Food insecurity and social protection in Europe: Quasi-natural experiment of Europe's great recessions 2004-2012

[Trends and factors associated with food insecurity in Brazil: the National Household Sample Survey, 2004, 2009, and 2013]

The aim of this study was to analyze trends and factors associated with food insecurity in Brazil in 2004, 2009, and 2013, using microdata from the National Household Sample Survey (PNAD). Food insecurity was assessed using the Brazilian Food Insecurity Scale. Independent variables were selected from a conceptual model of determination of food insecurity, which was also used in the elaboration of multiple generalized linear models. The results show a downward trend in food insecurity prevalence from 2004 to 2013, especially for moderate and severe food insecurity, from 17% in 2004 (95%CI: 15.7-18.4) to 7.9% in 2013 (95%CI: 7.2-8.7). Despite important decreases in the prevalence of moderate and severe food insecurity, regardless of the level of determination, the population strata with the lowest prevalence in 2004 showed the largest relative reduction. As for factors associated with moderate and severe food insecurity, they remained the same in the ten years covered by the PNAD survey, namely: the North and Northeast regions, urban areas with inadequate sanitation, household density > 2 persons per bedroom, ≤ 4 household durable consumer goods, and households headed by females, individuals < 60 years, and non-whites, ≤ 4 years of schooling, and being unemployed. From 2004 to 2013, the prevalence of Brazilian households with moderate and severe food insecurity dropped by half, but from the perspective of equity the advances occurred unequally and were lower in strata with greater social, economic, and demographic vulnerability.

Interventions to address household food insecurity in high-income countries

Household food insecurity is a serious public health concern in high-income countries. Canada and the USA regularly monitor household food insecurity, while in other countries, such as the UK, it has been the rapid rise of food bank usage that has drawn increased attention to this longstanding, but largely overlooked, problem. This review evaluates evidence on interventions intended to reduce household food insecurity in high-income countries. Research on social protection interventions suggests both cash transfers and food subsidies (e.g. the US Supplement Nutrition and Assistance Programme) reduce household food insecurity. In contrast, research on community-level interventions, such as food banks and other food programmes, suggests limited impacts. Although food banks have become a common intervention for food insecurity in high-income countries, evidence suggests their reliance on donations of volunteer time and food make them inevitably limited in the assistance they are able to provide. The stigma people feel using food banks may also make them untenable. Alternatives to, or enhanced, food banks such as community shops or community kitchens, have become common, but evidence also suggests they may be limited in effectiveness if they do not reach people experiencing food insecurity. This review highlights the difficulty of trying to address household food insecurity with community-based food interventions when solutions likely lie upstream in social protection policies.

Relation between household food insecurity and breastfeeding in Canada

BACKGROUND

Qualitative studies have suggested that food insecurity adversely affects infant feeding practices. We aimed to determine how household food insecurity relates to breastfeeding initiation, duration of exclusive breastfeeding and vitamin D supplementation of breastfed infants in Canada.

METHODS

We studied 10 450 women who had completed the Maternal Experiences - Breastfeeding Module and the Household Food Security Survey Module of the Canadian Community Health Survey (2005-2014) and who had given birth in the year of or year before their interview. We used multivariable Cox proportional hazards models and logistic regression to examine the relation between food insecurity and infant feeding practices, adjusting for sociodemographic characteristics, maternal mood disorders and diabetes mellitus.

RESULTS

Overall, 17% of the women reported household food insecurity, of whom 8.6% had moderate food insecurity and 2.9% had severe food insecurity (weighted percentages). After adjustment for sociodemographic factors, women with food insecurity were no less likely than others to initiate breastfeeding or provide vitamin D supplementation to their infants. Half of the women with food insecurity ceased exclusive breastfeeding by 2 months, whereas most of those with food security persisted with breastfeeding for 4 months or more. Relative to women with food security, those with marginal, moderate and severe food insecurity had significantly lower odds of exclusive breastfeeding to 4 months, but only women with moderate food insecurity had lower odds of exclusive breastfeeding to 6 months, independent of sociodemographic characteristics (odds ratio 0.60, 95% confidence interval 0.39-0.92). Adjustment for maternal mood disorder or diabetes slightly attenuated these relationships.

INTERPRETATION

Mothers caring for infants in food-insecure households attempted to follow infant feeding recommendations, but were less able than women with food security to sustain exclusive breastfeeding. Our findings highlight the need for more effective interventions to support food-insecure families with newborns.

Please sir, I want some more: an exploration of repeat foodbank use

Background

The sharp rise in foodbank use in Britain over the past five years suggests a proliferation of food insecurity that could herald a public health crisis. However, trends in foodbank use rely on imperfect figures that do not distinguish between single and repeat visits. Consequently, the true prevalence of foodbank use in Britain is unknown. By identifying repeat visits, this study provides the first estimate of the proportion of people using foodbanks.

Methods

Using data on referrals to West Cheshire Foodbank in the UK, this study offers a case study of 7769 referrals to one foodbank between 2013 and 2015. Foodbank use was explored in descriptive statistics, then negative binomial regression models were used to identify the household characteristics associated with the number of foodbank visits.

Results

Between 0.9 and 1.3% of people in West Cheshire sought assistance from West Cheshire Foodbank between 2013 and 2015. If scaled up nationally, this would equate to an estimated 850,000 people across Britain. The number of total recipients increased by 29% between 2013 and 2015, while the number of unique recipients rose by 14%. Multivariate analysis revealed that a larger number of visits were recorded in 2015 and among working-age and one-person households, while households referred due to domestic abuse and unemployment made fewer visits.

Conclusion

Food insecurity has emerged as a crucial challenge facing UK health professionals and policymakers. This study provides the first estimate of the proportion of individuals receiving emergency food in a single case study location, and demonstrates that foodbank use is becoming more prevalent, although headline figures overstate the scale of this growth. The potential nutrition and wider health consequences of reliance on emergency food – especially among those using foodbanks on multiple occasions – warns of an unfolding public health crisis.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4847-x) contains supplementary material, which is available to authorized users.

The growing disconnect between food prices and wages in Europe: cross-national analysis of food deprivation and welfare regimes in twenty-one EU countries, 2004-2012

OBJECTIVE

Food insecurity has been rising across Europe following the Great Recession, but to varying degrees across countries and over time. The reasons for this increase are not well understood, nor are what factors might protect people's access to food. Here we test the hypothesis that an emerging gap between food prices and wages can explain increases in reported inability to afford protein-rich foods and whether welfare regimes can mitigate its impact.

DESIGN

We collected data in twenty-one countries from 2004 to 2012 using two databases: (i) on food prices and deprivation related to food (denoted by reported inability to afford to eat meat, chicken, fish or a vegetarian equivalent every second day) from EuroStat 2015 edition; and (ii) on wages from the Organisation for Economic Co-operation and Development 2015 edition.

RESULTS

After adjusting for macroeconomic factors, we found that each 1 % rise in the price of food over and above wages was associated with greater self-reported food deprivation (β=0·060, 95 % CI 0·030, 0·090), particularly among impoverished groups. However, this association also varied across welfare regimes. In Eastern European welfare regimes, a 1 % rise in the price of food over wages was associated with a 0·076 percentage point rise in food deprivation (95 % CI 0·047, 0·105) while in Social Democratic welfare regimes we found no clear association (P=0·864).

CONCLUSIONS

Rising prices of food coupled with stagnating wages are a major factor driving food deprivation, especially in deprived groups; however, our evidence indicates that more generous welfare systems can mitigate this impact.

Living on the edge: precariousness and why it matters for health

The post-war period in Europe, between the late 1940s and the 1970s, was characterised by an expansion of the role of by the state, protecting its citizens from risks of unemployment, poverty, homelessness, and food insecurity. This security began to erode in the 1980s as a result of privatisation and deregulation. The withdrawal of the state further accelerated after the 2008 financial crisis, as countries began pursuing deep austerity. The result has been a rise in what has been termed 'precariousness'. Here we review the development of the concept of precariousness and related phenomena of vulnerability and resilience, before reviewing evidence of growing precariousness in European countries. It describes a series of studies of the impact on precariousness on health in domains of employment, housing, and food, as well as natural experiments of policies that either alleviate or worsen these impacts. It concludes with a warning, drawn from the history of the 1930s, of the political consequences of increasing precariousness in Europe and North America.

The impact of changes in social policies on household food insecurity in British Columbia, 2005-2012

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.