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Pakravan-Charvadeh MR, Flora C, Khan HA. Simulating Potential Associated Socio-Economic Determinants With Sustainable Food Security (A Macro-Micro Spatial Quantitative Model). Front Public Health 2022; 10:923705. [PMID: 35910863 PMCID: PMC9333187 DOI: 10.3389/fpubh.2022.923705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Improving sustainable food security status, nowadays, is an important challenge globally, especially in developing countries. The policy goal should be equity—everyone has the same opportunity to be food secure—rather than equality—everyone gets the same subsidy. Since the culture and socioeconomic status within a country vary from region to region, collapsing all areas into a unique region may introduce errors and inaccurate results, as most studies carried out. This study assesses the geographical pattern of association between food security and socioeconomic factors in urban areas in Iran using a nationally and regionally representative household consumption-expenditure survey from 2010 to 2018. The logistic regression model and big data are used to achieve this goal. The results show that a substantial number of households face food insecurity in urban areas in Iran. Also, different geographic regions have various salient factors that affect food insecurity. Aggregation tests confirmed that researchers should estimate separate models for different provinces, states, and districts to assess and monitor the food security status of a country instead of estimating a unique model for the whole of the country. Geographical disparities should be considered as an important issue before suggesting any catch-all policies for a country. The geo-locational factor of households is a key determinant of the association between socioeconomic factors and food security in urban areas in Iran. In sum, the practical suggestions for improving Iranian households' food security in urban areas are as follows: (1) Developing job opportunities for the head of household. (2) Enhancing the potential for self-employment. (3) Facilitating the study of children within households including providing inexpensive uniforms, books, and materials, especially for poor households. (4) Supporting young couples in terms of accessing to financial resources and providing inexpensive essential equipment of home for them; and (5) Introduction of the importance of dietary diversity and different foods which can be cooked by using these food ingredients within a household. Comparative case studies using similar methodologies can test if our results are generalizable.
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Affiliation(s)
- Mohammad Reza Pakravan-Charvadeh
- Department of Agricultural Economics and Rural Development, Lorestan University, Khorramabad, Iran
- *Correspondence: Mohammad Reza Pakravan-Charvadeh
| | - Cornelia Flora
- Department of Sociology, Iowa State University, Ames, IA, United States
| | - Haider A. Khan
- Department of Economics, Josef Korbel School of International Studies, University of Denver, Denver, CO, United States
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Wilson NLW, Calancie L, Adkins J, Folta SC. Understanding Micro-pantries as an Emergency Food Source During the COVID-19 Pandemic. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:299-310. [PMID: 35039234 PMCID: PMC8758996 DOI: 10.1016/j.jneb.2021.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the role of micro-pantries in addressing food insecurity during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN Qualitative interviews with 20 micro-pantry users and 10 stakeholders during April and May, 2020. SETTING Six US states. PARTICIPANTS Users, aged ≥ 18 years, had obtained food from a micro-pantry in the past 2 weeks; stakeholders, aged ≥ 18 years, played a role in organizing micro-pantries at the community, regional, or national levels. PHENOMENA OF INTEREST Impact of COVID-19 on food insecurity and use of micro-pantries to mitigate it; benefits of, suggested improvements to, and adoption and administration of micro-pantries. ANALYSIS We transcribed the data verbatim and performed deductive qualitative content analysis. RESULTS Micro-pantry users had increased their use of both micro-pantries and regular food pantries during the pandemic. Micro-pantries helped stretch resources. Users appreciated the anonymity and choice; the mutual aid aspects reduced stigma. Stakeholders described micro-pantries as providing a direct way for neighbors to help neighbors during the pandemic. They described a decentralized and informal system of administration. CONCLUSIONS AND IMPLICATIONS Findings suggest that micro-pantries provided a supplemental food source that supported the resilience of communities during the COVID-19 pandemic.
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Affiliation(s)
- Norbert L W Wilson
- Duke Divinity School and Sanford School of Public Policy, Duke University, Durham, NC
| | - Larissa Calancie
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Janna Adkins
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
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3
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Lachaud J, Mejia-Lancheros C, Liu M, Wang R, Nisenbaum R, Stergiopoulos V, Hwang SW, O'Campo P. Severe Psychopathology and Substance Use Disorder Modify the Association Between Housing Trajectories and Food Security Among Homeless Adults. Front Nutr 2021; 8:608811. [PMID: 34055849 PMCID: PMC8152664 DOI: 10.3389/fnut.2021.608811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association. Materials and Methods: We followed 487 homeless adults with mental illness at the Toronto site of the At Home/Chez-Soi project-a randomized trial of Housing First. Food security data were collected seven times during the follow-up period. Psychopathology (Colorado Symptom Index score) and alcohol and substance use disorders were assessed at baseline. Housing trajectories were identified using group-based trajectory modeling. Logistic regression was used to estimate the association between housing trajectory groups and food security. Results: Three housing trajectory groups were identified: rapid move to consistent stable housing (34.7%), slow and inconsistent housing (52.1%), and never moved to stable housing (13.2%). Individuals included in the rapid move to consistent housing trajectory group had higher odds of remaining food secure compared with those in the never moved to stable housing trajectory group over the follow-up period [AOR 2.9, 95% CI: 1.3-6.6, P-value: 0.009]. However, when interactions were considered, this association was significant among those with moderate psychopathology but not severe psychopathology. Individuals with substance use disorder and in the never moved to stable housing group had the lowest food security status. Discussion: Severe psychopathology and substance use disorders modified the association between housing trajectories and food security. International Standard Randomized Control Trial Number Register (ISRCTN42520374).
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Affiliation(s)
- James Lachaud
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michael Liu
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Harvard Medical School, Boston, MA, United States
| | - Ri Wang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stephen W. Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patricia O'Campo
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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4
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Redline B, Semborski S, Madden DR, Rhoades H, Henwood BF. Examining Sleep Disturbance Among Sheltered and Unsheltered Transition Age Youth Experiencing Homelessness. Med Care 2021; 59:S182-S186. [PMID: 33710093 PMCID: PMC7958980 DOI: 10.1097/mlr.0000000000001410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The estimated 3.5-million transition age youth (TAY) who experience homelessness in the United States annually are routinely exposed to inadequate sleep environments and other psychosocial risk factors for deficient sleep. Although staying in a shelter versus being unsheltered may facilitate sleep, research suggests that perceived safety wherever one sleeps may be just as important. In this study, which is the first known study to investigate sleep disturbances among TAY experiencing homelessness, we examine associations of sleep disturbances with sheltered status and perceived safety of usual sleep environment. METHODS We surveyed TAY (aged 18-25) experiencing homelessness in Los Angeles, CA about their sleep, psychosocial health, and living situations. Participants (n=103; 60% sheltered) self-reported sleep disturbances using the Patient-Reported Outcomes Measurement Information System Sleep Disturbance short form, while individual items assessed sheltered status and perceived safety where they usually slept. Regression analyses examined associations of sheltered status and perceived sleep environment safety with sleep disturbance, adjusting for age, sex, race, self-rated health, depression symptoms, serious mental illness, high-risk drinking, and severe food insecurity. RESULTS Twenty-six percent of participants reported moderate-severe sleep disturbances. Sleep disturbance was not associated with sheltered status, but was positively associated with feeling unsafe in one's sleep environment, depression symptoms, severe food insecurity, and decreased age. CONCLUSIONS Our findings suggest that sleep disturbances among TAY experiencing homelessness are associated more closely with how safe one feels rather than one's sheltered status. This highlights the importance of providing safe places to live for sheltered and unsheltered TAY.
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Affiliation(s)
- Brian Redline
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Sara Semborski
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Danielle R. Madden
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Harmony Rhoades
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Benjamin F. Henwood
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
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Fitzpatrick KM, Willis DE, Spialek ML, English E. Food Insecurity in the Post-Hurricane Harvey Setting: Risks and Resources in the Midst of Uncertainty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8424. [PMID: 33203035 PMCID: PMC7696393 DOI: 10.3390/ijerph17228424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Food insecurity is of heightened concern during and after natural disasters; higher prevalence is typically reported in post-disaster settings. The current study examines food insecurity prevalence and specific risk/resource variables that may act as barriers or advantages in accessing food in such a setting. Using a modified quota sample (n = 316), Hurricane Harvey survivors participated in face-to-face interviews and/or online surveys that assessed health, social and household factors, and sociodemographic characteristics. Using logistic regression analyses we find that social vulnerabilities, circumstantial risk, and social and psychological resources are important in determining the odds of food insecurity. Hispanic and/or Nonwhite survivors, renters, and those persons displaced during the natural disaster have higher food insecurity odds. Survivors with stronger social ties, higher levels of mastery, and a greater sense of connectedness to their community are found to have lower food insecurity odds. A more nuanced analysis of circumstantial risk finds that while the independent effects of displacement and home ownership are important, so too is the intersection of these two factors, with displaced-renters experiencing significantly higher odds than any other residence and displacement combinations, and particularly those who are homeowners not displaced during the disaster. Strategies for addressing differential risks, as well as practical approaches for implementation and education programming related to disaster recovery, are discussed.
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Affiliation(s)
- Kevin M. Fitzpatrick
- Department of Sociology and Criminology, University of Arkansas, Fayetteville, AR 72701, USA
| | - Don E. Willis
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR 72701, USA;
| | - Matthew L. Spialek
- Department of Communications, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Emily English
- Department of Pediatrics, University of Arkansas for Medical Sciences, Fayetteville, AR 72701, USA;
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Association of Problematic Alcohol Use and Food Insecurity among Homeless Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103631. [PMID: 32455769 PMCID: PMC7277400 DOI: 10.3390/ijerph17103631] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/11/2022]
Abstract
Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. The latter used DSM-IV diagnostic criteria to assess probable alcohol use dependence/abuse. Heavy drinking was considered >7 drinks (women) and >14 drinks (men) per week. Food insecurity was measured with the USDA Food Security Scale-Short Form. The link between alcohol problems and food insecurity was examined with logistic regression analyses controlling for sex, age, education, income, and months homeless. Overall, 28.4% of the sample had probable alcohol dependence, 25% were heavy drinkers, and 78.4% were food insecure. Probable alcohol dependence and heavy drinking were correlated at 0.53 (p < 0.001). Results indicated that heavy drinking (OR = 2.12, CI.95 = 1.21, 3.73) and probable alcohol dependence/abuse (OR = 2.72, CI.95 = 1.55, 4.77) were each associated with increased odds of food insecurity. Food insecurity and problematic alcohol use are major issues among homeless populations; this study suggests they are associated. Future research is needed to shed light on potential causal mechanisms and on whether alcohol may take precedence over eating or food purchases.
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Lachaud J, Mejia-Lancheros C, Wang R, Wiens K, Nisenbaum R, Stergiopoulos V, Hwang SW, O'Campo P. Mental and substance use disorders and food insecurity among homeless adults participating in the At Home/Chez Soi study. PLoS One 2020; 15:e0232001. [PMID: 32324795 PMCID: PMC7179857 DOI: 10.1371/journal.pone.0232001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 04/03/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Few studies have examined how food insecurity changes over time when living with severe mental disorders or substance use disorders. This study identifies food insecurity trajectories of homeless adults participating in a trial of a housing intervention and examines whether receiving the intervention and having specific mental and substance disorders predict food insecurity trajectories. MATERIALS AND METHODS We studied 520 participants in the Toronto site of the At Home/Chez-Soi project. Food insecurity data were collected at seven times during a follow-up period of up to 5.5 years. Mental and substance use disorders were assessed at baseline. Food insecurity trajectories were identified using group based-trajectory modeling. Multinomial logistic regression was used to examine the effects of the intervention and mental and substance use disorders on food insecurity trajectories. RESULTS Four food insecurity trajectories were identified: persistently high food insecurity, increasing food insecurity, decreasing food insecurity, and consistently low food insecurity. Receiving the intervention was not a predictor of membership in any specific food insecurity trajectory group. Individuals with major depressive episode, mood disorder with psychotic features, substance disorder, and co-occurring disorder (defined as having at least one alcohol or other substance use disorder and at least one non-substance related mental disorder] were more likely to remain in the persistently high food insecurity group than the consistently low food insecurity group. CONCLUSION A persistently high level of food insecurity is common among individuals with mental illness who have experienced homelessness, and the presence of certain mental health disorders increases this risk. Mental health services combined with access to resources for basic needs, and re-adaptation training are required to enhance the health and well-being of this population.
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Affiliation(s)
- James Lachaud
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Cilia Mejia-Lancheros
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Ri Wang
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Kathryn Wiens
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Rosane Nisenbaum
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Applied Health Research Centre, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stephen W. Hwang
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patricia O'Campo
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Pandey S, Fusaro V. Food insecurity among women of reproductive age in Nepal: prevalence and correlates. BMC Public Health 2020; 20:175. [PMID: 32019537 PMCID: PMC7001376 DOI: 10.1186/s12889-020-8298-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food insecurity is widely prevalent in certain sections of society in low and middle-income countries. The United Nations has challenged all member countries to eliminate hunger for all people by 2030. This study examines the prevalence and correlates of household food insecurity among women, especially Dalit women of reproductive age in Nepal. METHODS Data came from 2016 Nepal Demographic Health Survey, a cross-sectional, nationally representative survey that included 12,862 women between 15 and 49 years of age of which 12% were Dalit. Descriptive analysis was used to assess the prevalence of household food insecurity while logistic regression examined the relationship between women's ethnicity and the risk of food insecurity after accounting for demographic, economic, cultural, and geo-ecological characteristics. RESULTS About 56% of all women and 76% of Dalit women had experienced food insecurity. Ethnicity is strongly related to food insecurity. Dalit women were most likely to be food insecure, even after accounting for factors such as education and wealth. They were 82, 85, 89 and 92% more vulnerable to food insecurity than Muslims, Brahmin/Chhetri, Terai Indigenous, and Hill Indigenous populations, respectively. Education was a protective factor-women with secondary education (6th to 10th grade) were 39% less likely to be food insecure compared to their counterparts without education. With a more than 10th grade education, women were 2.27 times more likely to be food secure compared to their counterparts without education. Marriage was also protective. Economically, household wealth is inversely correlated with food insecurity. Finally, residence in the Mid-Western, Far-Western and Central Development regions was correlated with food insecurity. CONCLUSION To reduce food insecurity in Nepal, interventions should focus on improving women's education and wealth, especially among Dalit and those residing in the Far- and Mid-Western regions.
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Affiliation(s)
- Shanta Pandey
- Boston College School of Social Work, McGuinn Hall, Room 311, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Vincent Fusaro
- Boston College School of Social Work, McGuinn Hall, Room 311, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA
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9
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Food Insecurity and Socioeconomic Disadvantage in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020559. [PMID: 31952327 PMCID: PMC7014009 DOI: 10.3390/ijerph17020559] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
Research on food insecurity in Australia has typically relied on a single-item measure and finds that approximately 5% of the population experiences food insecurity. This research also finds that demographic characteristics such as household composition and marital status affect levels of food insecurity, independent of income level. The present study examines the prevalence and correlates of food insecurity in a cohort (n = 400) of people experiencing entrenched disadvantage in Perth, Western Australia. Using the US Department of Agriculture Household Food Security Survey Module, we find that food insecurity at the household, adult, and child level is at sharply elevated levels, with 82.8% of the sample reporting household food insecurity, 80.8% and 58.3% experiencing food insecurity among adults and children, respectively. Demographic characteristics do not significantly affect levels of food insecurity, and food insecurity is associated with negative physical and mental health outcomes. Food insecurity is positively correlated with access to food emergency relief services, indicating that these services are being used by those most in need, but do not address the root causes of food insecurity. Policy and practice should focus on increasing stable access to adequate quantities and quality of food and addressing the structural causes of food insecurity.
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10
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Tong M, Tieu L, Lee CT, Ponath C, Guzman D, Kushel M. Factors associated with food insecurity among older homeless adults: results from the HOPE HOME study. J Public Health (Oxf) 2019; 41:240-249. [PMID: 29617886 PMCID: PMC6636692 DOI: 10.1093/pubmed/fdy063] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/09/2018] [Accepted: 03/15/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. METHODS We conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. We assessed food security and receipt of food assistance. We used multivariable logistic regression to examine factors associated with very low food security. RESULTS The majority of the cohort was male and African American. Over half (55.4%) met criteria for food insecurity, 24.3% reported very low food security. Half (51.7%) reported receiving monetary food assistance. In the multivariable model, those who were primarily sheltered in the prior 6 months, (multi-institution users [AOR = 0.44, 95% CI: 0.22-0.86]) had less than half the odds of very low food security compared with those who were unsheltered. Depressive symptoms (AOR = 3.01, 1.69-5.38), oral pain (AOR = 2.15, 1.24-3.74) and cognitive impairment (AOR = 2.21, 1.12-4.35) were associated with increased odds of very low food security. CONCLUSIONS Older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.
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Affiliation(s)
- M Tong
- School of Public Health, University of California, Berkeley, USA
| | - L Tieu
- Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA, USA
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA
| | - C T Lee
- Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA, USA
| | - C Ponath
- Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA, USA
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA
| | - D Guzman
- Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA, USA
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA
| | - M Kushel
- Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA, USA
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA
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11
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Parpouchi M, Somers JM. Beyond Housing for Homeless People, It Is Crucial to Remediate Food Insecurity. Am J Public Health 2019; 109:535-536. [PMID: 30865507 DOI: 10.2105/ajph.2019.304977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Milad Parpouchi
- Milad Parpouchi is a PhD candidate with and Julian M. Somers is with the Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Julian M Somers
- Milad Parpouchi is a PhD candidate with and Julian M. Somers is with the Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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12
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Hernandez DC, Daundasekara SS, Arlinghaus KR, Sharma AP, Reitzel LR, Kendzor DE, Businelle MS. Fruit and vegetable consumption and emotional distress tolerance as potential links between food insecurity and poor physical and mental health among homeless adults. Prev Med Rep 2019; 14:100824. [PMID: 30997322 PMCID: PMC6453825 DOI: 10.1016/j.pmedr.2019.100824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 12/21/2018] [Accepted: 02/06/2019] [Indexed: 01/04/2023] Open
Abstract
Food insecurity is associated with mental health outcomes among adults experiencing homelessness. Different theoretical explanations have emerged to account for the negative health outcomes among vulnerable populations. The neomaterial theoretical perspective suggests that nutritional deficiencies from experiencing food insecurity are related to negative health outcomes. Whereas, the psychosocial theoretical perspective indicates that perceived disadvantages or inability to cope emotionally (i.e. lower distress tolerance) from food insecurity leads to adverse health outcomes. Building on these theoretical perspectives, the purpose of the study was to determine whether fruit and vegetable consumption (as a measure of diet quality) or emotional distress tolerance act as potential links between food insecurity and poor physical and mental health among adults experiencing homelessness. Adults were recruited from six area shelters in Oklahoma City (N = 566) during July–August 2016. Data was collected via a self-administered questionnaire on a tablet computer. Self-rated poor health, depression, and post-traumatic stress disorder (PTSD) were regressed on food insecurity using logistic regressions. Indirect effects were assessed using bootstrapping methods outlined by Preacher and Hayes. In covariate-adjusted models, lower levels of distress tolerance, but not fruit and vegetable consumption, partially mediated the association between food insecurity and poor health (β = 0.28, [0.14, 0.44]), depression (β = 0.56, [0.33, 0.88]), and PTSD (β = 0.39, [0.22, 0.60]). Results suggest that experiencing food insecurity may lower the ability to withstand emotional distress and consequently contributes to negative health outcomes. Among homeless adults, a positive link exists between food insecurity and poor health. Distress tolerance partially mediates the relation between food insecurity and health. Fruit and vegetable intake is not a mediator among homeless adults.
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Affiliation(s)
- Daphne C. Hernandez
- The University of Houston, Department of Health, & Health Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204-6015, USA
- The University of Houston, HEALTH Research Institute, 4849 Calhoun Road, Houston, TX 77204, USA
- Corresponding author at: Department of Health, & Health Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204-6015, USA.
| | - Sajeevika S. Daundasekara
- The University of Houston, Department of Health, & Health Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204-6015, USA
| | - Katherine R. Arlinghaus
- The University of Houston, Department of Health, & Health Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204-6015, USA
| | - Anika Pal Sharma
- The University of Houston, Honors College, 4333 University Drive, Houston, TX 77204-2001, USA
| | - Lorraine R. Reitzel
- The University of Houston, HEALTH Research Institute, 4849 Calhoun Road, Houston, TX 77204, USA
- The University of Houston, Department of Psychological, Health, & Learning Sciences, Social Determinants/Health Disparities Lab, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
| | - Darla E. Kendzor
- The University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, USA
- The University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA
| | - Michael S. Businelle
- The University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, USA
- The University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104, USA
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'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access. Public Health Nutr 2018; 21:1943-1951. [PMID: 29502547 DOI: 10.1017/s1368980018000356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context. DESIGN The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking. SETTING Buffalo, a mid-sized city in the Northeastern USA. SUBJECTS A sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18-24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters. RESULTS Participants' food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends' or relatives' homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent's application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs. CONCLUSIONS Given endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.
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D'andreamatteo C, Slater J. Measuring Food Security in Canadian Homeless Adult Men. CAN J DIET PRACT RES 2017; 79:42-45. [PMID: 28971686 DOI: 10.3148/cjdpr-2017-026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE To assess whether the current food security measurement tool used in Canada, the Canadian Community Health Survey, is appropriate for use with homeless adults. METHODS The Household Food Security Survey Module (HFSSM), a validated measurement tool utilized for determining the food security status of Canadian households, was used with a group of homeless men (n = 40). In-depth interviews were also conducted with participants to obtain particulars about their food acquisition strategies. Data were analyzed by comparing the results of the HFSSM with qualitative data. RESULTS The HFSSM measurement tool found that 90% (n = 36) of the study participants experienced food insecurity with 67.5% (n = 27) experiencing severe food insecurity and 22.5% (n = 9) experiencing moderate food insecurity. The qualitative data, however, suggested that all participants (n = 40) were food insecure based on food acquisition practices, food accessibility, and diet quality. CONCLUSIONS The HFSSM has validity concerns when applied to homeless populations. Nutrition professionals and other key stakeholders should work to develop valid tools for measuring the food security status of homeless individuals who are highly vulnerable to food insecurity.
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Affiliation(s)
- Carla D'andreamatteo
- a Department of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB
| | - Joyce Slater
- a Department of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB
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Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial. Public Health Nutr 2017; 20:2023-2033. [PMID: 28560947 DOI: 10.1017/s1368980017000489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. DESIGN At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). SETTING Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). SUBJECTS Homeless adults with mental illness (n 2148). RESULTS Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. CONCLUSIONS Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.
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Parpouchi M, Moniruzzaman A, Russolillo A, Somers JM. Food Insecurity among Homeless Adults with Mental Illness. PLoS One 2016; 11:e0159334. [PMID: 27437937 PMCID: PMC4954689 DOI: 10.1371/journal.pone.0159334] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/30/2016] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Milad Parpouchi
- Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Akm Moniruzzaman
- Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Angela Russolillo
- Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Julian M Somers
- Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Prevalence and covariates of food insecurity among residents of single-room occupancy housing in Chicago, IL, USA. Public Health Nutr 2015; 19:1122-30. [DOI: 10.1017/s1368980015002384] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveEmerging evidence suggests that food insecurity is a significant public health concern among people who are homeless or marginally housed. The present study assessed prevalence of food insecurity and its covariates among a group of marginally housed individuals living in single-room occupancy (SRO) dwellings, a population for which there is little extant health or nutrition research.DesignCross-sectional survey incorporating the Household Food Insecurity Access Scale.SettingTen private SRO residences in the Uptown neighbourhood of Chicago, IL, USA, 2013.SubjectsSRO residents over 18 years of age who were able to communicate verbally in English (n153).ResultsFood insecurity was widespread among SRO residents, with 75 % of the sample considered food insecure and 52 % meeting criteria for severe food insecurity. Bivariate analyses indicated that female gender, eating most meals at a soup kitchen, having a mental health condition, problem drinking, having at least one chronic health condition, and diabetes were all significantly associated with food insecurity. In the multivariate ordered logistic regression model, eating most meals at a soup kitchen remained as the only significant correlate of food insecurity (OR=10·13).ConclusionsSRO residents and other marginally housed populations face unique food access challenges. Although targeted assistance in the form of food stamps and congregate meal programmes remains critical, efforts to prevent and address food insecurity among homeless and marginally housed individuals should include policy interventions that recognize poverty as the root cause of food insecurity and aim to increase overall income and improve housing conditions.
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