter fluency, and digit span backward tests. Conclusions: Very low food security was prevalent among the study subjects and was associated with lower cognitive performance. Further studies, both observational and experimental, are warranted to clarify the direction of causality in this association. PMID:19225117
Moreno, Gerardo; Morales, Leo S.; Isiordia, Marilu; de Jaimes, Fatima Nunez; Tseng, Chi-Hong; Noguera, Christine; Mangione, Carol M.
Background Latinos from agricultural communities have a high prevalence of food insecurity and are at increased risk of obesity and diabetes, yet little is known about the associations between food insecurity and diabetes outcomes. Objective To examine the associations between food insecurity and diabetes outcomes among rural Latinos. Methods Cross-sectional survey with medical chart abstraction of 250 Latinos with diabetes. Primary outcomes are the control of three intermediate diabetes outcomes (hemoglobin A1C ≤ 8.0%, LDL-cholesterol ≤ 100 mg/dl, and blood pressure ≤ 140/90 mmHg), a composite of control of the three, and receipt of 6 processes of care. Secondary outcomes are cost-related medication underuse and participation in self-care activities. Results Fifty-two percent of patients reported food insecurity and one-in-four reported cost-related medication underuse. Patients with food insecurity were more likely to report cost-related medication underuse (adjusted odds ratio [AOR] =2.49; 95% confidence intervals [CI] 1.30, 4.98; p = 0.003); less likely to meet the composite measure for control of the 3 intermediate outcomes (AOR 0.24; 95% CI 0.07, 0.84; p < 0.05), and less likely to receive a dilated eye exam (AOR 0.37; 95% CI 0.18, 0.77; p < 0.05) and annual foot exams (AOR 0.42; 95% CI 0.20, 0.84; p < 0.05) compared to those who were food secure. Conclusion Among this rural Latino population, food insecurity was independently associated with not having control of the intermediate diabetes outcomes captured in the composite measure, not receiving dilated eye and foot exams, and with self-reporting cost-related medication underuse. PMID:25811632
Byrne, T. R.; Byrne, J. M.; McDaniel, S.
Food insecurity is one of the most important challenges facing humanity in the 21st century - a challenge that will be further exacerbated by the changing climate. The effects of human induced climate change will be most disproportionate and severe in the developing world, where a stable food supply, decreased purchasing power, and adequate nutrition are often already a daily struggle. This study will build on work done by the Food and Agriculture Organization (FAO) of the United Nations (UN), and will assess how vulnerability to household food insecurity will be affected by global warming in various rural parts of Latin America. Temperature data from downscaled Global Circulation Models (GCM) will be used in conjunction with the results of national household surveys to generate information on each rural farming household's probability of falling below a food poverty threshold in the near future. The results of the study will allow us to distinguish between households that are likely to experience chronic food insecurity and those that are likely to experience transitory food insecurity, permitting for improved targeting of policy responses.
Melgar-Quinonez, Hugo R; Zubieta, Ana C; MkNelly, Barbara; Nteziyaremye, Anastase; Gerardo, Maria Filipinas D; Dunford, Christopher
This study examined the association between food insecurity, determined by a modified version of the U.S. Household Food Security Survey Module (US HFSSM), and total daily per capita (DPC) consumption (measured as household expenditures) in Bolivia, Burkina Faso, and the Philippines. Household food insecurity was determined by an adapted 9-item US HFSSM version. A short version of the World Bank's Living Standards Measurement Study (LSMS) consumption module measured household expenditures. Focus groups were used to adapt the survey instrument to each local context. The sample (n approximately 330 per country) includes residents of urban and rural areas. A 12-month food expenditure aggregate was generated as part of the total household expenditures calculation. DPC food expenditure, which represented over 60% of the total household consumption, as well as expenditures on specific food groups correlated with food insecurity both as a continuous Food Insecurity Score (FinSS) and a tricategorical food insecurity status variable. ANOVA and regression analysis were executed adjusting for social and demographic covariates. Food-secure households have significantly higher (P < 0.05) total DPC food expenditures as well as expenditures on animal source foods, vegetables, and fats and oils than moderately and severely food-insecure households. The results offer evidence that the US HFSSM is able to discriminate between households at different levels of food insecurity status in diverse developing world settings.
Maroto, Maya E.
The latest U.S. government surveys indicate that one in six Americans suffer from food insecurity, which means they have trouble affording adequate food. Previous research has shown that food insecurity affects adult cognitive ability, energy levels, ability to concentrate as well as child academic success. Food insecurity has been studied in…
Quandt, Sara A.; Shoaf, John I.; Tapia, Janeth; Hernández-Pelletier, Mercedes; Clark, Heather M.; Arcury, Thomas A.
Household food insecurity is higher among minority households in the U.S., but few data exist on households of recent minority immigrants, in part because such households are difficult to sample. Four studies of a total of 317 Latino immigrant families were conducted in different regions and during different seasons in North Carolina. A Spanish translation of the 18-item U.S. Food Security Survey Module was used to assess the prevalence of food insecurity and hunger. In 3 of the studies, a total of 76 in-depth interviews were conducted to gather information on immigrants' experiences of food insecurity. Households in the 4 studies classified as food secure ranged from 28.7 to 50.9%, compared with 82.4% in the U.S. in 2004. Food insecurity without hunger ranged from 35.6% to 41.8%, compared with 13.3% in the U.S. The highest rates of hunger reported were 18.8% (moderate hunger) and 16.8% (severe hunger) in an urban sample. Qualitative data indicate that food insecurity has both quantitative and qualitative effects on diet. Immigrants experience adverse psychological effects of food insecurity. They report experiencing a period of adjustment to food insecurity leading to empowerment to resolve the situation. Reactions to food insecurity differ from those reported by others, possibly because immigrants encounter a new and not chronic situation. Overall, these findings suggest that immigrant Latinos experience significant levels of food insecurity that are not addressed by current governmental programs. PMID:16988139
Quandt, Sara A; Shoaf, John I; Tapia, Janeth; Hernández-Pelletier, Mercedes; Clark, Heather M; Arcury, Thomas A
Household food insecurity is higher among minority households in the U.S., but few data exist on households of recent minority immigrants, in part because such households are difficult to sample. Four studies of a total of 317 Latino immigrant families were conducted in different regions and during different seasons in North Carolina. A Spanish translation of the 18-item U.S. Food Security Survey Module was used to assess the prevalence of food insecurity and hunger. In 3 of the studies, a total of 76 in-depth interviews were conducted to gather information on immigrants' experiences of food insecurity. Households in the 4 studies classified as food secure ranged from 28.7 to 50.9%, compared with 82.4% in the U.S. in 2004. Food insecurity without hunger ranged from 35.6% to 41.8%, compared with 13.3% in the U.S. The highest rates of hunger reported were 18.8% (moderate hunger) and 16.8% (severe hunger) in an urban sample. Qualitative data indicate that food insecurity has both quantitative and qualitative effects on diet. Immigrants experience adverse psychological effects of food insecurity. They report experiencing a period of adjustment to food insecurity leading to empowerment to resolve the situation. Reactions to food insecurity differ from those reported by others, possibly because immigrants encounter a new and not chronic situation. Overall, these findings suggest that immigrant Latinos experience significant levels of food insecurity that are not addressed by current governmental programs.
Mohamadpour, M; Sharif, Z Mohd; Keysami, M Avakh
-based interventions should be designed and implemented to address the problems of food insecurity and possible health and nutritional outcomes.
Wetherill, Marianna S.; Hearod, Jordan; Jacob, Tvli; Salvatore, Alicia L.; Cannady, Tamela; Grammar, Mandy; Standridge, Joy; Fox, Jill; Spiegel, Jennifer; Wiley, AnDina; Noonan, Carolyn; Buchwald, Dedra
Objectives. To examine food insecurity and cardiovascular disease–related health outcomes among American Indians (AIs) in rural Oklahoma. Methods. We surveyed a cross-sectional sample of 513 AI adults to assess food insecurity domains (i.e., food quality and quantity) and obesity, diabetes, and hypertension. Results. Among AIs surveyed, 56% reported inadequate food quantity and 62% reported inadequate food quality. The unadjusted prevalence of diabetes (28.4% vs 18.4%), obesity (60.0% vs 48.3%), and hypertension (54.1% vs 41.6%) was higher among participants with inadequate food quantity than among those with adequate food quantity. These associations did not reach statistical significance after adjustment for age, gender, study site, education, and income. The unadjusted prevalence of obesity (60.7% vs 45.8%), diabetes (27.3% vs 18.8%), and hypertension (52.5% vs 42.5%) was higher among those with inadequate food quality than among those with adequate food quality, even after adjustment for age, gender, study site, education, and income. Conclusions. Tribal, federal, and state policymakers, as well as businesses and nonprofit organizations, must collaboratively take aggressive action to address food insecurity and its underlying causes, including improving tribal food environments, reducing barriers to healthy foods, and increasing living wages. PMID:28103070
This study examines food insecurity during and after pregnancy and how that affects postpartum weight retention. The results show that food insecurity was associated with higher levels of stress, eating behaviors, dietary fat intake, and higher postpartum weight status.
Background High food prices have emerged as a major global challenge, especially for poor and urban households in low-income countries such as Ethiopia. However, there is little empirical evidence on urban food security and how people living in urban areas are coping with sustained high food prices. This study aims to address this gap by investigating the food insecurity situation in urban Ethiopia -a country experiencing sustained high food prices, high rates of urban poverty, and a growing urban population. Methods A community based cross-sectional study was conducted from January 18 to February 14, 2012. A total of 550 households were selected from three sub-cities of Addis Ababa using three-stage sampling technique. Data were collected using questionnaire based interview with household heads. Items in the questionnaire include, among others, basic socioeconomic variables, dietary diversity and coping strategies. Food security status of households was assessed by a Household Food Insecurity Access Score. Data analysis was done using SPSS software and both univariate and bivariate analysis were done. Results The study found that 75% of households were food insecure and 23% were in a state of hunger. Households with higher food insecurity scores tend to have lower dietary diversity and are less likely to consume high quality diets. Reduction in meal size and shifting to poor quality/less expensive/food types were among the common coping strategies to high food price used by households. Household incomes, occupational and educational status of household heads were significant determinants of food security. Conclusion Food insecurity in Ethiopia is not only a rural problem. Urban food insecurity is a growing concern due to the toxic combination of high rates of urban poverty, high dependency of urban households on food supplied by the market, and fluctuating food prices. Household food insecurity was particularly high among low income households and those headed by
Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.
Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…
Mammen, Sheila; Bauer, Jean W.; Richards, Leslie
Survey data from a U.S. Department of Agriculture funded multi-state longitudinal project revealed a paradox where rural low-income families from states considered prosperous were persistently more food insecure than similar families from less prosperous states. An examination of quantitative and qualitative data found that families in the food…
Despite the high prevalence rates of food insecurity and obesity among children of Hispanic immigrants, there has been a dearth of research on the direct relationship between food insecurity and obesity among this population. Further, prior research examining the association between food insecurity ...
Dunifon, Rachel; Kowaleski-Jones, Lori
This paper examines the associations between food insecurity, participation in the National School Lunch Program (NSLP), and children's well-being. We address problems of selection by restricting our sample to children in families in which at least one child participates in the NSLP. Results suggest that food insecurity is associated with…
Nagata, Jason M; Magerenge, Richard O; Young, Sera L; Oguta, Joel O; Weiser, Sheri D; Cohen, Craig R
Food insecurity is a considerable challenge in sub-Saharan Africa, disproportionately affecting persons living with HIV/AIDS. This study investigates the lived experience, determinants, and consequences of food insecurity and hunger among individuals living with HIV/AIDS on the shore of Lake Victoria in Suba District, Kenya. Parallel mixed methods included semi-structured interviews and administration of the Household Food Insecurity Access Scale among a systematic sample of 67 persons living with HIV/AIDS (49 of whom were receiving antiretroviral therapy [ART]). All respondents were either severely (79.1%) or moderately (20.9%) food insecure; no respondents were mildly food insecure or food secure. Qualitative data and simple and multiple linear regression models indicated that significant determinants of food insecurity include increased age, a greater number of children, and not being married. A number of themes related to food insecurity and ART emerged, including: (1) an increase in hunger or appetite since initiating ART; (2) exacerbation of ART-related side effects; and (3) non-adherence to ART due to hunger, food insecurity, or agricultural work responsibilities. HIV interventions should address food insecurity and hunger, particularly among at-risk populations, to promote ART adherence and better health outcomes.
Petralias, Athanassios; Papadimitriou, Eleni; Riza, Elena; Karagas, Margaret R.; Zagouras, Alexia B.A.
Background: We had a unique opportunity to establish the extent of food insecurity and the potential impact of a large-scale school-based nutritional program, in low-socioeconomic status districts of Greece, during the current economic crisis. Methods: Around 162 schools with 25 349 students participated during the 2012–2013 school year. Each student received a daily healthy meal designed by nutrition specialists. Food insecurity levels, measured using the Food Security Survey Module were assessed at baseline and after a 1–8-month intervention period. Pre–post intervention responses were matched at an individual level. Results: Around 64.2% of children’s households experienced food insecurity at baseline. This percentage decreased to 59.1% post-intervention, P < 0.001. On an individual level, food insecurity score diminished by 6.5%, P < 0.001. After adjustment for various socioeconomic factors, for each additional month of participation, the odds of reducing the food insecurity score increased by 6.3% (OR = 1.06, 95% CI: 1.02–1.11). Those experiencing food insecurity with hunger at baseline were more likely to improve food insecurity score than those who did not (OR = 3.51, 95%CI: 2.92–4.21). Conclusion: Children and families residing in low socioeconomic areas of Greece, experience high levels of food insecurity. Our findings suggest that participation in a school-based food aid program may reduce food insecurity for children and their families in a developed country in times of economic hardship. PMID:26873860
Weiser, Sheri D.; Tsai, Alexander C.; Gupta, Reshma; Frongillo, Edward A.; Kawuma, Annet; Senkungu, Jude; Hunt, Peter W.; Emenyonu, Nneka I.; Mattson, Jennifer E.; Martin, Jeffrey N.; Bangsberg, David R.
Objective We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program. Design Longitudinal cohort study. Methods Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations. Results Beginning in May 2007, 458 persons were followed for a median of 2.07 years, and 40% were severely food insecure at baseline. Severe food insecurity was associated with worse PHS, opportunistic infections, and increased hospitalizations (results were similar in concurrent and lagged models). Mild/moderate food insecurity was associated with missed clinic visits in concurrent models, whereas in lagged models, severe food insecurity was associated with reduced odds of missed clinic visits. Conclusion Based on the negative impact of food insecurity on morbidity and patterns of healthcare utilization among HIV-infected individuals, policies and programs that address food insecurity should be a critical component of HIV treatment programs worldwide. PMID:21904186
DeVoe, Jeanne Jackson
Since 1960, the incidence of food allergies in children has grown fivefold, from 1 in 100 children to 1 in 20 children, according to the Food Allergy Initiative. Food allergies cause anaphylactic shock, the most severe type of allergic reaction, which can lead to death within minutes if left untreated. While there are no standard guidelines from…
Li, Na; Dachner, Naomi; Tarasuk, Valerie
As concerns about food insecurity in high income countries grow, there is a need to better understand the impact of social policy decisions on this problem. In Canada, provincial government actions are particularly important because food insecurity places substantial burden on provincial health care budgets. This study was undertaken to describe the socio-demographic and temporal patterning of food insecurity in British Columbia (BC) from 2005 to 2012 and determine the impact of BC's one-time increase in social assistance and introduction of the Rental Assistance Program (RAP) on food insecurity rates among target groups. Using data from the Canadian Community Health Surveys, logistic regression analyses were conducted to identify trends and assess changes in food insecurity among subgroups differentiated by main source of income and housing tenure. Models were run against overall food insecurity, moderate and severe food insecurity, and severe food insecurity to explore whether the impact of policy changes differed by severity of food insecurity. Overall food insecurity rose significantly among households in BC between 2005 and 2012. Following the increase in social assistance benefits, overall food insecurity and moderate and severe food insecurity declined among households on social assistance, but severe food insecurity remained unchanged. We could discern no effect of the RAP on any measure of food insecurity among renter households. Our findings indicate the sensitivity of food insecurity among social assistance recipients to improvements in income and highlight the importance of examining severity of food insecurity when assessing the effects of policy interventions.
Camara, Maria Clara Coelho; Marinho, Carmem L C; Guilam, Maria Cristina Rodrigues; Nodari, Rubens Onofre
Based on a bibliographic review, the article identifies and offers a critical analysis of scientific production by the public health field in Brazil on genetically modified organisms and food (in)security. Of the 716 articles found on the portals of the Scientific Electronic Library Online (SciELO) and the Coordinating Agency for the Development of Higher Education (Capes), only 8 address the food security of transgenic products, primarily in terms of risk exposure and the uncertainties about how these products impact health and the environment. The main conclusion involves the fact that the eight analyzed articles do not speak to the question of the security but rather the insecurity of genetically modified foods.
For 1 in 12 North Dakotans the charitable feeding network is the difference between having food on the table and going hungry. The goal of this research was to determine needs, barriers to, and facilitators of optimal access to North Dakota’s charitable feeding programs. Focus groups and interviews ...
Ratcliffe, Caroline; McKernan, Signe-Mary; Zhang, Sisi
Nearly 15% of all U.S. households and 40% of near-poor households were food insecure in 2009. The Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of federal food assistance programs and serves as the first line of defense against food-related hardship. This paper measures the effectiveness of SNAP in reducing food insecurity using an instrumental variables approach to control for selection. Our results suggest that receipt of SNAP benefits reduces the likelihood of being food insecure by roughly 30% and reduces the likelihood of being very food insecure by 20%. PMID:25197100
Hanson, Karla L; Olson, Christine M
Longitudinal studies of food insecurity have not considered the unique circumstances of rural families. This study identified factors predictive of discontinuous and persistent food insecurity over three years among low-income families with children in rural counties in 13 U.S. states. Respondents reported substantial knowledge of community resources, food and finance skills, and use of formal public food assistance, yet 24% had persistent food insecurity, and another 41% were food insecure for one or two years. Multivariate multinomial regression models tested relationships between human capital, social support, financial resources, expenses, and food insecurity. Enduring chronic health conditions increased the risk of both discontinuous and persistent food insecurity. Lasting risk for depression predicted only persistent food insecurity. Education beyond high school was the only factor found protective against persistent food insecurity. Access to quality physical and mental health care services are essential to ameliorate persistent food insecurity among rural, low-income families.
Bartfeld, Judi; Dunifon, Rachel
Food security--access to enough food for a healthy, active life--is vital to the well-being of children. Yet, almost 17% of households with children experience food insecurity, considerably higher than the rate among childless households. Food insecurity has been linked to a variety of negative outcomes in children, related to health, behavior,…
Huet, Catherine; Rosol, Renata; Egeland, Grace M
Indigenous peoples experience a disproportionate burden of food insecurity and the Arctic is no exception. We therefore evaluated the prevalence, socio-demographic, and dietary correlates of food insecurity in the most comprehensive assessment of food insecurity in Arctic Canada. A cross-sectional survey of 1901 Inuit households was conducted in 2007-2008. Measurements included food insecurity, 24-h dietary recalls, socio-demographics, and anthropometry. Food insecurity was identified in 62.6% of households (95% CI = 60.3-64.9%) with 27.2% (95% CI = 25.1-29.3%) of households severely food insecure. The percent with an elevated BMI, waist circumference, and percent body fat was lower among individuals from food insecure households compared to food secure households (P ≤ 0.001). Adults from food insecure households had a significantly lower Healthy Eating Index score and consumed fewer vegetables and fruit, grains, and dairy products, and consumed a greater percent of energy from high-sugar foods than adults from food secure households (P ≤ 0.05). Food insecurity was associated with household crowding, income support, public housing, single adult households, and having a home in need of major repairs (P ≤ 0.05). The prevalence of having an active hunter in the home was lower in food insecure compared to food secure households (P ≤ 0.05). Food insecurity prevalence is high in Inuit communities, with implications for diet quality that over the long-term would be anticipated to exacerbate the risk of diet-related chronic diseases. Actions are required to improve food security that incorporate the traditional food system and healthy market food choices.
Rocha, Naruna Pereira; Milagres, Luana Cupertino; de Novaes, Juliana Farias; Franceschini, Sylvia do Carmo Castro
Abstract Objective: To address the association between food and nutrition insecurity and cardiometabolic risk factors in childhood and adolescence. Data source: Articles were selected from the Medline, Lilacs and SciELO databases with no publication date limit, involving children and adolescents, using the descriptors: food and nutrition security, diabetes mellitus, hypertension, metabolic syndrome, stress and dyslipidemia. The terms were used in Portuguese, English and Spanish. The search was carried out systematically and independently by two reviewers. Data synthesis: Exposure to food insecurity during childhood and adolescence ranged from 3.3% to 82% in the selected publications. Exposure to food insecurity was associated with stress, anxiety, greater chance of hospitalization, nutritional deficiencies, excess weight and inadequate diets with reduced intake of fruits and vegetables and increased consumption of refined carbohydrates and fats. Conclusions: Food and nutrition insecurity was associated with the presence of cardiometabolic risk factors in the assessed publications. Childhood and adolescence constitute a period of life that is vulnerable to food insecurity consequences, making it extremely important to ensure the regular and permanent access to food. Because this is a complex association, some difficulties are found, such as the synergy between risk factors, the assessment of heterogeneous groups and extrapolation of data to other populations, in addition to the influence of environmental factors. PMID:26564327
von Braun, Joachim
Ending food insecurity, hunger and malnutrition is a pressing global ethical priority. Despite differences in food production systems, cultural values and economic conditions, hunger is not acceptable under any ethical principles. Yet, progress in combating hunger and malnutrition in developing countries has been discouraging, even as overall global prosperity has increased in past decades. A growing number of people are deprived of the fundamental right to food, which is essential for all other rights as well as for human existence itself. The food and nutrition crisis has deepened in recent years, as increased food price volatility and global recession affected the poor. In a strategic agenda, it will be necessary to promote pro-poor agricultural growth, reduce extreme market volatility and expand social protection and child nutrition action.
Morton, Lois Wright; Bitto, Ella Annette; Oakland, Mary Jane; Sand, Mary
Rural regions include places where food sources are not evenly distributed, leading to areas of concentration and food desert--places where few or no grocery stores exist. Individuals are hypothesized to depend on personal connections and the civic structure of where they live to help them solve the problem of food insecurity. We find that…
McGinnis, Kathleen A.; Goulet, Joseph; Bryant, Kendall; Gibert, Cynthia; Leaf, David A.; Mattocks, Kristin; Fiellin, Lynn E.; Vogenthaler, Nicholas; Justice, Amy C.; Fiellin, David A.
Objective Food insecurity may be a modifiable and independent risk factor for worse control of medical conditions, but it has not been explored among veterans. We determined the prevalence of, and factors independently associated with, food insecurity among veterans in the Veterans Aging Cohort Study (VACS). Methods Using data from VACS from 2002–2008, we determined the prevalence of food insecurity among veterans who have accessed health care in the Veterans Health Administration (VA) as defined by “concern about having enough food for you or your family in the past month.” We used multivariable logistic regression to determine factors independently associated with food insecurity and tests of trend to measure the association between food insecurity and control of hypertension, diabetes, HIV, and depression. Results Of the 6,709 veterans enrolled in VACS, 1,624 (24%) reported being food insecure. Food insecurity was independently associated with being African American, earning <$25,000/year, recent homelessness, marijuana use, and depression. Being food insecure was also associated with worse control of hypertension, diabetes, HIV, and depression (p<0.001). Conclusion Food insecurity is prevalent and associated with worse control of medical conditions among veterans who have accessed care in the VA. PMID:25931630
Denney, Justin T; Kimbro, Rachel Tolbert; Heck, Katherine; Cubbin, Catherine
Objectives Food insecurity in the United States is a stubborn public health issue, affecting more than one in five households with children and disproportionately impacting racial and ethnic minority women and their children. Past research and policy has focused on household predictors of food insecurity, but neglected broader factors, such as perceived neighborhood social cohesion, that might protect those most vulnerable to food insecurity. Methods We use a racially and ethnically diverse data set from the Geographic Research on Wellbeing study (N = 2847) of women and their young children in California to investigate whether social cohesion influences food insecurity and whether it moderates the relationship between race/ethnicity and food insecurity. Results We find that lower levels of perceived residential neighborhood social cohesion associate with higher odds of food insecurity even after considering important household socioeconomic factors. In addition, our results suggest that social cohesion is most relevant for reducing the risk of food insecurity among racial and ethnic minority mothers. For example, the probability of food insecurity for immigrant Latina mothers is nearly 0.40 in neighborhoods where mothers perceive little to no cohesion and less than 0.10 in neighborhoods where mothers perceive high cohesion. Conclusions for Practice Higher levels of neighborhood perceived social cohesion are protective against food insecurity in households with children and especially so for racial and ethnic minority households who are at a heightened risk of food insecurity. Supporting programs that focus on building closer knit communities may be a key to reducing food insecurity overall and for reducing disparities in food insecurity by race and ethnicity.
Ntwenya, Julius Edward; Kinabo, Joyce; Msuya, John; Mamiro, Peter; Majili, Zahara Saidi
Introduction Few studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community. Methodology Three hundred and seven (307) randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February–May) and post harvest season (September–October) in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score. Results Four food consumption patterns namely (I) Meat and milk; (II) Pulses, legumes, nuts and cooking oils; (III) fish (and other sea foods), roots and tubers; (IV) Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I) Fruits, cooking oils, fats, roots and tubers (II) Eggs, meat, milk and milk products (III) Fish, other sea foods, vegetables, roots and tubers and (IV) Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest–seasons, respectively (P = 0.01). Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity. Conclusion Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at
"Food insecurity," which is the lack of access to enough food to fully meet basic needs at all times because of economic constraints, afflicts 40.6% of low-income households with children. Research shows that living in a food-insecure household can lead to negative health and developmental consequences for young children, including obesity.…
Maroto, Maya E.; Snelling, Anastasia; Linck, Henry
This study investigated the prevalence of food insecurity among community college students (N = 301) and the relationship between food insecurity and student grade point average (GPA). It employed a cross-sectional intercept survey, utilizing the U.S. Department of Agriculture's Household Food Security Survey Module, student self-reported GPA, and…
Maes, Kenneth C; Shifferaw, Selamawit; Hadley, Craig; Tesfaye, Fikru
Low-income volunteers constitute a major part of AIDS care workforces in sub-Saharan Africa, yet little research has been conducted to determine how poverty and insecurity among volunteers impact their wellbeing and the sustainability of the AIDS treatment programmes they support. This paper presents longitudinal ethnographic and epidemiological research documenting how the 2008 food crisis in Addis Ababa affected AIDS care volunteers' care relationships and motivations. Ethnographic results highlight the distress and demotivation that rising food costs created for caregivers by contributing to their own and their care recipients' experiences of food insecurity and HIV-related stigmatization. Epidemiological results underscore a high prevalence of food insecurity (approximately 80%) even prior to the peak of food prices. Rising food prices over the 3 years prior to 2008, underemployment and household per capita incomes averaging less than US$1/day, likely contributed to the very high prevalence of food insecurity reported by caregivers in our sample. We also show that new volunteers recruited in early 2008 by one of the non-governmental organizations (NGOs) involved in this study were more likely to be dependants within their households, and that these participants reported lower rates of food insecurity and higher household income. While this shift in volunteer recruitment may help sustain volunteer care programmes in the face of widespread poverty and underemployment, food insecurity was still highly prevalent (58-71%) among this sub-group. Given the inability of the local NGOs that organize volunteers to address the challenge of food insecurity for programme sustainability, our results raise important policy questions regarding compensation for volunteers' valuable labour and poverty reduction through public health sector job creation.
Increasingly, food is provided through an industrial food system that separates people from the source of their food and results in high rates of food insecurity, particularly for the most vulnerable in society. A lack of food is a symptom of a lack of power in a system that privileges free market principles over social justice and the protection of human rights. In Canada, the high rates of food insecurity among Canadian children is a reflection of their lack of power and the disregard of their human rights, despite the adoption of the United Nations (UN) Convention on the Rights of the Child in 1991 and ratification of the International Covenant on Social, Economic and Cultural Rights in 1976, which established the right to food for all Canadians. Dueling tensions between human rights and market forces underpin this unacceptable state of affairs in Canada. Gaventa's "power cube" that describes different facets of power - including spaces, levels, and forms - is used to help understand the power imbalances that underlie this injustice. The analysis considers the impact of neoliberal free market principles on the realization of human rights, and the negative impacts this can have on health and well-being for the most vulnerable in society. Canadian case studies from both community organizations provide examples of how power can be shifted to achieve more inclusive, rights-based policy and action. Given increased global pressures toward more open trade markets and national austerity measures that hollow out social supports, Canada provides a cautionary tale for countries in the EU and the US, and for overall approaches to protect the most vulnerable in society.
Rock, Melanie J; McIntyre, Lynn; Persaud, Steven A; Thomas, Karen L
Media advocacy is a well-established strategy for transmitting health messages to the public. This paper discusses a media advocacy intervention that raised issues about how the public interprets messages about the negative effects of poverty on population health. In conjunction with the publication of a manuscript illustrating how income-related food insecurity leads to disparities related to the consumption of a popular food product across Canada (namely, Kraft Dinner®), we launched a media intervention intended to appeal to radio, television, print and Internet journalists. All the media coverage conveyed our intended message that food insecurity is a serious population health problem, confirming that message framing, personal narratives and visual imagery are important in persuading media outlets to carry stories about poverty as a determinant of population health. Among politicians and members of the public (through on-line discussions), the coverage provoked on-message as well as off-message reactions. Population health researchers and health promotion practitioners should anticipate mixed reactions to media advocacy interventions, particularly in light of new Internet technologies. Opposition to media stories regarding the socio-economic determinants of population health can provide new insights into how we might overcome challenges in translating evidence into preventive interventions.
Rock, Melanie J.; McIntyre, Lynn; Persaud, Steven A.; Thomas, Karen L.
Media advocacy is a well-established strategy for transmitting health messages to the public. This paper discusses a media advocacy intervention that raised issues about how the public interprets messages about the negative effects of poverty on population health. In conjunction with the publication of a manuscript illustrating how income-related food insecurity leads to disparities related to the consumption of a popular food product across Canada (namely, Kraft Dinner®), we launched a media intervention intended to appeal to radio, television, print and Internet journalists. All the media coverage conveyed our intended message that food insecurity is a serious population health problem, confirming that message framing, personal narratives and visual imagery are important in persuading media outlets to carry stories about poverty as a determinant of population health. Among politicians and members of the public (through on-line discussions), the coverage provoked on-message as well as off-message reactions. Population health researchers and health promotion practitioners should anticipate mixed reactions to media advocacy interventions, particularly in light of new Internet technologies. Opposition to media stories regarding the socio-economic determinants of population health can provide new insights into how we might overcome challenges in translating evidence into preventive interventions. PMID:21685402
Greenwald, Howard P; Zajfen, Vanessa
Risk and prevalence of food insecurity and use of food security resources are important but incompletely understood factors in immigrant health. Key informant interviews and a survey (N = 809) of housing units were conducted in a San Diego, California neighborhood with a high proportion of immigrant and low income families. The difference in food insecurity between immigrant and non-immigrant households was non-significant (20.1 vs. 15.7 %, p = n.s.), though immigrant families were more likely to use food security resources such as SNAP (32.7 vs. 22.9 %, p < .01) and food pantries (28.2 vs. 19.7 %, p < .001). Among immigrants, neither national origin nor years in the United States predicted food insecurity or use of most food security resources. In immigrant families, food insecurity often remains a challenge long after immigration, suggesting a potentially increasing need for food security resources as immigration into the United States continues.
Fenton, Carol; Hatfield, Jennifer; McIntyre, Lynn
Background Food insecurity is an ongoing threat in rural sub-Saharan Africa and is complicated by cultural practices, the rise of chronic conditions such as HIV and land use availability. In order to develop a successful food security intervention program, it is important to be informed of the realities and needs of the target population. The purpose of this study was to pilot a qualitative method to understand food insecurity based on the lived experience of women of the Maasai population in the Ngorongoro Conservation Area of Tanzania. Methods Short semi-structured qualitative interviews with 4 Maasai women. Results Food insecurity was present in the Maasai community: the participants revealed that they did not always have access to safe and nutritious food that met the needs of themselves and their families. Themes that emerged from the data fell into three categories: Current practices (food sources, planning for enough, food preparation, and food preservation), food Insecurity (lack of food, emotions, coping strategies, and possible solutions), and division (co-wives, food distribution, and community relationships). Conclusion This pilot study suggested the presence of food insecurity in the Maasai community. Larger sample studies are needed to clarify the extent and severity of food insecurity among this population. Having a detailed understanding of the various aspects of the food insecurity lived experience could inform a targeted intervention program. PMID:23077702
Kapulsky, Leonid; Tang, Alice M; Forrester, Janet E
Previous research has identified an association between food insecurity and depression in a variety of world regions in both healthy and HIV-infected individuals. We examined this association in 183 HIV-infected Hispanic adults from the greater Boston area. We measured depression with the Burnam depression screen and food insecurity with the Radimer/Cornell Questionnaire. Dietary intake was assessed with an adapted version of the Block Food Frequency Questionnaire. Logistic regression models were created with depression as the outcome variable and food insecurity as the main predictor. In bivariate analyses, food insecurity was significantly associated with depression [odds ratio (OR) 2.5; 95% confidence interval (CI) 1.1, 5.5; p = 0.03]. When we accounted for social support, food insecurity was no longer significant. We found no differences in the quality or quantity of dietary intake between the food insecure and food secure groups. Our findings highlight the importance of social support in the association between food insecurity and depression. Food insecurity may reflect social support more than actual dietary intake in this population.
Kapulsky, Leonid; Tang, Alice M
Background Previous research has identified an association between food insecurity and depression in a variety of world regions in both healthy and HIV-infected individuals. We examined this association in 183 HIV-infected Hispanic adults from the Greater Boston area. Methods We measured depression with the Burnam Depression Screen and food insecurity with the Radimer/Cornell Questionnaire. Dietary intake was assessed with an adapted version of the Block Food Frequency Questionnaire. Logistic regression models were created with depression as the outcome variable and food insecurity as the main predictor. Results In bivariate analyses, food insecurity was significantly associated with depression (odds ratio [OR] = 2.5; 95% confidence interval [CI]: 1.1, 5.5; P = 0.03). When we accounted for social support, food insecurity was no longer significant. We found no differences in the quality or quantity of dietary intake between the food insecure and food secure groups. Discussion Our findings highlight the importance of social support in the association between food insecurity and depression. Food insecurity may reflect social support more than actual dietary intake in this population. PMID:25047405
Smith, Kristin; Savage, Sarah
The Food Stamp and the National School Lunch Programs play a vital role in helping poor, rural Americans obtain a more nutritious diet and alleviate food insecurity and hunger. This fact sheet looks at the extent to which rural America depends on these programs and describes characteristics of beneficiaries of these federal nutrition assistance…
Nam, Yunju; Jung, Hyo Jin
Purpose: The welfare reform bill of 1996 severely constrained noncitizens' eligibility for the Food Stamp Program (FSP). This study examined the effects of eligibility restrictions on older immigrants' FSP participation and food insecurity. We paid special attention to household composition and household eligibility as well as older immigrants'…
Ghattas, Hala; Sassine, AnnieBelle J; Seyfert, Karin; Nord, Mark; Sahyoun, Nadine R
Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1% (95% CI 17·3, 23·2) were found to be food secure, 35·5% (95% CI 32·0, 39·2) moderately food insecure and 44·4% (95% CI 40·8, 48·1) severely food insecure. Severe food insecurity was associated with the respondent's good self-reported health (OR 0·3, 95% CI 0·2, 0·5), length of stay as a refugee (OR 1·1, 95% CI 1·0, 1·2), very poor housing quality (OR 3·3, 95% CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95% CI 1·0, 1·4), and resulted in poor dietary diversity (P< 0·0001). Anaemia was found in 41% (95% CI 30·6, 51·9) of children below 5 years of age, but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.
Munro, Nicholas; Quayle, Michael; Simpson, Heather; Barnsley, Shelley
The experience of food insecurity in the South African university student population is not well documented or researched. Data to assess vulnerability to food insecurity in a sample of 1.083 students from the University of KwaZulu-Natal (Pietermaritzburg Campus) was collected between 2007 and 2010 via a questionnaire developed specifically for…
Sullivan, Ashley F.; Choi, Eunyoung
Noting that the persistence of hunger and food insecurity in the United States is an issue of pressing social and public health concern, this study examined the magnitude and severity of hunger and food insecurity in U.S. households in each of the 50 states and the District of Columbia. Data were obtained from the August 1998, April 1999, and…
Dhokarh, Rajanigandha; Himmelgreen, David A.; Peng, Yu-Kuei; Segura-Perez, Sofia; Hromi-Fiedler, Amber; Perez-Escamilla, Rafael
Objective: To examine whether acculturation and social networks influence household food insecurity in an inner-city Puerto Rican community. Methods: A survey was administered to 200 low-income female Puerto Rican caregivers with at least 1 child 12-72 months old living in Hartford, CT. Food insecurity was measured with the Radimer/Cornell Hunger…
Olson, Christine M.; Strawderman, Myla S.
Context: While food insecurity and obesity have been shown to be positively associated in women, little is known about the direction of the causal relationship between these 2 constructs. Purpose: To clarify the direction of the causal relationship between food insecurity and obesity. Methods: Chi-square and logistic regression analysis of data…
Kalil, Ariel; Chen, Jen-Hao
Recent data have shown that children of immigrant noncitizens experience more persistent and higher levels of food insecurity than the children of citizens following welfare reform. However, little is known about the range of factors that might explain different rates of food insecurity in the different populations. In this study, the authors used…
An understanding of the experience of food insecurity by children is essential for better measurement and assessment of its effect on children's nutritional, physical, and mental health. Our qualitative study explored children's perceptions of household food insecurity to identify these perceptions ...
Pan, Liping; Sherry, Bettylou; Njai, Rashid; Blanck, Heidi M.
A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question,“Howoften in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?” T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non- Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of <$25,000 or $50,000 to $74,999, and adults with none or two children in their households. One in three food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults. PMID:22939441
Pan, Liping; Sherry, Bettylou; Njai, Rashid; Blanck, Heidi M
A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question, "How often in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?" T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non-Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of <$25,000 or $50,000 to $74,999, and adults with none or two children in their households. One in three food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults.
Widome, Rachel; Himes, John H.; Smyth, Mary; Rock, Bonnie Holy; Hannan, Peter J.; Story, Mary
Objectives. We sought to better understand the prevalence and consequences of food insecurity among American Indian families with young children. Methods. Parents or caregivers of kindergarten-age children enrolled in the Bright Start study (dyad n = 432) living on the Pine Ridge Reservation in South Dakota completed a questionnaire on their child’s dietary intake, the home food environment, and food security. We assessed food security with a standard 6-item scale and examined associations of food insecurity with family sociodemographic characteristics, parents’ and children’s weight, children’s dietary patterns, and the home food environment. Results. Almost 40% of families reported experiencing food insecurity. Children from food-insecure households were more likely to eat some less healthful types of foods, including items purchased at convenience stores (P = .002), and food-insecure parents reported experiencing many barriers to accessing healthful food. Food security status was not associated with differences in home food availability or children’s or parents’ weight status. Conclusions. Food insecurity is prevalent among families living on the Pine Ridge Reservation. Increasing reservation access to food that is high quality, reasonably priced, and healthful should be a public health goal. PMID:22594740
Shariff, Zalilah Mohd; Khor, Geok Lin
This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that
Collings, Peter; Marten, Meredith G; Pearce, Tristan; Young, Alyson G
We examine the cultural context of food insecurity among Inuit in Ulukhaktok, Northwest Territories, Canada. An analysis of the social network of country food exchanges among 122 households in the settlement reveals that a household's betweenness centrality-a measure of brokerage-in the country food network is predicted by the age of the household. The households of married couples were better positioned within the sharing network than were the households of single females or single males. Households with an active hunter or elder were also better positioned in the network. The households of single men and women appear to experience limited access to country food, a considerable problem given the increasing number of single-adult households over time. We conclude that the differences between how single women and single men experience constrained access to country foods may partially account for previous findings that single women in arctic settlements appear to be at particular risk for food insecurity.
Jyoti, Diana F; Frongillo, Edward A; Jones, Sonya J
Food insecurity has been associated with diverse developmental consequences for U.S. children primarily from cross-sectional studies. We used longitudinal data to investigate how food insecurity over time related to changes in reading and mathematics test performance, weight and BMI, and social skills in children. Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort, a prospective sample of approximately 21,000 nationally representative children entering kindergarten in 1998 and followed through 3rd grade. Food insecurity was measured by parent interview using a modification of the USDA module in which households were classified as food insecure if they reported > or =1 affirmative response in the past year. Households were grouped into 4 categories based on the temporal occurrence of food insecurity in kindergarten and 3rd grade. Children's academic performance, height, and weight were assessed directly. Children's social skills were reported by teachers. Analyses examined the effects of modified food insecurity on changes in child outcomes using lagged, dynamic, and difference (i.e., fixed-effects) models and controlling for child and household contextual variables. In lagged models, food insecurity was predictive of poor developmental trajectories in children before controlling for other variables. Food insecurity thus serves as an important marker for identifying children who fare worse in terms of subsequent development. In all models with controls, food insecurity was associated with outcomes, and associations differed by gender. This study provides the strongest empirical evidence to date that food insecurity is linked to specific developmental consequences for children, and that these consequences may be both nutritional and nonnutritional.
Salarkia, Nahid; Neyestani, Tirang R.; Omidvar, Nasrin; Zayeri, Farid
Background: Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6–24 months children. Methods: In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Results: Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. Conclusions: We found no association between household food insecurity and the occurrence of anemia in the 6–24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children. PMID:26445633
Neter, Judith E; Dijkstra, S Coosje; Visser, Marjolein; Brouwer, Ingeborg A
Objective To determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security. Setting 11 of 135 Dutch food banks were selected throughout the Netherlands. Participants 251 Dutch food bank recipients participated in the study (93 men and 158 women). Inclusion criteria for participation were: (1) at least 18 years of age, (2) sufficiently fluent in Dutch to participate in oral and written interviews, (3) recipient of a Dutch food bank for at least 1 month and (4) collect own food parcel at the food bank. A single member per household was included. Primary outcome Level of food security. Results The prevalence of food insecurity was 72.9% (N=183), of which 40.4% (N=74) reported very low food security. Of the very low food secure participants, 56.8% (N=42) reported they were ever hungry but did not eat because they could not afford enough food in the previous 3 months. Adjusted multinomial logistic regression analyses showed that households without children were less likely to experience low food security (OR 0.39 (95% CI 0.18 to 0.88)) and men (OR 0.24 (95% CI 0.11 to 0.51)) were less likely to experience very low food security, while low-educated recipients (OR 5.05 (95% CI 1.37 to 18.61)) were more likely to experience very low food security. Furthermore, recipients with high satisfaction with overall food intake (OR 0.46 (95% CI 0.27 to 0.78)), high perceived healthiness of overall food intake (OR 0.34 (95% CI 0.19 to 0.62)) or high self-efficacy of eating healthy (OR 0.62 (95% CI 0.40 to 0.96)) were less likely to experience very low food security. Conclusions Our study showed high prevalence rates of food insecurity among Dutch food bank recipients, and identified subgroups at increased risk of food insecurity. More research is urgently needed on the underlying determinants of food insecurity and the effectiveness of
Hernandez, Daphne C
The study uses the Fragile Families and Child Well-being Study (N=2025) to examine the relationship between four cumulative family risk indices and refined measures of food hardship: marginal food security, low food security, and very low food security. Regression analyses indicate that cumulative family risk indices are useful in differentiating various levels of food insecurity. Specifically, the maternal poor health and risky health behaviors index is pertinent for distinguishing (1) food insecure from marginal food secure households and (2) very low food secure from low food secure households. In addition, the financial strain index is pertinent for differentiating between marginal food secure families from food secure families among non-poor households. Connecting food assistance programs with established social services may decrease the negative impact that cumulative family-level risk factors have on families' varying levels of food insecurity.
Motbainor, Achenef; Worku, Alemayehu; Kumie, Abera
Background Food insecurity has detrimental effects in protecting child undernutrition.This study sought to determine the level of child undernutrition and its association with food insecurity. Methods A community based comparative cross-sectional study design involving multistage sampling technique was implemented from 24th of May to 20th of July 2013. Using two population proportion formula, a total of 4110 randomly selected households were included in the study. Availability of the productive safety net programme was used for grouping the study areas. A multiple linear regression model was used to assess the association between food insecurity and child malnutrition. Clustering effects of localities were controlled during analysis. Results Stunting (37.5%), underweight (22.0%) and wasting (17.1%) were observed in East Gojjam zone, while 38.3% stunting, 22.5% underweight, and 18.6% wasting for the West Gojjam zone. Food insecurity was significantly associated with wasting (β = - 0.108, P < 0.05).Food diversity and number of meals the child ate per day significantly associated with stunting (β = 0.039, P < 0.01) and underweight (β = 0.035, P < 0.05) respectively. Residential area was the significant predictor of all indices. Conclusion The magnitude of child undernutrition was found to be very high in the study areas. Food insecurity was the significant determinant of wasting. Food diversity and number of meals the child ate per day were the significant determinants of stunting and underweight respectively. Child nutrition intervention strategies should take into account food security, dietary diversity, and carefully specified with regard to residential locations. Addressing food insecurity is of paramount importance. PMID:26285047
Ali Naser, Ihab; Wan Muda, Wan Manan; Wan Nik, Wan Suriati; Mohd Shariff, Zalilah; Abdullah, Mohamed Rusli
BACKGROUND/OBJECTIVES The purpose of the study was to investigate the relationship between household food insecurity and nutritional status of children in low-income households. A cross sectional study involved a survey of households (n = 223) receiving the financial assistance. SUBJECTS/METHODS Eligible mothers that fulfilled the inclusion criteria such as non-pregnant, non-lactating mothers, aged 18 to 55 years with their youngest children aged 2 to 12 years, were purposively selected. The Radimer/Cornell hunger and food-insecurity instrument was administered and children's height and weight were measured. RESULTS About 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity. Out of food insecure category, 29.6% households were food insecure, 19.3% women were individual food insecure and 35.0% fell into the child hunger category. Education of the mother (P = 0.047), household size (P = 0.024), number of children (P = 0.024), number of children going to school (P = 0.048), total monthly income (P < 0.001), income per capital (P < 0.001), number of household members contributing to the income (P = 0.018) and food expenditure (P = 0.006) were significant risk factors for household food insecurity. The prevalence of underweight, stunting and wasting in children were 61.0%, 61.4% and 30.6% respectively. Based on multinomial logistic regression, children in food-insecure households were 2.15 times more likely to be underweight and three times to be stunted than children in the food-secure households. CONCLUSIONS The findings suggest that household food insecurity is associated with the nutritional status of the children in the rural area of Northeastern Peninsular Malaysia. PMID:24944776
Miller, Daniel P; Chang, Jina; Ha, Yoonsook; Sprague Martinez, Linda
Although research consistently points to higher rates of food insecurity (FI) among children of immigrants (COI), this is the first study to examine longitudinal trajectories of FI for this group. We used growth curve modeling and data from the 1998 Early Childhood Longitudinal Study-Kindergarten Cohort to compare trajectories of FI for COI and children of U.S.-born parents. After controlling for socioeconomic status and participation in nutrition programs, first- and second-generation COI had significantly higher initial and ongoing rates of FI compared to children of U.S.-born parents. Additional analyses found that all differences between COI and children of U.S.-born parents occurred for families in poverty. We find that COI from poor families have higher rates of FI, with some differences among COI by immigrant generation. Policymakers may need to focus on avenues other than public assistance to reduce FI among COI living in poverty.
Funk, C. C.; Mishra, V.; Davenport, F.
As food prices rise, per capita harvested area diminishes and competition for limited resources mounts, the number of undernourished people has risen to more than a billion people. In this study, we target 80 potentially food insecure countries, examining hydrologic and undernourishment trends. For each country, primary cultivation areas are identified, and hydrologic variables extracted from simulations based on the Variable Infiltration Capacity model driven with the Princeton University climate data. Trends in runoff, soil moisture, precipitation, evapotranspiration, and temperature are evaluated. In addition to precipitation driven-aridity, the analysis also evaluates possible temperature-related shifts in sensible versus latent heat fluxes during energy-limited portions of the growing seasons. Changes in the timing and magnitude of streamflow are also investigated. The undernourishment trends are explored using the FAO percent under-nourished formulation, which determines the fraction of the population falling below a critical caloric threshold by using national food balance sheets (quantity) and a caloric distribution based on economic equality. Trends in quantity and equity, and their effects on undernourishment are evaluated, and vulnerability to price volatility quantified. Finally, a sub-set of countries facing both hydrologic declines and undernourishment increases are identified as food security hotspots.
Alipour, Beytollah; Abbasalizad Farhangi, Mahdieh; Asghari, Somayye; Amirkhizi, Farshad; Dahri, Monireh; Abedimanesh, Nasim; Farsad-Naimi, Alireza; Hojegani, Shiva
Despite strong evidence of the prevalence of food insecurity in adults and households with children in different areas of Iran, the prevalence of child-specific food insecurity in Iran and especially in Tabriz has not been evaluated. Therefore, the objective of the current study is to evaluate the prevalence of food insecurity in schoolchildren and to identify its social, demographic, and nutritional determinants in Tabriz, Iran. This cross-sectional study was conducted between April and September 2014 among 330 schoolchildren aged 7-11 years comprising 170 boys and 160 girls from ten public schools in Tabriz, Iran. Demographic and socioeconomic factors had been obtained from participants. Food security status was assessed by an eight-item U.S. Department of Agriculture (USDA) Food Security Module previously validated for use in Iran. Dietary information was obtained by a food frequency questionnaire (FFQ). In our findings, the prevalence of food insecurity among children was 30% with 29.1% being low food secure and 0.9% being very low food secure. Mean weight for age Z-score (WAZ) in the food insecure group was significantly lower than in the food secure group. The prevalence of food insecurity was more prevalent in boys (p = .006). Food insecure children had a significantly lower intake of energy, carbohydrate, protein, and meat (p < .001) and higher prevalence of wasting compared with their counterparts in the food secure group (p = .004). These results suggest a proportionally high prevalence of food insecurity in schoolchildren in Tabriz and its significant association with poor nutritional status and dietary habits. Our findings also ensures the necessity of nutritional support programs and nutritional education in Iranian low-income families to improve their overall health.
Afulani, Patience; Coleman-Jensen, Alisha; Harrison, Gail G.
Objectives. We investigated whether nonelderly US adults (aged 18–64 years) in food-insecure households are more likely to report cost-related medication underuse than the food-secure, and whether the relationship between food insecurity and cost-related medication underuse differs by gender, chronic disease, and health insurance status. Methods. We analyzed data from the 2011 and 2012 National Health Interview Survey (n = 67 539). We examined the relationship between food insecurity and cost-related medication underuse with the χ2 test and multivariate logistic regression with interaction terms. Results. Bivariate and multivariate analyses showed a dose–response relationship between food insecurity and cost-related medication underuse, with an increasing likelihood of cost-related medication underuse with increasing severity of food insecurity (P < .001). This association was conditional on health insurance status, but not substantially different by gender or chronic disease status. Being female, low-income, having no or partial health insurance, chronic conditions, functional limitations, or severe mental illness were positively associated with cost-related medication underuse. Conclusions. Using food insecurity as a risk factor to assess cost-related medication underuse could help increase identification of individuals who may need assistance purchasing medications and improve health for those in food-insecure households. PMID:26270308
Magombeyi, M. S.; Taigbenu, A. E.; Barron, J.
The mappings of poverty and food insecurity were carried out for the rural districts of the four riparian countries (Botswana, Mozambique, South Africa and Zimbabwe) of the Limpopo river basin using the results of national surveys that were conducted between 2003 and 2013. The analysis shows lower range of food insecure persons (0-40%) than poverty stricken persons (0-95%) that is attributable to enhanced government and non-government food safety networks in the basin countries, the dynamic and transitory nature of food insecurity which depends on the timings of the surveys in relation to harvests, markets and food prices, and the limited dimension of food insecurity in relation to poverty which tends to be a more structural and pervasive socio-economic condition. The usefulness of this study in influencing policies and strategies targeted at alleviating poverty and improving rural livelihoods lies with using food insecurity mappings to address short-term socio-economic conditions and poverty mappings to address more structural and long-term deprivations. Using the poverty line of 1.25/day per person (2008-2013) in the basin, Zimbabwe had the highest percentage of 68.7% of its rural population classified as poor, followed by Mozambique with 68.2%, South Africa with 56.1% and Botswana with 20%. While average poverty reduction of 6.4% was observed between 2003 and 2009 in Botswana, its population growth of 20.1% indicated no real poverty reduction. Similar observations are made about Mozambique and Zimbabwe where population growth outstripped poverty reductions. In contrast, both average poverty levels and population increased by 4.3% and 11%, respectively, in South Africa from 2007 to 2010. While areas of high food insecurity and poverty consistently coincide with low water availability, it does not indicate a simple cause-effect relationship between water, poverty and food insecurity. With limited water resources, rural folks in the basin require stronger
Rodrigues, Livia Penna Firme; Carvalho, Raissa Costa; Maciel, Agatha; Otanasio, Polyanna Nunes; Garavello, Maria Elisa de Paula Eduardo; Nardoto, Gabriela Bielefeld
Aiming to investigate the effect of diet and food consumption with regard to health, environment, and economy in light of nutrition ecology, we studied the dimensions of nutrition and food security in urban and rural settings in the region of Chapada dos Veadeiros, Central Brazil. We tracked diet and food consumption through carbon and nitrogen stable isotope ratios in fingernails of these inhabitants together with food intake data as a proxy for their diet patterns. We estimated household food insecurity by using the Brazilian Food Insecurity Scale. Nutrition and food insecurity was observed in both urban and rural areas, but was accentuated in rural settings. The diet pattern had high δ(13)C values in fingernails and low δ(15)N. Both urban and rural areas have diets with low diversity and relying on low-quality processed food staples at the same time that nutrition and food insecurity is quite high in the region.
Cook, John T; Black, Maureen; Chilton, Mariana; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C; Rose-Jacobs, Ruth; Sandel, Megan; Casey, Patrick H; Coleman, Sharon; Weiss, Ingrid; Frank, Deborah A
This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with "marginal food security," as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children's fair/poor health and developmental risk and caregivers' depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers.
Young, Sera L; Cohen, Craig R; Kushel, Margot B; Tsai, Alexander C; Tien, Phyllis C; Hatcher, Abigail M; Frongillo, Edward A; Bangsberg, David R
Food insecurity, which affects >1 billion people worldwide, is inextricably linked to the HIV epidemic. We present a conceptual framework of the multiple pathways through which food insecurity and HIV/AIDS may be linked at the community, household, and individual levels. Whereas the mechanisms through which HIV/AIDS can cause food insecurity have been fairly well elucidated, the ways in which food insecurity can lead to HIV are less well understood. We argue that there are nutritional, mental health, and behavioral pathways through which food insecurity leads to HIV acquisition and disease progression. Specifically, food insecurity can lead to macronutrient and micronutrient deficiencies, which can affect both vertical and horizontal transmission of HIV, and can also contribute to immunologic decline and increased morbidity and mortality among those already infected. Food insecurity can have mental health consequences, such as depression and increased drug abuse, which, in turn, contribute to HIV transmission risk and incomplete HIV viral load suppression, increased probability of AIDS-defining illness, and AIDS-related mortality among HIV-infected individuals. As a result of the inability to procure food in socially or personally acceptable ways, food insecurity also contributes to risky sexual practices and enhanced HIV transmission, as well as to antiretroviral therapy nonadherence, treatment interruptions, and missed clinic visits, which are strong determinants of worse HIV health outcomes. More research on the relative importance of each of these pathways is warranted because effective interventions to reduce food insecurity and HIV depend on a rigorous understanding of these multifaceted relationships. PMID:22089434
Crews, Deidra C.; Kuczmarski, Marie Fanelli; Grubbs, Vanessa; Hedgeman, Elizabeth; Shahinian, Vahakn B.; Evans, Michele K.; Zonderman, Alan B.; Burrows, Nilka Rios; Williams, Desmond E.; Saran, Rajiv; Powe, Neil R.
Background The relation of food insecurity (inability to acquire nutritionally adequate and safe foods) and chronic kidney disease (CKD) is unknown. We examined whether food insecurity is associated with prevalent CKD among lower income individuals in both the general U.S. adult population and an urban population. Methods We conducted cross-sectional analyses of lower income participants of the National Health and Nutrition Examination Survey (NHANES) 2003–2008 (n=9,126); and the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n=1,239). Food insecurity was defined based on questionnaires and CKD was defined by reduced estimated glomerular filtration rate or albuminuria; adjustment was performed with multivariable logistic regression. Results In NHANES, the age-adjusted prevalence of CKD was 20.3%, 17.6% and 15.7% for the high, marginal and no food insecurity groups, respectively. Analyses adjusting for sociodemographics and smoking status revealed high food insecurity to be associated with greater odds of CKD only among participants with either diabetes [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.14–2.45 comparing high to no food insecurity group] or hypertension (OR 1.37, 95% CI 1.03–1.82). In HANDLS, the age-adjusted CKD prevalence was 5.9% and 4.6% for those with and without food insecurity, respectively (P=0.33). Food insecurity was associated with a trend towards greater odds of CKD (OR 1.46, 95% CI 0.98–2.18) with no evidence of effect modification across diabetes, hypertension or obesity subgroups. Conclusion Food insecurity may contribute to disparities in kidney disease, especially among persons with diabetes or hypertension, and is worthy of further study. PMID:24434743
Singer, Amanda W; Weiser, Sheri D; McCoy, Sandra I
A growing body of research has identified food insecurity as a barrier to antiretroviral therapy (ART) adherence. We systematically reviewed and summarized the quantitative literature on food insecurity or food assistance and ART adherence. We identified nineteen analyses from eighteen distinct studies examining food insecurity and ART adherence. Of the thirteen studies that presented an adjusted effect estimate for the relationship between food insecurity and ART adherence, nine found a statistically significant association between food insecurity and sub-optimal ART adherence. Four studies examined the association between food assistance and ART adherence, and three found that ART adherence was significantly better among food assistance recipients than non-recipients. Across diverse populations, food insecurity is an important barrier to ART adherence, and food assistance appears to be a promising intervention strategy to improve ART adherence among persons living with HIV. Additional research is needed to determine the effectiveness and cost-effectiveness of food assistance in improving ART adherence and other clinical outcomes among people living with HIV in the era of widespread and long-term treatment.
Willis, Don E; Fitzpatrick, Kevin M
Research regarding the association between food insecurity and weight status among youth has produced mixed results. However, few studies on this topic have utilized data that includes survey responses from children themselves regarding their experience with food insecurity. This study was undertaken to examine the association between food insecurity and weight status among youth, as well as the potential mediation by psychosocial factors. A survey of 5th-7th grade students was administered to gather information on food insecurity, social and psychological resources, and health. The primary analysis includes OLS (Ordinary Least Squares) regression conducted using SPSS software and Sobel's test for mediation. Results suggest a positive association between food insecurity and weight status even when controlling for key demographic variables. In addition, we find that this association is mediated by psychosocial factors-namely, perceived social status and depression. Insights from this work highlight the need to consider non-nutritional pathways through which food insecurity impacts health as well the need to continue surveying youth directly when examining their experiences with food insecurity.
Cook, John T; Frank, Deborah A; Berkowitz, Carol; Black, Maureen M; Casey, Patrick H; Cutts, Diana B; Meyers, Alan F; Zaldivar, Nieves; Skalicky, Anne; Levenson, Suzette; Heeren, Tim; Nord, Mark
The U.S. Household Food Security Scale, developed with federal support for use in national surveys, is an effective research tool. This study uses these new measures to examine associations between food insecurity and health outcomes in young children. The purpose of this study was to determine whether household food insecurity is associated with adverse health outcomes in a sentinel population ages < or = 36 mo. We conducted a multisite retrospective cohort study with cross-sectional surveys at urban medical centers in 5 states and Washington DC, August 1998-December 2001. Caregivers of 11,539 children ages < or = 36 mo were interviewed at hospital clinics and emergency departments (ED) in central cities. Outcome measures included child's health status, hospitalization history, whether child was admitted to hospital on day of ED visit (for subsample interviewed in EDs), and a composite growth-risk variable. In this sample, 21.4% of households were food insecure (6.8% with hunger). In a logistic regression, after adjusting for confounders, food-insecure children had odds of "fair or poor" health nearly twice as great [adjusted odds ratio (AOR) = 1.90, 95% CI = 1.66-2.18], and odds of being hospitalized since birth almost a third larger (AOR = 1.31, 95% CI = 1.16-1.48) than food-secure children. A dose-response relation appeared between fair/poor health status and severity of food insecurity. Effect modification occurred between Food Stamps and food insecurity; Food Stamps attenuated (but did not eliminate) associations between food insecurity and fair/poor health. Food insecurity is associated with health problems for young, low-income children. Ensuring food security may reduce health problems, including the need for hospitalizations.
Huang, Jin; Vaughn, Michael G
This study examined the association between household food insecurity (insufficient access to adequate and nutritious food) and trajectories of externalising and internalising behaviour problems in children from kindergarten to fifth grade using longitudinal data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative study in the USA. Household food insecurity was assessed using the eighteen-item standard food security scale, and children's behaviour problems were reported by teachers. Latent growth curve analysis was conducted on 7,348 children in the ECLS-K, separately for boys and girls. Following adjustment for an extensive array of confounding variables, results suggest that food insecurity generally was not associated with developmental change in children's behaviour problems. The impact of food insecurity on behaviour problems may be episodic or interact with certain developmental stages.
Dastgiri, Saeed; Sharafkhani, Rahim; Gharaaghaji, Rasool; Ghavamzadeh, Saeed
Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general population. The aim of this study was to assess food insecurity, its influencing factors and control measures in the northwest of Iran. A total population of 15,070 (2,911 households) were studied. A short questionnaire was used for the screening of food insecurity and energy intake in this study. After the screening programme, those families identified as having food insecurity were recruited for the second part of the study which was a community trial. We organized small training campaigns (through peer education) for target households. Six months later, the same techniques were applied again to assess the impact of educational intervention in reducing the rate of food insecurity. Total prevalence of food insecurity in the study population was 59.3 percent (95% confidence interval: 57.4-61.3). Logistic regression showed that apart from the mother's age and smoking status of the head of the family, there was a significant association between household food insecurity and other variables in the model (mainly economic factors). The prevalence of food insecurity reduced by 7.3 percent after the intervention (p>0.10). The high prevalence of food insecurity in this study indicates that there is an urgent need for a close collaboration between governmental, international and local leadership to identify and implement the key interventional programmes to overcome this ever increasing health problem. According to our findings, a special attention should be paid on the economic improvement in the region.
This study explored the association between food insecurity and dietary intake among Mexican-American women after controlling for sociocultural and economic factors including participation in federal food assistance programs. A cross-sectional design was used. Demographics, anthropometrics, accultur...
Chen, Yiyun; Kalichman, Seth C.
Food insecurity and drug use are closely connected in the context of poverty, and both have been suggested to interfere with HIV medication adherence among people living with HIV/AIDS (PLWH). Yet the potential interaction between the two factors on adherence has not been examined. For this study we collected longitudinal data on HIV medication adherence among PLWH in Atlanta, GA, to assess a possible synergistic effect between the two factors on HIV medication adherence. People informed about the study came to the research site and completed an audio computer-assisted self-interview and instructions for pill counting. Over the next five weeks participants received three unscheduled follow-up phone assessments conducted two weeks apart to collect pill counts of their HIV medication. The prevalence of food insecurity was 60% (488) and that of drug use was 33% (274) in the sample of 809 participants. Among 770 participants who completed follow-up phone assessments, both food insecurity and drug use were associated with HIV medication adherence after adjusting for socio-demographic characteristics. The negative association between drug use and adherence persisted after further adjusting for health-related characteristics. Moreover, drug use appeared to moderate the effect of food insufficiency on adherence, with drug users who were food insufficient being the least likely to achieve 85% adherence. Results from the current study demonstrate a synergism between food insecurity and drug use that may impede adherence among PLWH. The findings imply that the disruptive effects of food insecurity and drug use on adherence are likely to be intensified with the presence of each other, and encourage interventions to address the problem of HIV medication adherence from a multi-faceted perspective that takes into account detrimental combination of problem factors. PMID:25533641
Omidvar, Nasrin; Ghazi-Tabatabie, Mahmoud; Sadeghi, Rasoul; Mohammadi, Fatemeh; Abbasi-Shavazi, Mohammad Jalal
The study determined the prevalence of food insecurity and its sociodemographic determinants among Afghan immigrants in two major cities of Iran. This cross-sectional study was conducted on a sample of 310 adult females from immigrant Afghan households in Tehran (n=155) and Mashhad (n=155), who were recruited through multistage sampling. Data were collected through face-to-face interviews, using a questionnaire. Food security was measured by a locally-adapted Household Food Insecurity Access Scale. More than 60% suffered from moderate-to-severe food insecurity, 37% were mildly food-insecure while about 23% were food-secure. Food insecurity was significantly more prevalent in female-headed households, households whose head and spouse had lower level of education, belonged to the Sunni sect, and those with illegal residential status, unemployment/low job status, not owning their house, low socioeconomic status (SES), and living in Mashhad. Prevalence of food insecurity was relatively high among Afghan immigrants in Iran. This calls for the need to develop community food security strategies for ensuring their short- and long-term health.
Grisaru, Nimrod; Kaufman, Roni; Mirsky, Julia; Witztum, Eliezer
The objective of this study was to examine food insecurity among psychiatric patients and as a concern for mental health practitioners. Food security and psychological distress were measured among 113 patients hospitalized in a psychiatric emergency unit. Of 113 respondents 67 (59.3%) enjoyed food security and 46 (40.7%) lacked food security. Food insecure respondents showed a higher level of psychological distress than food secure respondents. A large proportion of in-patients may be suffering food insecurity which is negatively associated with their psychological well being. Mental health practitioners need to be aware of the potential association of food insecurity and mental distress among psychiatric patients.
JERNIGAN, VALARIE BLUE BIRD; GARROUTTE, EVA; KRANTZ, ELIZABETH M.; BUCHWALD, DEDRA
Food insecurity is linked to obesity among some, but not all, racial and ethnic populations. We examined the prevalence of food insecurity and the association between food insecurity and obesity among American Indians (AIs) and Alaska Natives (ANs) and a comparison group of whites. Using the 2009 California Health Interview Survey, we analyzed responses from 592 AIs/ANs and 7371 white adults with household incomes at or below 200% of the federal poverty level. Food insecurity was measured using a standard 6-item scale. Sociodemographics, exercise, and obesity were all obtained using self-reported survey data. Logistic regression was used to estimate associations. The prevalence of food insecurity was similar among AIs/ANs and whites (38.7% vs 39.3%). Food insecurity was not associated with obesity in either group in analyses adjusted for sociodemographics and exercise. The ability to afford high-quality foods is extremely limited for low-income Californians regardless of race. Health policy discussions must include increased attention on healthy food access among the poor, including AIs/ANs, for whom little data exist. PMID:26865900
Jordan, Monica L; Perez-Escamilla, Rafael; Desai, Mayur M; Shamah-Levy, Teresa
To examine the independent association of household food insecurity with sleep duration and quality in a nationally representative survey of adults in Mexico. The Latin American and Caribbean Food Security Scale was used to categorize households as secure, mild (43.7 %), moderate (19.0 %), or severe (11.8 %). We assessed the association between household food insecurity and self-reported sleep duration and quality among 11,356 adults using weighted multinomial and binomial logistic regression. After adjusting for potential confounders, a significant association was found between severe household food insecurity and getting less than the recommended 7-8 h of sleep [adjusted odds ratio (AOR) =1.83, 95 % confidence interval (CI) =1.37-2.43]. Compared with food-secure households, odds of poor sleep quality increased with level of severity (AOR = 1.27, 95 % CI 1.04-1.56 for mild; AOR = 1.71, 95 % CI 1.36-2.14 for moderate; and AOR = 1.89, 95 % CI 1.45-2.45 for severe household food insecurity). Household food insecurity is associated with inadequate sleep duration and poor sleep quality among Mexican adults. This study underscores the adverse effects of household food insecurity on the well-being of vulnerable populations.
McDonald, Christine M; McLean, Judy; Kroeun, Hou; Talukder, Aminuzzaman; Lynd, Larry D; Green, Timothy J
The objective of this study was to identify correlates of household food insecurity and poor dietary diversity in rural Cambodia. Trained interviewers administered a survey to 900 households in four rural districts of Prey Veng Province, Cambodia. The Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Score (HDDS) were used to assess household food insecurity and dietary diversity. Multivariate logistic regression models were constructed to identify independent correlates of household food insecurity and poor dietary diversity (HDDS
Papas, Mia A; Trabulsi, Jillian C; Dahl, Alicia; Dominick, Gregory
Obesity is a growing public health concern and is more prevalent among low-income and minority populations. Food insecurity may increase the odds of obesity in children. We investigated the association between food insecurity and obesity among low-income, Hispanic, mother-child dyads (n = 74). The United States Department of Agriculture 18-item Household Food Security Survey was used to determine food security status. The majority of households were food insecure (74 %) and one-third (30 %) of children were obese. Food insecurity increased the odds of childhood obesity (OR 10.2; 95 % CI 1.2, 85.5) with stronger associations found within households where mothers were also overweight/obese compared to normal weight (p-for interaction < 0.05). Rates of household food insecurity and childhood obesity were high among this low-income Hispanic sample. Future studies should elucidate the mechanisms through which food insecurity impacts childhood obesity.
Vicenzi, Keli; Henn, Ruth Liane; Weber, Ana Paula; Backes, Vanessa; Paniz, Vera Maria Vieira; Donatti, Talita; Olinto, Maria Teresa Anselmo
This cross-sectional school-based study in São Leopoldo, Rio Grande do Sul State, Brazil, evaluated the association between food insecurity and overweight in first grade students in the municipal elementary school system. A total of 2,369 students were invited to participate, of whom 847 were examined, and of these, 782 had data available on weight and height. Dietary data were obtained from a parent or guardian. Food insecurity was measured by the Brazilian Food Insecurity Scale (EBIA). Data on weight and height were provided by the Nutrition Service of the Municipal Department of Education. Prevalence rates for overweight and food insecurity were 38.1% and 45.1%, respectively. After controlling for potential confounders, children with food insecurity had 22% lower odds of overweight. Notwithstanding the inverse association between the exposure and outcome, this sample showed high rates of food insecurity and overweight, revealing a complex relationship and indicating that further research is needed to understand it. Robust public policies are critical for addressing these conditions.
Gany, Francesca; Leng, Jennifer; Ramirez, Julia; Phillips, Serena; Aragones, Abraham; Roberts, Nicole; Mujawar, Mohammed Imran; Costas-Muñiz, Rosario
Purpose: The association between food insecurity and health-related quality of life (QOL) of racial/ethnic minority patients with cancer has not been examined. The purpose of this study is to determine the relationship between food insecurity and health-related QOL reported by racial/ethnic minority patients with cancer. Methods: A consecutive sample of 1,390 underserved ethnic minority patients receiving cancer care in 10 cancer clinics and hospitals in New York City participated in this study. Health-related QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and food security was assessed by the US Department of Agriculture Core Food Security Module. Results: Of the 1,390 patients, 581 (41.8%) were classified as food secure, 571 (41.1%) with low food security, and 238 (17.1%) with very low food security. Health-related QOL decreased with each lower food security level. Patient self-reported physical, functional, social, and emotional well-being subscale scores decrease significantly with increasing food insecurity. After controlling for demographic and medical-related factors, the decreases in QOL, physical, functional, social and emotional well-being scores with increasing food insecurity remained significant. Conclusion: Food insecurity was associated with lower QOL in this sample of underserved racial/ethnic minority patients with cancer. Underserved ethnic minority patients diagnosed with cancer are a vulnerable patient population, at significant risk for inadequate food access and the related lower QOL. PMID:26286100
Njai, Rashid S.; Greenlund, Kurt J.; Chapman, Daniel P.; Croft, Janet B.
Introduction Housing insecurity and food insecurity may be psychological stressors associated with insufficient sleep. Frequent mental distress may mediate the relationships between these variables. The objective of this study was to examine the relationships between housing insecurity and food insecurity, frequent mental distress, and insufficient sleep. Methods We analyzed data from the 2009 Behavioral Risk Factor Surveillance System in 12 states. Housing insecurity and food insecurity were defined as being worried or stressed “sometimes,” “usually,” or “always” during the previous 12 months about having enough money to pay rent or mortgage or to buy nutritious meals. Results Of 68,111 respondents, 26.4% reported frequent insufficient sleep, 28.5% reported housing insecurity, 19.3% reported food insecurity, and 10.8% reported frequent mental distress. The prevalence of frequent insufficient sleep was significantly greater among those who reported housing insecurity (37.7% vs 21.6%) or food insecurity (41.1% vs 22.9%) than among those who did not. The prevalence of frequent mental distress was also significantly greater among those reporting housing insecurity (20.1% vs 6.8%) and food insecurity (23.5% vs 7.7%) than those who did not. The association between housing insecurity or food insecurity and frequent insufficient sleep remained significant after adjustment for other sociodemographic variables and frequent mental distress. Conclusion Sleep health and mental health are embedded in the social context. Research is needed to assess whether interventions that reduce housing insecurity and food insecurity will also improve sleep health and mental health. PMID:24625361
Leung, Cindy W; Epel, Elissa S; Ritchie, Lorrene D; Crawford, Patricia B; Laraia, Barbara A
Food insecurity acts as a chronic stressor independent of poverty. Food-insecure adults may consume more highly palatable foods as a coping mechanism, leading to poorer diet quality and increased risks of chronic disease over time. Using data from the 1999-2008 National Health and Nutrition Examination Surveys, this study aimed to examine the cross-sectional differences in dietary intake and diet quality by household food security among 8,129 lower-income adults (≤300% of the federal poverty level). Food insecurity was assessed using the 18-item US Household Food Security Survey Module. Dietary intake was assessed from 24-hour recalls and diet quality was measured using the Healthy Eating Index-2005 and the Alternate Healthy Eating Index-2010. Relative mean differences in dietary outcomes by household food security were estimated using linear regression models, adjusting for sociodemographic characteristics. Lower-income food-insecure adults reported higher consumption of some highly palatable foods, including high-fat dairy products (P trend<0.0001) and salty snacks (P trend=0.01) compared with lower-income food-secure adults. Food insecurity was also associated with more sugar-sweetened beverages (P trend=0.003); more red/processed meat (P trend=0.005); more nuts, seeds, and legumes (P trend=0.0006); fewer vegetables (P trend<0.0001); and fewer sweets and bakery desserts (P trend=0.0002). No differences were observed for intakes of total energy and macronutrients. Food insecurity was significantly associated with lower Healthy Eating Index-2005 (P trend<0.0001) and Alternate Healthy Eating Index-2010 scores (P trend<0.0001). Despite no macronutrient differences, food insecurity was associated with characteristics of poor diet quality known to increase chronic disease risk.
McLaughlin, Katie A.; Green, Jennifer Greif; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.
Objective To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method Data were drawn from 6,483 adolescent–parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture’s Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Results Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14%increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Conclusions Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. PMID:23200286
Guerra, Lúcia Dias da Silva; Espinosa, Mariano Martínez; Bezerra, Aída Couto Dinucci; Guimarães, Lenir Vaz; Lima-Lopes, Maria Aparecida
This cross-sectional population-based study in 2007 focused on prevalence of food insecurity and associated factors in households with adolescents in four towns in the Legal Amazonia located along highway BR-163, from Cuiabá, Mato Grosso State, to Santarém, Pará State, Brazil. The study applied the Brazilian Food Insecurity Scale to a sample of 363 households. Anthropometric assessment was performed on 534 adolescents from 10 to 19 years of age. A Poisson model was used in the multiple regression analysis. The results showed 23.1% prevalence of moderate to severe food insecurity, suggesting association with the following: low income, poor sanitation, head of household born in Mato Grosso State, and the adolescent's race (black). The results emphasize the need for improved access to basic sanitation, training of human resources to generate employment/income, and educational activities to improve understanding of food insecurity and its determinants.
Balistreri, Kelly Stamper
Rates of food insecurity in the US have been rising since 2000 spiking with the onset of the Great Recession in 2008, and have remained essentially unchanged since then despite improvements in the economy. The present study employed a series of indices adapted from the poverty literature to examine the depth and severity of food insecurity across the decade by race and ethnicity among low-income households with and without children. The most rapid increases in the depth and severity of food insecurity were found among low-income households without children. Non-Hispanic White households with and without children had lower prevalence rates but steeper increases in the depth and severity of food insecurity throughout the decade. Non-Hispanic Black households with and without children were at the most disadvantaged among low-income populations.
Godoy, Kátia Cruz; Sávio, Karin Eleonora Oliveira; Akutsu, Rita de Cássia; Gubert, Muriel Bauermann; Botelho, Raquel Braz Assunção
This study aimed to characterize users of a government soup-kitchen program and the association with family food insecurity, using a cross-sectional design and random sample of 1,637 soup-kitchen users. The study used a questionnaire with socioeconomic variables and the Brazilian Food Insecurity Scale, and measured weight and height. The chi-square test was applied, and the crude and adjusted prevalence ratios (PR) were calculated using Poisson regression. Prevalent characteristics included per capita income ranging from one-half to one minimum wage (35.1%), complete middle school (39.8%), and food security (59.4%). Users in the North of Brazil showed the worst data: incomplete primary school (39.8%), per capita income up to one-half the minimum wage (50.8%), and food insecurity (55.5%). Prevalence ratios for food insecurity were higher among users with per capita income up to one-fourth the minimum wage (p < 0.05). Income was the only variable that remained associated with higher prevalence of food insecurity in the adjusted PR. Knowing the characteristics of soup-kitchen users with food insecurity can help orient the program's work, location, and operations.
Monteiro, Flávia; Schmidt, Suely Teresinha; da Costa, Islandia Bezerra; Almeida, Claudia Choma Bettega; Matuda, Nívea da Silva
This is a descriptive cross-sectional study of the population base conducted in the town of Colombo in the state of Paraná. The objectives were to identify the prevalence of food insecurity in families that are beneficiaries of the Bolsa Família Program and the factors related to this condition, and describe the nutritional status of children under five years of age. Analyses of association were performed using Fisher's exact test. The sample included 442 families, of which 168 have children under five years of age. The Brazilian Food Insecurity Scale was applied to evaluate food insecurity and the nutritional status of the 199 children evaluated was determined by the height-for-age, weight-for-age and body mass-for-age indices in accordance with the WHO reference values for 2006. The prevalence of food insecurity was 81.6%. Overweight and stunting among children coexisted. Food insecurity was found to be associated with the height-for-age index among children under two years of age. The per capita income and food deficits influenced the situation of food insecurity significantly.
Background Food insecurity is a serious public health issue for Aboriginal people (First Nations [FN], Métis, and Inuit) living in Canada. Food security challenges faced by FN people are unique, especially for those living in remote and isolated communities. Conceptualizations of food insecurity by FN people are poorly understood. The purpose of this study was to explore the perceptions of food insecurity by FN adults living in a remote, on-reserve community in northern Ontario known to have a high prevalence of moderate to severe food insecurity. Methods A trained community research assistant conducted semi-directed interviews, and one adult from each household in the community was invited to participate. Questions addressed traditional food, coping strategies, and suggestions to improve community food security and were informed by the literature and a community advisory committee. Thematic data analyses were carried out and followed an inductive, data-driven approach. Results Fifty-one individuals participated, representing 67% of eligible households. The thematic analysis revealed that food sharing, especially with family, was regarded as one of the most significant ways to adapt to food shortages. The majority of participants reported consuming traditional food (wild meats) and suggested that hunting, preserving and storing traditional food has remained very important. However, numerous barriers to traditional food acquisition were mentioned. Other coping strategies included dietary change, rationing and changing food purchasing patterns. In order to improve access to healthy foods, improving income and food affordability, building community capacity and engagement, and community-level initiatives were suggested. Conclusions Findings point to the continued importance of traditional food acquisition and food sharing, as well as community solutions for food systems change. These data highlight that traditional and store-bought food are both part of the
Myles, TaMara; Porter Starr, Kathryn N; Johnson, Kristen B; Sun Lee, Jung; Fischer, Joan G; Ann Johnson, Mary
This study explored relationships of food insecurity with cognitive restraint, uncontrolled eating, and emotional eating behaviors among congregate meal participants in northeast Georgia [n = 118 years, age 60 years and older, mean (SD) age = 75 ( 8 ) years, 75% female, 43% Black, 53% obese (Body Mass Index ≥ 30)]. Food insecurity was assessed with a 6-item questionnaire. Scores ranged from 0 to 6 and were defined as high or marginal food security, FS, 0-1 (70%); low food security, LFS, 2-4 (20%); very low food security, VLFS, 5-6 (10%); and low and very low food security, LVLFS, 2-6 (30%). Eating behavior was assessed with an 18-item Three-Factor Eating Questionnaire R-18. In bivariate analyses food insecurity was consistently associated with cognitive restraint scores above the median split and to a lesser extent with uncontrolled eating scores (p ≤ 0.05). No association was found between emotional eating and food insecurity. In multivariate linear and logistic regression analyses, food insecurity was consistently associated with cognitive restraint (p ≤ 0.05) even when controlled for potential confounders (demographics, Body Mass Index, and chronic diseases). Food insecurity was also associated with uncontrolled eating (p ≤ 0.05), but the relationship was attenuated when controlled for potential confounding variables. Although cognitive restraint is defined as the conscious restriction of food intake to control body weight or promote weight loss, these findings suggest there may be other dimensions of cognitive restraint to consider in nutritional assessment and interventions among food-insecure older adults.
Eighty-four percent of U.S. households with children were food secure throughout 2007, meaning that they had consistent access to adequate food for active, healthy lives for all household members. Nearly 16 percent of households with children were food insecure sometime during the year, including 8.3 percent in which children were food insecure…
Ghattas, Hala; Sassine, AnnieBelle J.; Seyfert, Karin; Nord, Mark; Sahyoun, Nadine R.
Lebanon hosts the highest per capita refugee concentration worldwide. The Palestinian presence in Lebanon dates from 1948 and they remain a marginalized population. No information on their food security status has been reported previously. A survey of a representative sample of Palestinian refugee households in Lebanon (n = 2501) was conducted using a stratified two stage cluster sampling approach. We measured food insecurity using a modified USDA household food security module, locally validated. We collected data on household demographic, socioeconomic, health, housing, coping strategies and household intake of food groups and analysed these by food security status. About 41% (CI: 39-43) of households reported being food insecure and 20% (CI: 18-22) severely food insecure. Poor households were more likely to be severely food insecure (OR 1.41 (1.06-1.86)) while higher education of the head of household was significantly associated with protection against severe food insecurity (OR 0.66 (0.52-0.84)). Additionally, higher food expenditure and possession of food-related assets were significantly associated with food security (OR 0.93 (0.89-0.97) and OR 0.74 (0.59-0.92), respectively). After adjusting for confounders, households where at least one member suffered from an acute illness remained significantly more likely to be severely food insecure (OR 1.31(1.02-1.66)), as were households whose proxy respondent reported poor mental health (OR 2.64 (2.07-3.38)) and poor self-reported health (OR 1.62 (1.22-2.13). Severely food insecure households were more likely to eat cheaper foods when compared to non-severely food insecure households (p<0.001) and were more likely to rely on gifts (p<0.001) or welfare (p<0.001). They were also more likely to have exhausted all coping strategies, indicating significantly more frequently that they could not do anything (p = 0.0102). Food insecurity is a significant problem among Palestinian refugees in Lebanon and is likely to be
Ghattas, Hala; Sassine, AnnieBelle J; Seyfert, Karin; Nord, Mark; Sahyoun, Nadine R
Lebanon hosts the highest per capita refugee concentration worldwide. The Palestinian presence in Lebanon dates from 1948 and they remain a marginalized population. No information on their food security status has been reported previously. A survey of a representative sample of Palestinian refugee households in Lebanon (n = 2501) was conducted using a stratified two stage cluster sampling approach. We measured food insecurity using a modified USDA household food security module, locally validated. We collected data on household demographic, socioeconomic, health, housing, coping strategies and household intake of food groups and analysed these by food security status. About 41% (CI: 39-43) of households reported being food insecure and 20% (CI: 18-22) severely food insecure. Poor households were more likely to be severely food insecure (OR 1.41 (1.06-1.86)) while higher education of the head of household was significantly associated with protection against severe food insecurity (OR 0.66 (0.52-0.84)). Additionally, higher food expenditure and possession of food-related assets were significantly associated with food security (OR 0.93 (0.89-0.97) and OR 0.74 (0.59-0.92), respectively). After adjusting for confounders, households where at least one member suffered from an acute illness remained significantly more likely to be severely food insecure (OR 1.31(1.02-1.66)), as were households whose proxy respondent reported poor mental health (OR 2.64 (2.07-3.38)) and poor self-reported health (OR 1.62 (1.22-2.13). Severely food insecure households were more likely to eat cheaper foods when compared to non-severely food insecure households (p<0.001) and were more likely to rely on gifts (p<0.001) or welfare (p<0.001). They were also more likely to have exhausted all coping strategies, indicating significantly more frequently that they could not do anything (p = 0.0102). Food insecurity is a significant problem among Palestinian refugees in Lebanon and is likely to be
Mohammadi-Nasrabadi, F; Omidvar, N; Khoshfetrat, M R; Kolahdooz, F
Using a systematic review of all available studies between 1991 and 2011, the prevalence of food insecurity in the Islamic Republic of Iran was estimated. After document evaluation and data aggregation, studies were analysed in separate categories based on the methods used: dietary recall, household income/expenditure or experiential/perception-based surveys. Meta-analysis of dietary-recall studies showed small non-significant increases between 1994 and 2004 in the prevalence of mild (from 8.8% to 9.3%) and moderate food insecurity (from 5.4% to 5.6%). Severe food insecurity was 3.8% and 3.7% in 1994 and 2004 respectively. Prevalence of food insecurity (moderate to severe) based on household income/expenditure surveys was consistently reported to be 10%. A separate meta-analysis of experiential/perception-based studies revealed rates of mild, moderate and severe food insecurity of 28.6%, 14.9% and 6.0% respectively. By combining study results in this manner makes it possible to come up with more realistic estimates for evidence-informed policy-making, until development of a national food insecurity surveillance system.
Shahraki, Soudabeh Hamedi; Amirkhizi, Farshad; Amirkhizi, Behzad; Hamedi, Sousan
This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7-11 years was selected by a multistage cluster random sampling method during December 2013-May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother's and father's education level (p = .005 and p = .042, respectively), father's occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.
Chilton, Mariana; Rose, Donald
Food insecurity is a serious public health problem associated with poor cognitive and emotional development in children and with depression and poor health in adults. Despite sizable continued investments in federal food assistance, food insecurity still affects 11.1% of US households--almost the same rate as in 1995, when annual measurement began. As a fresh approach to solving the problem of food insecurity, we suggest adoption of a human rights framework. This approach could actively engage those affected and would ensure that food security monitoring would be compared to benchmarks in national action plans. We describe key elements of a right-to-food approach, review challenges to implementing it, and suggest actions to foster its adoption.
Hromi-Fiedler, Amber; Bermúdez-Millán, Angela; Segura-Pérez, Sofia; Pérez-Escamilla, Rafael
Latinas experience high rates of poverty, household food insecurity and prenatal depression. To date, only one USA study has examined the relationship between household food insecurity and prenatal depression, yet it focused primarily on non-Latina white and non-Latina black populations. Therefore, this study examined the independent association of household food insecurity with depressive symptoms among low-income pregnant Latinas. This cross-sectional study included 135 low income pregnant Latinas living in Hartford, Connecticut. Women were assessed at enrolment for household food security during pregnancy using an adapted and validated version of the US Household Food Security Survey Module. Prenatal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. A cut-off of ≥21 was used to indicate elevated levels of prenatal depressive symptoms (EPDS). Multivariate backwards stepwise logistic regression was used to identify risk factors for EPDS. Almost one third of participants had EPDS. Women who were food insecure were more likely to experience EPDS compared to food secure women (OR = 2.59; 95% CI = 1.03-6.52). Being primiparous, experiencing heartburn and reporting poor/fair health during pregnancy, as well as having a history of depression were also independent risk factors for experiencing EPDS. Findings from this study suggest the importance of assessing household food insecurity when evaluating depression risk among pregnant Latinas.
Gany, Francesca; Lee, Trevor; Ramirez, Julia; Massie, Dana; Moran, Alyssa; Crist, Michael; McNish, Thelma; Winkel, Gary; Leng, Jennifer C
This study assessed the prevalence and predictors of food insecurity among a cohort of underserved oncology patients at New York City cancer clinics. A demographic survey and the U.S. Household Food Security Survey Module were administered. A multivariate General Linear Model Analysis of Covariance was used to evaluate predictors of food insecurity. Four hundred and four (404) completed the surveys. Nearly one-fifth (18%) had very low, 38% low, 17% marginal, and 27% high food security. The Analysis of Covariance was statistically significant (F[7, 370] = 19.08; p < .0001; R-Square = 0.26). Younger age, Spanish language, poor health care access, and having less money for food since beginning cancer treatment were significantly associated with greater food insecurity. This cohort of underserved cancer patients had rates of food insecurity nearly five times those of the state average. More research is needed to understand better the causes and impact of food insecurity among cancer and chronic disease patients.
Swindale, Anne; Bilinsky, Paula
The United States Public Law 480 Title II food aid program is the largest U.S. government program directed at reducing hunger, malnutrition, and food insecurity in the developing world. USAID and Title II implementing partners face challenges in measuring the success of Title II programs in reducing household food insecurity because of the technical difficulty and cost of collecting and analyzing data on traditional food security indicators, such as per capita income and caloric adequacy. The Household Food Insecurity Access Scale (HFIAS) holds promise as an easier and more user-friendly approach for measuring the access component of household food security. To support the consistent and comparable collection of the HFIAS, efforts are under way to develop a guide with a standardized questionnaire and data collection and analysis instructions. A set of domains have been identified that is deemed to capture the universal experience of the access component of household food insecurity across countries and cultures. Based on these domains, a set of questions has been developed with wording that is deemed to be universally appropriate, with minor adaptation to local contexts. These underlying suppositions, based on research in multiple countries, are being verified by potential users of the guide. The key remaining issue relates to the process for creating a categorical indicator of food insecurity status from the HFIAS.
Surratt, Hilary L; O'Grady, Catherine L; Levi-Minzi, Maria A; Kurtz, Steven P
This study examines the prevalence of food/housing insecurity and its association with psychological, behavioral, and environmental factors impacting antiretroviral (ARV) medication adherence and diversion among substance using HIV+ patients in South Florida. Five hundred and three HIV+ substance abusers were recruited through targeted sampling. Participants completed a standardized instrument assessing demographics, mental health status, sex risk behaviors, HIV diagnosis, treatment history and access, ARV adherence and diversion, and attitudes toward health-care providers. Chi-square and t-tests were used to examine differences by food/housing status and a multivariate linear regression model examined food/housing insecurity and its associations to ARV adherence. Food/housing insecurity was reported by 43.3% of the sample and was associated with higher likelihood of severe psychological distress and substance dependence. Nearly 60% reported recent ARV diversion; only 47.2% achieved 95% medication adherence over one week. Food/housing insecure participants had deficits in their HIV care, including less time in consistent care, lower access to medical care, and less favorable attitudes toward care providers. Multivariate linear regression showed food/housing insecurity demonstrated significant main effects on adherence, including lower past week adherence. Medication diversion was also associated with reduced adherence. Our findings suggest that food/housing insecurity operates as a significant driver of ARV non-adherence and diversion in this population. In the pursuit of better long-term health outcomes for vulnerable HIV+ individuals, it is essential for providers to understand the role of food and housing insecurity as a stressor that negatively impacts ARV adherence and treatment access, while also significantly contributing to higher levels of distress and substance dependence.
Surratt, Hilary L.; O’Grady, Catherine L.; Levi-Minzi, Maria A.; Kurtz, Steven P.
This study examines the prevalence of food/housing insecurity and its association with psychological, behavioral and environmental factors impacting ARV medication adherence and diversion among substance using HIV+ patients in South Florida. 503 HIV+ substance abusers were recruited through targeted sampling. Participants completed a standardized instrument assessing demographics, mental health status, sex risk behaviors, HIV diagnosis, treatment history and access, ARV adherence and diversion, and attitudes toward health care providers. Chi-square and t-tests were used to examine differences by food/housing status and a multivariate linear regression model examined food/housing insecurity and its associations to ARV adherence. Food/housing insecurity was reported by 43.3% of the sample and was associated with higher likelihood of severe psychological distress and substance dependence. Nearly 60% reported recent ARV diversion; only 47.2% achieved 95% medication adherence over one week. Food/housing insecure participants had deficits in their HIV care, including less time in consistent care, lower access to medical care, and less favorable attitudes toward care providers. Multivariate linear regression showed food/housing insecurity demonstrated significant main effects on adherence, including lower past week adherence. Medication diversion was also associated with reduced adherence. Our findings suggest that food/housing insecurity operates as a significant driver of ARV non-adherence and diversion in this population. In the pursuit of better long term health outcomes for vulnerable HIV+ individuals, it is essential for providers to understand the role of food and housing insecurity as a stressor that negatively impacts ARV adherence and treatment access, while also significantly contributing to higher levels distress and substance dependence. PMID:25314042
Shanafelt, Amy; Hearst, Mary O.; Wang, Qi; Nanney, Marilyn S.
Background: Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security…
Stuff, Janice E.; Horton, Jacqueline A.; Bogle, Margaret L.; Connell, Carol; Ryan, Donna; Zaghloul, Sahar; Thornton, Alma; Simpson, Pippa; Gossett, Jeff
Residents of the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi are at risk for food insecurity since a high proportion of the population live in households with incomes below the poverty level and have reduced access to food and decreased availability of a variety of foods. However, the magnitude of the problem is unknown because…
Dollahite, Jamie; Olson, Christine; Scott-Pierce, Michelle
Comparison of 15,846 completers and 300 noncompleters of New York's Expanded Food and Nutrition Education Program showed that both groups significantly decreased food insecurity scores. Multiple regression analyses indicated that scores decreased significantly more for completers. The number of lessons was associated with food insecurity…
Discusses the continued incidence of food insecurity and hunger among American families despite a booming economy, and discusses the impact of malnutrition on children's development. Describes increases in demands for emergency food, suggesting changes in the Food Stamp Program. Identifies continued earnings inequalities. (KB)
Rukundo, Peter M; Andreassen, Bård A; Kikafunda, Joyce; Rukooko, Byaruhanga; Oshaug, Arne; Iversen, Per Ole
In 2010, a landslide in Bududa, Eastern Uganda, killed about 350 people and nearly 1000 affected households were resettled in Kiryandongo, Western Uganda. A cross-sectional survey assessed household food insecurity and diet diversity among 1078 affected and controls. In Bududa, the affected had a lower adjusted mean score of food insecurity than controls - 9·2 (se 0·4) v. 12·3 (se 0·4) (P<0·01)--but higher diet diversity score (DDS) - 7·1 (se 0·1) v. 5·9 (se 0·1) (P<0·01). On controlling for disaster and covariates, recipients of relief food had higher food insecurity - 12·0 (se 0·6) v. 10·4 (se 0·3) (P=0·02)--whereas farmers had higher DDS - 6·6 (se 0·2) v. 5·6 (se 0·3) (P<0·01). Household size increased the likelihood of food insecurity (OR 1·15; 95% CI 1·00, 1·32; P<0·05) but reduced DDS (OR 0·93; 95% CI 0·87, <1·00; P=0·04). Low DDS was more likely in disaster affected (OR 4·22; 95% CI 2·65, 6·72; P<0·01) and farmers (OR 2·52; 95% CI 1·37, 4·64; P<0·01). In Kiryandongo, affected households had higher food insecurity - 12·3 (se 0·8) v. 2·6 (se 0·8) (P<0·01)--but lower DDS - 5·8 (se 0·3) v. 7·0 (se 0·3) (P=0·02). The latter reduced with increased age (OR 0·99; 95% CI 0·97, 1·00; P<0·05), lowest education (OR 0·54; 95% CI 0·31, 0·93; P=0·03), farmers (OR 0·59; 95 % CI 0·35, 0·98; P=0·04) and asset ownership (OR 0·56; 95% CI 0·39, 0·81; P<0·01). Addressing social protection could mitigate food insecurity.
Rosso, María Amalia; Wicky, Mariel Ivana; Nessier, María Celeste; Meyer, Roberto
The aim of this research study was to describe the perceived level of food security in the households of the city of Santa Fe, Argentina, in 2011. A descriptive, cross-sectional study was performed, incorporating 592 homes included in the Panel of Households of the Social Observatory of the Universidad Nacional del Litoral. Households were characterized sociodemographically and classified according to the level of food security by applying the Latin American and Caribbean Food Security Scale. Association with sociodemographical factors was determined by odds ratios and logistic regression. It was found that 31.5% of households in Santa Fe show food insecurity: 21.7% is mild, 7.4% is moderate and 2.4% is severe, and insecurity is greater when children live in the household. Food insecurity is positively associated with lack of health coverage, lack of economic activity, inability to save, incomplete secondary level education and four or more people living in the household.
Sis-Medina, Reacheal Connie; Reyes, Alexa; Becerra, Monideepa B.
Introduction Food insecurity has been associated with negative health outcomes, but the relationship between psychological distress and food insecurity among ethnic minorities has not been extensively examined in the literature. The goal of this study was to evaluate whether low food security and very low food security were significantly associated with past month serious psychological distress (SPD) among Hispanic adults living in poverty. Methods We studied 10,966 Hispanic respondents to the California Health Interview Survey for 2007, 2009, and 2011–2012 whose income was below 200% of the federal poverty level. The relationship between food insecurity and SPD was evaluated by using survey-weighted univariate and logistic regression analyses. Results Nearly 30% of the study population had low food security and 13% had very low food security. Low food security and very low food security were associated with 1.99 and 4.43 odds of past month SPD, respectively, and perceived low neighborhood safety was related to 1.47 odds of past month SPD. Conclusions We found that food insecurity was prevalent among Hispanic people living in poverty and was significantly associated with past month SPD. These results demonstrate the need for further targeted public health efforts, such as community gardens led by promotores, faith-based initiatives, and initiatives to reduce barriers to participation in food-assistance programs. PMID:26605706
Lopes, Taís S; Sichieri, Rosely; Salles-Costa, Rosana; Veiga, Gloria V; Pereira, Rosangela A
The study objective was to analyse the association between food insecurity and the weight and height status of adolescents from a low-income area in the metropolitan region of Rio de Janeiro, Brazil. The population-based cross-sectional survey included 523 adolescents aged 12-18 years, selected by a three-stage cluster sample. Dietary intake was ascertained with a food frequency questionnaire and family food insecurity was assessed with a validated questionnaire. The analysis estimated weighted means of energy and nutrient intakes by families' socioeconomic characteristics and the association between dietary intake with overweight and stunting. The prevalence of mild family food insecurity was 36%, and 24% of the families reported moderate or severe food insecurity. Overweight prevalence was 24%, and the prevalence of stunting was 9%, with no significant differences between sex or age groups. Family food insecurity was associated with unfavourable socioeconomic characteristics, but there was no association between socioeconomic characteristics (including family food insecurity) and overweight or stunting. Moderate or severe family food insecurity was inversely associated with intake of protein and calcium. In addition, stunting was associated with low calcium and iron intake. The co-existence of family food insecurity with overweight and stunting implies a high nutritional risk for adolescents from poor areas of Rio de Janeiro. Nevertheless, the observed absence of a statistical association between family food insecurity and weight status attests to the complexity of this issue.
Bernal, Jennifer; Frongillo, Edward A; Herrera, Héctor A; Rivera, Juan A
Household food insecurity has substantial detrimental effects on children, but little is known about the mechanisms through which these effects occur. This study investigated some possible mechanisms by examining associations of food insecurity reported by children and mothers with daily activities, school absenteeism, and stunting. We conducted a cross-sectional study in a nonprobabilistic sample of 131 mother-child pairs from a poor peri-urban area in Miranda State, Venezuela. We assessed food insecurity in children by using an instrument developed through a naturalistic approach that had 10 items for food insecurity and 9 items for management strategies. To obtain mothers' reports of food insecurity, a previously validated 12-item instrument was used. Children's daily activities, school absenteeism, and stunting were measured. Chi-square tests for contingency tables and logistic and multiple regression analyses were used to test associations of food insecurity with outcomes. There was no association between mothers' reports of food-insecurity and any child outcome. Children's reports of food insecurity were associated with higher odds of doing passive home chores (OR: 1.17; 95% CI: 1.02, 1.32), cooking at home (OR: 1.21; 95% CI: 1.05, 1,38), taking care of siblings (OR: 1.15; 95% CI: 1.01, 1.31), and doing labor (OR: 1.22; 95% CI: 1.04, 1.42) and lower odds of playing video games (OR: 0.86; 95% CI: 0.76, 0.98) (all P < 0.03). Children's reports of management strategies were associated with 5 of 7 work activities measured. Labor in food-insecure children was the main activity that explained school absenteeism. Food insecurity reported by children can be assessed by pediatricians, school personnel, and other practitioners by using a simple instrument to identify food-insecure children and to respond to mitigate their food insecurity and its consequences.
Kimbro, Rachel Tolbert; Denney, Justin T
Children living in food-insecure households face myriad challenges to their well-being. The Great Recession of December 2007-June 2009 increased food insecurity to the highest levels ever measured in the United States. Using nationally representative data from the period 2010-12 for 6,300 children in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, with household incomes below 300 percent of the federal poverty level and a dynamic measure of food insecurity transitions, we assessed the impact of transitions into and out of household food insecurity on the academic achievement, behavioral problems, and health status of young children. We found negligible impacts of food insecurity transitions on academic achievement in first grade. However, we found consistent negative impacts of the transitions on teachers' reports of children's externalizing behaviors, self-control, and interpersonal skills and on parents' reports of children's overall health status. Taken together, our findings underline the importance of food security for children's healthy development.
Maes, Kenneth; Shifferaw, Selamawit
With the rollout of AIDS therapies, volunteer AIDS care has been promoted across Africa under the assumption that volunteerism is economically imperative in settings of health professional and resource scarcity. As low-income volunteers have become a major part of HIV/AIDS prevention and treatment workforces, it is imperative to question how poverty impacts their well-being. This chapter presents epidemiologic data collected during the 2008 food crisis from a sample of 110 AIDS care volunteers in Addis Ababa, Ethiopia, as well as narratives offered by HIV-positive volunteers, highlighting a widely overlooked way in which food insecurity and mental distress impact efforts to treat AIDS in sub-Saharan Africa. Food insecurity and elevated common mental disorder (CMD) symptom loads were common and tightly linked among the volunteers in the sample. Volunteers who were HIV-positive (17 percent) fared slightly worse in terms of food insecurity and psychosocial well-being. However, positive HIV serostatus was not associated with CMD in multivariate analyses accounting for food insecurity. Narratives illustrate how being HIV-positive shaped experiences of psychosocial stress, which involved unemployment and lack of prospects for marital relationships or strife within them. Our focus demonstrates the potential for mixing ethnographic and epidemiological methods to inform policy questions regarding poverty-reduction through compensation for volunteers’ valuable labor, as well as AIDS care program sustainability. [volunteerism, AIDS care, food insecurity, livelihoods, HIV, psychosocial health] PMID:24077603
Abdurahman, Ahmed A; Mirzaei, Khadijeh; Dorosty, Ahmed Reza; Rahimiforoushani, A; Kedir, Haji
The aim of this study was to examine the association between household food insecurity and nutritional status among children aged 24-59 months in Haromaya District. Children (N = 453) aged 24-59 months were recruited in a community-based cross-sectional survey with a representative sample of households selected by a multistage sampling procedure in Haromaya District. Household Food Insecurity Access Scale and anthropometry were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. The prevalences of stunting, underweight, and wasting among children aged 24-59 months were 61.1%, 28.1%, and 11.8%, respectively. The mean household food insecurity access scale score was 3.34, and 39.7% of households experienced some degree of food insecurity. By logistic regression analysis and after adjusting for the confounding factors, household food insecurity was significantly predictive of underweight (AOR = 2.48, CI = 1.17-5.24, p = .05) and chronic energy deficiency (AOR = 0.47, CI = 0.23-0.97, p = .04) and marginally significant for wasting (AOR = 0.53, CI = 0.27-1.03, p = .06). It is concluded that household food security improves child growth and nutritional status.
MOHAMMADI, Fatemeh; OMIDVAR, Nasrin; HARRISON, Gail G; GHAZI-TABATABAEI, Mahmood; ABDOLLAHI, Morteza; HOUSHIAR-RAD, Anahita; MEHRABI, Yadollah; DOROSTY, Ahmad Reza
Background Despite reports on association between overweight/obesity among women and household food insecurity (FI) in developed countries, such association is not evident in developing countries. This study aimed to assess the association between household FI and weight status in adult females in Tehran, Iran. Methods: In this cross-sectional study, 418 households were selected through systematic cluster sampling from 6 districts of Tehran. Height and weight were measured and body mass index (BMI) was calculated. Socio-economic status of the household was assessed by a questionnaire. Three consecutive 24-hour diet recalls were completed. FI was measured using adapted Household Food Insecurity Access Scale. Logistic regression was used to test the effects of SES and food security on weight status, simultaneously. Using Structural Equation Modeling (SEM) potential causal relationships between FI and weight status was explored. Results: Only 1.0% of women were underweight, while 40.3% were overweight and 33% were obese, respectively. Severe, moderate, and mild food insecurity was observed in 11.5, 14.7, and 17.8%, respectively. Among women in moderately food insecure households, the possibility of overweight was lower than those of food secure households (OR 0.41; CI95%:0.17–0.99), while in severely food insecure households, the risk of abdominal obesity for women was 2.82 times higher than food secures (CI95%:1.12–7.08) (P<0.05). SEM detected no causal relationship between FI and weight status. Conclusion: Association of severe food insecurity with abdominal obesity in adult females of households may indicate their vulnerability and the need for tailoring programs to prevent further health problems in this group. PMID:23785677
Ke, Janice; Ford-Jones, Elizabeth Lee
Food insecurity and hunger are significant problems in Canada, with millions of Canadians experiencing some level of food insecurity. The purpose of the present article is to review what is currently known about the effects of food insecurity and hunger on children. Longitudinal studies in Canada indicate that hunger is related to poor health outcomes, including a higher risk of depression and suicidal ideation in adolescents, and chronic conditions, particularly asthma. In addition, nutrient deficiencies, such as iron deficiency, are known to impair learning and cause decreased productivity in school-age children, and maternal depressive disorders. School-based nutrition programs and innovations, such as subsidized food (apples, cheese, soy nuts, carrots and broccoli), are an essential immediate need, but long-term solutions lie in adequate incomes for families.
Holben, David H
It is the position of the American Dietetic Association that systematic and sustained action is needed to achieve food and nutrition security for all in the United States. To eliminate food insecurity, interventions are needed, including adequate funding for and increased utilization of food and nutrition assistance programs, inclusion of food and nutrition education in such programs, and innovative programs to promote and support individual and household economic self-sufficiency. More than 49 million individuals living in the United States experienced food insecurity in 2008. Negative nutrition and non-nutrition-related outcomes have been associated with food insecurity in children, adolescents, and adults, including substandard academic achievement, inadequate intake of key nutrients, poor health, increased risk for and development of chronic disease, poor disease management, and poor psychological and cognitive functioning. Registered dietitians and dietetic technicians, registered, can play key roles in ending food insecurity and are uniquely positioned to make valuable contributions through provision of comprehensive food and nutrition education; competent and collaborative practice; innovative research related to accessing a safe, secure, and sustainable food supply; and advocacy efforts at the local, state, regional, and national levels.
Poblacion, Ana Paula; Marín-León, Leticia; Segall-Corrêa, Ana Maria; Silveira, Jonas Augusto; Taddei, José Augusto de Aguiar Carrazedo
This article analyzes food insecurity and hunger in Brazilian families with children under five years of age. This was a nationally representative cross-sectional study using data from the National Demographic and Health Survey on Women and Children (PNDS-2006), in which the outcome variable was moderate to severe food insecurity, measured by the Brazilian Food Insecurity Scale (EBIA). Prevalence estimates and prevalence ratios were generated with 95% confidence intervals. The results showed a high prevalence of moderate to severe food insecurity, concentrated in the North and Northeast regions (30.7%), in economic classes D and E (34%), and in beneficiaries of conditional cash transfer programs (36.5%). Multivariate analysis showed that the socioeconomic relative risks (beneficiaries of conditional cash transfers), regional relative risks (North and Northeast regions), and economic relative risks (classes D and E) were 1.8, 2.0 and 2.4, respectively. Aggregation of the three risks showed 48% of families with moderate to severe food insecurity, meaning that adults and children were going hungry during the three months preceding the survey.
Normén, Lena; Chan, Keith; Braitstein, Paula; Anema, Aranka; Bondy, Greg; Montaner, Julio S G; Hogg, Robert S
Hunger and food insecurity are important factors that may affect an individual's nutritional state and should therefore be assessed in nutrition surveillance activities. The objective of this study was to determine the level of food insecurity and hunger among HIV-positive persons accessing antiretroviral therapy in British Columbia. A cross-sectional study was performed in the BC HIV/AIDS drug treatment program, a province-wide source of free-of-charge antiretroviral medications. In 1998-1999, participants completed a questionnaire focusing on personal information, health, and clinical status. Food and hunger issues were evaluated with the Radimer/Cornell questionnaire. Overall, 1213 responding men and women were classified as food secure (52%), food insecure without hunger (27%), or food insecure with hunger (21%). In both categories of food insecurity, individuals were significantly more likely to be women, aboriginals, living with children, and to have less education, a history of recreational injection drug and/or alcohol abuse, and an unstable housing situation (P < 0.05). In logistic multivariate modeling, income < or = Can$10,000 [adjusted odds ratio (AOR) 3.78, 95% CI (2.53-5.65)], shared household with children [AOR 3.68, 95% CI (1.98-6.84)] and unemployment [AOR 3.15, 95% CI (1.94-5.13)] were the strongest predictors of hunger. In HIV-positive individuals, the occurrence of food insecurity was nearly 5 times higher than in the general Canadian population. The results should stimulate further research to identify to what extent hunger-associated factors are reversible with interventions built on nutritional and/or social strategies.
Eicher-Miller, Heather A.; Mason, April C.; Abbott, Angela R.; McCabe, George P.; Boushey, Carol J.
Objective: To determine the effect of Food Stamp Nutrition Education (FSNE) in Indiana on participants' food insecurity and food insufficiency. Design: A single-blind randomized design. A randomized experimental group completed 5 FSNE lessons as an intervention between a pre- and posttest, whereas a control group completed a pre- and posttest…
Fiese, Barbara H.; Gundersen, Craig; Koester, Brenda; Washington, LaTesha
In 2009, 14.7% of households were food insecure at some time during the year. In other words, members of those households did not have access at all times to enough food for an active, healthy life. This is arguably the most serious nutrition-related public health problem facing the U.S. today. The serious developmental consequences of food…
Brandeis Univ., Waltham, MA. Center on Hunger and Poverty.
Asserting that 13 million U.S. children live in households with limited or uncertain access to sufficient food, this report highlights recent findings showing the adverse consequences of hunger and food insecurity for children. The findings are grouped into three broad areas: health consequences, psychosocial and behavioral impacts, and learning…
Gundersen, Craig; Ziliak, James P.
In 2012, nearly 16 million U.S. children, or over one in five, lived in households that were food-insecure, which the U.S. Department of Agriculture defines as "a household-level economic and social condition of limited access to food." Even when we control for the effects of other factors correlated with poverty, these children are more…
Food security is especially important for children because their nutrition affects not only their current health, but also their future health and well-being. Previous studies that used various data sources suggest that children in food-insecure households face elevated risks of health and development problems, compared with children in otherwise…
Bartelink, Imke H; Savic, Rada M; Mwesigwa, Julia; Achan, Jane; Clark, Tamara; Plenty, Albert; Charlebois, Edwin; Kamya, Moses; Young, Sera L; Gandhi, Monica; Havlir, Diane; Cohan, Deborah; Aweeka, Francesca
Pregnancy and food insecurity may impact antiretroviral (ART) pharmacokinetics (PK), adherence and response. We sought to quantify and characterize the PK of lopinavir/ritonavir (LPV/r) and efavirenz (EFV) by pregnancy and nutritional status among HIV-infected women in Tororo, Uganda. In 2011, 62/225 ante-partum/post-partum single dried blood spot samples DBS and 43 post-partum hair samples for LPV/r were derived from 116 women, 51/194 ante-/post-partum DBS and 53 post-partum hair samples for EFV from 105 women. Eighty percent of Ugandan participants were severely food insecure, 26% lost weight ante-partum, and median BMI post-partum was only 20.2 kg/m(2) . Rich PK-data of normally nourished (pregnant) women and healthy Ugandans established prior information. Overall, drug exposure was reduced (LPV -33%, EFV -15%, ritonavir -17%) compared to well-nourished controls (P < 0.001), attributable to decreased bioavailability. Pregnancy increased LPV/r clearance 68% (P < 0.001), whereas EFV clearance remained unchanged. Hair concentrations correlated with plasma-exposure (P < 0.001), explaining 29% PK-variability. In conclusion, pregnancy and food insecurity were associated with lower ART exposures in this cohort of predominantly underweight women, compared to well-nourished women. Much variability in plasma-exposure was quantified using hair concentrations. Addressing malnutrition as well as ART-PK in this setting should be a priority.
Bartelink, Imke H.; Savic, Rada M.; Mwesigwa, Julia; Achan, Jane; Clark, Tamara; Plenty, Albert; Charlebois, Edwin; Kamya, Moses; Young, Sera L.; Gandhi, Monica; Havlir, Diane; Cohan, Deborah; Aweeka, Francesca
Pregnancy and food insecurity may impact antiretroviral (ART) pharmacokinetics (PK), adherence and response. We sought to quantify and characterize the PK of lopinavir/ritonavir (LPV/r) and efavirenz (EFV) by pregnancy and nutritional status among HIV-infected women in Tororo, Uganda. In 2011, 62/225 ante-partum/post-partum single dried blood spot samples DBS and 43 post-partum hair samples for LPV/r were derived from 116 women, 51/194 ante-/post-partum DBS and 53 post-partum hair samples for EFV from 105 women. 80% of Ugandan participants were severely food insecure, 26% lost weight ante-partum, and median BMI post-partum was only 20.2 kg/m2. Rich PK-data of normally nourished (pregnant) women and healthy Ugandans established prior information. Overall, drug exposure was reduced (LPV −33%, EFV −15%, ritonavir −17%) compared to well-nourished controls [p < 0.001], attributable to decreased bioavailability. Pregnancy increased LPV/r clearance 68% [p < 0.001], whereas EFV clearance remained unchanged. Hair concentrations correlated with plasma-exposure [p < 0.001], explaining 29% PK-variability. In conclusion, pregnancy and food insecurity were associated with lower ART exposures in this cohort of predominantly underweight women, compared to well-nourished women. Much variability in plasma-exposure was quantified using hair concentrations. Addressing malnutrition as well as ART-PK in this setting should be a priority. PMID:24038035
Lindstrom, David; Belachew, Tefera; Hadley, Craig; Lachat, Carl; Verstraeten, Roos; De Cock, Nathalie; Kolsteren, Patrick
Background Although the consequences of food insecurity on physical health and nutritional status of youth living have been reported, its effect on their mental health remains less investigated in developing countries. The aim of this study was to examine the pathways through which food insecurity is associated with poor mental health status among youth living in Ethiopia. Methods We used data from Jimma Longitudinal Family Survey of Youth (JLFSY) collected in 2009/10. A total of 1,521 youth were included in the analysis. We measured food insecurity using a 5-items scale and common mental disorders using the 20-item Self-Reporting Questionnaire (SRQ-20). Structural and generalized equation modeling using maximum likelihood estimation method was used to analyze the data. Results The prevalence of common mental disorders was 30.8% (95% CI: 28.6, 33.2). Food insecurity was independently associated with common mental disorders (β = 0.323, P<0.05). Most (91.8%) of the effect of food insecurity on common mental disorders was direct and only 8.2% of their relationship was partially mediated by physical health. In addition, poor self-rated health (β = 0.285, P<0.05), high socioeconomic status (β = -0.076, P<0.05), parental education (β = 0.183, P<0.05), living in urban area (β = 0.139, P<0.05), and female-headed household (β = 0.192, P<0.05) were associated with common mental disorders. Conclusions Food insecurity is directly associated with common mental disorders among youth in Ethiopia. Interventions that aim to improve mental health status of youth should consider strategies to improve access to sufficient, safe and nutritious food. PMID:27846283
Gholami, Ali; Sani, Tayebeh Rezaei; Askari, Mina; Jahromi, Zahra Moosavi; Dehghan, Azizallah
Background: To assess the prevalence of food insecurity and associated factors among rural households in north-east of Iran. Methods: In this cross-sectional study, a total of 4647 rural households (18,061 persons) were studied in Neyshabur, a city in north-east of Iran. The Iranian version of the Six-Item Short questionnaire of Household Food Security Scale was used to measure food insecurity. Logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: Total prevalence of food insecurity in this study was 40.9% (95% CI 39.49-42.31). Backward Multivariate Logistic Regression model showed that OR of food insecurity increased with: The presence of chronic disease in household in comparison the absence (OR = 2.02), the rural distance >30 km from the city in comparison the distance ≤30 km (OR = 1.41), the presence of smoker in household in comparison the absence (OR = 1.8), the residential infrastructure of household ≤50 m2 in comparison the >50 m2 (OR = 1.57), the presence of single parent in comparison the presence of both parents at home (OR = 1.38) and the household income (per month) <4,000,000 Rial in comparison the ≥4,000,000 Rial (OR = 3.91). But OR of food insecurity decreased with having a car in family in comparison not having (OR = 0.54) and the family having a house in comparison not having (OR = 0.61). Conclusions: According to results of this study, food insecurity is prevalent among rural households of Neyshabur, so it is an important public health problem in this region. PMID:24130942
Background Food insecurity is a significant public health problem in North America and elsewhere. The prevalence of food insecurity varies by country of residence; within countries, it is strongly associated with household socioeconomic status, but the local environment may also play an important role. In this study, we analyzed secondary data from a population-based survey conducted in Québec, Canada, to determine if five local environmental factors: material and social deprivation, social cohesion, disorder, and living location were associated with changes in household food insecurity over a period of 6 years, while adjusting for household socioeconomic status (SES) and other factors. Methods Data from the Québec Longitudinal Study of Child Development, following same-aged children from 4–10 y of age, were analyzed using generalized estimating equations, to determine the longitudinal association between these environmental factors and food insecurity over a period of 6 years. Results Of the 2120 children originally included in the cohort, 1746 (82%) were included in the present analysis. The prevalence of food insecurity was 9.2% when children were 4 y of age (95% CI: 7.8 – 10.6%) but no significant changes were observed over time. On average over the 6 year period, three environmental factors were positively related to food insecurity: high social deprivation (OR 1.62, 95%CI: 1.16 – 2.26), low social cohesion (OR 1.45 95%CI: 1.10 – 1.92), and high disorder (OR 1.76, 95%CI: 1.37 – 2.27), while living location and material deprivation were not related to food insecurity. These associations were independent of household SES and other social variables. Conclusion These results highlight the potential role of the local social environment in preventing and ameliorating food insecurity at the household level. Stakeholders providing food security interventions at the community level should consider interactions with local social characteristics and perhaps
Rebick, Gabriel W; Franke, Molly F; Teng, Jessica E; Gregory Jerome, J; Ivers, Louise C
Food rations are increasingly offered as part of HIV programs in resource-poor settings, often targeted solely to those with under-nutrition by low body mass index (BMI). This practice does not consider food insecurity, another important risk factor for poor outcomes in people living with HIV/AIDS (PLWH). We analyzed factors associated with low BMI and severe food insecurity in 523 PLWH receiving antiretroviral therapy in rural Haiti using logistic regression. Food insecurity was present in 89 % of individuals. Among those with severe food insecurity, 86 % had a BMI ≥ 18.5 kg/m(2). Severe food insecurity was associated with illiteracy [adjusted odds ratio (AOR) 1.79, p = 0.005], having no income (AOR 1.58, p = 0.04), and poverty (p < 0.001). Compared with those with little to no food insecurity, individuals with severe food insecurity had a less diverse diet. We found that food insecurity was highly prevalent in PLWH receiving antiretroviral therapy in rural Haiti. Using BMI as a sole criterion for food supplementation in HIV programs can exclude highly vulnerable individuals who may benefit from such support.
Kalil, Ariel; Chen, Jen-Hao
Recent data have shown that children of immigrant noncitizens experience more persistent and higher levels of food insecurity than the children of citizens following welfare reform. However, little is known about the range of factors that might explain different rates of food insecurity in the different populations. In this study, the authors used national data from the Early Childhood Longitudinal Study-Kindergarten cohort to assess this question, using multivariate probit regression analyses in a low-income sample. They found that households of children (foreign and U.S.-born) with noncitizen mothers are at substantially greater risk of food insecurity than their counterparts with citizen mothers and that demographic characteristics such as being Latina, levels of maternal education, and large household size explain about half of the difference in rates.
Dixon, Jane M; Donati, Kelly J; Pike, Lucy L; Hattersley, Libby
Affluent diets have negative effects on the health of the population and the environment. Moreover, the ability of industrialised agricultural ecosystems to continue to supply these diets is threatened by the anticipated consequences of climate change. By challenging the ongoing supply the diets of affluent countries, climate change provides a population and environmental health opportunity. This paper contrasts two strategies for dealing with climate change-related food insecurity. Functional foods are being positioned as one response because they are considered a hyper-efficient mechanism for supplying essential micronutrients. An alternative response is civic and urban agriculture. Rather than emphasising increased economic or nutritional efficiencies, civic agriculture presents a holistic approach to food security that is more directly connected to the economic, environmental and social factors that affect diet and health.
de Souza Bittencourt, Liliane; Chaves dos Santos, Sandra Maria; de Jesus Pinto, Elizabete; Aliaga, Marie Agnes; de Cássia Ribeiro-Silva, Rita
This cross-sectional study was conducted to find out the factors associated with food insecurity (FI) in households of the students aged 6-12 years in public schools of Salvador city, Bahia, Brazil. The study included 1,101 households. Food and nutritional insecurity was measured using the Brazilian Food Insecurity Scale (BFIS). Data on socioeconomic and demographic characteristics as well as environmental and housing conditions were collected during the interviews conducted with the reference persons. Multivariate polytomous logistic regression was used in assessing factors associated with food insecurity. We detected prevalence of food insecurity in 71.3% of the households. Severe and moderate forms of FI were diagnosed in 37.1% of the households and were associated with: (i) female gender of the reference person in the households (OR 2.21, 95% CI 1.47-3.31); (ii) a monthly per-capita income below one-fourth of the minimum wage (US$ 191.73) (OR 2.63, 95% CI 1.68-4.08); (iii) number of residents per bedroom below 3 persons (OR 1.91, 95% CI 1.23-2.96); and (iv) inadequate housing conditions (OR 1.84, 95% CI 1.12-4.49). Socioeconomic inequalities determine the factors associated with FI of households in Salvador, Bahia. Identifying vulnerabilities is necessary to support public policies in reducing food insecurity in the country. The results of the present study may be used in re-evaluating strategies that may limit the inequalities in school environment.
Bittencourt, Liliane de Souza; dos Santos, Sandra Maria Chaves; Pinto, Elizabete de Jesus; Aliaga, Marie Agnès
This cross-sectional study was conducted to find out the factors associated with food insecurity (FI) in households of the students aged 6-12 years in public schools of Salvador city, Bahia, Brazil. The study included 1,101 households. Food and nutritional insecurity was measured using the Brazilian Food Insecurity Scale (BFIS). Data on socioeconomic and demographic characteristics as well as environmental and housing conditions were collected during the interviews conducted with the reference persons. Multivariate polytomous logistic regression was used in assessing factors associated with food insecurity. We detected prevalence of food insecurity in 71.3% of the households. Severe and moderate forms of FI were diagnosed in 37.1% of the households and were associated with: (i) female gender of the reference person in the households (OR 2.21, 95% CI 1.47-3.31); (ii) a monthly per-capita income below one-fourth of the minimum wage (US$ 191,73) (OR 2.63, 95% CI 1.68-4.08); (iii) number of residents per bedroom below 3 persons (OR 1.91, 95% CI 1.23-2.96); and (iv) inadequate housing conditions (OR 1.84, 95% CI 1.12-4.49). Socioeconomic inequalities determine the factors associated with FI of households in Salvador, Bahia. Identifying vulnerabilities is necessary to support public policies in reducing food insecurity in the country. The results of the present study may be used in re-evaluating strategies that may limit the inequalities in school environment. PMID:24592588
Munger, Ashley L; Hofferth, Sandra L; Grutzmacher, Stephanie K
Food insecurity is a substantial stressor for many households. Though an association between food insecurity and depression has been well established, most studies have been cross-sectional. Although many receive benefits from the Supplemental Nutrition Assistance Program (SNAP), its role in reducing distress associated with food insecurity is unclear. Using data from 1,225 women who participated in the Fragile Families and Child Wellbeing Study, this study investigated 1) whether change in food security status predicts change in depression severity over a two-year period, 2) whether participating in SNAP predicts depression, and 3) whether the relationship between food insecurity and depression varies based on receipt of SNAP. Food insecurity was linked to probability of depression over time. Additionally, for those who became food insecure over the two-year period, losing SNAP benefits was associated with increased probability of depression, while gaining benefits was associated with reduced probability of depression. This suggests that the SNAP program offsets emotional hardship for those who have recently become food insecure. Further research is needed to evaluate the most efficient and efficacious means to reduce food insecurity and improve emotional wellbeing among vulnerable families.
Dharod, Jigna M.; Croom, Jamar E.; Sady, Christine G.
Objective: To examine the association between food insecurity, dietary intake, and body mass index among Somali refugee women living in the United States. Methods: Cross-sectional study utilizing the snowball sampling method. Results: Most (67%) participants experienced some level of food insecurity, which was common among recent arrivals and…
Our goal was to determine the relationship between food insecurity and CD4 counts and viral suppression among pediatric HIV-positive patients. Food insecurity was assessed by validated survey. CD4 counts and viral load were abstracted from patients’ charts. We used linear regression for the dependen...
Davison, Karen M.; Gondara, Lovedeep; Kaplan, Bonnie J.
Background: To address nutrition-related population mental health data gaps, we examined relationships among food insecurity, diet quality, and perceived mental health. Methods: Stratified and logistic regression analyses of respondents aged 19–70 years from the Canadian Community Health Survey, Cycle 2.2 were conducted (n = 15,546). Measures included the Household Food Security Survey Module, diet quality (i.e., comparisons to the Dietary Reference Intakes, Healthy Eating Index), perceived mental health (poor versus good), sociodemographics, and smoking. Results: In this sample, 6.9% were food insecure and 4.5% reported poor mental health. Stratified analysis of food security and mental health status by age/gender found associations for poor diet quality, protein, fat, fibre, and several micronutrients (p-values < 0.05); those who were food insecure tended to have higher suboptimal intakes (p-values < 0.05). After adjustment for covariates, associations in relation to mental health emerged for food insecurity (OR = 1.60, 95% CI 1.45–1.71), poor diet quality (1.61, 95% CI 1.34–1.81), and suboptimal intakes of folate (OR = 1.58, 95% CI 1.17–1.90) and iron (OR = 1.45, 95% CI 1.23–1.88). Conclusions: Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health. PMID:28335418
Hadley, Craig; Stevenson, Edward Geoffrey Jedediah; Tadesse, Yemesrach; Belachew, Tefera
The rise in food prices since 2007 is widely recognized as signaling a crisis of food insecurity among the world's poor. Scholars sought to chart the impacts of the crisis on food insecurity by conducting simulation studies, assessing anthropometric outcomes, and evaluating shifts in experience-based measures of food security. Few studies, however, have investigated the broader impacts on those most vulnerable and how rapid rises in food prices play out in the everyday lives of those most impacted. We used qualitative methods to investigate the impact of the rise in food prices on the urban poor in Ethiopia. Twenty semi-structured interviews were conducted in August 2011, in the provincial town of Jimma. Themes identified in these interviews included coping strategies, consumption priorities, and impacts on institutional networks of sharing. Our results suggest that several important cultural practices, including funerals and coffee ceremonies, were undermined by the rise in prices, and that respondents linked food prices to increasing food insecurity, which they in turn linked to high levels of stress, poor mental health, and reduced physical health. Our results are consistent with several other studies that suggest that food insecurity has a range of non-nutritional consequences, and that these are due in part to the highly social nature of food. Recognizing the effects of food insecurity on dimensions of everyday life such as interaction with neighbors, and feelings of shame, draws attention to the potential for food price increases to have erosive effects on communal social capital, and to increase the vulnerability of affected peoples to future shocks.
Background Access to sufficient food is essential for household welfare as well as for accomplishing other development activities. Households with insufficient access to food often face other challenges related to food insecurity including poor health and a decline in productivity. These challenges can often create a vicious circle whereby households are unable to produce enough food even during a good crop season. Thus, this study aimed to determine the magnitude of food insecurity and its determinants in rural households of Farta District, Northwest Ethiopia. Methods A community based cross-sectional study was conducted from September to October 2012. Household heads were recruited using a multistage random sampling technique. Data were collected by face-to-face interviews using the Household Food Insecurity Access Scale (HFIAS) tool after verbal informed consent. Data were entered to Epi info 2002 and exported to SPSS version 16 for analysis. Multiple logistic regressions were fitted and odds ratios with 95% confidence intervals were calculated to identify associated factors and control confounding effect. Results A total of 836 households were included in this study. Nearly three quarters of the households (70.7%) had food insecurity. Households headed by females (AOR = 3.18, 95% CI:1.08, 15.21), lack of education (AOR = 2.59, 95% CI: 1.46, 4.60), family size of 4-7 (AOR = 2.39, 95% CI: 1.21,4.70), family size of >7 (AOR = 13.23,95% CI:6.18, 28.32), few or absence of livestock (AOR = 5.60, 95% CI:1.28, 24.43), absence of income from off-farm activities (AOR = 3.12, 95% CI:1.53, 6.36), lack of irrigation (AOR = 3.54, 95% CI:2.14, 5.18) and lack of perennial income (AOR = 3.15, 95% CI:1.88, 5.27) were factors associated with food insecurity. Conclusions This study revealed that most households of the district were food insecure. Hence, the promotion of contraceptive use, off-farm employment activities and the development of small
Khan, Shamima; Pinckney, Richard G.; Keeney, Dorigen; Frankowski, Barbara; Carney, Jan K.
Background: Access to sufficient food--in terms of both quality and quantity--is especially critical for children. Undernourishment during childhood and adolescence can have health implications, both short and long term. The prevalence of food insecurity was assessed in a sample of Vermont school children, as well as the relationship between food…
Morales, Mary E.; Epstein, Michael H.; Marable, Danelle E.; Oo, Sarah A.
Background Food insecurity, uncertainty about the ability to acquire adequate food, is associated with cardiometabolic disease in pregnant women. Whether food insecurity interventions improve cardiometabolic health is unknown. Methods We conducted a retrospective analysis of women who visited the obstetrics clinic in a community health center from 2013 through 2015. Patients could be referred to the Food for Families (Food for Families) program, which connects food insecure women to food resources. We hypothesized that participation in Food for Families would be associated with better blood pressure and blood glucose trends during pregnancy. We used a propensity score–matched design to reduce bias from differential entry into Food for Families. Results Eleven percent of women who visited the obstetrics clinic were referred to Food for Families. In propensity score–matched analyses, we found no difference in baseline systolic blood pressure (SBP) between those who were referred and enrolled in Food for Families (113.5 mm Hg), those who were referred and did not enroll in Food for Families (113.9 mm Hg), and those who were not referred to Food for Families (114 mm Hg) (P = .79). However, during pregnancy, women who were referred to and enrolled in Food for Families had a better SBP trend (0.2015 mm Hg/wk lower, P = .006). SBP trends did not differ between women who were referred and did not enroll in Food for Families and those who were not referred. We observed no differences in blood glucose trends between groups (P = .40). Conclusions Food for Families participation was associated with better blood pressure trends in pregnant women but no differences in blood glucose trends. Food insecurity reduction programs may improve cardiovascular health for vulnerable pregnant women, and this topic deserves further study incorporating randomized program entry. PMID:27809418
Ghose, Bishwajit; Tang, Shangfeng
Background: Food insecurity and hidden hunger (micronutrient deficiency) affect about two billion people globally. Household food insecurity (HFI) has been shown to be associated with one or multiple micronutrient (MMN) deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh. Methodology: Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011). Food security was measured by the Household Food Insecurity Access Scale (HFIAS). Capillary hemoglobin concentration (Hb) measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods. Results: Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840–1.082), wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176–1.594; and average: p = 0.030; 95%CI = 1.017–1.398), educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132–1.439) and household food insecurity (p < 0.001; 95%CI = 1.348–1.830). Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts. Conclusion: HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken into
Chinnakali, Palanivel; Upadhyay, Ravi P.; Shokeen, Deepa; Singh, Kavita; Kaur, Manpreet; Singh, Arvind K.; Goswami, Anil; Pandav, Chandrakant S.
ABSTRACT An adequate food intake, in terms of quantity and quality, is a key to healthy life. Malnutrition is the most serious consequence of food insecurity and has a multitude of health and economic implications. India has the world's largest population living in slums, and these have largely been underserved areas. The State of Food Insecurity in the World (2012) estimates that India is home to more than 217 million undernourished people. Various studies have been conducted to assess food insecurity at the global level; however, the literature is limited as far as India is concerned. The present study was conducted with the objective of documenting the prevalence of food insecurity at the household level and the factors determining its existence in an urban slum population of northern India. This cross-sectional study was conducted in an urban resettlement colony of South Delhi, India. A pre-designed, pre-tested, semi-structured questionnaire was used for collecting socioeconomic details and information regarding dietary practices. Food insecurity was assessed using Household Food Insecurity Access Scale (HFIAS). Logistic regression analysis was performed to determine the factors associated with food insecurity. A total of 250 women were interviewed through house-to-house survey. Majority of the households were having a nuclear family (61.6%), with mean family-size being 5.5 (SD±2.5) and the mean monthly household income being INR 9,784 (SD±631). Nearly half (53.3%) of the mean monthly household income was spent on food. The study found that a total of 77.2% households were food-insecure, with 49.2% households being mildly food-insecure, 18.8% of the households being moderately food-insecure, and 9.2% of the households being severely food-insecure. Higher education of the women handling food (OR 0.37, 95% CI 0.15-0.92; p≤0.03) and number of earning members in the household (OR 0.68, 95% CI 0.48-0.98; p≤0.04) were associated with lesser chance/odds of being
Leonard, Tammy; Xuan, Lei; Amory, Richard; Higashi, Robin T.; Nguyen, Oanh Kieu; Pezzia, Carla; Swales, Stephanie
Introduction Food insecurity is negatively associated with health; however, health needs may differ among people participating in food assistance programs. Our objectives were to characterize differences in health among people receiving different types of food assistance and summarize strategies for targeted recruitment and outreach of various food insecure populations. Methods We examined health status, behaviors, and health care access associated with food insecurity and receipt of food assistance among US adults aged 20 years or older using data from participants (N = 16,934) of the National Health and Nutrition Examination Survey from 2005 through 2010. Results Food insecurity affected 19.3% of US adults (95% confidence interval, 17.9%–20.7%). People who were food insecure reported poorer health and less health care access than those who were food secure (P < .001 for all). Among those who were food insecure, 58.0% received no assistance, 20.3% received only Supplemental Nutrition Assistance Program (SNAP) benefits, 9.7% received only food bank assistance, and 12.0% received both SNAP and food bank assistance. We observed an inverse relationship between receipt of food assistance and health and health behaviors among the food insecure. Receipt of both (SNAP and food bank assistance) was associated with the poorest health; receiving no assistance was associated with the best health. For example, functional limitations were twice as prevalent among people receiving both types of food assistance than among those receiving none. Conclusion Receipt of food assistance is an overlooked factor associated with health and has the potential to shape future chronic disease prevention efforts among the food insecure. PMID:27736055
Loopstra, Rachel; Reeves, Aaron; McKee, Martin; Stuckler, David
Food insecurity rose sharply in Europe after 2009, but marked variation exists across countries and over time. We test whether social protection programs protected people from food insecurity arising from economic hardship across Europe. Data on household food insecurity covering 21 EU countries from 2004 to 2012 were taken from Eurostat 2015 edition and the Organisation for Economic Cooperation and Development. Cross-national first difference models were used to evaluate how rising unemployment and declining wages related to changes in the prevalence of food insecurity and the role of social protection expenditure in modifying observed effects. Economic hardship was strongly associated with greater food insecurity. Each 1 percentage point rise in unemployment rates was associated with an estimated 0.29 percentage point rise in food insecurity (95% CI: 0.10 to 0.49). Similarly, each $1000 decreases in annual average wages was associated with a 0.62 percentage point increase in food insecurity (95% CI: 0.27 to 0.97). Greater social protection spending mitigated these risks. Each $1000 spent per capita reduced the associations of rising unemployment and declining wages with food insecurity by 0.05 percentage points (95% CI: -0.10 to -0.0007) and 0.10 (95% CI: -0.18 to -0.006), respectively. The estimated effects of economic hardship on food insecurity became insignificant when countries spent more than $10,000 per capita on social protection. Rising unemployment and falling wages are strong statistical determinants of increasing food insecurity, but at high levels of social protection, these associations could be prevented.
Bernal, Jennifer; Frongillo, Edward A; Rivera, Juan A
Household food security shows little indication of nutrient inadequacy among children, according to reports made by parents. We examined the associations of food insecurity as reported by children and mothers with children's consumption of energy, macronutrients such as vitamin A, calcium, iron and zinc, and selected foods, and whether these associations differed by child's gender. This cross-sectional study had non-probabilistic 128 Venezuelan mother-child pairs. We assessed food insecurity and management strategies in children using 10- and nine-item instruments, respectively. Mothers' report of food insecurity came from a previously validated 12-item instrument. Nutrient intake of children was assessed with a 67-item food frequency questionnaire. Comparisons were made using chi-square test for contingency tables and t-tests for trends (P < 0.05). Linear regression models were used for intakes of nutrients and selected foods. We tested for interactions with gender. Prevalence of child- and mother-reported food insecurity was 83.6 and 61.7%, respectively (P < 0.01). Greater food insecurity or management strategies reported by boys was associated with lower calcium, iron and zinc intake (P < 0.05), but reported intakes were low in girls who are even food secure. Rice and corn flour consumption was higher with higher food insecurity in children. Papaya and banana were less consumed by food-insecure children. We found shifts in 13 of 67 foods consumed, with less quality in those food insecure, as reported by children. Mother-reported food insecurity was associated only with rice intake of children. In contrast to mothers' reports, food insecurity reported by children was associated with children's lower quality of diet and shifts in foods consumed.
Wight, Vanessa; Kaushal, Neeraj; Waldfogel, Jane; Garfinkel, Irv
This paper examines the association between poverty and food insecurity among children, using two different definitions of poverty-the official poverty measure (OPM) and the new supplemental poverty measure (SPM) of the Census Bureau, which is based on a more inclusive definition of family resources and needs. Our analysis is based on data from the 2001-11 Current Population Survey and shows that food insecurity and very low food security among children decline as income-to-needs ratio increases. The point estimates show that the associations are stronger as measured by the new supplemental measure of income-to-needs ratio than when estimated through the official measure. Statistical tests reject the hypothesis that poor households' odds of experiencing low food security are the same whether the SPM or OPM measure is used; but the tests do not reject the hypothesis when very low food security is the outcome.
Wight, Vanessa; Kaushal, Neeraj; Waldfogel, Jane; Garfinkel, Irv
This paper examines the association between poverty and food insecurity among children, using two different definitions of poverty—the official poverty measure (OPM) and the new supplemental poverty measure (SPM) of the Census Bureau, which is based on a more inclusive definition of family resources and needs. Our analysis is based on data from the 2001–11 Current Population Survey and shows that food insecurity and very low food security among children decline as income-to-needs ratio increases. The point estimates show that the associations are stronger as measured by the new supplemental measure of income-to-needs ratio than when estimated through the official measure. Statistical tests reject the hypothesis that poor households’ odds of experiencing low food security are the same whether the SPM or OPM measure is used; but the tests do not reject the hypothesis when very low food security is the outcome. PMID:25045244
The purpose of this study was to assess the overall relationships among food insecurity, parent mediators, and parent behaviors towards children’s dietary behavior in a predominantly Hispanic population. This cross-sectional study was a secondary analysis of baseline data from women with families wh...
McLaughlin, Katie A.; Green, Jennifer Greif; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.
Objective: To examine whether food insecurity is associated with past-year "DSM-IV" mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method: Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication…
Slopen, Natalie; Fitzmaurice, Garrett; Williams, David R.; Gilman, Stephen E.
Objective: This study investigated the associations of poverty and food insecurity over a 2-year period with internalizing and externalizing problems in a large, community-based sample. Method: A total of 2,810 children were interviewed between ages 4 and 14 years at baseline, and between ages 5 and 16 years at follow-up. Primary caregivers…
Sonik, Rajan; Parish, Susan L.; Ghosh, Subharati; Igdalsky, Leah
The authors examined food insecurity in households including children with disabilities, analyzing data from the 2004 and 2008 panels of the Survey of Income and Program Participation, which included 24,729 households with children, 3,948 of which had children with disabilities. Logistic regression models were used to estimate the likelihood of…
Bhattacharya, Jayanta; Currie, Janet; Haider, Steven
This study examined the extent to which food insecurity questions and the standard poverty measure were correlated with various dietary and physiologic outcomes. It used the National Health and Nutrition Examination Survey III, which between 1994-98 collected dietary recall information, surveyed respondents, and analyzed blood samples.…
Gorman, Kathleen S.; Zearley, Karli Kondo; Favasuli, Stephen
Recent literature has noted that in some cases, less acculturation may be protective against adverse outcomes. This study sought to clarify the relationships between acculturation, food insecurity, and child outcomes. A sample of 339 low-income participants, comprised of non-Hispanic Whites (n = 171), English-speaking Hispanics (n = 89), and…
Hutson, Samantha; Anderson, Melinda; Swafford, Melinda
This paper develops the argument that using the Double ABC-X model in family and consumer sciences (FCS) curricula is a way to educate nutrition and dietetics students regarding a family's perceptions of food insecurity. The Double ABC-X model incorporates ecological theory as a basis to explain family stress and the resulting adjustment and…
Suresh, E; Srinivasan, R; Valan, A S; Klinton, Joel S; Padmapriyadarsini, C
We studied the level of food insecurity among households with HIV-infected children and its relationship with childhood nutritional indicators. Among the 147 children assessed, food insecurity was present in 59% of households. Majority of children with stunting belonged to-food insecure families. Stunting and Underweight were more prevalent among children >5 years of age.
Chung, Wai Ting; Gallo, William T; Giunta, Nancy; Canavan, Maureen E; Parikh, Nina S; Fahs, Marianne C
Among the 14.6% of American households experiencing food insecurity, approximately 2 million are occupied by older adults. Food insecurity among older adults has been linked to poor health, lower cognitive function, and poor mental health outcomes. While evidence of the association between individual or household-level factors and food insecurity has been documented, the role of neighborhood-level factors is largely understudied. This study uses data from a representative sample of 1,870 New York City senior center participants in 2008 to investigate the relationship between three neighborhood-level factors (walkability, safety, and social cohesion) and food insecurity among the elderly. Issues relating to food security were measured by three separate outcome measures: whether the participant had a concern about having enough to eat this past month (concern about food security), whether the participant was unable to afford food during the past year (insufficient food intake related to financial resources), and whether the participant experienced hunger in the past year related to not being able to leave home (mobility-related food insufficiency). Unadjusted and adjusted logistic regression was performed for each measure of food insecurity. Results indicate that neighborhood walkability is an important correlate of mobility-related food insufficiency and concern about food insecurity, even after controlling the effects of other relevant factors.
Anema, A; Weiser, S D; Fernandes, K A; Ding, E; Brandson, E K; Palmer, A; Montaner, J S G; Hogg, R S
This study aimed to assess the prevalence and correlates of food insecurity in a cohort of HIV-infected individuals on highly active antiretroviral therapy (HAART) in British Columbia (BC), Canada. Adults receiving HAART voluntarily enrolled into the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) cohort. Individual food insecurity was measured using a modified version of the Radimer/Cornell Questionnaire. We performed bivariate analyses to determine differences between explanatory variables for individuals who were food secure and food insecure. We performed logistic regression to determine independent predictors of food insecurity. Of the 457 individuals enrolled in the LISA cohort, 324 (71.0%) were found to be food insecure. Multivariate analysis indicated that individuals who had an annual incomes less than $15,000 (odds ratio [OR] 3.15, 95% confidence interval [CI] 1.83, 5.44), used illicit drugs (OR 1.85, 95% CI 1.03, 3.33), smoked tobacco (OR 2.30, 95% CI 1.30, 4.07), had depressive symptoms (OR 2.34, 95% CI 1.38, 3.96), and were younger (OR 0.95, 95% CI, 0.92, 0.98) were more likely to be food insecure. Our results demonstrated a high (71%) prevalence of food insecurity among HIV-infected individuals receiving HAART in this resource-rich setting, and that food insecurity is associated with a compendium of environmental and behavioral factors. More research is needed to understand the biological and social pathways linking food insecurity to these variables in order to identify program strategies that can effectively improve food security among HIV-infected populations.
dos Santos, Leonardo Pozza; Lindemann, Ivana Loraine; Motta, Janaína Vieira dos Santos; Mintem, Gicele; Bender, Eliana; Gigante, Denise Petrucci
OBJECTIVE To propose a short version of the Brazilian Food Insecurity Scale. METHODS Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of 230 low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15,575 women, whose data were obtained from the 2006 National Survey on Demography and Health. Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. RESULTS Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points. In the sensitivity analysis, the short version of seven questions obtained 97.8% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively, while specificity was 100% in both studies. The five-question model showed similar results (sensitivity of 95.7% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively). In the Pelotas sample, the kappa test of the seven-question version totaled 97.0% and that of the five-question version, 95.0%. In the National Survey on Demography and Health sample, the two models presented a 99.0% kappa. CONCLUSIONS We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions. This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters. PMID:25372169
Collins, Patricia A; Power, Elaine M; Little, Margaret H
Household food insecurity (HFI) is a persistent public health problem affecting 3.8 million Canadians. While the causes of HFI are rooted in income insecurity, solutions to HFI have been primarily food-based, with the bulk of activity occurring at the municipal level across Canada. We conceptualize these municipal-level actions as falling within three models: "charitable", "household improvements and supports" and "community food systems". Many initiatives, especially non-charitable ones, generate widespread support, as they aim to increase participants' food security using an empowering and dignified approach. While these initiatives may offer some benefits to their participants, preliminary research suggests that any food-based solution to an income-based problem will have limited reach to food-insecure households and limited impact on participants' experience of HFI. We suspect that widespread support for the local-level food-based approach to HFI has impeded critical judgement of the true potential of these activities to reduce HFI. As these initiatives grow in number across Canada, we are in urgent need of comprehensive and comparative research to evaluate their impact on HFI and to ensure that municipal-level action on HFI is evidence-based.
Kleve, Sue; Davidson, Zoe E; Gearon, Emma; Booth, Sue; Palermo, Claire
Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006-09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40000-$80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9-4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.
Weaver, Lesley Jo; Hadley, Craig
Food insecurity is a significant problem in the developing world, and one that is likely to increase given the current global food crisis spurred by rising oil prices, conversion of food to biofuels, and reduced harvests in the wake of natural disasters. The impacts of food insecurity on nutrition status, growth, and development are well substantiated; less is known about the non-nutritional impacts of food insecurity, such as its effects on mental health. This systematic review assesses current findings regarding the impacts of food insecurity on mental health in developing countries. Both qualitative and quantitative studies are considered. The results of the search reveal that little work has examined these issues directly, and serious methodological flaws are present in many of the existing studies. Gaps in the literature, implications, and research priorities are discussed.
Njai, Rashid S.; Siegel, Paul Z.
Food insecurity is positively linked to risk of hypertension; however, it is not known whether this relationship persists after adjustment for socioeconomic position (SEP). We examined the association between food insecurity and self-reported hypertension among adults aged 35 or older (N = 58,677) in 12 states that asked the food insecurity question in their 2009 Behavioral Risk Factor Surveillance System questionnaire. After adjusting for SEP, hypertension was more common among adults reporting food insecurity (adjusted prevalence ratio, 1.27; 95% confidence interval, 1.19–1.36). Our study found a positive relationship between food insecurity and hypertension after adjusting for SEP and other characteristics. PMID:25232748
Irving, Shalon M; Njai, Rashid S; Siegel, Paul Z
Food insecurity is positively linked to risk of hypertension; however, it is not known whether this relationship persists after adjustment for socioeconomic position (SEP). We examined the association between food insecurity and self-reported hypertension among adults aged 35 or older (N = 58,677) in 12 states that asked the food insecurity question in their 2009 Behavioral Risk Factor Surveillance System questionnaire. After adjusting for SEP, hypertension was more common among adults reporting food insecurity (adjusted prevalence ratio, 1.27; 95% confidence interval, 1.19-1.36). Our study found a positive relationship between food insecurity and hypertension after adjusting for SEP and other characteristics.
Gallegos, Danielle; Ramsey, Rebecca; Ong, Kai Wen
Insufficient access to food is known to compromise tertiary studies. Students often belong to groups known to have poor food security such as those renting or relying on government payments. The present study administered a cross-sectional survey incorporating the USDA food security survey module (FSSM) to 810 students at a metropolitan university…
In the decade since the World Food Conference of 1974, increased attention has been directed to the problems of world food security. The emphasis on technologies of production, while important, have not sufficed. Two major shortcomings of the World Food Conference and the efforts it stimulated were (1) the failure to recognize the relationship…
Norhasmah, S; Zalilah, M S; Mohd Nasir, M T; Kandiah, M; Asnarulkhadi, A S
Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to
Vega-López, Sonia; Chhabra, Jyoti; Segura-Pérez, Sofia; Damio, Grace; Pérez-Escamilla, Rafael
Racial/ethnic minorities are disproportionately affected by barriers to health care access and utilization. The primary objective was to test for an independent association between household food insecurity and health care access/utilization. In this cross-sectional survey, 211 Latinos (predominantly, Puerto-Ricans) with type 2 diabetes (T2D) were interviewed at their homes. Factor analyses identified four barriers for health care access/utilization: enabling factor, doctor access, medication access and forgetfulness. Multivariate logistic regression models examined the association between each of the barrier factors and food insecurity controlling for sociodemographic, cultural, psychosocial, and diabetes self-care variables. Higher food insecurity score was a risk factor for experiencing enabling factor (OR = 1.46; 95% CI = 1.17–1.82), medication access (OR = 1.26; 95 CI% = 1.06–1.50), and forgetfulness (OR = 1.22; 95 CI% = 1.04–1.43) barriers. Higher diabetes management self-efficacy was protective against all four barriers. Other variables associated with one or more barriers were health insurance, perceived health, depression, blood glucose, age and education. Findings suggest that addressing barriers such as food insecurity, low self-efficacy, lack of health insurance, and depression could potentially result in better health care access and utilization among low income Puerto-Ricans with T2D. PMID:22101725
Kollannoor-Samuel, Grace; Vega-López, Sonia; Chhabra, Jyoti; Segura-Pérez, Sofia; Damio, Grace; Pérez-Escamilla, Rafael
Racial/ethnic minorities are disproportionately affected by barriers to health care access and utilization. The primary objective was to test for an independent association between household food insecurity and health care access/utilization. In this cross-sectional survey, 211 Latinos (predominantly, Puerto-Ricans) with type 2 diabetes (T2D) were interviewed at their homes. Factor analyses identified four barriers for health care access/utilization: enabling factor, doctor access, medication access and forgetfulness. Multivariate logistic regression models examined the association between each of the barrier factors and food insecurity controlling for sociodemographic, cultural, psychosocial, and diabetes self-care variables. Higher food insecurity score was a risk factor for experiencing enabling factor (OR = 1.46; 95% CI = 1.17-1.82), medication access (OR = 1.26; 95 CI% = 1.06-1.50), and forgetfulness (OR = 1.22; 95 CI% = 1.04-1.43) barriers. Higher diabetes management self-efficacy was protective against all four barriers. Other variables associated with one or more barriers were health insurance, perceived health, depression, blood glucose, age and education. Findings suggest that addressing barriers such as food insecurity, low self-efficacy, lack of health insurance, and depression could potentially result in better health care access and utilization among low income Puerto-Ricans with T2D.
Hutson, Royce A.; Trzcinski, Eileen; Kolbe, Athena R.
Background Recent commentary on the health consequences of natural disasters has suggested a dearth of research on understanding the antecedents prior to the disaster that are associated with health consequences after the disaster. Utilizing data from a two-wave panel survey of Port-au-Prince, Haiti, conducted just prior to and six weeks after the January 2010 earthquake, we test factors prior to the quake hypothesized to be associated with food insecurity after the quake. Methods Using random Global Positioning System (GPS) sampling, we re-interviewed 93.1% (N = 1732) of the original 1,800 households interviewed in 2009. Respondents were queried with regard to mortalities, injuries, food security, housing, and other factors after the quake. Findings Child food insecurity was found to be common on all three indices of food security (17.2%–22.6%). Additionally, only 36.5% of school-aged children were attending school prior to the quake. Findings suggest that prior schooling was associated with a substantial reduction on food insecurity indices (OR 0.62–0.75). Findings further suggest that several household characteristics were associated with food insecurity for children. Prior chronic/acute illnesses, poor living conditions, remittances from abroad, primary respondent mental health, and histories of criminal and other human rights violations committed against family members prior to the quake were associated with food insecurity after the earthquake. Earned household income after the quake was only associated with one of the measures of food insecurity. Interpretation Food insecurity for children was common after the quake. Those households vulnerable on multiple dimensions prior to the quake were also vulnerable to food insecurity after the quake. Remittances from abroad were leading protective factors for food security. Because Haiti is well known for the potentiality of both hurricanes and earthquakes, reconstruction and redevelopment should focus on
Webb-Girard, Aimee; Cherobon, Anne; Mbugua, Samwel; Kamau-Mbuthia, Elizabeth; Amin, Allison; Sellen, Daniel W
This study aimed to document whether food insecurity was associated with beliefs and attitudes towards exclusive breastfeeding (EBF) among urban Kenyan women. We conducted structured interviews with 75 human immunodeficiency virus (HIV)-affected and 75 HIV-status unknown, low-income women who were either pregnant or with a child ≤24 months and residing in Nakuru, Kenya to generate categorical and open-ended responses on knowledge, attitudes and beliefs towards EBF and food insecurity. We facilitated six focus group discussions (FGD) with HIV-affected and HIV-status unknown mothers (n = 50 women) to assess barriers and facilitators to EBF. Of 148 women with complete interview data, 77% were moderately or severely food insecure (FIS). Women in FIS households had significantly greater odds of believing that breast milk would be insufficient for 6 months [odds ratio (OR), 2.6; 95% confidence interval (95% CI), 1.0, 6.8], that women who EBF for 6 months would experience health or social problems (OR, 2.7; 95% CI, 1.0, 7.3), that women need adequate food to support EBF for 6 months (OR, 2.6; 95% CI, 1.0, 6.7) and that they themselves would be unable to follow a counsellor's advice to EBF for 6 months (OR, 3.2; 95% CI, 1.3, 8.3). Qualitative analysis of interview and FGD transcripts indicated that the maternal experience of hunger contributes to perceived milk insufficiency, anxiety about infant hunger and a perception that access to adequate food is necessary for successful breastfeeding. The lived experience of food insecurity among a sample of low-income, commonly FIS, urban Kenyan women reduces their capacity to implement at least one key recommended infant feeding practices, that of EBF for 6 months.
Frith, Amy L; Naved, Ruchira T; Persson, Lars Ake; Rasmussen, Kathleen M; Frongillo, Edward A
Food insecurity is detrimental to child development, yet little is known about the combined influence of food insecurity and nutritional interventions on child development in low-income countries. We proposed that women assigned to an early invitation time to start a prenatal food supplementation program could reduce the negative influence of food insecurity on maternal-infant interaction. A cohort of 180 mother-infant dyads were studied (born between May and October 2003) from among 3267 in the randomized controlled trial Maternal Infant Nutritional Interventions Matlab, which was conducted in Matlab, Bangladesh. At 8 wk gestation, women were randomly assigned an invitation time to start receiving food supplements (2.5 MJ/d; 6 d/wk) either early (~9 wk gestation; early-invitation group) or at the usual start time (~20 wk gestation; usual-invitation group) for the government program. Maternal-infant interaction was observed in homes with the use of the Nursing Child Assessment Satellite Training Feeding Scale, and food-insecurity status was obtained from questionnaires completed when infants were 3.4-4.0 mo old. By using a general linear model for maternal-infant interaction, we found a significant interaction (P = 0.012) between invitation time to start a prenatal food supplementation program and food insecurity. Those in the usual-invitation group with higher food insecurity scores (i.e., more food insecure) had a lower quality of maternal-infant interaction, but this relationship was ameliorated among those in the early-invitation group. Food insecurity limits the ability of mothers and infants to interact well, but an early invitation time to start a prenatal food supplementation program can support mother-infant interaction among those who are food insecure.
Farrell, Kenneth R.
Effective economic demand, rather than resource constraints, will continue to be the dominant limiting factor in improving the security of world food supplies between now and the year 2000. The global demand for food will continue to grow but the rate of growth is declining in virtually all regions, easing the pressure on agricultural resources.…
Gubert, Muriel Bauermann; Benício, Maria Helena D'Aquino; da Silva, Joseane Padilha; da Costa Rosa, Tereza Etsuko; dos Santos, Soane Mota; dos Santos, Leonor Maria Pacheco
In 2004 the National Household Survey (Pesquisa Nacional por Amostras de Domicilios-PNAD) estimated the prevalence of food and nutrition insecurity in Brazil. However, PNAD data cannot be disaggregated at the municipal level. The objective of this study was to build a statistical model to predict severe food insecurity for Brazilian municipalities based on the PNAD dataset. Exclusion criteria were: incomplete food security data (19.30%); informants younger than 18 years old (0.07%); collective households (0.05%); households headed by indigenous persons (0.19%). The modeling was carried out in three stages, beginning with the selection of variables related to food insecurity using univariate logistic regression. The variables chosen to construct the municipal estimates were selected from those included in PNAD as well as the 2000 Census. Multivariate logistic regression was then initiated, removing the non-significant variables with odds ratios adjusted by multiple logistic regression. The Wald Test was applied to check the significance of the coefficients in the logistic equation. The final model included the variables: per capita income; years of schooling; race and gender of the household head; urban or rural residence; access to public water supply; presence of children; total number of household inhabitants and state of residence. The adequacy of the model was tested using the Hosmer-Lemeshow test (p = 0.561) and ROC curve (area = 0.823). Tests indicated that the model has strong predictive power and can be used to determine household food insecurity in Brazilian municipalities, suggesting that similar predictive models may be useful tools in other Latin American countries.
Brown, Molly E.; Tondel, Fabien; Thorne, Jennifer A.; Essam, Timothy; Mann, Bristol F.; Stabler, Blake; Eilerts, Gary
Large price increases over a short time period can be indicative of a deteriorating food security situation. Food price indices developed by the United Nations Food and Agriculture Organization (FAO) are used to monitor food price trends at a global level, but largely reflect supply and demand conditions in export markets. However, reporting by the United States Agency for International Development (USAID)'s Famine Early Warning Systems Network (FEWS NET) indicates that staple cereal prices in many markets of the developing world, especially in surplus-producing areas, often have a delayed and variable response to international export market price trends. Here we present new price indices compiled for improved food security monitoring and assessment, and specifically for monitoring conditions of food access across diverse food insecure regions. We found that cereal price indices constructed using market prices within a food insecure region showed significant differences from the international cereals price, and had a variable price dispersion across markets within each marketshed. Using satellite-derived remote sensing information that estimates local production and the FAO Cereals Index as predictors, we were able to forecast movements of the local or national price indices in the remote, arid and semi-arid countries of the 38 countries examined. This work supports the need for improved decision-making about targeted aid and humanitarian relief, by providing earlier early warning of food security crises.
Frongillo, Edward A; Nguyen, Hoa T; Smith, Michael D; Coleman-Jensen, Alisha
Background: Food insecurity is an aspect of living conditions that is particularly important for quality of life, health, and subjective well-being. The implementation of the 8-item Food Insecurity Experience Scale in 147 countries in the 2014 Gallup World Poll provided an unprecedented opportunity to understand the association of food insecurity with subjective well-being.Objective: We examined how food insecurity relates with measures of living conditions and how food insecurity and other living conditions relate with physical health and, in turn, subjective well-being.Methods: Data were collected from individuals aged ≥15 y by telephone in 38 countries and via face-to-face interviews in 111 others. The available sample was 132,618 (138 countries) and 122,137 (137 countries) for the daily experience and life evaluation indexes of subjective well-being, respectively. Daily experience was a continuous measure and life evaluation was categorized into thriving, struggling, and suffering. We estimated 6 linear or logistic regression models for each index controlling for country as a fixed effect.Results: Food insecurity was associated with the other 3 measures of living conditions: household income, shelter and housing, and employment. Food insecurity explained poor physical health and lower subjective well-being beyond other measures of living conditions. Instrumental and emotional support was associated with higher subjective well-being. The associations of food insecurity with subjective well-being were larger than with other explanatory variables. Food insecurity was associated with subjective well-being within each of the 4 World Bank income classes of countries, with a larger magnitude of differences for the higher-income classes.Conclusions: Food insecurity was strongly and negatively associated with subjective well-being in a large global sample of individuals aged ≥15 y. These results demonstrate the consistency of goal 2 of the Sustainable Development
Loopstra, Rachel; Tarasuk, Valerie
Cross-sectional studies have established a relationship between poverty and food insecurity, but little is known about the acute changes within households that lead to changes in food insecurity. This study examined how changes in income, employment status, and receipt of welfare related to change in severity of food insecurity during 1 y among low-income families. In 2005-2007, 501 families living in market and subsidized rental housing were recruited through door-to-door sampling in high-poverty neighborhoods in Toronto. One year later, families were re-interviewed. The final longitudinal analytic sample included 331 families. Within-household change in income, employment, and welfare receipt were examined in relation to change in severity of food insecurity. Severity was denoted by the aggregate raw score on the Household Food Security Survey Module (HFSSM). Analyses were stratified by housing subsidy status owing to differences in characteristics between households. Food insecurity was a persistent problem among families; 68% were food insecure at both interviews. Severity was dynamic, however, as 73.4% answered more or fewer questions affirmatively on the HFFSM between baseline and follow-up. Among market-rent families, a $2000 gain in income during the year and gain of full-time employment were associated with a 0.29 and 1.33 decrease in raw score, respectively (P < 0.01). This study suggests that improvements in income and employment are related to improvements in families' experiences of food insecurity, highlighting the potential for income- and employment-based policy interventions to affect the severity of household food insecurity for low-income families.
Jilcott, Stephanie B; Wall-Bassett, Elizabeth D; Burke, Sloane C; Moore, Justin B
Obesity disproportionately affects low-income and minority individuals and has been linked with food insecurity, particularly among women. More research is needed to examine potential mechanisms linking obesity and food insecurity. Therefore, this study's purpose was to examine cross-sectional associations between food insecurity, Supplemental Nutrition Assistance Program (SNAP) benefits per household member, perceived stress, and body mass index (BMI) among female SNAP participants in eastern North Carolina (n=202). Women were recruited from the Pitt County Department of Social Services between October 2009 and April 2010. Household food insecurity was measured using the validated US Department of Agriculture 18-item food security survey module. Perceived stress was measured using the 14-item Cohen's Perceived Stress Scale. SNAP benefits and number of children in the household were self-reported and used to calculate benefits per household member. BMI was calculated from measured height and weight (as kg/m(2)). Multivariate linear regression was used to examine associations between BMI, SNAP benefits, stress, and food insecurity while adjusting for age and physical activity. In adjusted linear regression analyses, perceived stress was positively related to food insecurity (P<0.0001), even when SNAP benefits were included in the model. BMI was positively associated with food insecurity (P=0.04). Mean BMI was significantly greater among women receiving <$150 in SNAP benefits per household member vs those receiving ≥$150 in benefits per household member (35.8 vs 33.1; P=0.04). Results suggest that provision of adequate SNAP benefits per household member might partially ameliorate the negative effects of food insecurity on BMI.
Mendoza, Jason A; Matshaba, Mogomotsi; Makhanda, Jeremiah; Liu, Yan; Boitshwarelo, Matshwenyego; Anabwani, Gabriel M.
We investigated the association between household food insecurity (HFI) and CD4% among 2-6 year old HIV+ outpatients (n=78) at the Botswana-Baylor Children's Clinical Center of Excellence in Gaborone, Botswana. HFI was assessed by a validated survey. CD4% data were abstracted from the medical record. We used multiple linear regression with CD4% (dependent variable), HFI (independent variable), and controlled for socio-demographic and clinical covariates. Multiple linear regression showed a significant main effect for HFI (beta=−0.6, 95% CI [−1.0, −0.1]) and child gender (beta=5.6, 95% CI [1.3, 9.8]). Alleviating food insecurity may improve pediatric HIV outcomes in Botswana and similar Sub-Saharan settings. PMID:24798763
Mendoza, Jason A; Matshaba, Mogomotsi; Makhanda, Jeremiah; Liu, Yan; Boitshwarelo, Matshwenyego; Anabwani, Gabriel M
We investigated the association between household food insecurity (HFI) and CD4% among 2-6-year old HIV+ outpatients (n = 78) at the Botswana-Baylor Children's Clinical Center of Excellence in Gaborone, Botswana. HFI was assessed by a validated survey. CD4% data were abstracted from the medical record. We used multiple linear regression with CD4% (dependent variable), HFI (independent variable), and controlled for sociodemographic and clinical covariates. Multiple linear regression showed a significant main effect for HFI [beta = -0.6, 95% confidence interval (CI): -1.0 to -0.1] and child gender (beta = 5.6, 95% CI: 1.3 to 9.8). Alleviating food insecurity may improve pediatric HIV outcomes in Botswana and similar Sub-Saharan settings.
Kaushal, Neeraj; Waldfogel, Jane; Wight, Vanessa
We study the factors associated with food insecurity and participation in the Supplemental Nutrition Assistance Program (SNAP) in Mexican immigrant families in the US. Estimates from analyses that control for a rich set of economic, demographic, and geographic variables show that children in Mexican immigrant families are more likely to be food insecure than children in native families, but are less likely to participate in SNAP. Further, more vulnerable groups such as the first-generation Mexican immigrant families, families in the US for less than 5 years, and families with non-citizen children – that are at a higher risk of food insecurity are the least likely to participate in SNAP. Our analysis suggests that the US Department of Agriculture outreach initiative and SNAP expansion under the American Recovery and Reinvestment Act increased SNAP participation of the mixed-status Mexican families. We do not find any evidence that the outreach and ARRA expansion increased SNAP receipt among Mexican immigrant families with only non-citizen members who are likely to be undocumented. PMID:27570576
Vedovato, Gabriela M.; Surkan, Pamela J.; Jones-Smith, Jessica; Steeves, Elizabeth Anderson; Han, Eunkyung; Trude, Angela C.B.; Kharmats, Anna Y.; Gittelsohn, Joel
Objective To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviors among low-income African-American (AA) families. Design Cross-sectional survey of participants in the baseline evaluation of the B’More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socioeconomic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programs, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Setting Fourteen low-income, predominantly AA neighborhoods in Baltimore City. Subjects 298 adult caregiver-child (10–14 years old) dyads. Results 41.6% of households had some level of food insecurity, and 12.4% experienced some level of hunger. Food insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obese) among adults and children (82.8% and 37.9% food insecure without hunger; 89.2% and 45.9% with hunger, respectively), although there were no significant differences by security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. Conclusions In this setting, obesity and food insecurity are major problems. For many food insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption. PMID:26441159
Aibibula, Wusiman; Cox, Joseph; Hamelin, Anne-Marie; Mamiya, Hiroshi; Klein, Marina B; Brassard, Paul
Food insecurity is defined as a limited or uncertain ability to acquire acceptable foods in socially acceptable ways, or limited or uncertain availability of nutritionally adequate and safe foods. While effective antiretroviral treatment can significantly increase CD4 counts in the majority of patients, there are certain populations who remain at relatively low CD4 count levels. Factors possibly associated with poor CD4 recovery have been extensively studied, but the association between food insecurity and low CD4 count is inconsistent in the literature. The objective is to systematically review published literature to determine the association between food insecurity and CD4 count among HIV-infected people. PubMed, Web of Science, ProQuest ABI/INFORM Complete, Ovid Medline and EMBASE Classic, plus bibliographies of relevant studies were systematically searched up to May 2015, where the earliest database coverage started from 1900. Studies that quantitatively assessed the association between food insecurity and CD4 count among HIV-infected people were eligible for inclusion. Study results were summarized using random effects model. A total of 2093 articles were identified through electronic database search and manual bibliographic search, of which 8 studies included in this meta-analysis. Food insecure people had 1.32 times greater odds of having lower CD4 counts compared to food secure people (OR = 1.32, 95% CI: 1.15-1.53) and food insecure people had on average 91 fewer CD4 cells/µl compared to their food secure counterparts (mean difference = -91.09, 95% CI: -156.16, -26.02). Food insecurity could be a potential barrier to immune recovery as measured by CD4 counts among HIV-infected people.
Anema, Aranka; Fielden, Sarah J.; Shurgold, Susan; Ding, Erin; Messina, Jennifer; Jones, Jennifer E.; Chittock, Brian; Monteith, Ken; Globerman, Jason; Rourke, Sean B.; Hogg, Robert S.
Objective People living with HIV in high-resource settings suffer severe levels of food insecurity; however, limited evidence exists regarding dietary intake and sub-components that characterize food insecurity (i.e. food quantity, quality, safety or procurement) in this population. We examined the prevalence and characteristics of food insecurity among people living with HIV across British Columbia, Canada. Design This cross-sectional analysis was conducted within a national community-based research initiative. Methods Food security was measured using the Health Canada Household Food Security Scale Module. Logistic regression was used to determine key independent predictors of food insecurity, controlling for potential confounders. Results Of 262 participants, 192 (73%) reported food insecurity. Sub-components associated with food insecurity in bivariate analysis included: < RDI consumption of protein (p = 0.046); being sick from spoiled/unsafe food in the past six months (p = 0.010); and procurement of food using non-traditional methods (p <0.05). In multivariable analyses, factors significantly associated with food insecurity included: procurement of food using non-traditional methods [AOR = 11.11, 95% CI: 4.79–25.68, p = <0.001]; younger age [AOR = 0.92, 95% CI: 0.86–0.96, p = <0.001]; unstable housing [AOR = 4.46, 95% CI: 1.15–17.36, p = 0.031]; household gross annual income [AOR = 4.49, 95% CI: 1.74–11.60, p = 0.002]; and symptoms of depression [AOR = 2.73, 95% CI: 1.25–5.96, p = 0.012]. Conclusions Food insecurity among people living with HIV in British Columbia is characterized by poor dietary quality and food procurement methods. Notably, participants who reported procuring in non-traditional manners were over 10 times more likely to be food insecure. These findings suggest a need for tailored food security and social support interventions in this setting. PMID:27487041
Wagner, Julie; Damio, Grace; Segura-Pérez, Sofia; Chhabra, Jyoti; Vega-López, Sonia; Pérez-Escamilla, Rafael
Prevalence of depression is high among individuals with type 2 diabetes (T2D). The objective of the current study was to identify the socio-demographic, psychosocial, cultural, and clinical risk factors that predispose to depression, and resources that protect from depression among low income Latinos with T2D. Participants (N = 211) were interviewed in their homes upon enrollment. Multivariate logistic regression was used to identify factors associated with depressive symptoms based on a score of ≥21 on the Center for Epidemiological Studies Depression scale. Lower household income, interference of diabetes with daily activities, and more T2D clinical symptoms were associated with depression risk in the multivariate analyses. At each level of food insecurity the risk of depression was lower the higher the level of social support (P < 0.05). Findings suggest that social support buffers against the negative influence of household food insecurity on depression risk. A comprehensive approach is necessary to address the mental health needs of low income Latinos with T2D. PMID:21789561
The inexplicable nature of food insecurity in parts of Uganda and worldwide necessitated an investigation into the nature, extent, and differentials of household food security. The main objective of this study was to examine the food security dynamics and model household food insecurity. The Rasch modelling approach was employed on a dataset from a sample of 1175 (Tororo = 577; Busia = 598) randomly selected households in the year 2010. All households provided responses to the food security questions and none was omitted from the analysis. At 5 percent level of significance the analysis indicated that Tororo district average food security assessment (0.137 ± 0.181) was lower than that for Busia district (0.768 ± 0.177). All the mean square fit statistics were in the range of 0.5 to 1.5, and none of them showed any signs of distortion, degradation, or less productivity for measurement. This confirmed that items used in this study were very productive for measurement of food security in the study area. The study recommends further analysis where item responses are ordered polytomous rather than the dichotomous item response functions used. Furthermore, consideration should be given to fit models that allow for different latent distributions for households with children and those without children and possibly other subgroups of respondents. PMID:26904617
Fatmaningrum, Dewi; Roshita, Airin; Februhartanty, Judhiastuty
One in eight people suffer from chronic hunger, leading to an insecure food situation. Chronic hunger mostly occurs in developing countries and includes adolescent girls. Our qualitative study, with data collected in December 2012, provided the results of an exploration of the experiences and strategies implemented by fifteen adolescent girls who tried to cope with their condition of living in food-insecure families. The age of the girls ranged from 10 to 19 years. Their coping strategies were grouped into self-initiated and parent-initiated strategies. Self-initiated coping strategies that were the girls' own initiatives included eating only rice without any vegetables or side dish, eating less-desirable food, reducing portion size, skipping meals, saving pocket money and earning money to buy food. The parent-initiated coping strategies that were initiated by the parents and followed by the girls included selling their own field produce and livestock, asking for food, borrowing food and storing maize for 6 months up to 1 year. These results show that adolescent girls living in food-insecure areas implement several coping strategies in severe conditions, which parents may not be aware of, and such conditions may compromise their growth and health. The acknowledgement of such coping strategies and the girls' food insecurity condition can lead to a useful and suitable food insecurity alleviation programme for the girls and their families.
Seligman, Hilary K; Davis, Terry C; Schillinger, Dean; Wolf, Michael S
More than 14% of the American population is food insecure, or at risk of going hungry because of an inability to afford food. Food-insecure (FI) adults often reduce food intake or substitute inexpensive, energy-dense carbohydrates for healthier foods. We hypothesized these behaviors would predispose FI adults with diabetes to hypoglycemia and impaired diabetes self-management. We therefore assessed whether food insecurity was associated with multiple indicators of diabetes self-management (self-efficacy, medication- and glucose-monitoring adherence, hypoglycemia, or glycemic control) among 40 low-income adults with diabetes. Mean self-efficacy score was lower among FI than food-secure (FS) participants (34.4 vs. 41.2, p=.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR=3.5, p=.008) and more hypoglycemia-related emergency department visits (RR=2.2, p=.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p=.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia.
Jansen, Erica C; Kasper, Nicole; Lumeng, Julie C; Brophy Herb, Holly E; Horodynski, Mildred A; Miller, Alison L; Contreras, Dawn; Peterson, Karen E
Children living in households that have recently become food insecure may be particularly vulnerable to adverse weight and dietary changes, but longitudinal studies examining these associations are lacking. Using data from 501 Head Start preschoolers from Michigan (48% male) who were followed during one school year as a part of a randomized obesity prevention trial, we examined changes in children's adiposity indices and dietary quality according to changes in household food insecurity. Household food insecurity change status was categorized as persistently food secure, became food secure, persistently food insecure, or became food insecure. Linear mixed effects models were used to estimate relative changes in BMI-for-age z scores (BAZ), triceps skinfolds-for-age z scores (TAZ), or diet quality (assessed with the 2010 Healthy Eating Index) over the school year according to food insecurity category. We found that girls from households that became food insecure over the year had a 0.21 unit higher gain in BAZ than girls from households that were persistently food secure, after adjustment for potential confounders (95% CI 0.02 to 0.39, P = 0.03). Girls from households that became food secure had improvements in dietary quality over the year compared to girls from persistently food insecure households (adjusted difference in Healthy Eating Index score change = 9.1 points; 95% CI 3.0 to 15.0; p = 0.003). There were no statistically significant associations with changes in TAZ. Among boys, there were no associations between changes in household food insecurity and changes in BAZ, TAZ, or dietary quality. In summary, we found that BMI and diet quality changes of Head Start preschool girls were correlated with short-term changes in household food insecurity. Continued research efforts should focus on identifying the most effective ways to promote the health of children in food insecure households, especially those who may have recently transitioned or are
Evidence demonstrates food insecurity has a detrimental impact on a range of outcomes for children, but little research has been conducted in the UK, and children have rarely been asked to describe their experiences directly. We examined the experiences of food insecure families living in South London. Our mixed-methods approach comprised a survey of parents (n = 72) and one-to-one semi-structured interviews with children aged 5-11 years (n = 19). The majority of parents (86%) described their food security during the preceding year as very low. Most reported they had often or sometimes had insufficient food, and almost all had worried about running out of food. Two thirds of parents had gone hungry. Most parents reported they had been unable to afford a nutritionally balanced diet for their children, and just under half reported that their children had gone hungry. Four themes emerged from the interviews with children: sources of food; security of food, nutritional quality of food, and experiences of hunger. Children's descriptions of insufficient food being available indicate that parents are not always able to shield them from the impact of food insecurity. The lack of school-meals and after-school clubs serving food made weekends particularly problematic for some children. A notable consequence of food insecurity appears to be reliance on low-cost takeaway food, likely to be nutritionally poor.
Maes, Kenneth C; Hadley, Craig; Tesfaye, Fikru; Shifferaw, Selamawit
The 2008 food crisis may have increased household food insecurity and caused distress among impoverished populations in low-income countries. Policy researchers have attempted to quantify the impact that a sharp rise in food prices might have on population wellbeing by asking what proportion of households would drop below conventional poverty lines given a set increase in prices. Our understanding of the impact of food crises can be extended by conducting micro-level ethnographic studies. This study examined self-reported household food insecurity (FI) and common mental disorders (CMD) among 110 community health AIDS care volunteers living in Addis Ababa, Ethiopia during the height of the 2008 food crisis. We used generalized estimating equations that account for associations between responses given by the same participants over 3 survey rounds during 2008, to model the longitudinal response profiles of FI, CMD symptoms, and socio-behavioral and micro-economic covariates. To help explain the patterns observed in the response profiles and regression results, we examine qualitative data that contextualize the cognition and reporting behavior of AIDS care volunteers, as well as potential observation biases inherent in longitudinal, community-based research. Our data show that food insecurity is highly prevalent, that is it associated with household economic factors, and that it is linked to mental health. Surprisingly, the volunteers in this urban sample did not report increasingly severe FI or CMD during the peak of the 2008 food crisis. This is a counter-intuitive result that would not be predicted in analyses of population-level data such as those used in econometrics simulations. But when these results are linked to real people in specific urban ecologies, they can improve our understanding of the psychosocial consequences of food price shocks.
Frongillo, Edward A.; Ragland, Kathleen; Hogg, Robert S.; Riley, Elise D.; Bangsberg, David R.
Background and Objectives There is growing international concern that food insecurity may negatively impact antiretroviral (ARV) treatment outcomes, but no studies have directly evaluated the effect of food insecurity on viral load suppression and antiretroviral adherence. We hypothesized that food insecurity would be associated with poor virologic response among homeless and marginally housed HIV-positive ARV-treated patients. Design This is a cross-sectional study. Participants and Setting Participants were ARV-treated homeless and marginally housed persons receiving adherence monitoring with unannounced pill counts in the Research on Access to Care in the Homeless (REACH) Cohort. Measurements Food insecurity was measured by the Household Food Insecurity Access Scale (HFIAS). The primary outcome was suppression of HIV viral RNA to <50 copies/ml. We used multivariate logistic regression to assess whether food insecurity was associated with viral suppression. Results Among 104 participants, 51% were food secure, 24% were mildly or moderately food insecure and 25% were severely food insecure. Severely food insecure participants were less likely to have adherence >=80%. In adjusted analyses, severe food insecurity was associated with a 77% lower odds of viral suppression (95% CI = 0.06–0.82) when controlling for all covariates. In analyses stratified by adherence level, severe food insecurity was associated with an 85% lower odds of viral suppression (95% CI = 0.02–0.99) among those with <=80% adherence and a 66% lower odds among those with >80% adherence (95% CI = 0.06–1.81). Conclusions Food insecurity is present in half of the HIV-positive urban poor in San Francisco, one of the best resourced settings for HIV-positive individuals in the United States, and is associated with incomplete viral suppression. These findings suggest that ensuring access to food should be an integral component of public health HIV programs serving impoverished
Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the "First World." In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and community-based nature of the initiatives, and their origins in publicly funded health and social service sectors.
Tsai, Alexander C; Bangsberg, David R; Frongillo, Edward A; Hunt, Peter W; Muzoora, Conrad; Martin, Jeffrey N; Weiser, Sheri D
Depression is common among people living with HIV/AIDS and contributes to a wide range of worsened HIV-related outcomes, including AIDS-related mortality. Targeting modifiable causes of depression, either through primary or secondary prevention, may reduce suffering as well as improve HIV-related outcomes. Food insecurity is a pervasive source of uncertainty for those living in resource-limited settings, and cross-sectional studies have increasingly recognized it as a critical determinant of poor mental health. Using cohort data from 456 men and women living with HIV/AIDS initiating HIV antiretroviral therapy in rural Uganda, we sought to (a) estimate the association between food insecurity and depression symptom severity, (b) assess the extent to which social support may serve as a buffer against the adverse effects of food insecurity, and (c) determine whether the buffering effects are specific to certain types of social support. Quarterly data were collected by structured interviews and blood draws. The primary outcome was depression symptom severity, measured by a modified Hopkins Symptom Checklist for Depression. The primary explanatory variables were food insecurity, measured with the Household Food Insecurity Access Scale, and social support, measured with a modified version of the Functional Social Support Questionnaire. We found that food insecurity was associated with depression symptom severity among women but not men, and that social support buffered the impacts of food insecurity on depression. We also found that instrumental support had a greater buffering influence than emotional social support. Interventions aimed at improving food security and strengthening instrumental social support may have synergistic beneficial effects on both mental health and HIV outcomes among PLWHA in resource-limited settings.
De Marco, Molly; Thorburn, Sheryl; Kue, Jennifer
Many factors are associated with food insecurity in the United States. We conducted interviews with 25 low-income and/or food-insecure Oregonians to explore their experiences with food insecurity, the role of social support, and whether these experiences differed based on rural/urban residence. Ill health and unemployment emerged as food-insecurity contributors. Coping strategies cited included use of nutrition assistance programs, alternate food sources, and drawing on social support. The findings suggest that policy and practice efforts should be directed at increasing the human capital of low-income Oregonians and the benefit levels of essential nutrition assistance programs.
Nalty, Courtney C; Sharkey, Joseph R; Dean, Wesley R
In 2011, an estimated 50.2 million adults and children lived in US households with food insecurity, a condition associated with adverse health effects across the life span. Relying solely on parent proxy may underreport the true prevalence of child food insecurity. The present study sought to understand mothers' and children's (aged 6-11 y) perspectives and experiences of child food insecurity and its seasonal volatility, including the effects of school-based and summertime nutrition programs. Forty-eight Mexican-origin mother-child dyads completed standardized, Spanish-language food-security instruments during 2 in-home visits between July 2010 and March 2011. Multilevel longitudinal logistic regression measured change in food security while accounting for correlation in repeated measurements by using a nested structure. Cohen's κ statistic assessed dyadic discordance in child food insecurity. School-based nutrition programs reduced the odds of child food insecurity by 74% [OR = 0.26 (P < 0.01)], showcasing the programs' impact on the condition. Single head of household was associated with increased odds of child food insecurity [OR = 4.63 (P = 0.03)]. Fair dyadic agreement of child food insecurity was observed [κ = 0.21 (P = 0.02)]. Obtaining accurate prevalence rates and understanding differences of intrahousehold food insecurity necessitate measurement at multiple occasions throughout the year while considering children's perceptions and experiences of food insecurity in addition to parental reports.
Garthwaite, K A; Collins, P J; Bambra, C
Emergency foodbanks have become an increasingly prominent and controversial feature of austerity in Europe and the USA. In the UK, foodbanks have been called a 'public health emergency'. Despite this, there has been no UK research examining the health of foodbank users. Through an ethnographic study, this paper is the first to explore the health and health perceptions of foodbank users via a case study of Stockton-on-Tees in the North East of England, UK during a period of welfare reform and austerity. Participant observation, field notes and interviews with foodbank users and volunteers were conducted over a seventeen month period (November 2013 to March 2015) inside a Trussell Trust foodbank. Foodbank users were almost exclusively of working age, both men and women, with and without dependent children. All were on very low incomes - from welfare benefits or insecure, poorly paid employment. Many had pre-existing health problems which were exacerbated by their poverty and food insecurity. The latter meant although foodbank users were well aware of the importance and constitution of a healthy diet, they were usually unable to achieve this for financial reasons - constantly having to negotiate their food insecurity. More typically they had to access poor quality, readily available, filling, processed foods. Foodbank users are facing the everyday reality of health inequalities at a time of ongoing austerity in the UK.
Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza
Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.
Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza
Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support. PMID:26576154
Martin, Molly A; Lippert, Adam M
This paper investigates one explanation for the consistent observation of a strong, negative correlation in the United States between income and obesity among women, but not men. We argue that a key factor is the gendered expectation that mothers are responsible for feeding their children. When income is limited and households face food shortages, we predict that an enactment of these gendered norms places mothers at greater risk for obesity relative to child-free women and all men. We adopt an indirect approach to study these complex dynamics using data on men and women of childrearing age and who are household heads or partners in the 1999-2003 waves of the Panel Study of Income Dynamics (PSID). We find support for our prediction: Food insecure mothers are more likely than child-free men and women and food insecure fathers to be overweight or obese and to gain more weight over four years. The risks are greater for single mothers relative to mothers in married or cohabiting relationships. Supplemental models demonstrate that this pattern cannot be attributed to post-pregnancy biological changes that predispose mothers to weight gain or an evolutionary bias toward biological children. Further, results are unchanged with the inclusion of physical activity, smoking, drinking, receipt of food stamps, or Women, Infants and Children (WIC) nutritional program participation. Obesity, thus, offers a physical expression of the vulnerabilities that arise from the intersection of gendered childcare expectations and poverty.
ABOLHASSANI, Mohammad Hassan; KOLAHDOOZ, Fariba; MAJDZADEH, Reza; ESHRAGHIAN, Mohammadreza; SHANESHIN, Mahboubeh; JANG, Se Lim; DJAZAYERY, Abolghasem
Background: Food security is a multi-dimensional phenomenon. The objective of this study was to identify and prioritize major indices for determining food insecurity in Iran. Methods: Descriptive study using the Delphi method was conducted through an email-delivered questionnaire. Forty-three senior experts at national or provincial level were selected based on their work experience and educational background through study panel consultation and snowballing from Tehran and other cities of Iran. During two rounds of Delphi, participants were asked to identify priority indicators for food security at provincial level in Iran. Results: Sixty five percent of Delphi panel participated in the first round and eighty-nine percent of them participated in the second round of Delphi. Initially, 243 indices were identified through review of literature; after excluding indictors, which was not available or measurable at provincial level in Iran, 103 indictors remained. The results of study showed that experts identified “percentage of individuals receiving less than 70% of daily energy requirement” with a median score of 90, as the most influential index for determining food insecurity. “Food expenses as a proportion of the overall expenses of the family”, “per capita of dietary energy supply”, and “provision of micro-nutrient supply requirement per capita” with median of 80 were in the second rank of food security priority indicators. Conclusion: Out of 243 identified indicators for food security, 38 indicators were selected as the most priority indicators for food security at provincial level in Iran. PMID:25905059
Bronte-Tinkew, Jacinta; Zaslow, Martha; Capps, Randolph; Horowitz, Allison
Periodically not having enough to eat, having a diet that is inadequate, and worrying about being able to afford the amount and type of food that a household needs are all markers of food insecurity. Food insecurity persists across many households with young children and may have negative consequences for the health and well-being of infants and…
Food insecurity may negatively impact children’s nutritional status by affecting parenting quality. Because parents have a strong influence on their children’s eating and food choices, examining the effects of food insecurity on parenting may provide important insights into obesity prevention effort...
Mabuza, Majola L; Ortmann, Gerald F; Wale, Edilegnaw; Mutenje, Munyaradzi J
The aim of this article was to investigate the food (in)security effect of household income generated from major economic activities in rural Swaziland. From a sample of 979 households, the results of a multinomial treatment regression model indicated that gender of household head, labor endowment, education, size of arable land, and location significantly influenced the households' choice of primary economic activity. Further results suggested that off-farm-income-dependent households were less likely to be food insecure when compared with on-farm-income-dependent households. However, on-farm-income-dependent households had a better food security status than their counterparts who depended on remittances and nonfarm economic activities.
Steenkamp, L; Goosen, A; Venter, D; Beeforth, M
The HIV prevalence in South Africa among students at higher education institutions (HEIs) in 2008 was reported to be 3.4%, with the highest HIV prevalence found in the Eastern Cape Province. Students at these facilities are also increasingly affected by socio-economic constraints that may impact on food security. Little is known about the impact of food insecurity on HIV-infected students in HEIs in South Africa. The purpose of this paper is to describe food insecurity and the nutritional status among HIV-infected students on the Nelson Mandela Metropolitan University campuses in South Africa, as well as current initiatives to strengthen the safety nets for food-insecure students. This descriptive, cross-sectional survey was conducted among a convenience sample of known HIV-infected, registered students (n = 63), older than 18 years of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme. Ethical approval for the study was obtained from the Research Ethics Committee (NMMU) and participants were included in the sample after providing written, informed consent. Findings indicate that food insecurity was common with more than 60% of the sample reporting food insecurity at the household level during the previous month. Of the sample, 51% were classified as being either overweight or obese. Although food insecurity did not contribute to weight loss in our sample, food-insecure students were more likely to consume inadequate amounts of vitamins and minerals, especially antioxidants that are important in supporting the immune system. Food insecurity has been identified as affecting the majority of HIV-infected students in this study, especially regarding their difficulty in accessing nutritious foods. As overweight and obesity also seem to threaten the health and future well-being of the students, appropriate management of the overweight individuals and those with obesity should be instituted in order to prevent the development
Increasingly, food is provided through an industrial food system that separates people from the source of their food and results in high rates of food insecurity, particularly for the most vulnerable in society. A lack of food is a symptom of a lack of power in a system that privileges free market principles over social justice and the protection of human rights. In Canada, the high rates of food insecurity among Canadian children is a reflection of their lack of power and the disregard of their human rights, despite the adoption of the United Nations (UN) Convention on the Rights of the Child in 1991 and ratification of the International Covenant on Social, Economic and Cultural Rights in 1976, which established the right to food for all Canadians. Dueling tensions between human rights and market forces underpin this unacceptable state of affairs in Canada. Gaventa’s “power cube” that describes different facets of power – including spaces, levels, and forms – is used to help understand the power imbalances that underlie this injustice. The analysis considers the impact of neoliberal free market principles on the realization of human rights, and the negative impacts this can have on health and well-being for the most vulnerable in society. Canadian case studies from both community organizations provide examples of how power can be shifted to achieve more inclusive, rights-based policy and action. Given increased global pressures toward more open trade markets and national austerity measures that hollow out social supports, Canada provides a cautionary tale for countries in the EU and the US, and for overall approaches to protect the most vulnerable in society. PMID:27563642
Weiser, Sheri D.; Gupta, Reshma; Tsai, Alexander C.; Frongillo, Edward A.; Grede, Nils; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W.; Martin, Jeffrey N.; Bangsberg, David R.
Objective To investigate whether time on antiretroviral treatment (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status (PHS). Design The Uganda AIDS Rural Treatment Outcomes study (UARTO), a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda. Methods Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each three-month period. Outcomes were food insecurity, nutritional status and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and socio-demographic characteristics. Results 228 ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P<0.0001), beginning with the second quarter (b=-1.6; 95% CI, -2.7 to -0.45) and ending with the final quarter (b=-6.4; 95% CI, -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P<0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security. Conclusions Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings prior to decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes. PMID:22692093
Santin, Gabriela Cristina; Pintarelli, Tatiana Pegoretti; Fraiz, Fabian Calixto; de Oliveira, Ana Cristina Borges; Paiva, Saul Martins; Ferreira, Fernanda Morais
The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.
Lindsay, Ana Cristina; Ferarro, Mabel; Franchello, Alejandra; Barrera, Raul de La; Machado, Marcia Maria Tavares; Pfeiffer, Martha Erin; Peterson, Karen Eileen
This qualitative study of low-income mothers in Buenos Aires, Argentina, examines the influence of socio-economic conditions, organizational structures, family relationships, and food insecurity on child feeding practices and weight status. Thirty-eight mothers of preschool children living in urban Buenos Aires participated in four focus group discussions. The results indicated that many mothers were aware that obesity may be detrimental to the child's health, but most of them are unclear about the specific consequences. Maternal employment, family pressures, food insecurity and financial worries seem to influence child feeding practices. These findings have important implications for developing strategies for nutritional assistance that could benefit the health of children and provide opportunities for educational programs that are directed to nutritional awareness in Buenos Aires, Argentina. The right to eat regularly and properly is an obligation of the State and must be implemented taking into account the notion of food sovereignty and respecting the importance of preserving the culture and eating habits of a country and its diverse population groups.
Gwatirisa, Pauline; Manderson, Lenore
In Zimbabwe, unpredictable conditions associated with structural and institutional factors exacerbated the combined effects of structural violence, economic and political instability, and climate change in the mid 2000s, contributing to widespread food insecurity. Drought, food shortages, and government settlement policy affecting both rural and urban populations has yielded a national human rights crisis. Drawing on ethnographic research conducted in Mutare, southeast Zimbabwe, in 2005-2006, the authors illustrate the flow-on effects of drought and government policy on the livelihoods of households already suffering as a result of the social impacts of AIDS, and how people in a regional city responded to these factors, defining and meeting their basic food needs in diverse ways.
Tse, Sze Man; Weiler, Hope; Kovesi, Tom
Background Food insecurity, vitamin D deficiency and lower respiratory tract infections are highly prevalent conditions among Inuit children. However, the relationship between these conditions has not been examined in this population. Objective The objective of this study was to examine the relationship between food insecurity and severe respiratory infections before age 2 years and health centre visits for a respiratory problem in the past year. We also explored the relationship between serum vitamin D status and respiratory outcomes in this population. Design We included children aged 3-5 years who participated in a cross-sectional survey of the health of preschool Inuit children in Nunavut, Canada, from 2007 to 2008 (n=388). Parental reports of severe respiratory infections in the first 2 years of life and health care visits in the past 12 months were assessed through a questionnaire. Child and adult food security were assessed separately and serum 25-hydroxyvitamin D3 levels were measured in a subgroup of participants (n=279). Multivariate logistic regression was performed to assess the association between food security, vitamin D and each of the 2 respiratory outcomes. Results Child and adult food insecurity measures were not significantly associated with adverse respiratory outcomes. Household crowding [odds ratio (OR)=1.51, 95% confidence interval (CI) 1.09-2.09, p=0.01 for the child food security model] and higher birth weight (OR=1.21, 95% CI: 1.02-1.43, p=0.03) were associated with reported severe chest infections before age 2 years while increasing age was associated with decreased odds of reported health care visits for a respiratory problem (OR=0.66, 95% CI: 0.48-0.91, p=0.02). Neither vitamin D insufficiency nor deficiency was associated with these respiratory outcomes. Conclusions Using a large cross-sectional survey of Inuit children, we found that household crowding, but not food security or vitamin D levels, was associated with adverse respiratory
Doocy, Shannon; Teferra, Shimeles; Norell, Dan; Burnham, Gilbert
This paper presents findings of a survey that was primarily intended as (1) an assessment of coping capacity in drought and food insecure conditions and (2) a microfinance program outcome study. A three group cross-sectional survey of 819 households was conducted in May 2003 in two predominantly rural sites in Ethiopia. Established clients of the WISDOM Microfinance Institution were compared with similar incoming clients and community controls. No overall pattern of enhanced prevalence of coping mechanisms was observed in any participant group, suggesting that participation in the lending program did not affect coping capacity at the household level. No significant differences in mean mid-upper arm circumference or prevalence of acute malnutrition were found in males or females when the total sample was assessed. In the primary survey site, Sodo, female clients and their children had significantly better nutritional status than other comparison groups: the odds of malnourishment in female community controls compared to established female clients was 3.2 (95% CI: 1.1-9.8) and the odds of acute malnutrition in children 6-59 months of age were 1.6 times greater in children of both male clients and community controls (95% CI: .78-3.32). Household food security among female client households in Sodo was significantly better than in other comparison groups according to a variety of indicators. As compared to female clients, male clients and community controls, respectively, were 1.94 (95% CI: 1.05-3.66) and 2.08 (95% CI: 1.10-4.00) times more likely to have received food aid during the past year. Findings of the present study suggest that microfinance programs may have an important impact on nutritional status and well-being of female clients and their families. That female clients were significantly less likely to be food aid recipients suggests that microfinance programs may be successful in reducing vulnerability to prolonged drought and food insecurity.
Nanama, Siméon; Frongillo, Edward A
Food insecurity negatively impacts outcomes in adults and children including parenting practices, child development, educational achievement, school performance, diet, and nutritional status. Ethnographic and quantitative research suggests that food insecurity affects well-being not only through the lack food, poor diet, and hunger, but also through social and psychological consequences that are closely linked to it. These studies are limited in number, and have mostly been carried out in contexts with market economies where household access to food depends almost solely on income. This study considers the social and psychological experiences closely linked to food insecurity in northern Burkina Faso, a context marked by subsistence farming, chronic food insecurity with a strong seasonal pattern, and a complex social structure. A total of 33 men and women from ten households were interviewed in February 2001 using semi-structured interview guides. Data were analyzed following the principles of thematic analysis. Food insecurity is closely linked with consequences such as concern, worries, and anxiety that ultimately lead to weight and sleep loss. Food insecurity results in feelings of alienation (e.g., shame) and deprivation (e.g., guilt), and alters household cohesion leading to disputes and difficulties keeping children at home. Decisions made by household members to manage and cope with food insecurity are shaped by their fear of alienation and other cultural and social norms. These findings, although derived from data collected 10 years ago before the 2008 food and fuel crises, remain valid in the study context, and emphasize the importance of social and psychological consequences closely linked to food insecurity and their negative impact on the well-being at both individual and household levels in contexts of non-market economy and chronic food insecurity. Attention to these non-nutritional consequences will improve the design, implementation, and evaluation
Muckle, Gina; Dewailly, Éric; Jacobson, Joseph L.; Jacobson, Sandra W.; Ayotte, Pierre; Riva, Mylène
Objectives. We examined the relation of household crowding to food insecurity among Inuit families with school-aged children in Arctic Quebec. Methods. We analyzed data collected between October 2005 and February 2010 from 292 primary caregiver–child dyads from 14 Inuit communities. We collected information about household conditions, food security, and family socioeconomic characteristics by interviews. We used logistic regression models to examine the association between household crowding and food insecurity. Results. Nearly 62% of Inuit families in the Canadian Arctic resided in more crowded households, placing them at risk for food insecurity. About 27% of the families reported reducing the size of their children’s meals because of lack of money. The likelihood of reducing the size of children’s meals was greater in crowded households (odds ratio = 3.73; 95% confidence interval = 1.96, 7.12). After we adjusted for different socioeconomic characteristics, results remained statistically significant. Conclusions. Interventions operating across different levels (community, regional, national) are needed to ensure food security in the region. Targeting families living in crowded conditions as part of social and public health policies aiming to reduce food insecurity in the Arctic could be beneficial. PMID:25602890
Faber, Aida; Dubé, Laurette
Eating habits are established early and are difficult to change once formed. This study investigated the role of caregiver-child attachment quality and its associations with high-caloric food consumption in a sample of middle socio-economic status children and adults, respectively. Survey data were collected from an online questionnaire administered separately to 213 (143 girls) children and 216 parents (adult sample; 180 women). Two studies showed that an insecure parental attachment, whether actual (Study 1; children) or recalled (Study 2; adults), significantly and positively predicted high-caloric food consumption in both samples. The present findings highlight the importance of parental attachment and its association with unhealthy eating patterns in children and adults.
Nord, Mark; Cafiero, Carlo; Viviani, Sara
Statistical methods based on item response theory are applied to experiential food insecurity survey data from 147 countries, areas, and territories to assess data quality and develop methods to estimate national prevalence rates of moderate and severe food insecurity at equal levels of severity across countries. Data were collected from nationally representative samples of 1,000 adults in each country. A Rasch-model-based scale was estimated for each country, and data were assessed for consistency with model assumptions. A global reference scale was calculated based on item parameters from all countries. Each country's scale was adjusted to the global standard, allowing for up to 3 of the 8 scale items to be considered unique in that country if their deviance from the global standard exceeded a set tolerance. With very few exceptions, data from all countries were sufficiently consistent with model assumptions to constitute reasonably reliable measures of food insecurity and were adjustable to the global standard with fair confidence. National prevalence rates of moderate-or-severe food insecurity assessed over a 12-month recall period ranged from 3 percent to 92 percent. The correlations of national prevalence rates with national income, health, and well-being indicators provide external validation of the food security measure.
Laraia, Barbara A; Borja, Judith B; Bentley, Margaret E
African Americans experience household food insecurity, ie, the limited availability of nutritionally adequate and safe food, or ability to acquire acceptable foods in socially acceptable ways, at three times the rate of non-Hispanic whites. Thirty percent of all African-American children live in food-insecure households. The purpose of this study was to identify characteristics associated with household food insecurity among a high-risk postpartum population. Two-hundred six low-income, African-American mother-infant dyads were recruited through the Special Supplemental Nutrition Program for Women, Infants, and Children clinics. The six-item US Department of Agriculture food security scale was used to classify households as food secure, marginally food secure, or food insecure. Multinomial logistic regression was used to estimate the association between selected maternal/household characteristics and household food-security status. Fifty-three percent of households were food secure, 34% were marginally food secure, and 13% were food insecure. Maternal education less than college (relative risk ratio [RRR]=0.46; 95% confidence interval [CI]: 0.22 to 0.98) was inversely associated with marginal food security. Depressive symptoms (RRR=1.09; 95% CI: 1.02 to 1.16) and having the baby's father in the household (RRR=3.46; 95% CI: 1.22 to 9.82) were associated with household food insecurity, while having a grandmother in the household (RRR=0.15; 95% CI: 0.03 to 0.80) was inversely associated with experiencing household food insecurity. Findings from this study suggest that young, low-income, African-American families with only one child are particularly susceptible to experiencing household food insecurity. Intergenerational support and transfer of knowledge can be a key protective attribute among low-income African-American households.
Maes, Kenneth C; Hadley, Craig; Tesfaye, Fikru; Shifferaw, Selamawit; Tesfaye, Yihenew Alemu
Our objective in this study was to assess the validity and dependability of the Household Food Insecurity Access Scale (HFIAS), which was developed for international use, among community health volunteers in Addis Ababa, Ethiopia. The HFIAS was translated into Amharic and subsequently tested for content and face validity. This was followed by a quantitative validation study based on a representative sample (n = 99) of female community volunteers (HIV/AIDS home-based caregivers), with whom the HFIAS was administered at 3 time points over the course of 2008, in the context of the local and global "food crisis." By pooling observations across data collection rounds and accounting for intra-individual correlation in repeated measures, we found that the HFIAS performed well according to standards in the field. We also observed slight amelioration in reported food insecurity (FI) status over time, which seems paradoxical given the increasing inaccessibility of food over the same time period due to inflating prices and disappearing food aid. We attempted to resolve this paradox by appealing to self-report-related phenomena that arise in the context of longitudinal study designs: 1) observation bias, in which respondents change their reports according to changing expectations of the observer-respondent relationship or change their behavior in ways that ameliorate FI after baseline self-reports; and 2) "response shift," in which respondents change their reports according to reassessment of internal standards of FI. Our results are important for the validation of FI tools and for the sustainability of community health programs reliant on volunteerism in sub-Saharan Africa.
Bordeleau, Serge; Asselin, Hugo; Mazerolle, Marc J; Imbeau, Louis
Food insecurity is a growing concern for indigenous communities worldwide. While the risk of heavy metal contamination associated to wild food consumption has been extensively studied in the Arctic, data are scarce for the Boreal zone. This study addressed the concerns over possible heavy metal exposure through consumption of traditional food in four Anishnaabeg communities living in the Eastern North American boreal forest. Liver and meat samples were obtained from 196 snowshoe hares (Lepus americanus) trapped during winter 2012 across the traditional lands of the participating communities and within 56-156km of a copper smelter. Interviews were conducted with 78 household heads to assess traditional food habits, focusing on snowshoe hare consumption. Concentrations in most meat and liver samples were below the detection limit for As, Co, Cr, Ni and Pb. Very few meat samples had detectable Cd and Hg concentrations, but liver samples had mean dry weight concentrations of 3.79mg/kg and 0.15mg/kg respectively. Distance and orientation from the smelter did not explain the variability between samples, but percent deciduous and mixed forest cover had a marginal negative effect on liver Cd, Cu and Zn concentrations. The estimated exposition risk from snowshoe hare consumption was low, although heavy consumers could slightly exceed recommended Hg doses. In accordance with the holistic perspective commonly adopted by indigenous people, the nutritional and sociocultural importance of traditional food must be considered in risk assessment. Traditional food plays a significant role in reducing and preventing serious health issues disproportionately affecting First Nations, such as obesity, diabetes, and cardiovascular diseases.
Howard, Larry L.
This paper estimates models of the transitional effects of food insecurity experiences on children's non-cognitive performance in school classrooms using a panel of 4710 elementary students enrolled in 1st, 3rd, and 5th grade (1999-2003). In addition to an extensive set of child and household-level characteristics, we use information on U.S.…
Dunifon, Rachel; Kowaleski-Jones, Lori
This study examined the association between food insecurity, participation in the National School Lunch Program (NSLP), and child well-being. Participants were children age 6-12 years in families in which at least one child participated in the NSLP. Data came from the 1997 Child Development Supplement to the Panel Study of Income Dynamics. Food…
Tsai, Alexander C.; Hung, Kristin J.; Weiser, Sheri D.
Background Understanding how food insecurity among women gives rise to differential patterning in HIV risks is critical for policy and programming in resource-limited settings. This is particularly the case in Brazil, which has undergone successive changes in the gender and socio-geographic composition of its complex epidemic over the past three decades. We used data from a national survey of Brazilian women to estimate the relationship between food insecurity and HIV risk. Methods and Findings We used data on 12,684 sexually active women from a national survey conducted in Brazil in 2006–2007. Self-reported outcomes were (a) consistent condom use, defined as using a condom at each occasion of sexual intercourse in the previous 12 mo; (b) recent condom use, less stringently defined as using a condom with the most recent sexual partner; and (c) itchy vaginal discharge in the previous 30 d, possibly indicating presence of a sexually transmitted infection. The primary explanatory variable of interest was food insecurity, measured using the culturally adapted and validated Escala Brasiliera de Segurança Alimentar. In multivariable logistic regression models, severe food insecurity with hunger was associated with a reduced odds of consistent condom use in the past 12 mo (adjusted odds ratio [AOR] = 0.67; 95% CI, 0.48–0.92) and condom use at last sexual intercourse (AOR = 0.75; 95% CI, 0.57–0.98). Self-reported itchy vaginal discharge was associated with all categories of food insecurity (with AORs ranging from 1.46 to 1.94). In absolute terms, the effect sizes were large in magnitude across all outcomes. Underweight and/or lack of control in sexual relations did not appear to mediate the observed associations. Conclusions Severe food insecurity with hunger was associated with reduced odds of condom use and increased odds of itchy vaginal discharge, which is potentially indicative of sexually transmitted infection, among sexually active women in Brazil
Iglesias-Rios, Lisbeth; Bromberg, Julie E; Moser, Richard P; Augustson, Erik M
Prevalence of food insecurity (FI) among Latinos in the United States is almost double the national average. To better understand FI among Latinos, potential risk factors beyond poverty, including acculturation indicators and smoking status, were explored. Cross-sectional data from 6,681 Latino adults from the 1999-2008 National Health and Nutrition Examination Surveys were used. Partial proportional odds (PPO) models were used to estimate associations of FI, including cigarette smoking and acculturation. The PPO models indicated that compared with never smokers, current smokers had significantly higher odds of FI (odds ratios ranged from 1.32 to 1.51 across models). Lower levels of acculturation and poverty and being a younger or middle-aged adult were also significantly associated with FI. Among Latinos, current smoking and low acculturation are important risk factors for FI. Current smoking and low acculturation may exacerbate nutritional deprivation in a population that is already disproportionally affected by poverty and poor health outcomes.
Rodríguez, Luis A; Mundo-Rosas, Verónica; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael; Shamah-Levy, Teresa
Seventy percent of Mexican households experience some level of food insecurity (FI). Studies have shown positive associations between FI and poor dietary quality. As far as it is known, this is the first time the Healthy Eating Index (HEI-2010) has been used to assess dietary quality of children and adolescents in Mexico, and to examine if FI is related to it. The objective of this research is to assess dietary quality and its association with FI among Mexican children and adolescents from a nationally representative cross-sectional sample. We analyzed data from 4635 2-19-year-old Mexican children and adolescents participating in the Mexican National Health and Nutrition Survey (Ensanut 2012). FI was measured using the Latin American and Caribbean Household Food Security Scale (ELCSA) and dietary quality with the HEI-2010. We examined the association between FI and dietary quality using multivariate linear regressions. Dietary quality was worst as FI became more severe among children and adolescents compared with their counterparts living in households with food security. Specifically, FI had a negative association with fruits, vegetables, and protein foods, and a positive association with refined grains consumption. Dairy intake was negatively associated with FI among older children and adolescents. Added sugars were not associated with FI, but intake was excessive across the population at 15% of total daily energy intake. Decreasing FI may help improve dietary quality of Mexican children and adolescents.
Wicks, Rosemary; Trevena, Lyndal J; Quine, Susan
Adequate nutrition is an essential determinant of health. Disadvantaged individuals within the cities of developed countries continue to have poor health, yet the role of food insecurity in such groups is poorly understood. This cross-sectional study describes such experiences among 22 randomly selected participants who participated in interviews at a charity-run soup kitchen in urban Sydney, Australia. Interviews explored four constructs of food insecurity (quantitative, qualitative, psychological, and social), identifying related barriers and coping strategies. Reliable access to food was limited. Low income; high rents; poor health; and addictions to cigarettes, alcohol, illicit drugs, and gambling were associated with dependence on charities. Poor dentition and lack of food storage and cooking facilities were important barriers to adequate nutrition. Meals were missed and quantities restricted as a coping strategy. Participants demonstrated adequate knowledge and a desire to eat healthful food. Opportunities for social interaction and trust in soup kitchen staff were important motivators of attendance. Strategies to reduce food insecurity among seriously disadvantaged city dwellers should focus less on education and more on practical solutions, such as accessing affordable healthful food for those without kitchen facilities, improving dentition, and reducing addictions. It is also important to facilitate social networks with trusted support organizations.
Cox, Joseph; Hamelin, Anne-Marie; McLinden, Taylor; Moodie, Erica E M; Anema, Aranka; Rollet-Kurhajec, Kathleen C; Paradis, Gilles; Rourke, Sean B; Walmsley, Sharon L; Klein, Marina B
While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study of the Canadian Co-infection Cohort collected between November 2012-June 2014 at 15 health centres. FI was measured using the Household Food Security Survey Module and classified using Health Canada criteria. Generalized estimating equations were used to assess factors associated with FI. Among 525 participants, 59 % experienced FI at their first study visit (baseline). Protective factors associated with FI (p < 0.05) included: enrolment at a Quebec study site (aOR: 0.42, 95 % CI: 0.27, 0.67), employment (aOR: 0.55, 95 % CI: 0.35, 0.87), and average personal monthly income (aOR per $100 CAD increase: 0.98, 95 % CI: 0.97, 0.99). Risk factors for FI included: recent injection drug use (aOR: 1.98, 95 % CI: 1.33, 2.96), trading away food (aOR: 5.23, 95 % CI: 2.53, 10.81), and recent experiences of depressive symptoms (aOR: 2.11, 95 % CI: 1.48, 3.01). FI is common in this co-infected population. Engagement of co-infected individuals in substance use treatments, harm reduction programs, and mental health services may mitigate FI in this vulnerable subset of the HIV-positive population.
Cornelius, Talea; Jones, Maranda; Merly, Cynthia; Welles, Brandi; Kalichman, Moira O; Kalichman, Seth C
Antiretroviral therapy (ART) has transformed HIV into a manageable illness. However, high levels of adherence must be maintained. Lack of access to basic resources (food, transportation, and housing) has been consistently associated with suboptimal ART adherence. Moving beyond such direct effects, this study takes a hierarchical resources approach in which the effects of access to basic resources on ART adherence are mediated through interpersonal resources (social support and care services) and personal resources (self-efficacy). Participants were 915 HIV-positive men and women living in Atlanta, GA, recruited from community centers and infectious disease clinics. Participants answered baseline questionnaires, and provided prospective data on ART adherence. Across a series of nested models, a consistent pattern emerged whereby lack of access to basic resources had indirect, negative effects on adherence, mediated through both lack of access to social support and services, and through lower treatment self-efficacy. There was also a significant direct effect of lack of access to transportation on adherence. Lack of access to basic resources negatively impacts ART adherence. Effects for housing instability and food insecurity were fully mediated through social support, access to services, and self-efficacy, highlighting these as important targets for intervention. Targeting service supports could be especially beneficial due to the potential to both promote adherence and to link clients with other services to supplement food, housing, and transportation. Inability to access transportation had a direct negative effect on adherence, suggesting that free or reduced cost transportation could positively impact ART adherence among disadvantaged populations.
Robaina, Kate A.; Martin, Katie S.
Objective: Examine relationships between food security, diet quality, and body mass index (BMI) among food pantry users. Methods: Convenience sample of 212 food pantry clients in Hartford, CT from June, 2010 to May, 2011. Main outcomes included food security (United States Department of Agriculture module), fruit and vegetable consumption (Block…
Abdollahi, Morteza; Abdollahi, Zahra; Sheikholeslam, Robabeh; Kalantari, Nasser; Kavehi, Ziba; Neyestani, Tirang R
This research aimed to evaluate food security and its association with anthropometric measures among Afghan refugees living in Pakdasht, one of the main harbors of Afghan refugees in the neighborhood of Tehran. A total of 414 registered Afghan refugee households were recruited in a cross-sectional study. About 88% of households were food insecure. Unemployment and socioeconomic status were the major determinants of food insecurity among the refugee households. While about 58% of women were overweight/obese, the prevalence of underweight and wasting were remarkable in children (11.0% and 12.7%, respectively), indicating a recent malnutrition. Government and organizations working for refugees must focus their activities on empowering Afghan refugees.
Vijayaraghavan, Maya; Jacobs, Elizabeth A; Seligman, Hilary; Fernandez, Alicia
Limited data exist on whether structural factors associated with poverty such as inadequate housing and food insecurity affect diabetes care. In a sample of low-income participants with diabetes (N=711), we sought to determine if housing instability was associated with lower diabetes self-efficacy, and whether this relationship was mediated by food insecurity. We ordered housing from most to least stable. We observed a linear decrease in diabetes self-efficacy as housing instability increased (p<.01). After adjusting for age, sex, race/ethnicity, and alcohol or substance use, adults lacking a usual place to stay had lower self-efficacy than those who owned their own home (ß-coefficient -0.94, 95% CI -1.88, -0.01). Food insecurity mediated the association between housing instability and diabetes self-efficacy (ß-coefficient -0.64, 95% CI -1.57, 0.31). Our findings suggest that inadequate access to food lowers self-efficacy among adults with diabetes, and supports provision of food to unstably housed adults as part of diabetes care.
Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012–2013
Chung, Hye-Kyung; Kim, Oh Yoen; Kwak, So Young; Cho, Yoonsu; Lee, Kyong Won; Shin, Min-Jeong
Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans (n = 5862, 20–64 years) using data from the Korea National Health and Nutritional Examination Survey (2012–2013). Household food security status was categorized as “food-secure household”, “food-insecure household without hunger”, and “food-insecure household with hunger”. Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health. A greater proportion of food-insecure participants were nutritionally deficient compared with expectations of the 2015 Korean Dietary Reference Intakes. These deficiencies were generally higher in both “food-insecure household” groups. Both “food-insecure household” groups, particularly the “food-insecure household with hunger” group showed significantly adverse mental health status (ORs: 1.52–3.83) and lower QOL (ORs: 1.49–3.92) than did the “food-secure household” group before and after adjusting for sex, age, education, household income, smoking/alcohol consumption, physical activity, marital status, and receiving food assistance. In conclusion, food insecurity may be significantly associated with adverse mental health indicators and decreased QOL in young/middle-aged Koreans. PMID:27999277
Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012-2013.
Chung, Hye-Kyung; Kim, Oh Yoen; Kwak, So Young; Cho, Yoonsu; Lee, Kyong Won; Shin, Min-Jeong
Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans (n = 5862, 20-64 years) using data from the Korea National Health and Nutritional Examination Survey (2012-2013). Household food security status was categorized as "food-secure household", "food-insecure household without hunger", and "food-insecure household with hunger". Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health. A greater proportion of food-insecure participants were nutritionally deficient compared with expectations of the 2015 Korean Dietary Reference Intakes. These deficiencies were generally higher in both "food-insecure household" groups. Both "food-insecure household" groups, particularly the "food-insecure household with hunger" group showed significantly adverse mental health status (ORs: 1.52-3.83) and lower QOL (ORs: 1.49-3.92) than did the "food-secure household" group before and after adjusting for sex, age, education, household income, smoking/alcohol consumption, physical activity, marital status, and receiving food assistance. In conclusion, food insecurity may be significantly associated with adverse mental health indicators and decreased QOL in young/middle-aged Koreans.
Underwood, Barbara A
Food and nutrition insecurity, which affects an estimated 815 million households (the majority in developing countries), is in large part due to micronutrient deficiencies. The magnitude of the problem, causes, consequences and cost-effective solutions elucidated by scientists over the last few decades changed perceptions and drew political commitments in the 1990s to alleviate micronutrient deficiencies. Prevalence was reduced for iodine and vitamin A deficiency disorders largely through mandated universal fortification of salt with iodine and wide distribution of vitamin A supplements associated with immunization campaigns. Less progress was achieved in the control of iron deficiency. The challenge now is to move forward with interventions that are sustainable within the context of vulnerable communities, which possibly include applied biotechnology to enhance yields and micronutrient contents of staple foods. Scientific progress and political commitment are key factors, but consumer and public acceptance is key to sustainable progress. Achieving public confidence requires increased partnerships among scientists, policymakers, community leaders and consumers in the decision-making processes.
Whittle, Henry J; Palar, Kartika; Hufstedler, Lee Lemus; Seligman, Hilary K; Frongillo, Edward A; Weiser, Sheri D
Food insecurity continues to be a major challenge in the United States, affecting 49 million individuals. Quantitative studies show that food insecurity has serious negative health impacts among individuals suffering from chronic illnesses, including people living with HIV/AIDS (PLHIV). Formulating effective interventions and policies to combat these health effects requires an in-depth understanding of the lived experience and structural drivers of food insecurity. Few studies, however, have elucidated these phenomena among people living with chronic illnesses in resource-rich settings, including in the United States. Here we sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. Thirty-four semi-structured in-depth interviews were conducted with low-income PLHIV receiving food assistance from a local non-profit in San Francisco and Alameda County, California, between April and June 2014. Interview transcripts were coded and analysed according to content analysis methods following an inductive-deductive approach. The lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet. Participants also reported procuring food using personally and socially unacceptable strategies, including long-term dependence on friends, family, and charity; stealing food; exchanging sex for food; and selling controlled substances. Food insecurity often arose from the need to pay high rents exacerbated by gentrification while receiving limited disability income--a situation resulting in large part from the convergence of long-standing urban policies amenable to gentrification and an outdated disability policy that constrains financial viability. The experiences of food insecurity described by participants in this
Nagata, Jason M; Fiorella, Kathryn J; Salmen, Charles R; Hickey, Matthew D; Mattah, Brian; Magerenge, Richard; Milner, Erin M; Weiser, Sheri D; Bukusi, Elizabeth A; Cohen, Craig R
The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.
Heylen, Elsa; Panicker, Siju Thomas; Chandy, Sara; Steward, Wayne T.; Ekstrand, Maria L.
Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19% of men and 26% of women reported moderate or severe FI over a six-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV. PMID:25488171
Heylen, Elsa; Panicker, Siju Thomas; Chandy, Sara; Steward, Wayne T; Ekstrand, Maria L
Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19 % of men and 26 % of women reported moderate or severe FI over a 6-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV.
Bhargava, Alok; Jolliffe, Dean; Howard, Larry L
Recent increases in obesity prevalence among children in developed countries are of policy concern. While significant positive associations between households' food insecurity status and body weights have been reported for adults, it is known from the energy physiology literature that energy requirements depend on BMR, anthropometric measures and physical activity. It is therefore important to model the bi-directional relationships between body weights and households' food insecurity scores especially for children that have evolving nutrient and energy requirements. The present paper estimated dynamic random effects models for children's body weights and BMI, and households' food insecurity scores using longitudinal data on 7635 children in the USA enrolled in 1st, 3rd and 5th grades (1999-2003) of the Early Childhood Longitudinal Study-Kindergarten. The main findings were, first, physical exercise and numbers of siblings were significantly (P < 0.05) negatively associated with body weights, while households' food insecurity score was not a significant predictor. Moreover, children's body weights were significantly lower in households with higher parental education and incomes; time spent watching television and in non-parental care were positively associated with weights. Second, models for households' food insecurity scores showed that poverty and respondents' poor emotional and physical health significantly increased food insecurity. Moreover, households with children who were taller and heavier for their ages faced significantly higher food insecurity levels. Overall, the results showed that household food insecurity was unlikely to exacerbate child obesity in the USA and it is important that children receive balanced school meals and perform higher physical activity.
Gubert, Muriel Bauermann; Spaniol, Ana Maria; Segall-Corrêa, Ana Maria; Pérez-Escamilla, Rafael
Household food insecurity (HFI) has been associated with both obesity among mothers and undernutrition among children. However, this association has not been well investigated in mother/child pairs living in the same household. The objective of this study was to examine the relationship of coexistence of maternal overweight and child stunting with HFI in Brazil. We conducted secondary data analyses of the 2006 Brazilian National Demographic and Health Survey. We analyzed the nutritional status of 4299 pairs of 15-49-year-olds mothers and their children under 5 years of age. The double burden of malnutrition (DBM) was defined as the presence of an overweight mother and a stunted child in the same household. HFI was measured with the Brazilian HFI Measurement Scale. The association between DBM and HFI was examined with hierarchical multivariable logistic regression analyses. Severe HFI was associated with DBM after adjusting for macroeconomic and household level socio-economic and demographic variables (Adjusted OR: 2.65 - CI: 1.17-8.53). Findings suggest that policies and programmes targeting HFI are needed to prevent the coexistence of child chronic undernutrition and maternal overweight/obesity in the same household. These investments are likely to be highly cost-effective as stunting has been identified as one of the major risk factors for poor child development and adult overweight/obesity and a strong risk factor for the development of costly chronic diseases including type 2 diabetes and cardiovascular disease.
Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D
Background Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Methods Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Results Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Conclusions Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities. PMID:26546789
Chhabra, Surbhi; Falciglia, Grace A; Lee, Seung-Yeon
The purpose of this study was to examine the relationship between food security, social capital, and social support among urban food pantry users in Cincinnati. In-person interviews with 53 participants were completed using the U.S. Household Food Security Survey Module, Social Capital questionnaire, and Social Support questionnaire. Social capital was assessed through four subscales using a Likert scale, with a response range 1 to 4, and social support was measured by rating significant others' emotional, informational, and instrumental support as well as companionship (ranged from 0 to 4). The findings suggested that there were no significant associations among them. This may be due to a small sample size. Thus, the associations need to be examined with a larger sample. Further, a qualitative approach may be necessary to explore the contextual nature of social capital and social support related to food security.
Ejajo, Tekle; Alemseged, Fissahaye; Massa, Desalegn
Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.
Shukla, Shraddhanand; McNally, Amy; Husak, Greg; Funk, Chris
In East Africa, agriculture is mostly rainfed and hence sensitive to interannual rainfall variability, and the increasing food and water demands of a growing population place further stresses on the water resources of this region. Skillful seasonal agricultural drought forecasts for this region can inform timely water and agricultural management decisions, support the proper allocation of the region's water resources, and help mitigate socio-economic losses. Here we describe the development and implementation of a seasonal drought forecast system that is being used for providing seasonal outlooks of agricultural drought in East Africa. We present a test case of the evaluation and applicability of this system for March-April-May growing season over equatorial East Africa (latitude 20 south to 80 North and 360 E to 460E) that encompasses one of the most food insecure and climatically and socio-economically vulnerable regions in East Africa. This region experienced famine as recently as in 2011. The system described here combines advanced satellite and re-analysis as well as station-based long term and real-time observations (e.g. NASA's TRMM, Infra-red remote sensing, Climate Forecast System Reanalysis), state-of-the-art dynamical climate forecast system (NCEP's Climate Forecast System Verison-2) and large scale land surface models (e.g. Variable Infiltration Capacity, NASA's Land Information System) to provide forecasts of seasonal rainfall, soil moisture and Water Requirement Satisfaction Index (WRSI) throughout the season - with an emphasis on times when water is the most critical: start of season/planting and the mid-season/crop reproductive phase. Based on the hindcast assessment of this system, we demonstrate the value of this approach to the US Agency for International Development (USAID)'s efforts to mitigate future losses of lives and economic losses by allowing a proactive approach of drought management that includes early warning and timely action.
Africa remains the only region in the world where the number of hungry people will still be on the increase in 2020, and the number of malnourished children will have increased correspondingly. In this report I have acknowledged the general public policy trends across Africa in terms of macroeconomic policy reforms and political transitions. These welcome trends have to still produce stable nations and economies. Although economic development is the long-term solution to Africa's challenge on hunger and poverty, this will take time. And it follows therefore that African nations have to pursue policies and strategies that promote long-term growth while at the same time offering short-term safety nets for the poorest of the poor. The growth and development strategy will have at its core the need to increase significantly the levels of public-sector investment in agriculture and rural development and to give top priority to the commercialization of smallholder agriculture so as to increase productivity and competitiveness. But food security at the household level is ultimately a balance between availability and access, and in this regard governments need complementary food security policies that increase the probability of food access by the vulnerable groups.
Shukla, Shraddhanand; McNally, Amy; Husak, Gregory; Funk, Christopher C.
The increasing food and water demands of East Africa's growing population are stressing the region's inconsistent water resources and rain-fed agriculture. More accurate seasonal agricultural drought forecasts for this region can inform better water and agricultural management decisions, support optimal allocation of the region's water resources, and mitigate socio-economic losses incurred by droughts and floods. Here we describe the development and implementation of a seasonal agricultural drought forecast system for East Africa (EA) that provides decision support for the Famine Early Warning Systems Network's science team. We evaluate this forecast system for a region of equatorial EA (2° S to 8° N, and 36° to 46° E) for the March-April-May growing season. This domain encompasses one of the most food insecure, climatically variable and socio-economically vulnerable regions in EA, and potentially the world: this region has experienced famine as recently as 2011. To assess the agricultural outlook for the upcoming season our forecast system simulates soil moisture (SM) scenarios using the Variable Infiltration Capacity (VIC) hydrologic model forced with climate scenarios for the upcoming season. First, to show that the VIC model is appropriate for this application we forced the model with high quality atmospheric observations and found that the resulting SM values were consistent with the Food and Agriculture Organization's (FAO's) Water Requirement Satisfaction Index (WRSI), an index used by FEWS NET to estimate crop yields. Next we tested our forecasting system with hindcast runs (1993–2012). We found that initializing SM forecasts with start-of-season (5 March) SM conditions resulted in useful SM forecast skill (> 0.5 correlation) at 1-month, and in some cases at 3 month lead times. Similarly, when the forecast was initialized with mid-season (i.e. 5 April) SM conditions the skill until the end-of-season improved. This shows that early-season rainfall
Shukla, S.; McNally, A.; Husak, G.; Funk, C.
The increasing food and water demands of East Africa's growing population are stressing the region's inconsistent water resources and rain-fed agriculture. More accurate seasonal agricultural drought forecasts for this region can inform better water and agricultural management decisions, support optimal allocation of the region's water resources, and mitigate socio-economic losses incurred by droughts and floods. Here we describe the development and implementation of a seasonal agricultural drought forecast system for East Africa (EA) that provides decision support for the Famine Early Warning Systems Network's science team. We evaluate this forecast system for a region of equatorial EA (2° S to 8° N, and 36° to 46° E) for the March-April-May growing season. This domain encompasses one of the most food insecure, climatically variable and socio-economically vulnerable regions in EA, and potentially the world: this region has experienced famine as recently as 2011. To assess the agricultural outlook for the upcoming season our forecast system simulates soil moisture (SM) scenarios using the Variable Infiltration Capacity (VIC) hydrologic model forced with climate scenarios for the upcoming season. First, to show that the VIC model is appropriate for this application we forced the model with high quality atmospheric observations and found that the resulting SM values were consistent with the Food and Agriculture Organization's (FAO's) Water Requirement Satisfaction Index (WRSI), an index used by FEWS NET to estimate crop yields. Next we tested our forecasting system with hindcast runs (1993-2012). We found that initializing SM forecasts with start-of-season (5 March) SM conditions resulted in useful SM forecast skill (> 0.5 correlation) at 1-month, and in some cases at 3 month lead times. Similarly, when the forecast was initialized with mid-season (i.e. 5 April) SM conditions the skill until the end-of-season improved. This shows that early-season rainfall is
Shukla, S.; McNally, A.; Husak, G.; Funk, C.
The increasing food and water demands of East Africa's growing population are stressing the region's inconsistent water resources and rain-fed agriculture. More accurate seasonal agricultural drought forecasts for this region can inform better water and agropastoral management decisions, support optimal allocation of the region's water resources, and mitigate socioeconomic losses incurred by droughts and floods. Here we describe the development and implementation of a seasonal agricultural drought forecast system for East Africa (EA) that provides decision support for the Famine Early Warning Systems Network's (FEWS NET) science team. We evaluate this forecast system for a region of equatorial EA (2° S-8° N, 36-46° E) for the March-April-May (MAM) growing season. This domain encompasses one of the most food-insecure, climatically variable, and socioeconomically vulnerable regions in EA, and potentially the world; this region has experienced famine as recently as 2011. To produce an "agricultural outlook", our forecast system simulates soil moisture (SM) scenarios using the Variable Infiltration Capacity (VIC) hydrologic model forced with climate scenarios describing the upcoming season. First, we forced the VIC model with high-quality atmospheric observations to produce baseline soil moisture (SM) estimates (here after referred as SM a posteriori estimates). These compared favorably (correlation = 0.75) with the water requirement satisfaction index (WRSI), an index that the FEWS NET uses to estimate crop yields. Next, we evaluated the SM forecasts generated by this system on 5 March and 5 April of each year between 1993 and 2012 by comparing them with the corresponding SM a posteriori estimates. We found that initializing SM forecasts with start-of-season (SOS) (5 March) SM conditions resulted in useful SM forecast skill (> 0.5 correlation) at 1-month and, in some cases, 3-month lead times. Similarly, when the forecast was initialized with midseason (i.e., 5
Funk, C.; Dettinger, M.; Verdin, J.
Given that more than 200 million sub-Saharan Africans are food insecure, abrupt climate change in Africa could be devastating. Recent observations for eastern and southern Africa suggest substantial declines in main growing season rainfall over the past 20 years. In this talk we present research from a multi-year study that examined the causes and implications of these drying trends. Our statistical and dynamic modeling results suggest that warming in the Indian Ocean has been linked to increased oceanic convection and disruptions in onshore moisture transports. These moisture transport disruptions, in turn, are probably associated with an increased frequency in agricultural drought in sub-tropical countries along Africa's eastern seaboard. This 'warm ocean-dry Africa' dipole appears to be a major driver of decadal variability. An evaluation of 11 climate change models suggests that increased tropical Indian Ocean precipitation, and the associated moisture transport disruptions, may in fact be anthropogenic, accounting for at least part of the regional drought tendencies in eastern and southern Africa over the past 20 years. These simulations also suggest continued increases in oceanic convection will be very likely over the next century. This diabatic forcing will likely produce continuing rainfall declines across 7 food insecure nations. These drying trends, combined with declining per capita agricultural capacity, are likely to contribute to a ~250 percent increase in food shortages over the next 30 years. Modest agricultural and market development, however, could alleviate the food problem substantially.
Baxter, Suzanne D.; Smith, Albert F.; Hitchcock, David B.; Collins, Kathleen L.; Guinn, Caroline H.; Finney, Christopher J.; Royer, Julie A.; Miller, Patricia H.
Objective To examine test-retest reliability and internal consistency of a 5-question food insecurity survey used in the National Health and Nutrition Examination Survey. Methods Researchers administered the National Health and Nutrition Examination Survey in the classroom to 92 fourth-grade children (74 African American; 48 girls) in 2 sessions 27–30 days apart in spring, 2011. Each classroom administration lasted 5–10 minutes. Results Test-retest reliability was 0.66 (Kendall tau), which is modest. Internal consistency (Cronbach alpha) was .67 and .70 for respective administrations. Food insecurity scores were related to gender (adjusted P = .05) and academic achievement (adjusted P = .004) but not to socioeconomic status or body mass index percentile (binomial regression). On average, boys reported higher food insecurity than girls. Children with lower academic achievement scores reported higher food insecurity than children with higher academic achievement scores. Conclusions and Implications The National Health and Nutrition Examination 5-question survey may be group administered to assess food insecurity efficiently as reported by individual fourth-grade children. PMID:26363937
Smith, Teresa M; Colón-Ramos, Uriyoán; Pinard, Courtney A; Yaroch, Amy L
An estimated 78% of Hispanics in the United States (US) are overweight or obese. Household food insecurity, a condition of limited or uncertain access to adequate food, has been associated with obesity rates among Hispanic adults in the US. However, the Hispanic group is multi-ethnic and therefore associations between obesity and food insecurity may not be constant across Hispanic country of origin subgroups. This study sought to determine if the association between obesity and food insecurity among Hispanics is modified by Hispanic ancestry across low-income (≤200% of poverty level) adults living in California. Data are from the cross-sectional 2011-12 California Health Interview Survey (n = 5498). Rates of overweight or obesity (BMI ≥ 25), Calfresh receipt (California's Supplemental Nutrition Assistance Program), and acculturation were examined for differences across subgroups. Weighted multiple logistic regressions examined if household food insecurity was significantly associated with overweight or obesity and modified by country of origin after controlling for age, education, marital status, country of birth (US vs. outside of US), language spoken at home, and Calfresh receipt (P < .05). Significant differences across subgroups existed for prevalence of overweight or obesity, food security, Calfresh receipt, country of birth, and language spoken at home. Results from the adjusted logistic regression models found that food insecurity was significantly associated with overweight or obesity among Mexican-American women (β (SE) = 0.22 (0.09), p = .014), but not Mexican-American men or Non-Mexican groups, suggesting Hispanic subgroups behave differently in their association between food insecurity and obesity. By highlighting these factors, we can promote targeted obesity prevention interventions, which may contribute to more effective behavior change and reduced chronic disease risk in this population.
Dalma, A.; Veloudaki, A.; Petralias, A.; Mitraka, K.; Zota, D.; Kastorini, C.-M.; Yannakoulia, M.; Linos, A.
Introduction: Aiming at reducing the rates of food insecurity and promoting healthy diet for children and adolescents, we designed and implemented the Program on Food Aid and Promotion of Healthy Nutrition-DIATROFI, a school-based intervention program including the daily provision of a free healthy mid-day meal in disadvantaged areas across…
Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena
Background The limited or uncertain access to adequate food in elderly people includes not only economic restrictions but also inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy. Objective The aim of this work is to present the protocol of the randomized controlled trial Saúde.Come Senior, an educational and motivational television (TV)-based intervention to promote healthy lifestyles and decrease food insecurity in elderly people. Methods A randomized controlled study will be conducted in subjects aged 60 years and older with food insecurity, identified at 17 primary care centers in the Lisboa e Vale do Tejo health region in Lisbon, Portugal. The primary outcome will be the changes in participants’ food insecurity score (evaluated by the Household Food Insecurity Scale) at 3 months. Change in other outcomes will be assessed (dietary habits, nutritional status, physical activity, health status, and clinical outcomes). Subjects will be followed over 6 months; the intervention will last 3 months. Data collection will be performed at 3 different time points (baseline, end of intervention at 3 months, and follow-up at 6 months). The intervention is based on an interactive TV app with an educational and motivational program specifically developed for the elderly that has weekly themes and includes daily content in video format: (1) nutrition and diet tips for healthy eating, (2) healthy, easy to cook and low-cost recipes, and (3) physical exercise programs. Furthermore, brief reminders on health behaviors will also be broadcasted through the TV app. The total duration of the study will be 6 months. The intervention is considered to be effective and meaningful if 50% of the individuals in the experimental group have a decrease of 1 point in the food insecurity score, all the remaining being unchanged. We expect to include and randomize 282 (141 experimental and 141 control) elderly with food insecurity. We will
Schlüssel, Michael Maia; Silva, Antonio Augusto Moura da; Pérez-Escamilla, Rafael; Kac, Gilberto
Household food insecurity (HFI) may increase obesity risk, but results are not consistent across the life course or between developed/underdeveloped settings. The objective of this paper is to review findings from previous analyses in Brazil among adult women, female adolescents, and children up to five. Data were derived from the 2006 Brazilian Demographic and Health Survey. Associations between HFI (measured with the Brazilian Food Insecurity Scale) and excess weight/obesity were investigated through Poisson regression models. While severe HFI was associated with obesity risk among adult women (PR: 1.49; 95%CI: 1.17-1.90), moderate HFI was associated with excess weight among female adolescents (PR: 1.96; 95%CI: 1.18-3.27). There was no association between HFI and obesity among children (either boys or girls). The nutrition transition in Brazil may be shaping the differential deleterious effect of HFI on body fat accumulation across the life course; the association is already evident among female adolescents and adult women but still not among children.
Page-Reeves, Janet; Scott, Amy Anixter; Moffett, Maurice; Apodaca, Veronica; Apodaca, Vanessa
In this article, we explore women's everyday experiences with food insecurity. Women's narratives from a Hispanic community in New Mexico depict the poignant struggles women confront as they actively engage with buffering the experience of hunger to hide scarcity and mask and cope with emotional distress. These data give us a lens for understanding women's lives in the context of disparity as it relates to food insecurity as a public health issue and provide a way to conceptualize how social determinants operate and integrate with quotidian life activities and processes.
Masa, Rainier; Chowa, Gina
The objective of this study was to describe a multilevel conceptual framework to understand the role of food insecurity on antiretroviral therapy adherence. The authors illustrated an example of how they used the multilevel framework to develop an intervention for poor people living with HIV in a rural and low-resource community. The framework incorporates intrapersonal, interpersonal, and structural-level theories of understanding and changing health behaviors. The framework recognizes the role of personal, social, and environmental factors on cognition and behavior, with particular attention to ways in which treatment adherence is enabled or prevented by structural conditions, such as food insecurity.
PAGE-REEVES, JANET; SCOTT, AMY ANIXTER; MOFFETT, MAURICE; APODACA, VERONICA; APODACA, VANESSA
In this article, we explore women’s everyday experiences with food insecurity. Women’s narratives from a Hispanic community in New Mexico depict the poignant struggles women confront as they actively engage with buffering the experience of hunger to hide scarcity and mask and cope with emotional distress. These data give us a lens for understanding women’s lives in the context of disparity as it relates to food insecurity as a public health issue and provide a way to conceptualize how social determinants operate and integrate with quotidian life activities and processes. PMID:27570572
Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R
The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.
Dean, Wesley R; Sharkey, Joseph R; Johnson, Cassandra M
This study examined the association of compositional measures of collective social functioning, composed of community and familial social capital and perceived personal disparity, with food security among older (aged 50-59 y) and senior (aged ≥ 60 y) adult residents of the largely rural Brazos Valley in Central Texas using data from the 2006 Brazos Valley Community Health Assessment (analytic N = 1059, 74% response rate). Among older adults and seniors, 18.6% reported food insecurity (5.5% often and 13.1% sometimes), defined as running out of food and not having money to buy more. Low community social capital was reported by 22.4% of participants, and 30.8% indicated they were single, widowed, or divorced, an indicator of limited familial social capital. A robust multinomial regression model found the odds of reporting greater food insecurity increased for individuals who were women, African American, residents of a household with a low or poverty-level income, individuals who perceived themselves to be worse off than others within their community, and those who had low social capital. The odds of being food insecure decreased for older respondents, partnered respondents and persons with more education (pseudo r(2) = 0.27, p < 0.0000). Compositional level measures of collective social functioning are important associates of food insecurity among older adults and seniors, regardless of severity.
Johnson, Cassandra M.; Dean, Wesley R.
We examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life (HRQOL), household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three HRQOL measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not employed full-time, and being household food insecure were independently significantly associated with increased odds for all HRQOL outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being non-white were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women. PMID:21797678
Shahriar, Pervez M.; Ramachandran, Mahadevan; Mutuwatte, Lal
It is becoming increasingly recognized that computer methods such as models and Geographic Information Systems (GIS) can be valuable tools for analyzing a geographical area in terms of it's hazards vulnerability, Vulnerability is an important aspect of households' experience of poverty. The measurement and analysis of poverty, inequality and vulnerability are crucial for cognitive purposes (to know what the situation is), for analytical purposes (to understand the factors determining this situation), for policy making purposes (to design interventions best adapted to the issues), and for monitoring and evaluation purposes (to assess whether current policies are effective, and whether the situation is changing). Here vulnerability defined as the probability or risk today of being in poverty - or falling deeper into poverty - in the future. Vulnerability is a key dimension of well being since it affects individuals' behavior (in terms of investment, production patterns, coping strategies) and their perception of their own situation. This study has been conducted with the joint collaboration of World Food Programme (WFP) and International Water Management Institute (IWMI) in Sri Lanka for identifying regions and population which are food insecure, for analyzing the reasons for vulnerability to food insecurity in order to provide decision-makers with information to identify possible sectors of intervention and for identifying where and for whom food aid can be best utilized in Sri Lanka. This new approach integrates GIS and Remote sensing with other statistical packages to allow consideration of more spatial/physical parameters like accessibility to economic resources, particularly land and the assets of the built environment, creating employment, and attracting investment in order to improve the quality and quantity of goods and services for the analysis which leads the analysis to represent the real scenario. For this study a detailed topographic data are being used
Park, Clara Y; Eicher-Miller, Heather A
Food-insecure pregnant females may be at greater risk of iron deficiency (ID) because nutrition needs increase and more resources are needed to secure food during pregnancy. This may result in a higher risk of infant low birth weight and possibly cognitive impairment in the neonate. The relationships of food insecurity and poverty income ratio (PIR) with iron intake and ID among pregnant females in the United States were investigated using National Health and Nutrition Examination Survey 1999-2010 data (n=1,045). Food security status was classified using the US Food Security Survey Module. One 24-hour dietary recall and a 30-day supplement recall were used to assess iron intake. Ferritin, soluble transferrin receptor, or total body iron classified ID. Difference of supplement intake prevalence, difference in mean iron intake, and association of ID and food security status or PIR were assessed using χ(2) analysis, Student t test, and logistic regression analysis (adjusted for age, race, survey year, PIR/food security status, education, parity, trimester, smoking, C-reactive protein level, and health insurance coverage), respectively. Mean dietary iron intake was similar among groups. Mean supplemental and total iron intake were lower, whereas odds of ID, classified by ferritin status, were 2.90 times higher for food-insecure pregnant females compared with food-secure pregnant females. Other indicators of ID were not associated with food security status. PIR was not associated with iron intake or ID. Food insecurity status may be a better indicator compared with income status to identify populations at whom to direct interventions aimed at improving access and education regarding iron-rich foods and supplements.
Lewnard, Joseph A.; Berrang-Ford, Lea; Lwasa, Shuaib; Namanya, Didacus Bambaiha; Patterson, Kaitlin A.; Donnelly, Blánaid; Kulkarni, Manisha A.; Harper, Sherilee L.; Ogden, Nicholas H.; Carcamo, Cesar P.
Although malnutrition and malaria co-occur among individuals and populations globally, effects of nutritional status on risk for parasitemia and clinical illness remain poorly understood. We investigated associations between Plasmodium falciparum infection, nutrition, and food security in a cross-sectional survey of 365 Batwa pygmies in Kanungu District, Uganda in January of 2013. We identified 4.1% parasite prevalence among individuals over 5 years old. Severe food insecurity was associated with increased risk for positive rapid immunochromatographic test outcome (adjusted relative risk [ARR] = 13.09; 95% confidence interval [95% CI] = 2.23–76.79). High age/sex-adjusted mid-upper arm circumference was associated with decreased risk for positive test among individuals who were not severely food-insecure (ARR = 0.37; 95% CI = 0.19–0.69). Within Batwa pygmy communities, where malnutrition and food insecurity are common, individuals who are particularly undernourished or severely food-insecure may have elevated risk for P. falciparum parasitemia. This finding may motivate integrated control of malaria and malnutrition in low-transmission settings. PMID:24821844
Lewnard, Joseph A; Berrang-Ford, Lea; Lwasa, Shuaib; Namanya, Didacus Bambaiha; Patterson, Kaitlin A; Donnelly, Blánaid; Kulkarni, Manisha A; Harper, Sherilee L; Ogden, Nicholas H; Carcamo, Cesar P
Although malnutrition and malaria co-occur among individuals and populations globally, effects of nutritional status on risk for parasitemia and clinical illness remain poorly understood. We investigated associations between Plasmodium falciparum infection, nutrition, and food security in a cross-sectional survey of 365 Batwa pygmies in Kanungu District, Uganda in January of 2013. We identified 4.1% parasite prevalence among individuals over 5 years old. Severe food insecurity was associated with increased risk for positive rapid immunochromatographic test outcome (adjusted relative risk [ARR] = 13.09; 95% confidence interval [95% CI] = 2.23-76.79). High age/sex-adjusted mid-upper arm circumference was associated with decreased risk for positive test among individuals who were not severely food-insecure (ARR = 0.37; 95% CI = 0.19-0.69). Within Batwa pygmy communities, where malnutrition and food insecurity are common, individuals who are particularly undernourished or severely food-insecure may have elevated risk for P. falciparum parasitemia. This finding may motivate integrated control of malaria and malnutrition in low-transmission settings.
Weigel, M Margaret; Armijos, Rodrigo X; Racines, Marcia; Cevallos, William
Household food insecurity (HFI) is becoming an increasingly important issue in Latin America and other regions undergoing rapid urbanization and nutrition transition. The survey investigated the association of HFI with the nutritional status of 794 adult women living in households with children in low-income neighborhoods in Quito, Ecuador. Data were collected on sociodemographic characteristics, household food security status, and nutritional status indicators (dietary intake, anthropometry, and blood hemoglobin). Data were analyzed using multivariate methods. The findings identified revealed a high HFI prevalence (81%) among the urban households that was associated with lower per capita income and maternal education; long-term neighborhood residency appeared protective. HFI was associated with lower dietary quality and diversity and an increased likelihood of anemia and short stature but not increased high-calorie food intake or generalized or abdominal obesity. Although significant progress has been made in recent years, low dietary diversity, anemia, and growth stunting/short stature in the Ecuadorian maternal-child population continue to be major public health challenges. The study findings suggest that improving urban food security may help to improve these nutritional outcomes. They also underscore the need for food security policies and targeted interventions for urban households and systematic surveillance to assess their impact.
Weigel, M. Margaret; Armijos, Rodrigo X.; Racines, Marcia; Cevallos, William
Household food insecurity (HFI) is becoming an increasingly important issue in Latin America and other regions undergoing rapid urbanization and nutrition transition. The survey investigated the association of HFI with the nutritional status of 794 adult women living in households with children in low-income neighborhoods in Quito, Ecuador. Data were collected on sociodemographic characteristics, household food security status, and nutritional status indicators (dietary intake, anthropometry, and blood hemoglobin). Data were analyzed using multivariate methods. The findings identified revealed a high HFI prevalence (81%) among the urban households that was associated with lower per capita income and maternal education; long-term neighborhood residency appeared protective. HFI was associated with lower dietary quality and diversity and an increased likelihood of anemia and short stature but not increased high-calorie food intake or generalized or abdominal obesity. Although significant progress has been made in recent years, low dietary diversity, anemia, and growth stunting/short stature in the Ecuadorian maternal-child population continue to be major public health challenges. The study findings suggest that improving urban food security may help to improve these nutritional outcomes. They also underscore the need for food security policies and targeted interventions for urban households and systematic surveillance to assess their impact. PMID:27110253
Davis, Katy B
Low-income women of color who are HIV positive and living in violent relationships are at significant risk for stigma and problems with attachment security. This article explores the ways in which these women may experience internalized stigma from incorporating society's negative views of HIV and domestic violence. It also addresses the ways in which insecure attachment may develop or intensify in this population through violence in their adult intimate relationships and/or living with a life threatening illness. A model of medical and psychosocial care utilized at the Women's HIV Program at the University of California San Francisco is offered as an intervention to reduce stigma and enhance healthy attachment. Clinical examples demonstrate how this system of medical and psychosocial care can help women in this situation establish stability and improve their lives despite the intense challenges they face.
Arteaga, Irma; Potochnick, Stephanie; Parsons, Sarah
Using the Early Childhood Longitudinal Study-K, multivariate analysis, state fixed effects, and regression decomposition, we examine changes in food insecurity for Hispanic kindergarteners between 1998 and 2011, a time period of rapid immigration and political/socio-economic changes. During this time the household food insecurity gap between children of U.S.-born and foreign-born mothers increased by almost 7 percentage points. The factors-child, family, and state-that contributed to the nativity gap differed over time. In both periods, lower familial resources among immigrant families, i.e. endowment effects, contributed to the gap; this was the main component of the gap in 2011 but only one component in 1998. In 1998, heterogeneity in state effects was positively associated with the nativity food insecurity gap. This means that children of foreign-born mothers experience higher household food insecurity than do children of U.S.-born mothers in the same state, even after controlling for child and family characteristics. In 2011, almost half of the gap remained unexplained. This unexplained portion could be driven by differential effects of the Great Recession, growing anti-immigrant sentiment, and/or the relatively large share of unauthorized immigrants in 2011.
This study was aimed to examine the prevalence of food insecurity and what social, health, and environmental characteristics could constitute such situation in a national and population-based setting. Data was retrieved from the National Health and Nutrition Examination Survey, 2005-2006. Information on demographics, lifestyle factors, self-reported ever medical conditions in the past and self-reported food security conditions in the last 12 months calculated on the household level was obtained by household interview. Bloods and urines (subsample) were collected at the interview as well. Only adults aged 20 years and above (n = 4979) were included for statistical analysis in the present study. Chi-square test, t test, and survey-weighted logistic regression modeling were performed. Three thousand eight hundred thirty-four (77.9%) people were with full food security, 466 (9.5%) people were with marginal food security and 624 (12.7%) people were with low or very low food security. Being younger, having higher ratios of family income to poverty thresholds (due to low level of education or lack of financial support), having prior asthma, arthritis, chronic bronchitis, depression, diabetes, eczema, emphysema or liver problems, having higher levels of serum cotinine, urinary antimony, bisphenol A, pesticides, or having lower levels of urinary Benzophenone-3 were associated with food insecurity. In addition to socioeconomic and smoking conditions, evidence on people with several prior health conditions and being exposed to environmental chemicals and food insecurity is further provided. Future social, health and environmental policy, and programs protecting people from food insecurity by considering both health and environmental factors mentioned above would be suggested.
Bukania, Zipporah N; Mwangi, Moses; Karanja, Robert M; Mutisya, Richard; Kombe, Yeri; Kaduka, Lydia U; Johns, Timothy
Machakos and Makueni counties in Kenya are associated with historical land degradation, climate change, and food insecurity. Both counties lie in lower midland (LM) lower humidity to semiarid (LM4), and semiarid (LM5) agroecological zones (AEZ). We assessed food security, dietary diversity, and nutritional status of children and women. Materials and Methods. A total of 277 woman-child pairs aged 15-46 years and 6-36 months respectively, were recruited from farmer households. Food security and dietary diversity were assessed using standard tools. Weight and height, or length in children, were used for computation of nutritional status. Findings. No significant difference (P > 0.05) was observed in food security and dietary diversity score (DDS) between LM4 and LM5. Stunting, wasting, and underweight levels among children in LM4 and LM5 were comparable as were BMI scores among women. However, significant associations (P = 0.023) were found between severe food insecurity and nutritional status of children but not of their caregivers. Stunting was significantly higher in older children (>2 years) and among children whose caregivers were older. Conclusion. Differences in AEZ may not affect dietary diversity and nutritional status of farmer households. Consequently use of DDS may lead to underestimation of food insecurity in semiarid settings.
Bukania, Zipporah N.; Mwangi, Moses; Karanja, Robert M.; Mutisya, Richard; Kombe, Yeri; Kaduka, Lydia U.
Machakos and Makueni counties in Kenya are associated with historical land degradation, climate change, and food insecurity. Both counties lie in lower midland (LM) lower humidity to semiarid (LM4), and semiarid (LM5) agroecological zones (AEZ). We assessed food security, dietary diversity, and nutritional status of children and women. Materials and Methods. A total of 277 woman-child pairs aged 15–46 years and 6–36 months respectively, were recruited from farmer households. Food security and dietary diversity were assessed using standard tools. Weight and height, or length in children, were used for computation of nutritional status. Findings. No significant difference (P > 0.05) was observed in food security and dietary diversity score (DDS) between LM4 and LM5. Stunting, wasting, and underweight levels among children in LM4 and LM5 were comparable as were BMI scores among women. However, significant associations (P = 0.023) were found between severe food insecurity and nutritional status of children but not of their caregivers. Stunting was significantly higher in older children (>2 years) and among children whose caregivers were older. Conclusion. Differences in AEZ may not affect dietary diversity and nutritional status of farmer households. Consequently use of DDS may lead to underestimation of food insecurity in semiarid settings. PMID:25328691
Household food security is defined as access to enough food at all times for active, healthy living. Low food security may influence consumption because those households may lack sufficient resources to purchase more healthful items like fruit and vegetables. Because home availability is related to ...
Armijos, Rodrigo X.; Racines, Marcia; Cevallos, William; Castro, Nancy P.
Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition. PMID:27752266
Weigel, M Margaret; Armijos, Rodrigo X; Racines, Marcia; Cevallos, William; Castro, Nancy P
Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition.
Ralph, Lauren J.; Njau, Prosper F.; Msolla, Mbette Mshindo; Padian, Nancy S.
Food insecurity (FI) is associated with higher-risk sexual behavior in some studies. However, the overlap between FI and socioeconomic status (SES) has been poorly described. The study objectives were to: (1) determine the relationship between household FI and four dimensions of SES among sexually active Tanzanian women in farming households: expenditures, assets, flooring material of the home, and land ownership; and (2) determine whether FI is associated with higher-risk sexual behavior and relationship power. In male-headed households, FI was associated with assets, flooring material, and land ownership but not expenditures. There was no association between FI and the four dimensions of SES in female-headed households. Among women in male-headed households, but not female household heads themselves, severe FI was associated with a non-significant increase in the likelihood of being in a relationship because of material goods [adjusted prevalence ratio (PRa) = 1.76, 95 % confidence interval (CI) 0.81, 3.81] and was inversely associated with being able to ask partners to use condoms (PRa = 0.47, 95 % CI 0.25, 0.88). There was not a strong association between food security and relationship power. Our findings suggest that the association between FI and HIV risk behavior may differ depending on the type of household. PMID:24097335
Hobkirk, Andréa L; Towe, Sheri L; Patel, Puja; Meade, Christina S
People living with HIV/AIDS (PLWHA) in the United States (US) have disproportionately high rates of food insecurity (FI). In the general population, FI has been associated with cognitive impairment among older adults and may exacerbate HIV-associated neurocognitive disorders. The current study assessed the effects of FI and HIV infection on the neuropsychological performance of 61 HIV-positive and 36 HIV-negative adults in the US. While the main effects were minimal, the interactive effects revealed that FI was related to deficits in speed of information processing, learning, memory, motor function, and overall cognitive impairment for the HIV-positive group, but not the HIV-negative group. The interactive effects remained after controlling for relevant sociodemographic characteristics. Although bidirectional associations cannot be ruled out in a cross-sectional study, the results suggest that FI may contribute to cognitive impairment among HIV-positive adults in the US. Given the high rates of socioeconomic disadvantage among PLWHA in the US, addressing FI as part of routine clinical care may be warranted.
Bartfeld, Judi; Dunifon, Rachel
This article examines interstate variation in household food security. Using hierarchical modeling, we identify several kinds of state characteristics that appear linked to household food security: the availability and accessibility of federal nutrition assistance programs, policies affecting economic wellbeing of low income families, and states'…
Derose, Kathryn P.; Felician, Melissa; Han, Bing; Palar, Kartika; Ramírez, Blanca; Farías, Hugo; Martínez, Homero
Background Food insecurity and poor nutrition are key barriers to anti-retroviral therapy (ART) adherence. Culturally-appropriate and sustainable interventions that provide nutrition counseling for people on ART and of diverse nutritional statuses are needed, particularly given rising rates of overweight and obesity among people living with HIV (PLHIV). Methods As part of scale-up of a nutritional counseling intervention, we recruited and trained 17 peer counselors from 14 government-run HIV clinics in Honduras to deliver nutritional counseling to ART patients using a highly interactive curriculum that was developed after extensive formative research on locally available foods and dietary patterns among PLHIV. All participants received the intervention; at baseline and 2 month follow-up, assessments included: 1) interviewer-administered, in-person surveys to collect data on household food insecurity (15-item scale), nutritional knowledge (13-item scale), dietary intake and diversity (number of meals and type and number of food groups consumed in past 24 hours); and 2) anthropometric measures (body mass index or BMI, mid-upper arm and waist circumferences). We used multivariable linear regression analysis to examine changes pre-post in food insecurity and the various nutritional outcomes while controlling for baseline characteristics and clinic-level clustering. Results Of 482 participants at baseline, we had complete follow-up data on 356 (74%), of which 62% were women, median age was 39, 34% reported having paid work, 52% had completed primary school, and 34% were overweight or obese. In multivariate analyses adjusting for gender, age, household size, work status, and education, we found that between baseline and follow-up, household food insecurity decreased significantly among all participants (β=−0.47, p<.05) and among those with children under 18 (β=−1.16, p<.01), while nutritional knowledge and dietary intake and diversity also significantly improved
Frongillo, Edward A; Wolfe, Wendy S
The aim of this study was to determine if (1) participation in Home-Delivered Meals (HDM) results in improved dietary patterns and nutrient intake, lower food insecurity, and reduced loss of weight; (2) subgroups of older persons are more likely to benefit; and (3) nutritional indicators of impact other than nutrient intake may be useful. The design used was quasi-experimental, with longitudinal assessment of individuals on HDM at baseline (before receipt of services), 6, and 12 months, and comparison to non-randomized group receiving other services. Outcomes included measured weight and height, 24-hour dietary recall, and food insecurity. Paired t test, multiple linear regression, and selection models using multiple logistic regression were performed. All older persons in three New York State counties referred for aging services over a 5-month period were asked to participate (n = 456), and 212 agreed (171 on HDM). At 6 months, the sample size was 101 (34 discharged, 42 hospital/died/moved, 26 chose not to continue), and at 12 months it was 68 (similar reasons). After receiving meals for 6 and 12 months, participants showed greater improvement in most dietary intake variables than either a non-HDM comparison group or HDM participants who ate no HDM meal on the day of assessment. Compared to initial values, participants improved significantly in some variables for dietary patterns, nutrient intake, and nutrient density, and were less likely to be food insecure. Furthermore, HDM was more likely to impact those living alone and those with poorer initial status. This study provides strong evidence that HDM has a positive impact on the nutritional well-being of older persons. Food insecurity and dietary patterns are useful nutritional indicators of impact.
Ferreira, Haroldo da Silva; de Souza, Maria Eduarda Di Cavalcanti Alves; Moura, Fabiana Andréa; Horta, Bernardo Lessa
The scope of this study was to identify the prevalence and factors associated with food insecurity (INSEC) in families of northern Alagoas. A cross-sectional study was conducted with a random sample of 1444 households classified in accordance with the Brazilian INSEC scale into the following categories: mild, moderate or severe. The prevalence ratio calculated by Poisson regression was used to investigate the association of moderate + severe INSEC with the independent variables in both crude and adjusted analysis. The variables that in the crude analysis reached p < 0.2 were included. INSEC was detected in 919 families, of which, 23.3% and 14.2% were in the moderate or severe form, respectively. There was a higher proportion of food insecurity in the families with subjects < 18 years. The variables that remained independently associated to moderate + severe food insecurity were: rooms in the household ≤ 4, schooling of the household head ≤ 4 years, drinking water other than mineral, beneficiary of the Bolsa Família Program, number of residents in the household > 4, head of household is female and schooling of the housewife ≤ 4 years. The conclusion was that the families studied showed a high prevalence of INSEC, especially those with individuals < 18 years.
Craveiro, Isabel; Alves, Daniela; Amado, Miguel; Santos, Zélia; Fortes, Argentina Tomar; Delgado, António Pedro; Correia, Artur; Gonçalves, Luzia
Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project “UPHI-STAT: Urban Planning and Health Inequalities—moving from macro to micro statistics”. Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor. PMID:27879689
Craveiro, Isabel; Alves, Daniela; Amado, Miguel; Santos, Zélia; Fortes, Argentina Tomar; Delgado, António Pedro; Correia, Artur; Gonçalves, Luzia
Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project "UPHI-STAT: Urban Planning and Health Inequalities-moving from macro to micro statistics". Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor.
Green-LaPierre, Rebecca J.; Williams, Patricia L.; Glanville, N. Theresa; Norris, Deborah; Hunter, Heather C.; Watt, Cynthia G.
Building on earlier quantitative work where we showed that lone senior households reliant on public pensions in Nova Scotia (NS), Canada lacked the necessary funds for a basic nutritious diet, here we present findings from a qualitative study involving in-depth interviews with eight low-income lone senior women living in an urban area of NS. Using a phenomenological inquiry approach, in-depth interviews were used to explore lone senior women's experiences accessing food with limited financial resources. Drawing upon Bronfenbrenner's Ecological Systems Theory, we explored their perceived ability to access a nutritionally adequate and personally acceptable diet, and the barriers and enablers to do so; as well in light of our previous quantitative research, we explored their perceptions related to adequacy of income, essential expenses, and their strategies to manage personal finances. Seven key themes emerged: world view, income adequacy, transportation, health/health problems, community program use, availability of family and friends, and personal food management strategies. World view exerted the largest influence on seniors' personal perception of food security status. The implications of the findings and policy recommendations to reduce the nutritional health inequities among this vulnerable subset of the senior population are considered. PMID:22997580
Mamlin, Joseph; Kimaiyo, Sylvester; Lewis, Stephen; Tadayo, Hannah; Jerop, Fanice Komen; Gichunge, Catherine; Petersen, Tomeka; Yih, Yuehwern; Braitstein, Paula; Einterz, Robert
The Academic Model Providing Access to Healthcare (AMPATH) is a partnership between Moi Teaching and Referral Hospital, Moi University School of Medicine, and a consortium of universities led by Indiana University. AMPATH has over 50,000 patients in active care in 17 main clinics around western Kenya. Despite antiretroviral therapy, many patients were not recovering their health because of food insecurity. AMPATH therefore established partnerships with the World Food Program and United States Agency for International Development and began high-production farms to complement food support. Today, nutritionists assess all AMPATH patients and dependents for food security and refer those in need to the food program. We describe the implementation, challenges, and successes of this program.
Household food insecurity is inversely associated with social capital and health in females from special supplemental nutrition program for women, infants, and children households in Appalachian Ohio.
Walker, Jennifer L; Holben, David H; Kropf, Mary L; Holcomb, John P; Anderson, Heidi
Food insecurity has been negatively associated with social capital (a measure of perceived social trust and community reciprocity) and health status. Yet, these factors have not been studied extensively among women from households participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the WIC Farmers' Market Nutrition Program. A cross-sectional, self-administered, mailed survey was conducted in Athens County, Ohio, to examine the household food security status, social capital, and self-rated health status of women from households receiving WIC benefits alone (n=170) and those from households receiving both WIC and Farmers' Market Nutrition Program benefits (n=65), as well as the relationship of food security, social capital, and self-rated health status. Household food security and perceived health status were not significantly different between groups; however, high social capital was greater (chi(2)=8.156, P=0.004) among WIC, compared to WIC/Farmers' Market Nutrition Program group respondents. Overall, household food insecurity was inversely associated with perceived health status (r=-0.229, P=0.001) and social capital (r=0.337, P<0.001). Enabling networking among clients, leading to client-facilitated programs and projects, and developing programs that strengthen social capital, including community-based mentoring programs and nutrition education programs that are linked to community-based activities, are needed, as is additional research to verify these findings.
Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study
Trappmann, Jessica L.; Jimenez, Elizabeth Yakes; Keane, Patricia C.; Cohen, Deborah A.; Davis, Sally M.
Associations between food insecurity and overweight/obesity, feeding behaviors, and public food assistance utilization have been explored to a greater extent among adults and adolescents than among young children. This cross-sectional study examines a subset of pre-intervention implementation data (n = 347) among families participating in the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study conducted in rural New Mexico among predominantly Hispanic and American Indian Head Start centers. No significant relationships emerged between food insecurity and child overweight/obesity, certain feeding behaviors, or public food assistance utilization. Additional research is necessary to understand relationships between food insecurity and child overweight/obesity status, use of public assistance benefits, and certain feeding behaviors among rural preschool-aged children in predominantly Hispanic and American Indian communities. PMID:27547288
Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study.
Trappmann, Jessica L; Jimenez, Elizabeth Yakes; Keane, Patricia C; Cohen, Deborah A; Davis, Sally M
Associations between food insecurity and overweight/obesity, feeding behaviors, and public food assistance utilization have been explored to a greater extent among adults and adolescents than among young children. This cross-sectional study examines a subset of pre-intervention implementation data (n = 347) among families participating in the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study conducted in rural New Mexico among predominantly Hispanic and American Indian Head Start centers. No significant relationships emerged between food insecurity and child overweight/obesity, certain feeding behaviors, or public food assistance utilization. Additional research is necessary to understand relationships between food insecurity and child overweight/obesity status, use of public assistance benefits, and certain feeding behaviors among rural preschool-aged children in predominantly Hispanic and American Indian communities.
Morrissey, Taryn W.; Jacknowitz, Alison; Vinopal, Katie
The authors of this research brief were co-principal investigators on a grant awarded by the IRP RIDGE Center for National Food and Nutrition Assistance Research at the University of Wisconsin-Madison, in partnership with the Economic Research Service of the U.S. Department of Agriculture. Their project, summarized here, was one of five proposals…
Young, Sera L; Plenty, Albert H J; Luwedde, Flavia A; Natamba, Barnabas K; Natureeba, Paul; Achan, Jane; Mwesigwa, Julia; Ruel, Theodore D; Ades, Veronica; Osterbauer, Beth; Clark, Tamara D; Dorsey, Grant; Charlebois, Edwin D; Kamya, Moses; Havlir, Diane V; Cohan, Deborah L
Household food insecurity (HHFI) may be a barrier to both optimal maternal nutritional status and infant feeding practices, but few studies have tested this relationship quantitatively, and never among HIV-infected individuals. We therefore described the prevalence of HHFI and explored if it was associated with poorer maternal nutritional status, shorter duration of exclusive breastfeeding (EBF) and fewer animal-source complementary foods. We assessed these outcomes using bivariate and multivariate analyses among 178 HIV-infected pregnant and breastfeeding (BF) women receiving combination antiretroviral therapy in the PROMOTE trial (NCT00993031), a prospective, longitudinal cohort study in Tororo, Uganda. HHFI was common; the prevalence of severe, moderate, and little to no household hunger was 7.3, 39.9, and 52.8 %, respectively. Poor maternal nutritional status was common and women in households experiencing moderate to severe household hunger (MSHH) had statistically significantly lower body mass index (BMIs) at enrollment (21.3 vs. 22.5, p < 0.01) and prior to delivery (22.6 vs. 23.8, p < 0.01). BMI across time during pregnancy, but not gestational weight gain, was significantly lower for MSHH [adjusted beta (95 % CI) -0.79 (-1.56, -0.02), p = 0.04; -2.06 (-4.31, 0.19), p = 0.07], respectively. The prevalence (95 % CI) of EBF at 6 months was 67.2 % (59.7-73.5 %), and the proportion of women BF at 12 months was 80.4 % (73.3-85.7 %). MSHH was not associated with prevalence of EBF at 6 months or BF at 12 months. However, among those women still EBF at 4 months (81.4 % of population), those experiencing MSHH were significantly more likely to cease EBF between 4 and 6 months (aHR 2.38, 95 % CI 1.02-5.58). The prevalence of HHFI, maternal malnutrition, and suboptimal infant feeding practices are high and the causal relationships among these phenomena must be further explored.
Vervisch, Thomas G A; Vlassenroot, Koen; Braeckman, Johan
The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor-based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework.
Kac, Gilberto; Schlüssel, Michael M; Pérez-Escamilla, Rafael; Velásquez-Melendez, Gustavo; da Silva, Antônio Augusto Moura
We examined the association between Household Food Insecurity (HFI), weight for height z-score (WHZ) and Body Mass Index for age z-score (BMI-Z) in a representative sample of children 0-60 months of age (n = 3,433) in five Brazilian geographical regions. Data were derived from the 2006-07 Brazilian Demographic and Health Survey. HFI was measured with the Brazilian Food Insecurity Scale. Associations were estimated using multiple linear regression models (β coefficients and 95% CI) taking into account the complex sampling design. Interaction terms between HFI and geographical region and HFI and child sex and child age were assessed. The weighted prevalence of any level of HFI was 48.6%. Severe food insecurity was more prevalent among children from the North region (16.8%), born from mothers with <4 years of schooling (15.9%) and those from families with ≥3 children (18.8%). The interaction between HFI and geographical region was non-significant for BMI-Z (P = 0.119) and WHZ (P = 0.198). Unadjusted results indicated that HFI was negatively associated with BMI-Z (moderate to severe HFI: β = -0.19, 95% CI: -0.35 - -0.03, P = 0.047), and WHZ (moderate to severe HFI: β = -0.26, 95% CI: -0.42 - -0.09, P = 0.009). Estimates lost significance after adjustments for key confounders such as mothers' skin color, mothers' years of schooling, place of household, household income quartiles, mothers' smoking habit, mothers' marital status, number of children 0-60 months in the household, and birth order. HFI is unrelated to weight outcomes among Brazilian children 0-60 months.
Sobrinho, Fernanda Martins; Silva, Yara Cardoso; Abreu, Mery Natali Silva; Pereira, Simone Cardoso Lisboa; Dias Júnior, Cláudio Santiago
The scope of this study is to evaluate the condition of household food and nutrition (in)security (IAN) of the users of low-budget restaurants in Belo Horizonte (BH). This is an analytical cross-sectional study carried out on all low-budget restaurants and cafeteria in BH with a sample of 1613 users. The IAN was assessed using the Brazilian Food Insecurity Scale and cross-checked with the socioeconomic profile of the users. The Chisquare and Mann-Whitney tests were applied. All p-value < 0.25 variables were included in the multivariate analysis. The groups most exposed to IAN among users of low-budget restaurants are those with a lower socioeconomic level and per capita income class and those with a large number of residents in the household. Also affected are those who admit to having different kinds of wants and needs, and those for whom price and living alone are the main reasons for frequenting low-budget restaurants. The factors affecting the IAN are varied and multifactorial, thus representing a major challenge for public policy makers and for those who live directly with these dietary restrictions. The low-budget restaurants serve as a strategy for promoting healthy eating habits.
Pinard, Courtney; Smith, Teresa M; Calloway, Eric E; Fricke, Hollyanne E; Bertmann, Farryl M; Yaroch, Amy L
The objective of this paper is to describe the development and preliminary testing of new scales to assess hunger-coping behaviors in a very low-income population. Very low-income adults (≥ 19 years), caregivers to at least one child (n = 306) completed a survey in a community setting (e.g., libraries). The survey included novel items assessing hunger-coping behaviors (e.g., trade-offs to purchase food, strategies to stretch and obtain food), food insecurity status, and physiological hunger. Internal consistency of hunger-coping scales, one-way ANOVAs, post-hoc analyses, Spearman's correlations among variables. Respondents were 75% female, 51% African American, 34% White, and 15% Hispanic, and 73% earned <$20,000/year. Four scales emerged: hunger-coping trade-offs, financial coping strategies, rationing coping strategies, and physiological adult hunger symptoms. All scales demonstrated acceptable internal consistency (α/KR-20 = 0.70-0.90). Predictive, construct, and content validity were demonstrated by correlations between hunger-coping scales and food insecurity (FI), measured with the USDA 6-item HFSSM (rs = 0.42-0.68, ps < 0.001). Higher levels of hunger-coping trade-offs (F(2,297) = 42.54, p < 0.001), financial coping strategies (F(2,287) = 70.77, p < 0.001), and rationing coping strategies (F(2,284) = 69.19, p < 0.001), corresponded with increasing levels of FI. These preliminary results support use of newly developed hunger-coping scales in a very low-income population and can compliment traditional food security measures to inform hunger prevention policy and programming.
dependent on such positive agricultural policies which aim at eradicating hunger and food insecurity , the presence of which may cause instability within...which could result in food insecurity and thus conflict. As already mentioned, countries in West Africa mainly export primary products which generally...deforestation. Deforestation also makes agricultural production unsustainable which affects both 13 food and cash crop production. Food insecurity brings
Jones, Andrew D; Mundo-Rosas, Verónica; Cantoral, Alejandra; Levy, Teresa Shamah
We aimed to determine the association between household food insecurity (HFI) and the co-occurrence of overweight and anemia among women of reproductive age in the Mexican population. We analyzed data on 4,039 nonpregnant female adolescents (15-19 years) and 10,760 nonpregnant adult women of reproductive age (20-49 years) from the 2012 National Health and Nutrition Survey of Mexico. The survey uses a two-stage sampling design, stratified by rural and urban regions. The Latin American and Caribbean Food Security Scale was used to assess HFI. We assessed overweight and obesity in women based on World Health Organization classifications for body mass index, and BMI-for-age Z-scores for female adolescents, and defined anemia as an altitude-adjusted hemoglobin (Hb) concentration < 120 g/L based on measurement of capillary Hb concentrations. In multiple logistic regression models adjusting for potential confounding covariates, HFI was not associated with the co-occurrence of anemia and overweight among female adolescents. The adjusted odds of women of reproductive age from mildly and moderately food-insecure households, respectively, experiencing concurrent anemia and overweight were 48% (OR: 1.48; 95% CI: 1.15, 1.91) and 49% (OR: 1.49; 95% CI: 1.08, 2.06) higher than among women from food-secure households. Severe HFI was not associated with concurrent overweight and anemia among female adolescents or women. HFI may be a shared mechanism for dual forms of malnutrition within the same individual, simultaneously contributing to overconsumption and dietary inadequacy.
Fram, Maryah Stella; Frongillo, Edward A.; Fishbein, Eliza M.; Burke, Michael P.
Food insecurity is associated with a range of child developmental, behavioral, and emotional challenges, all of which can inhibit a child's school success. Schools offer a number of formal and informal services aimed at reducing food insecurity, but the problems associated with identifying children in need, addressing issues of stigma, and…
Grace, K.; Husak, G. J.; Bogle, S.
Determining the amount of food produced in a food insecure, isolated, subsistence farming community can be used to help identify households or communities who may be in need of additional food resources. Measuring annual food production in developing countries, much less at a sub-national level, is complicated by lack of data. It can be difficult and costly to access all of the farming households engaged in subsistence farming. However, recent research has focused on the use of remotely sensed data to aid in the estimation of area under cultivation and because food production is the measure of yield (production per hectare) multiplied by area (number of hectares), we can use the area measure to reduce uncertainty in food production estimates. One strategy for estimating cultivated area relies on a fairly time intensive manual interpretation of very high resolution data. Due to the availability of very high resolution data it is possible to construct estimates of cultivated area, even in communities where fields are small. While this strategy has been used to effectively estimate cultivated area in a timely manner, questions remain about the spatial and temporal generalizability of this approach. The purpose of this paper is to produce and compare estimates of cultivated area in two very different agricultural areas of Kenya, a highly food insecure country in East Africa, during two different agricultural seasons. The areas selected represent two different livelihood zones: a marginal growing area where poor farmers rely on inconsistent rainfall and a lush growing area near the mountainous region of the middle-West area of the country where rainfall is consistent and therefore more suited to cultivation. The overarching goal is to determine the effectiveness of very high resolution remotely sensed imagery in calculating estimates of cultivated area in areas where food production strategies are different. Additionally the results of this research will explore the
Weber, Jessica; Gutierrez, Anibal
Feeding difficulties and feeding disorders are a commonly occurring problem for young children, particularly children with developmental delays including autism. Behavior analytic interventions for the treatment of feeding difficulties oftentimes include escape extinction as a primary component of treatment. The use of escape extinction, while effective, may be problematic as it is also associated with the emergence of challenging behavior (e.g., extinction burst). Such challenging behavior may be an acceptable side effect in treatment cases where feeding problems are severe and chronic (e.g., failure to thrive). However, in more acute cases (e.g., selective eating), the negative side effect may be unwarranted and undesired. More recent research on the behavioral treatment of food selectivity has begun to evaluate treatments for feeding difficulties that do not include escape extinction (e.g., demand fading, behavioral momentum), with some success. However, research to date reveals individual differences in responsiveness to such treatments and no clear preferable treatment has emerged. This manuscript describes a multi-component treatment package that includes shaping, sequential presentation and simultaneous presentation, for the treatment of food selectivity in four young children with developmental delays. This treatment package extends the literature on the behavioral treatment for food selectivity and offers a multi-component treatment protocol that may be clinically applicable across a range of treatment scenarios and settings.
Ali, Disha; Saha, Kuntal K; Nguyen, Phuong H; Diressie, Michael T; Ruel, Marie T; Menon, Purnima; Rawat, Rahul
Household food insecurity (HFI) is a recognized underlying determinant of child undernutrition, but evidence of associations between HFI and child undernutrition is mixed. The purpose of this study was to investigate if HFI is associated with undernutrition in children aged 6-59.9 mo in Bangladesh (n = 2356), Ethiopia (n = 3422), and Vietnam (n = 3075) and if child dietary diversity (DD) mediated this effect. We used baseline survey data from the Alive & Thrive project. Logistic regression, adjusting for potential confounding factors, was used to determine the magnitude and significance of the association of HFI with stunting, underweight, and wasting. The mediating effect of child DD was tested by using a Sobel-Goodman mediation test. The prevalences of HFI were 66%, 40%, and 32% in Ethiopia, Vietnam, and Bangladesh, respectively. The prevalences of stunting, underweight, and wasting were higher in Bangladesh (47.1%, 43.7%, and 19.1%, respectively) and Ethiopia (50.7%, 27.5%, and 5.9%, respectively) than in Vietnam (20.7%, 15.8%, and 5%, respectively). In the adjusted models, the odds of being stunted or underweight were significantly higher for children in severely food-insecure households in Bangladesh (stunting OR: 1.36; 95% CI: 1.05, 1.76; underweight OR: 1.28; 95% CI: 0.99, 1.65) and Ethiopia (stunting OR: 1.48; 95% CI: 1.09, 2.00; underweight OR: 1.68; 95% CI: 1.22, 2.30) and in moderately food-insecure households in Vietnam (stunting OR: 1.39; 95% CI: 1.16, 1.65; underweight OR: 1.69; 95% CI: 1.28, 2.23). HFI was significantly associated with wasting in Bangladesh where close to 1 in 5 children demonstrated wasting. Child DD did not mediate the relation between HFI and undernutrition in any of the countries. Further research is recommended to investigate potential mediators in this pathway.
Bernal, Jennifer; Frongillo, Edward A; Herrera, Héctor; Rivera, Juan
Children's experiences of food insecurity (FI) may be conceptually distinct and different from those of adults. Previous study of children's experiences of FI has relied primarily on their parents' perspective. This study explored, described, and conceptualized experiences of FI in children attending 5 public schools in peri-urban areas of the Miranda State, Venezuela, South America using a naturalistic approach. Children aged 10-17 y were studied through focus groups (n = 42) and individual interviews (n = 13). Interviews were recorded, transcribed, and analyzed using grounded theory. Children were cognitively aware of FI, worry in their parents, and causes both external and internal to their households. Children were also emotionally aware of FI, with feelings of concern, anguish, and sadness, and manifestations such as crying. Children reported being physically hungry, experiencing reduced quantity and quality of food intake, having smaller meals, and recognizing thinness and fainting as consequences. Children's responses to FI included reduction of quality and quantity of food, child labor, sacrifice in food consumption, food from waste, support from extended family members, and strategies for purchasing, acquiring, preparing, and cooking food. Children were not always protected, especially when the head of the family was unemployed, had drug-alcohol problems, or was extremely poor. Protection could come from parents to children and from older children to parents and younger children. Children should have certain access to food that is dignified, timely, efficient, and adequate in harmonious social conditions to prevent and resolve situations that compromise their physical, cognitive, and socio-emotional well-being.
Richter, Beate; Bokelmann, Wolfgang
In the food industry the subject of food losses is of great importance due to economic balance and an efficient application of resources as well as the development of an efficient food chain system. This paper presents the explorative results of a quantitative survey of leading companies of the German food industry to evaluate the relevance and handling of this issue. The investigation reveals that the topic food losses have a high significance in the food industry which will probably increase in future. A sample breakdown by branches indicates that the issue has the highest relevance for companies in the confectionery industry. These companies as well as those in the meat and fish industry want to consider the subject prospectively more powerful in their companies. Across the food industry, there is no communication to consumers of the efforts concerning food losses. And companies in the confectionery industry and in the fruit and vegetable industry rather want to engage more powerful in this topic if consumers' interest increases. But in order to minimize food losses at all stages along the supply chain, communication and collaboration at all stages is essential, especially the communication to consumers. Thus, it has to be verified whether a suitable communication can lead to advantages in competition and become an important issue for companies to differentiate from competitors.
Muhajarine, Nazeem; Ridalls, Tracy; Abonyi, Sylvia; Vatanparast, Hassan; Whiting, Susan; Walker, Ryan
Background This is a 2-year study to assess the early impacts of a new grocery store intervention in a former food desert. Objective The purpose of the study is to understand the early health effects of the introduction of a large-scale food and nutrition-focused community-based population health intervention, the Good Food Junction (GFJ) Cooperative Store, in a geographically bounded group of socially disadvantaged neighborhoods (the “core neighborhoods”) in a midsized Canadian city. The GFJ grocery store was tasked with improving the access of residents to healthy, affordable food. The 5 research questions are: (1) What is the awareness and perception of the GFJ store among residents of the core neighborhoods? (2) Are there differences in awareness and perception among those who do and do not shop at the GFJ? (3) Will healthy food purchasing at the GFJ by residents of the core neighborhoods change over time, and what purchases are these individuals making at this store? (4) What early impact(s) will the GFJ have on key health-related outcomes (such as household food security status, vegetable and fruit intake, key aspects of self-reported mental health, self-reported health)? and (5) Are the effects of the intervention seen for specific vulnerable population groups, such as Aboriginal people, seniors (65 years old or older) and new immigrants (settled in Saskatoon for less than 5 years)? Methods The research project examined initial impacts of the GFJ on the health of the residents in surrounding neighborhoods through a door-to-door cross-sectional survey of food access and household demographics; an examination of GFJ sales data by location of shoppers' residences; and a 1-year, 3-time-point longitudinal study of self-reported health of GFJ shoppers. Results Analyses are on-going, but preliminary results show that shoppers are using the store for its intended purpose, which is to improve access to healthy food in a former food desert. Conclusions To our
Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C; Bailey, Mark; Gordon, Iain J; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin
China's increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies.
Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C.; Bailey, Mark; Gordon, Iain J.; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin
China’s increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies. PMID:26601127
Summary Increasingly, food companies play an important role in stemming the rising burden of nutrition-related chronic diseases. Concrete actions taken by these companies include global public commitments to address food reformulation, consumer information, responsible marketing, promotion of healthy lifestyles, and public-private partnerships. These actions are reviewed together with eleven specific PepsiCo goals and commitments that address products, the marketplace, and communities at large. Interim progress on these goals and commitments are discussed as well as constraints hampering faster progress. Further disease prevention depends on increasing implementation of private-public initiatives. PMID:20509876
Angeluccetti, Irene; Perez, Francesca; Cámaro, Walther; Demarchi, Alessandro
Early Warning Systems (EWS) for drought are currently underdeveloped compared to those related to other natural hazards. Both forecasting and monitoring of drought events are still posing challenges to the scientific community. In fact, the multifaceted nature of drought (i.e. hydrological, meteorological, and agricultural) is source of coexistence for different ways to measure this phenomenon and its effects. Similarly, drought impacts are various and complex thus difficult to be univocally measured. In the present study an approach for monitoring drought in near-real time and for estimating its impacts is presented. The EWS developed runs on a global extent and is mainly based on the early detection and monitoring of vegetation stress. On the one hand the monitoring of vegetation phenological parameters, whose extraction is based on the analysis of the MODIS-derived NDVI function, allows the fortnightly assessment of the vegetation productivity which could be expected at the end of the growing season. On the other hand, the Standardized Precipitation Index (SPI), calculated adapting TRMM-derived precipitation data in a selected distribution is used, before the growing season start, in order to early detect meteorological conditions which could give rise to vegetation stress events. During the growing season the SPI is used as check information for vegetation conditions. The relationships between rainfall and vegetation dynamics have been statistically analyzed considering different types of vegetation, in order to identify the most suitable rainfall cumulating interval to be used for the proposed monitoring procedures in different areas. A simplified vulnerability model, coupled with the above-mentioned hazard data, returns food security conditions, i.e. the estimated impacts over an investigated area. The model includes a set of agricultural indicators that accounts for the diversity of cultivated crops, the percentage of irrigated area and the suitability of
Pelto, Gretel H; Armar-Klemesu, Margaret
An ethnographic study was conducted in two areas in southern and western Kenya to identify potential interventions to improve the quality, availability and affordability of foods consumed by infants and young children. A cultural-ecological model of determinants of nutrition identified the sectors of information for data collection related to infant and young child (IYC) diet and feeding-related behaviours, and the focused ethnographic study manual was used to guide the research. The results provide qualitative evidence about facilitators and constraints to IYC nutrition in the two geographical areas and document their inter-connections. We conclude with suggestions to consider 13 potential nutrition-sensitive interventions. The studies provide empirical ethnographic support for arguments concerning the importance of combining nutrition-specific and nutrition-sensitive interventions through a multi-sectoral, integrated approach to improve the nutrition of infants and young children in low-income, resource-constrained populations. They also document the value of ethnography as a component of landscape analysis in nutrition programme and policy planning. Key messages In addition to constraints on infant and young child diet that originate in environmental and technological conditions in both agro-ecological zones, other factors that affect feeding practices include features of social organisation, household access to social support, caregivers income-earning activities and their own health. The results of the ethnographies, which highlight the importance of obtaining the knowledge and perspectives of caregivers of infants and young children, reveal the interactions of the multiple factors that affect child nutrition and the need for simultaneous nutrition-sensitive interventions to complement nutrition-specific intervention actions. Most caregivers in both areas not only understood the importance of diet and food quality for child survival, they also regarded it as
Drimie, Scott; Casale, Marisa
Several countries in Southern Africa now see large numbers of their population barely subsisting at poverty levels in years without shocks, and highly vulnerable to the vagaries of the weather, the economy and government policy. The combination of HIV/AIDS, food insecurity and a weakened capacity for governments to deliver basic social services has led to the region experiencing an acute phase of a long-term emergency. "Vulnerability" is a term commonly used by scientists and practitioners to describe these deteriorating conditions. There is particular concern about the "vulnerability" of children in this context and implications for children's future security. Through a review of literature and recent case studies, and using a widely accepted conceptualisation of vulnerability as a lens, we reflect on what the regional livelihoods crisis could mean for children's future wellbeing. We argue that an increase in factors determining the vulnerability of households - both through greater intensity and frequency of shocks and stresses ("external" vulnerability) and undermined resilience or ability to cope ("internal" vulnerability) - are threatening not only current welfare of children, but also their longer-term security. The two specific pathways we explore are (1) erosive coping strategies employed by families and individuals; and (2) their inability to plan for the future. We conclude that understanding and responding to this crisis requires looking at the complexity of these multiple stressors, to try to comprehend their interconnections and causal links. Policy and programme responses have, to date, largely failed to take into account the complex and multi-dimensional nature of this crisis. There is a misfit between the problem and the institutional response, as responses from national and international players have remained relatively static. Decisive, well-informed and holistic interventions are needed to break the potential negative cycle that threatens the
Vásquez, Victoria Breckwich; Lanza, Dana; Hennessey-Lavery, Susana; Facente, Shelley; Halpin, Helen Ann; Minkler, Meredith
Community-based participatory research (CBPR) is an increasingly utilized research approach that involves the affected community identifying a health-related problem, developing a research agenda, and planning an appropriate intervention to address the problem. This report on a CBPR partnership in San Francisco's Bayview Hunters Point neighborhood documents the rise of a community food security policy in response to youth-involved research that found poor access to quality food in an economically disadvantaged area of the city. To analyze the impact of the research on public policy, a framework of specific steps in the policy-making process is used to organize and better understand the partnership's objectives, activities, strategies, and successes. This community-health department partnership has been able to achieve an innovative and sustainable public policy solution, the Good Neighbor Program, by working closely with policy makers and local businesses to expand community accessibility to healthy food.
Munro, Ian C; Haighton, Lois A; Lynch, Barry S; Tafazoli, Shahrzad
The risk assessment of migration products resulting from packaging material has and continues to pose a difficult challenge. In most jurisdictions, there are regulatory requirements for the approval or notification of food contact substances that will be used in packaging. These processes generally require risk assessment to ensure safety concerns are addressed. The science of assessing food contact materials was instrumental in the development of the concept of Threshold of Regulation and the Threshold of Toxicological Concern procedures. While the risk assessment process is in place, the technology of food packaging continues to evolve to include new initiatives, such as the inclusion of antimicrobial substances or enzyme systems to prevent spoilage, use of plastic packaging intended to remain on foods as they are being cooked, to the introduction of more rigid, stable and reusable materials, and active packaging to extend the shelf-life of food. Each new technology brings with it the potential for exposure to new and possibly novel substances as a result of migration, interaction with other chemical packaging components, or, in the case of plastics now used in direct cooking of products, degradation products formed during heating. Furthermore, the presence of trace levels of certain chemicals from packaging that were once accepted as being of low risk based on traditional toxicology studies are being challenged on the basis of reports of adverse effects, particularly with respect to endocrine disruption, alleged to occur at very low doses. A recent example is the case of bisphenol A. The way forward to assess new packaging technologies and reports of very low dose effects in non-standard studies of food contact substances is likely to remain controversial. However, the risk assessment paradigm is sufficiently robust and flexible to be adapted to meet these challenges. The use of the Threshold of Regulation and the Threshold of Toxicological Concern concepts may
Detzel, Patrick; Wieser, Simon
Iron deficiency is one of the most widespread nutritional disorders in both developing and industrialized countries, making it a global public health concern. Anemia, mainly due to iron deficiency, affects one third of the world's population and is concentrated in women and children below 5 years of age. Iron deficiency anemia has a profound impact on human health and productivity, and the effects of iron deficiency are especially pronounced in the first 1,000 days of life. This critical window of time sets the stage for an individual's future physiological and cognitive health, underscoring the importance of addressing iron deficiency in infants and young children. This review focuses on the use of fortified foods as a cost-effective tool for addressing iron deficiency in infants and young children in the Philippines.
Assessment of Caregiver’s Knowledge, Complementary Feeding Practices, and Adequacy of Nutrient Intake from Homemade Foods for Children of 6–23 Months in Food Insecure Woredas of Wolayita Zone, Ethiopia
Abeshu, Motuma Adimasu; Adish, Abdulaziz; Haki, Gulelat D.; Lelisa, Azeb; Geleta, Bekesho
Complementary feeding should fill the gap in energy and nutrients between estimated daily needs and amount obtained from breastfeeding from 6-month onward. However, homemade complementary foods are often reported for inadequacy in key nutrients despite reports of adequacy for energy and proteins. The aim of this study was to assess caregiver’s complementary feeding knowledge, feeding practices, and to evaluate adequacy daily intakes from homemade complementary foods for children of 6–23 months in food insecure woredas of Wolayita zone, Ethiopia. A cross-sectional study assessing mothers/caregiver’s knowledge and complementary feeding practice, adequacy of daily energy, and selected micronutrient intakes using weighed food record method. Multi-stage cluster sampling method was also used to select 68 households. Caregivers had good complementary feeding knowledge. Sixty (88.2%) children started complementary feeding at 6 months and 48 (70.6%) were fed three or more times per day. Daily energy intake, however, was significantly lower (p < 0.05) than estimated daily needs, with only 151.25, 253.77, and 364.76 (kcal/day) for 6–8, 9–11, and 12–23 months, respectively. Similarly, Ca and Zn intakes (milligrams per day) were below the daily requirements (p = 0.000), with value of 37.76, 0.96; 18.83, 1.21; 30.13, 1.96; for the 6–8, 9–11, and 12–23 months, respectively. Significant shortfall in daily intake of Fe (p = 0.000) was observed among the 6–8 and 9–11 months (3.25 and 4.17 mg/day, respectively), even accounting for high bioavailability. The complementary foods were energy dense. Daily energy, Ca, Zn, and Fe (except 12–23 months) intake, however, was lower than estimated daily requirements. PMID:27574604
Govender, Laurencia; Pillay, Kirthee; Siwela, Muthulisi; Modi, Albert; Mabhaudhi, Tafadzwanashe
Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas. PMID:28036008
Govender, Laurencia; Pillay, Kirthee; Siwela, Muthulisi; Modi, Albert; Mabhaudhi, Tafadzwanashe
Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas.
McCullum, Christine; Pelletier, David; Barr, Donald; Wilkins, Jennifer; Habicht, Jean-Pierre
A community food security movement has begun to address problems of hunger and food insecurity by utilizing a community-based approach. Although various models have been implemented, little empirical research has assessed how power operates within community-based food security initiatives. The purpose of this research was to determine how power…
Carman, Katherine G; Zamarro, Gema
Food insecurity, not having consistent access to adequate food for active, healthy lives for all household members, is most common among low income households. However, income alone is not sufficient to explain who experiences food insecurity. This study investigates the relationship between financial literacy and food security. We find that low income households who exhibit financial literacy are less likely to experience food insecurity.
Ghosh-Jerath, Suparna; Singh, Archna; Magsumbol, Melina S.; Kamboj, Preeti; Goldberg, Gail
ABSTRACT Traditional foods of indigenous communities can be explored as a sustainable means of addressing undernutrition. Our study aimed at identifying indigenous foods of the Santhal tribal community of Godda district of Jharkhand, India, assessing their nutritive value, and appraising their potential role in addressing hidden hunger. A cross-sectional survey using qualitative methods like focus group discussions with women of childbearing age (15–49 years), adult males, and elderly people was conducted for food identification. This was followed by taxonomic classification and quantitative estimate of nutritive value of the identified foods either in a certified laboratory or from secondary data. The community was well aware of the indigenous food resources in their environment. More than 100 different types of indigenous foods including a number of green leafy vegetables were identified. Taxonomic classification was available for 25 food items and an additional 26 food items were sent for taxonomic classification. Many indigenous foods (more than 50% of which were green leafy vegetables) were found to be rich sources of micronutrients like calcium, iron, vitamin A as beta carotene, and folate. Maximizing utilization of indigenous foods can be an important and sustainable dietary diversification strategy for addressing hidden hunger in this indigenous community. PMID:27867449
Ghosh-Jerath, Suparna; Singh, Archna; Magsumbol, Melina S; Kamboj, Preeti; Goldberg, Gail
Traditional foods of indigenous communities can be explored as a sustainable means of addressing undernutrition. Our study aimed at identifying indigenous foods of the Santhal tribal community of Godda district of Jharkhand, India, assessing their nutritive value, and appraising their potential role in addressing hidden hunger. A cross-sectional survey using qualitative methods like focus group discussions with women of childbearing age (15-49 years), adult males, and elderly people was conducted for food identification. This was followed by taxonomic classification and quantitative estimate of nutritive value of the identified foods either in a certified laboratory or from secondary data. The community was well aware of the indigenous food resources in their environment. More than 100 different types of indigenous foods including a number of green leafy vegetables were identified. Taxonomic classification was available for 25 food items and an additional 26 food items were sent for taxonomic classification. Many indigenous foods (more than 50% of which were green leafy vegetables) were found to be rich sources of micronutrients like calcium, iron, vitamin A as beta carotene, and folate. Maximizing utilization of indigenous foods can be an important and sustainable dietary diversification strategy for addressing hidden hunger in this indigenous community.
Meyers, Alan F.; Black, Maureen M.; Casey, Patrick H.; Chilton, Mariana; Cook, John T.; Geppert, Joni; Ettinger de Cuba, Stephanie; Heeren, Timothy; Coleman, Sharon; Rose-Jacobs, Ruth; Frank, Deborah A.
Objectives. We investigated the association between housing insecurity and the health of very young children. Methods. Between 1998 and 2007, we interviewed 22 069 low-income caregivers with children younger than 3 years who were seen in 7 US urban medical centers. We assessed food insecurity, child health status, developmental risk, weight, and housing insecurity for each child's household. Our indicators for housing insecurity were crowding (> 2 people/bedroom or > 1 family/residence) and multiple moves (≥ 2 moves within the previous year). Results. After adjusting for covariates, crowding was associated with household food insecurity compared with the securely housed (adjusted odds ratio [AOR] = 1.30; 95% confidence interval [CI] = 1.18, 1.43), as were multiple moves (AOR = 1.91; 95% CI = 1.59, 2.28). Crowding was also associated with child food insecurity (AOR = 1.47; 95% CI = 1.34, 1.63), and so were multiple moves (AOR = 2.56; 95% CI = 2.13, 3.08). Multiple moves were associated with fair or poor child health (AOR = 1.48; 95% CI = 1.25, 1.76), developmental risk (AOR 1.71; 95% CI = 1.33, 2.21), and lower weight-for-age z scores (–0.082 vs −0.013; P = .02). Conclusions. Housing insecurity is associated with poor health, lower weight, and developmental risk among young children. Policies that decrease housing insecurity can promote the health of young children and should be a priority. PMID:21680929
Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare
Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the
Orrell, Peter; Bennett, Alison E.
Can above–belowground interactions help address issues of food security? We address this question in this manuscript, and review the intersection of above–belowground interactions and food security. We propose that above–belowground interactions could address two strategies identified by Godfray etal. (2010): reducing the Yield Gap, and Increasing Production Limits. In particular, to minimize the difference between potential and realized production (The Yield Gap) above–belowground interactions could be manipulated to reduce losses to pests and increase crop growth (and therefore yields). To Increase Production Limits we propose two mechanisms: utilizing intercropping (which uses multiple aspects of above–belowground interactions) and breeding for traits that promote beneficial above–belowground interactions, as well as breeding mutualistic organisms to improve their provided benefit. As a result, if they are managed correctly, there is great potential for above–belowground interactions to contribute to food security. PMID:24198821
Burgard, Sarah A; Brand, Jennie E; House, James S
Economic recessions, the industrial shift from manufacturing toward service industries, and rising global competition have contributed to uncertainty about job security, with potential consequences for workers' health. To address limitations of prior research on the health consequences of perceived job insecurity, we use longitudinal data from two nationally-representative samples of the United States population, and examine episodic and persistent perceived job insecurity over periods of about three years to almost a decade. Results show that persistent perceived job insecurity is a significant and substantively important predictor of poorer self-rated health in the American's Changing Lives (ACL) and Midlife in the United States (MIDUS) samples, and of depressive symptoms among ACL respondents. Job losses or unemployment episodes are associated with perceived job insecurity, but do not account for its association with health. Results are robust to controls for sociodemographic and job characteristics, negative reporting style, and earlier health and health behaviors.
Siegfried, T. U.; Fishman, R.; Modi, V.; Lall, U.
Groundwater mining in India is one of the biggest water related present and future challenges of South Asia. In the agricultural sector, the negative impact from groundwater depletion is complex and affects farmers directly and indirectly in different ways according to their existing dependence on access to groundwater for irrigation. It stems from a) a reduction in buffer capacity of groundwater as a source of backup supply in critical times of drought, b) the deprivation of access to groundwater of those farmers that cannot raise the capital to continuously drill deeper so as to chase the declining groundwater table and c) the constant reduction of per pump well yield due to the declining water tables given more or less constant pumping energy supply. As a result, rural incomes have become less reliable and household as well as national level food security are increasingly compromised. It is feared that the current deterioration of the national food security situation in India might not easily be reversed due to the unsustainable nature of consumptive groundwater use over the past decades. Access to electricity and subsidized power so as to pump groundwater for irrigation have played a critical role in increasing food production thus linking the energy and agricultural sector. The current rural public finance mechanism is highly ineffective, however, and trapped in an inefficient equilibrium. The deficiencies are that low cost and low quality electricity for agriculture likely translate into wasteful groundwater as well as inefficient energy use and thus lead to resource depletion and contribute to an erosion of the rural electricity distribution system. It is estimated that the current commercial losses to the State Electricity Boards (SEBs) amount to about 23 percent of the gross fiscal deficit of the states. The original intent of the rural subsidy program is thus lost and the current system in urgent need of repair. The uncertain future development of energy
This study measured food security and hunger of households enrolled in Head Start in Houston, Texas, and Birmingham, Alabama and assessed factors that could affect food security. Interviewers collected data from primary caregivers on demographic characteristics, dietary intake, and the six-item US f...
Stein, Susan E.; Dirks, Brian P.; Quinlan, Jennifer J.
The authors determined the food safety knowledge, attitudes, and behaviors of undergraduates (n = 1122) on an urban college campus using a previously piloted survey tool. Data obtained found that while students reported high levels of confidence in their ability to engage in safe food handling practices, their knowledge and self-reported behaviors…
Stahre, Mandy; VanEenwyk, Juliet; Siegel, Paul; Njai, Rashid
Few studies of associations between housing and health have focused on housing insecurity and health risk behaviors and outcomes. We measured the association between housing insecurity and selected health risk behaviors and outcomes, adjusted for socioeconomic measures, among 8,415 respondents to the 2011 Washington State Behavioral Risk Factor Surveillance System. Housing insecure respondents were about twice as likely as those who were not housing insecure to report poor or fair health status or delay doctor visits because of costs. This analysis supports a call to action among public health practitioners who address disparities to focus on social determinants of health risk behaviors and outcomes.
In the theme of insecurity there is a potential for peace education to address social education. Insecurity underpins the arms race and lies at the root of the growing cycle of violence. Peace education must help students understand the forms of structural injustices that preserve inequities and breed violence. (RM)
Nair, Madhavan K.; Augustine, Little Flower; Konapur, Archana
Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies. PMID:26779472
Hoeft, Birgit; Eggersdorfer, Manfred; Heck, Stephan
Food safety is a primary concern for pregnant women and infants as the immune system is weakened during pregnancy and not developed enough in infants, which makes them especially vulnerable to suffering from the negative effects of nonquality food products. However, food contaminations not only affect an individual's health but also a country's economic development, social harmony, food trade and even politics, as seen during the Chinese infant formula crisis in 2008. Thus, quality control is crucial in the production processes in order to have safe food products on the market. But quality control alone is not enough: manufacturers must embrace quality beyond classic in-process parameters and perform a final microbiological analysis at the end of the production process. This requires a clear and trustworthy approach to quality and safety and the involvement of all stakeholders from industry, government and academia over policy makers to consumers. This paper provides an introductory context for current quality management systems and gives real-life examples of challenges that manufacturers face during quality management and control throughout the production process.
Cho, May Myat; Knowles, Jacqueline; Atwood, Stephen
This was a cross sectional study to measure any difference between Thai and Non-Thai households in the prevalence of food security and the effect of state and local buffering mechanisms on household food security status in Nong Loo Sub-district in Kanchanaburi Province. Seventy-five point eight percent of 211 households (120 Thai and 91 non-Thai households) were food insecure. Non-Thai households were found to be significantly more food insecure than Thai households (95.6% compared with 60.8%; OR=21.4). Non-Thais tended to have less knowledge of and access to buffering mechanisms; however, this was not statistically significant. Of interest, however, was that no statistically significant association was found between household food insecurity and lack of access to buffering mechanisms. Qualitative interview results suggested that landownership, possession of a Thai card (Government registration card), increased food prices, and a dependence on imported food from other districts were important factors associated with household food insecurity in the sub-district. This survey underlines the importance of the food insecurity as a problem among Thai and, more severely, among non-Thai households and provides stake holders with information that can be used to intensify programs to address this problem. Thailand has a long border area with a high proportion of non-Thai households, and it is likely that similar food insecurity problems exist in other areas also. Further research on nutrition security (as distinct from food security) of this population is recommended in order to better assess the impact of the observed food insecurity.
Brucker, Debra L.; Nord, Derek
People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may…
Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi
Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen. PMID:27928456
Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi
Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.
Spanakis, Marios; Spanakis, Emmanouil G; Kondylakis, Haridimos; Sfakianakis, Stelios; Genitsaridi, Irini; Sakkalis, Vangelis; Tsiknakis, Manolis; Marias, Kostas
Personalized healthcare systems support the provision of timely and appropriate information regarding healthcare options and treatment alternatives. Especially for patients that receive multi-drug treatments a key issue is the minimization of the risk of adverse effects due to drug-drug interactions (DDIs). DDIs may be the result of doctor prescribed drugs but also due to self-medication of conventional drugs, alternative medicines, food habits, alcohol or smoking. It is therefore crucial for personalized health systems, apart from assisting physicians for optimal prescription practices, to also provide appropriate information for individual users for drug-drug interactions or similar information regarding risks for modulation of the ensuing treatment. In this manuscript we describe a DDI service including drug-food, drug-herb and other lifestyle-related factors, developed in the context of a personalized patient empowerment platform. The solution enables guidance to patients for their medication on how to reduce the risk of unwanted drug interactions and side effects in a seamless and transparent way. We present and analyze the implemented services and provide examples on using an alerting service to identify potential DDIs in two different chronic diseases, congestive heart failure and osteoarthritis.
Wakegijig, Jennifer; Osborne, Geraldine; Statham, Sara; Issaluk, Michelle Doucette
Background Community members, Aboriginal organizations, public servants and academics have long been describing a desperate situation of food insecurity in the Eastern Canadian Arctic. Objective The Nunavut Food Security Coalition, a partnership of Inuit Organizations and the Government of Nunavut, is collaborating to develop a territorial food security strategy to address pervasive food insecurity in the context of poverty reduction. Design The Nunavut Food Security Coalition has carried out this work using a community consultation model. The research was collected through community visits, stakeholder consultation and member checking at the Nunavut Food Security Symposium. Results In this paper, we describe a continuous course of action, based on community engagement and collective action, that has led to sustained political interest in and public mobilization around the issue of food insecurity in Nunavut. Conclusions The process described in this article is a unique collaboration between multiple organizations that has led to the development of a sustainable partnership that will inform policy development while representing the voice of Nunavummiut. PMID:23984307
Khubchandani, Jagdish; Price, James H
Perceived job insecurity and health risk factors have not been well studied in the United States (US) workforce. The purpose of this study was to assess the association of specific health risk factors and morbidities with perceived job insecurity in a large national random sample of working adults in the US. The National Health Interview Survey data were analyzed for this study. We computed the prevalence of perceived job insecurity by demographic characteristics and tested the relative association between perceived job insecurity and selected health risk factors using logistic regression analysis with adjusted odds ratios (AORs). A total of 17,441 working adults were included in the study: 75 % Whites, 51.5 % females, 73.3 % worked for a private company, and 82.6 % were 25-64 years of age. One in three (33 %) workers perceived their job to be insecure. Those who reported job insecurity had significantly higher odds of: being obese, sleeping less than 6 h/day, smoking every day, having work loss days >2 weeks, and worsening of general health in the past year. Job insecure individuals had a likelihood of serious mental illness within the past 30 days almost five times higher than those who were not job insecure. In addition, job insecure individuals were significantly more likely to report pain conditions (i.e. headaches, neck pain, and low back pain), and lifetime histories of having ulcers, diabetes, hypertension, angina pectoris, and coronary heart diseases. Job insecurity is associated with poor health and health risk behaviors in American adults. Potential interventions to address job insecurity and improve the health and well-being of working adults have been discussed based on study findings.
Caroli, Eve; Godard, Mathilde
This paper estimates the causal effect of perceived job insecurity - that is, the fear of involuntary job loss - on health in a sample of men from 22 European countries. We rely on an original instrumental variable approach on the basis of the idea that workers perceive greater job security in countries where employment is strongly protected by the law and more so if employed in industries where employment protection legislation is more binding; that is, in induastries with a higher natural rate of dismissals. Using cross-country data from the 2010 European Working Conditions Survey, we show that, when the potential endogeneity of job insecurity is not accounted for, the latter appears to deteriorate almost all health outcomes. When tackling the endogeneity issue by estimating an instrumental variable model and dealing with potential weak-instrument issues, the health-damaging effect of job insecurity is confirmed for a limited subgroup of health outcomes; namely, suffering from headaches or eyestrain and skin problems. As for other health variables, the impact of job insecurity appears to be insignificant at conventional levels.
LUECK, WILLIAM R.
TO DETERMINE WHICH COMMON TEACHING PROBLEMS CAUSE THE GREATEST CONCERN OR INSECURITY AMONG PROSPECTIVE TEACHERS, 445 JUNIORS (243 IN 1962-63 AND 205 IN 1963-64) TAKING A SECONDARY SCHOOL METHODS COURSE WERE ASKED TO RANK TWELVE MAJOR PROBLEMS IN THE ORDER IN WHICH THEY CAUSED CONCERN. THE PROBLEMS WERE COMPILED FROM THOSE OCCURRING FREQUENTLY IN…
Walker, Renee E; Kawachi, Ichiro
Paradoxically, individuals with food insecurity have been observed to have higher rates of obesity compared with their counterparts with food security. The factors influencing food purchasing behaviors in households with food security vs food insecurity are poorly understood. Using the mixed methods approach of concept mapping, we examined the perceptions and preferences driving the food purchasing behaviors of households with food security vs food insecurity. Twenty-six men and women with food security and 41 men and women with food insecurity from four neighborhoods in Boston, MA, completed the concept mapping process during 2010. Prevalence of overweight and obesity was greater among participants with food insecurity (80.5%) compared with those with food security (61.5%). Participants identified 163 unique factors that influenced their food purchasing behavior. Using multivariate analyses, these factors were grouped into eight unique concepts or clusters that reflected their perceptions of factors hindering healthy eating. Average cluster ratings were similar between participants with food security and food insecurity, suggesting that similar food purchasing behaviors are employed and are perceived similarly in how they hinder or promote healthy eating. The use of emergency food assistance programs may play a role in minimizing the burden of food insecurity while providing access to foods with varying degrees of nutritional quality that may be associated with increased risk of overweight and obesity observed in individuals and households with food insecurity.
Roberts, Michael W; Wright, J Timothy
Caries and obesity are two common conditions affecting children in the United States and other developed countries. Caries in the teeth of susceptible children have often been associated with frequent ingestion of fermentable sugars such as sucrose, fructose, glucose, and maltose. Increased calorie intake associated with sugars and carbohydrates, especially when associated with physical inactivity, has been implicated in childhood obesity. Fortunately, nonnutritive artificial alternatives and non-/low-caloric natural sugars have been developed as alternatives to fermentable sugars and have shown promise in partially addressing these health issues. Diet counseling is an important adjunct to oral health instruction. Although there are only five artificial sweeteners that have been approved as food additives by the Food and Drug Administration (FDA), there are additional five non-/low caloric sweeteners that have FDA GRAS (Generally Recognized as Safe) designation. Given the health impact of sugars and other carbohydrates, dental professionals should be aware of the nonnutritive non-/low caloric sweeteners available on the market and both their benefits and potential risks. Dental health professionals should also be proactive in helping identify patients at risk for obesity and provide counseling and referral when appropriate.
Roberts, Michael W.; Wright, J. Timothy
Caries and obesity are two common conditions affecting children in the United States and other developed countries. Caries in the teeth of susceptible children have often been associated with frequent ingestion of fermentable sugars such as sucrose, fructose, glucose, and maltose. Increased calorie intake associated with sugars and carbohydrates, especially when associated with physical inactivity, has been implicated in childhood obesity. Fortunately, nonnutritive artificial alternatives and non-/low-caloric natural sugars have been developed as alternatives to fermentable sugars and have shown promise in partially addressing these health issues. Diet counseling is an important adjunct to oral health instruction. Although there are only five artificial sweeteners that have been approved as food additives by the Food and Drug Administration (FDA), there are additional five non-/low caloric sweeteners that have FDA GRAS (Generally Recognized as Safe) designation. Given the health impact of sugars and other carbohydrates, dental professionals should be aware of the nonnutritive non-/low caloric sweeteners available on the market and both their benefits and potential risks. Dental health professionals should also be proactive in helping identify patients at risk for obesity and provide counseling and referral when appropriate. PMID:22505906
Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world's poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented.
Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world’s poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. PMID:26927589
Cook, John T.; Black, Maureen; Chilton, Mariana; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C.; Rose-Jacobs, Ruth; Sandel, Megan; Casey, Patrick H.; Coleman, Sharon; Weiss, Ingrid; Frank, Deborah A.
This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with “marginal food security,” as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children’s fair/poor health and developmental risk and caregivers’ depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers. PMID:23319123
Cobern, Jade A; Shell, Kathryn J; Henderson, Everett R; Beech, Bettina M; Batlivala, Sarosh P
Food insecurity is simply defined as uncertain access to adequate food. Nearly 50 million Americans, 16 million of whom are children, are food insecure. Mississippi has 21% food insecure citizens, and has the most food insecure county in the nation. Our state's school system's National Breakfast and Lunch Programs help combat food insecurity, but a gap still exists. This gap widens during the summer. In this paper, we describe the Mississippi Summer Food Service Program. While the program has had success in our state, it still faces challenges. Organized action by physicians in Mississippi and the Mississippi State Medical Association could significantly increase participation in these programs that are vital to our state.
HERBERT, CLAIRE W.; MORENOFF, JEFFREY D.; HARDING, DAVID J.
The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports. PMID:26913294
Allen, M W; Wilson, M
The present studies examined if materialists have an elevated concern about food availability, presumably stemming from a general survival security motivation. Study 1 found that materialists set a greater life goal of food security, and reported more food insecurity during their childhood. Materialists reported less present-day food insecurity. Study 2 revealed that materialists stored/hoarded more food at home, and that obese persons endorsed materialism more than low/normal weight persons. Study 3 found that experimentally decreasing participants' feelings of survival security (via a mortality salience manipulation) led to greater endorsement of materialism, food security as goal, and using food for emotional comfort. The results imply that materialists overcame the food insecurity of their childhood by making food security a top life goal, but that materialists' current concerns about food security may not wholly stem from genuine threats to their food supply.
Sheldon, Frederick T; Weber, John Mark; Yoo, Seong-Moo; Pan, W. David
Wireless is a powerful core technology enabling our global digital infrastructure. Wi-Fi networks are susceptible to attacks on Wired Equivalency Privacy, Wi-Fi Protected Access (WPA), and WPA2. These attack signatures can be profiled into a system that defends against such attacks on the basis of their inherent characteristics. Wi-Fi is the standard protocol for wireless networks used extensively in US critical infrastructures. Since the Wired Equivalency Privacy (WEP) security protocol was broken, the Wi-Fi Protected Access (WPA) protocol has been considered the secure alternative compatible with hardware developed for WEP. However, in November 2008, researchers developed an attack on WPA, allowing forgery of Address Resolution Protocol (ARP) packets. Subsequent enhancements have enabled ARP poisoning, cryptosystem denial of service, and man-in-the-middle attacks. Open source systems and methods (OSSM) have long been used to secure networks against such attacks. This article reviews OSSMs and the results of experimental attacks on WPA. These experiments re-created current attacks in a laboratory setting, recording both wired and wireless traffic. The article discusses methods of intrusion detection and prevention in the context of cyber physical protection of critical Internet infrastructure. The basis for this research is a specialized (and undoubtedly incomplete) taxonomy of Wi-Fi attacks and their adaptations to existing countermeasures and protocol revisions. Ultimately, this article aims to provide a clearer picture of how and why wireless protection protocols and encryption must achieve a more scientific basis for detecting and preventing such attacks.
Lhermie, Guillaume; Gröhn, Yrjö T.; Raboisson, Didier
The growing concern regarding emergence of bacteria resistant to antimicrobials and their potential for transmission to humans via animal production has led various authorities worldwide to implement measures to decrease antimicrobial use (AMU) in livestock production. These measures are influenced by those implemented in human medicine, and emphasize the importance of antimicrobial stewardship, surveillance, infection prevention and control and research. In food producing animals, unlike human medicine, antimicrobials are used to control diseases which cause economic losses. This major difference may explain the failure of the public policies implemented to control antimicrobial usage. Here we first review the specific factors influencing AMU across the farm animal sector and highlighting the farmers’ decision-making process of AMU. We then discuss the efficiency of existing regulations implemented by policy makers, and assess the need for alternative strategies, such as substitution between antimicrobials and other measures for infectious disease control. We also discuss the interests of regulating antimicrobial prices. Finally, we emphasize the value of optimizing antimicrobial regimens, and developing veterinary precision medicine to achieve clinical efficacy in animals while limiting negative impacts on public health. The fight against antimicrobial resistance requires both a reduction and an optimization of antimicrobial consumption. The set of actions currently implemented by policy makers does not adequately address the economic interests of farmers’ use of antimicrobials. PMID:28111568
Fry, Jillian P.; Laestadius, Linnea I.; Grechis, Clare; Nachman, Keeve E.; Neff, Roni A.
Objectives Industrial food animal production (IFAP) operations adversely impact environmental public health through air, water, and soil contamination. We sought to determine how state permitting and agriculture agencies respond to these public health concerns. Methods We conducted semi-structured qualitative interviews with staff at 12 state agencies in seven states, which were chosen based on high numbers or rapid increase of IFAP operations. The interviews served to gather information regarding agency involvement in regulating IFAP operations, the frequency and type of contacts received about public health concerns, how the agency responds to such contacts, and barriers to additional involvement. Results Permitting and agriculture agencies’ responses to health-based IFAP concerns are constrained by significant barriers including narrow regulations, a lack of public health expertise within the agencies, and limited resources. Conclusions State agencies with jurisdiction over IFAP operations are unable to adequately address relevant public health concerns due to multiple factors. Combining these results with previously published findings on barriers facing local and state health departments in the same states reveals significant gaps between these agencies regarding public health and IFAP. There is a clear need for regulations to protect public health and for public health professionals to provide complementary expertise to agencies responsible for regulating IFAP operations. PMID:24587087
Lhermie, Guillaume; Gröhn, Yrjö T; Raboisson, Didier
The growing concern regarding emergence of bacteria resistant to antimicrobials and their potential for transmission to humans via animal production has led various authorities worldwide to implement measures to decrease antimicrobial use (AMU) in livestock production. These measures are influenced by those implemented in human medicine, and emphasize the importance of antimicrobial stewardship, surveillance, infection prevention and control and research. In food producing animals, unlike human medicine, antimicrobials are used to control diseases which cause economic losses. This major difference may explain the failure of the public policies implemented to control antimicrobial usage. Here we first review the specific factors influencing AMU across the farm animal sector and highlighting the farmers' decision-making process of AMU. We then discuss the efficiency of existing regulations implemented by policy makers, and assess the need for alternative strategies, such as substitution between antimicrobials and other measures for infectious disease control. We also discuss the interests of regulating antimicrobial prices. Finally, we emphasize the value of optimizing antimicrobial regimens, and developing veterinary precision medicine to achieve clinical efficacy in animals while limiting negative impacts on public health. The fight against antimicrobial resistance requires both a reduction and an optimization of antimicrobial consumption. The set of actions currently implemented by policy makers does not adequately address the economic interests of farmers' use of antimicrobials.
Zalilah, M S; Tham, B L
This study was conducted to determine the prevalence of household food insecurity and its potential risk factors and outcomes among the Orang Asli (Temuan) households. Socioeconomic, demographic and food security information of the households and anthropometric measurements and dietary intakes of preschoolers (n = 64) were obtained using a structured questionnaire. Food security was assessed using the Radimer/Cornell hunger and food insecurity instrument. Diet quality was based on 24 hour recall and analyzed according to the Malaysian RDA and Food Guide Pyramid. Majority of the households (82%) reported some kind of household food insecurity. The prevalence of significant underweight, stunting and wasting were 45.3%, 51.6% and 7.8%, respectively. Dietary intakes were less than 2/3 RDA levels for calories, calcium and iron. However, the intakes of protein, vitamin A, vitamin C and niacin exceeded the RDA and the sources for these nutrients were mainly rice, fish and green leafy vegetables. Among the five food groups, only the number of servings from cereals/cereal products/tubers group was achieved while that of the milk/diary products was the worst. Majority of the children (68.7%) had poor, 31.3% had fair and none with excellent diet quality. In general, diet quality and nutritional status of the children decreased as household food insecurity worsened. It is recommended that the nutritional problems of Orang Asli children be addressed through health, nutrition and economic programs and further studies should be carried out on determinants and consequences of household food insecurity.
Parnell, Winsome R; Gray, Andrew R
To determine the prevalence of household food insecurity in New Zealand (NZ), eight food security statements were included in the 1997 National Nutrition Survey of adults. Rasch model analysis was performed to determine whether each food security statement (addressing a food security attribute) was discrete and could be ranked on a unidimensional scale. The NZ model had marginal 'household' reliability (0·60-0·66), good item separation (17·20-17·77) and item infit/outfit values between 0·8 and 1·25. Indices could be ranked by level of severity and represent the experience of household food insecurity in NZ. Categories of food security were assigned and used to predict food choice, and energy and nutrient intakes. Compared with fully secure/almost fully secure households, those that were moderately secure or of low security were less likely to consume the recommended daily servings of fruit and vegetables, and more likely to consume fatty meats. Intake of total fat, saturated, monounsaturated and polyunsaturated fat, cholesterol, lactose and vitamin B12 increased with lower levels of food security. Intakes of glucose, fructose and vitamin C were highest in the fully secure/almost fully secure category. This unique eight-component food security measurement tool has less respondent burden than the US Core Food Security Measure. The relationships between the level of food insecurity and food choice and nutrient intakes illustrate that the most food-insecure households have less healthy diets. This relatively brief population-specific measurement tool is suitable to monitor population food security status, and is a useful marker of nutritional status.
Ashe, Leah M; Sonnino, Roberta
Public health nutrition sits at the nexus of a global crisis in food, environmental and health systems that has generated - along with numerous other problems - an urgent and changing problem of food insecurity. The 'new' food insecurity, however, is different from the old: it is bimodal, encompassing issues of both under- and over-consumption, hunger and obesity, quantity and quality; it has assumed a decidedly urban dimension; and it implicates rich and poor countries alike. The complexity of the expressions of this challenge requires new approaches to public health nutrition and food policy that privilege systemic, structural and environmental factors over individual and mechanistic ones. In this context, the current paper argues that school food systems rise with buoyant potential as promising intervention sites: they are poised to address both modes of the food security crisis; integrate systemic, structural and environmental with behavioural approaches; and comprise far-reaching, system-wide efforts that influence the wider functioning of the food system. Based on a discussion of Bogotá and other pioneering policies that explicitly aim to create a broader food system with long-term foundations for good public health and food security, the paper suggests a new research and action agenda that gives special attention to school food in urban contexts.
It had been widely claimed that quantum mechanics can protect private information during public decision in, for example, the so-called two-party secure computation. If this were the case, quantum smart-cards, storing confidential information accessible only to a proper reader, could prevent fake teller machines from learning the PIN (personal identification number) from the customers' input. Although such optimism has been challenged by the recent surprising discovery of the insecurity of the so-called quantum bit commitment, the security of quantum two-party computation itself remains unaddressed. Here I answer this question directly by showing that all one-sided two-party computations (which allow only one of the two parties to learn the result) are necessarily insecure. As corollaries to my results, quantum one-way oblivious password identification and the so-called quantum one-out-of-two oblivious transfer are impossible. I also construct a class of functions that cannot be computed securely in any two-sided two-party computation. Nevertheless, quantum cryptography remains useful in key distribution and can still provide partial security in ``quantum money'' proposed by Wiesner.
The concept of food insecurity is complex and goes beyond the simplistic idea of a country's inability to feed its population. The global food situation is redefined by many driving forces such as population growth, availability of arable lands, water resources, climate change and food availability, accessibility and loss. The combined effect of these factors has undeniably impacted global food production and security. This article reviews the key factors influencing global food insecurity and emphasises the need to adapt science-based technological innovations to address the issue. Although anticipated benefits of modern technologies suggest a level of food production that will sustain the global population, both political will and sufficient investments in modern agriculture are needed to alleviate the food crisis in developing countries. In this globalised era of the 21st century, many determinants of food security are trans-boundary and require multilateral agreements and actions for an effective solution. Food security and hunger alleviation on a global scale are within reach provided that technological innovations are accepted and implemented at all levels.
Climatic Influence on Human Conflict, Violence and Political Instability,” typescript. 2 FAO , WFP and IFAD, The State of Food Insecurity in the World 2012...Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 15. SUBJECT TERMS Climate, food insecurity , unrest, Africa Cullen S. Hendrix...rural sector – where chronic