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McKay FH, McKenzie H, Lindberg R. The coping continuum and acts reciprocity - a qualitative enquiry about household coping with food insecurity in Victoria, Australia. Aust N Z J Public Health 2023; 47:100004. [PMID: 36706551 DOI: 10.1016/j.anzjph.2022.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/20/2022] [Accepted: 10/30/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Food insecurity exists when a household has limited or uncertain access to food. This paper explores the strategies employed by households who are already accessing emergency and community food assistance to meet their food needs. METHOD Interviews to explore strategies used to mitigate food insecurity of people living in Victoria, Australia, between June 2018 and January 2019. Data were analysed thematically. RESULTS Seventy-eight interviews were conducted. Analysis resulted in two themes highlighting the range of coping strategies employed to mitigate the impacts of food insecurity; broadly described as 1) the coping continuum and 2) coping reciprocity. CONCLUSIONS Food insecure households employ a range of strategies to secure food. Households that engage with the emergency and community food sector are described as in crisis or struggling, often skipping meals or reducing food consumed, or as coping and managing, characterised by bulking meals and growing food. IMPLICATIONS FOR PUBLIC HEALTH Coping with food insecurity exists on a continuum from crisis to management and reciprocity. With the prevalence of food insecurity expected to increase, some of these coping strategies will need to be incorporated into the practice of emergency and community food providers to assist households to meet food needs.
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Affiliation(s)
- Fiona H McKay
- The School of Health and Social Development and the Institute for Health Transformation, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia.
| | - Hayley McKenzie
- The School of Health and Social Development and the Institute for Health Transformation, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia
| | - Rebecca Lindberg
- The Institute for Physical Activity and Nutrition Science (IPAN) and the School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia
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Esquivel M, Higa A, Guidry A, Shelton C, Okihiro M. A Qualitative Study on the Motivators, Barriers and Supports to Participation in a Pediatric Produce Prescription Program in Hawai'i. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16682. [PMID: 36554563 PMCID: PMC9778988 DOI: 10.3390/ijerph192416682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Produce prescriptions that provide vouchers to individuals to purchase fresh FVs at a specified retail outlet have the potential to positively impact food security status, diet, and chronic disease risk. However, maximizing program participation is vital to ensuring program success. This research describes motivators, barriers, and support for participation in a child produce prescription program among a population of Native Hawaiian and Other Pacific Islanders, who are underrepresented in this field of research. This qualitative grounded theory study was nestled within a quasi-experimental pilot intervention trial and included semi-structured interviews with pediatric program participants. Twenty-five interviews were conducted, which represented one-third of program participants. The top support factors for program participation included: ease of voucher use, program convenience, health center/pediatrician endorsement and positive communications with farmers' market vendors. Key motivators for program participation were produce enjoyment, child support, financial support, and positive impacts on family. Three themes emerged consistently as barriers to participation amongst participants, (1) difficult use of vouchers, (2) conflicting schedules, and (3) online market concerns. (4) Conclusions: This research offers insight into policy implications as the number of produce prescription programs has grown. These findings suggest that key program design characteristics can enhance and support program participation.
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Affiliation(s)
- Monica Esquivel
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Alicia Higa
- Elepaio Social Services, Waianae, HI 96792, USA
| | - Andrea Guidry
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | | | - May Okihiro
- Waianae Coast Comprehensive Health Center, Waianae, HI 96792, USA
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The acorn squash problem: a digestible conceptualisation of barriers to emergency food assistance. Public Health Nutr 2022; 25:1045-1049. [PMID: 34530951 PMCID: PMC9991550 DOI: 10.1017/s1368980021003748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In common narratives of emergency food assistance, donors likely believe their efforts directly manifest as people consuming their donated food. For example, a person donating canned lima beans during a canned food drive may visualise someone eventually eating those lima beans. However, cultural and socio-economic barriers often exist that prevent people from accessing and consuming the donated food. These barriers are often complex and otherwise well-intentioned donors, volunteers and organisations may not initially consider them. METHOD This commentary article, which draws from existing US emergency food systems literature, uses the imagery of an acorn squash one might find at a US food pantry to conceptualise these barriers in a straightforward way. RESULTS Examining emergency food assistance through the lens of the acorn squash problem can help donors, volunteers and organisations better connect with food-insecure people. The lens of the acorn squash problem also allows for deeper critiques of some practices of emergency food systems.
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Policies and initiatives/programs that promote health and self-care in asylum seekers living in high income countries: a narrative review. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2021. [DOI: 10.1108/ijhrh-09-2021-0165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to identify health-care entitlements that exist for asylum seekers with chronic non-communicable disease (CNCD) that promote their health and self-care, and to explore health policies, initiatives and programmes with the potential to foster self-care in this populace.
Design/methodology/approach
Narrative review of literature conducted by searching EMBASE, CINAHL, WEB OF SCIENCE and PSYCINFO databases for articles published from 2010 to 2021. Included articles focussed on policies, programmes or initiatives with the potential to promote health in adult asylum seekers residing in high-income countries. Studies inclusive of other migrant groups such as undocumented migrants and those with mental health conditions were excluded. Eleven studies fitting the inclusion criteria were assessed against the study objectives.
Findings
Free access to health-care services and pharmaceutical products, free access to food banks and supermarket model food banks, English and cooking lessons, community integration training sessions and culturally competent health-care workers were found to promote health and self-care. There is little research on self-care and health promotion in adult asylum seekers with CNCD. CNCDs represent high burden of disease in asylum seekers but have a low priority in reported research.
Originality/value
This narrative review is the first to explicitly focus on asylum seekers in high-income countries with CNCD, excluding mental health conditions, and to explore initiatives, programmes and policies that enhance health promotion to facilitate self-care in this populace.
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Quinn EL, Ortiz K, Titzer L, Houston-Shimizu B, Jones-Smith J. Healthy Food Environments in Food Pantries: Lessons Learned from a Sodium Reduction Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13206. [PMID: 34948815 PMCID: PMC8701667 DOI: 10.3390/ijerph182413206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022]
Abstract
In the United States, food pantries increasingly serve as regular food sources for low income households experiencing high rates of chronic disease, including hypertension. Sodium consumption is a modifiable risk factor for hypertension, so pantry customers would benefit from access to low-sodium foods. Pantry customers often experience difficulty acquiring healthy foods, however; little is known about pantry foods' sodium content specifically. This study assesses the sodium content of pantry foods and lessons learned from an adaptable intervention to support pantries in adopting policies and environmental changes to make healthy, lower-sodium foods appealing and accessible. We conducted sodium assessments of food at 13 food pantries, tracked implementation of intervention strategies, and interviewed 10 pantry directors. More than half of food items in 11 categories met sodium standards for foods to be chosen "often". Pantry directors reported valuing the intervention approach and implemented six of nine behavioral economics strategies, especially those targeting the visibility and convenience of foods, along with layout changes and expanded customer choice. One pantry adopted an agency-specific nutrition policy and 12 adopted a coalition-level policy. Results can inform intervention efforts to make available healthy options appealing and easy to select while also improving the customer experience in food pantries.
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Affiliation(s)
- Emilee L. Quinn
- Department of Health Systems and Population Health, University of Washington, Seattle, WA 98195, USA;
| | - Kate Ortiz
- Chronic Disease & Injury Prevention Division, Public Health Seattle and King County, Seattle, WA 98104, USA;
| | | | | | - Jessica Jones-Smith
- Department of Health Systems and Population Health, University of Washington, Seattle, WA 98195, USA;
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
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Rizvi A, Wasfi R, Enns A, Kristjansson E. The impact of novel and traditional food bank approaches on food insecurity: a longitudinal study in Ottawa, Canada. BMC Public Health 2021; 21:771. [PMID: 33882881 PMCID: PMC8061005 DOI: 10.1186/s12889-021-10841-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
Background Food insecurity is strongly associated with poor mental and physical health, especially with chronic diseases. Food banks have become the primary long-term solution to addressing food insecurity. Traditionally, food banks provide assistance in the form of pre-packed hampers based on the food supplies on hand, such that the food items often do not meet the recipients’ cultural, religious or medical requirements. Recently, new approaches have been implemented by food banks, including choice models of food selection, additional onsite programming, and integrating food banks within Community Resource Centres. Methods This study examined changes in food security and physical and mental health, at four time points over 18 months at eleven food banks in Ottawa, Ontario, Canada. The participants – people who accessed these food banks – were surveyed using the Household Food Security Survey Module (HFSSM) and the Short-Form Health Survey Version 2 (SF-12). Statistical analyses included: pairwise paired t-tests between the mean perceived physical and mental health scores across the four waves of data collection, and longitudinal mixed effects regression models to understand how food security changed over time. Results The majority of people who were food insecure at baseline remained food insecure at the 18-month follow-up, although there was a small downward trend in the proportion of people in the severely food insecure category. Conversely, there was a small but significant increase in the mean perceived mental health score at the 18-month follow-up compared to baseline. We found significant reductions in food insecurity for people who accessed food banks that offered a Choice model of food distribution and food banks that were integrated within Community Resource Centres. Conclusions Food banks offer some relief of food insecurity but they don’t eliminate the problem. In this study, reductions in food insecurity were associated with food banks that offered a Choice model and those that were integrated within a Community Resource Centre. There was a slight improvement in perceived mental health at the 18-month time point; however, moderately and severely food insecure participants still had much lower perceived mental health than the general population.
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Affiliation(s)
- Anita Rizvi
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Room VNR5015, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada.
| | - Rania Wasfi
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Room VNR5015, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada.,Centre for Surveillance and Applied Research, Public Health Agency of Canada, Government of Canada, Ottawa, Canada
| | - Aganeta Enns
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Room VNR5015, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada
| | - Elizabeth Kristjansson
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Room VNR5015, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada
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McKay FH, Haines BC, Beswick H, McKenzie H, Lindberg R. The prevalence, severity and experience of food insecurity in Australia: An investigation of food aid use. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2399-2407. [PMID: 32562318 DOI: 10.1111/hsc.13062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/07/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
High costs of living and low wage growth in Australia have resulted in an increase in the number of people experiencing food insecurity, and a corresponding increase in the number of people accessing food aid. This research employs qualitative methods alongside standard methods to explore food security to investigate these issues in food aid settings in Victoria, Australia. The two aims of this study were, 1) to explore the profile of people who access food aid and 2) to explore the experiences of people accessing food aid. A convenience sample of people was recruited from organisations that distribute food aid from across the state. People in need of food aid typically self-refer to charities, who then apply varied and localised criteria to manage access to the charitable service. Interviews were conducted with 78 participants between June 2018 and January 2019. Participants had been accessing food aid for 4 years on average (SD 5.7, range 1 month-40 years), most participants were female (n = 57, 73.1%), with an average age of 52.6 years (SD 15.9), and over half were born in Australia (n = 44, 56.4%). Most participants were in receipt of a government welfare payment (n = 75, 96.2%), and over 40% were living in private rental accommodation. Around two thirds of participants reported low or very low food security (n = 54, 67.5%). Participants reported a range of both positive and negative experiences accessing food aid. This study adds to the body of literature exploring food insecurity in high-income settings and its persistence despite significant national economic prosperity. Current economic and political conditions in Australia mean that the reliance on food aid by welfare recipients is unlikely to decrease.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Holly Beswick
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Hayley McKenzie
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Rebecca Lindberg
- The Institute for Physical Activity and Nutrition (IPAN) and School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Haines BC, McKay FH, Dunn M, Lippi K. The role of social enterprise in food insecurity among asylum seekers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:829-838. [PMID: 30027618 DOI: 10.1111/hsc.12593] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/29/2018] [Accepted: 05/20/2018] [Indexed: 06/08/2023]
Abstract
People seeking asylum in high-income countries are vulnerable to food insecurity due to limited opportunities for social and economic participation. Given this vulnerability, nongovernment organisations are attempting to improve food security outcomes through targeted programmes. This study explored the role of a subsidised mobile fresh fruit and vegetable market (the Food Justice Truck-FJT) on the experience of food insecurity for people seeking asylum living in Melbourne, Australia. This research uses a mixed methods approach, employing surveys and semistructured interviews to explore the lived experiences of asylum seekers using the FJT, including their experiences of food insecurity. Half of the asylum seekers interviewed in this study were found to be experiencing food insecurity. Participants in this study sourced food from multiple locations, with the FJT providing a supplemental, but highly valued source of fresh produce. The FJT was identified as positive social setting for some participants included in this research. This research has identified the ability of programmes such as the FJT to act as positive social settings.
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Affiliation(s)
- Bronte Claire Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Fiona Helen McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Matthew Dunn
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Kehla Lippi
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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McKay FH, Lippi K, Dunn M, Haines BC, Lindberg R. Food-Based Social Enterprises and Asylum Seekers: The Food Justice Truck. Nutrients 2018; 10:nu10060756. [PMID: 29895750 PMCID: PMC6024722 DOI: 10.3390/nu10060756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/11/2018] [Accepted: 06/11/2018] [Indexed: 11/16/2022] Open
Abstract
People seeking asylum in high-income countries are vulnerable to food insecurity due to limited opportunities for social and economic participation. While charity organizations have long sought to provide food aid to those in need, the increasing number of people seeking this assistance requires alternatives. Using a case study approach, this research investigates The Food Justice Truck, which is a social enterprise designed to provide low cost, nutritious food to people seeking asylum with an aim to reduce the food insecurity burden. Twenty-seven people seeking asylum completed a structured interview (n = 15) or a semi-structured interview (n = 12). The majority of participants were female (n = 20) with an average age of 38.3 years (Standard Deviation (SD) 7.3; range 30⁻59) and over half were from Iran (n = 16, 59.2%) with most holding a temporary visa to stay in Australia (n = 15, 55.5%). Two key findings were identified including the fact that the FJT is at risk of creating and perpetuating a power imbalance. However, as a social setting, the FJT has the potential to promote and enable a social connection and create a positive experience. This research study adds valuable information to the literature by providing research on one alternative to traditional food aid. It was found that alternatives to traditional food aid may play a role in reducing the food security burden.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
| | - Kehla Lippi
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
| | - Matthew Dunn
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
| | - Rebecca Lindberg
- The Institute for Physical Activity and Nutrition (IPAN) and School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
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