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Crawford G, Connor E, McCausland K, Reeves K, Blackford K. Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16946. [PMID: 36554827 PMCID: PMC9778908 DOI: 10.3390/ijerph192416946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Migrants from culturally and linguistically diverse (CaLD) backgrounds experience factors that may increase health inequities related to a range of determinants of health including housing and mental health. However, the intersection between mental health and housing for migrants is poorly understood. A scoping review searched four academic databases for concepts related to cultural and linguistic diversity, housing conditions, and public health interventions to address homelessness. A total of 49 articles were included and seven key themes identified: housing provision; mental health intersections and interventions; complexity and needs beyond housing; substance use; service provider and policy issues; the role of cultural and linguistic diversity; and consumer experience. The intersection of ethnicity with other social determinants of health and housing was highlighted though there were limited interventions tailored for migrants. Studies generally pointed to the positive impacts of Housing First. Other sub-themes emerged: social connection and community; shame, stigma, and discrimination; health and support requirements; and employment, financial assistance, and income. Consumer choice was identified as vital, along with the need for systemic anti-racism work and interventions. To support secure housing for migrants and mitigate mental health impacts, closer attention is required towards migration factors along with broader, tailored services complementing housing provision.
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Elizabeth Connor
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Karina Reeves
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
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Easton C, Oudshoorn A, Smith-Carrier T, Forchuk C, Marshall CA. The experience of food insecurity during and following homelessness in high-income countries: A systematic review and meta-aggregation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3384-e3405. [PMID: 35869792 DOI: 10.1111/hsc.13939] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Homelessness is a pervasive challenge caused by poverty which continues to grow in economically developed countries, posing significant health impacts (Fazel et al., Lancet, 384: 1529-1540, 2014). While food security related to poverty and low income has been investigated, this review specifically explores the experience of food security during and following homelessness. Given the fact that the health of individuals who experience homelessness is known to be poor and the importance of nutrition, this is a necessary contribution. Informed by a health equity lens, this review synthesises the findings and quality of the literature regarding experiences of food security during and following homelessness in high-income countries. We used the Joanna Briggs Institute methodology, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Qualitative studies published to date were obtained from six databases. We conducted a meta-aggregation of existing qualitative findings. Twenty-four studies on 462 participants were included in the review. Through meta-aggregation four themes were created: (1) imposed food options as a determinant of health out of my control; (2) obtaining food for survival despite stigma or other consequences; (3) situated within a system that maintains food insecurity; and (4) surviving hardships. Persons during and following homelessness in high-income countries face multiple challenges when securing food while situated in an oppressive system that lacks choice. Despite this, persons who have experienced homelessness demonstrate resilience by finding ways to meet their basic needs in the face of imposed barriers. Implications for research, policy and practice are offered.
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Affiliation(s)
- Corinna Easton
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- School of Nursing, Western University, London, Ontario, Canada
| | - Tracy Smith-Carrier
- School of Humanitarian Studies, Royal Roads University, Victoria, British Columbia, Canada
| | - Cheryl Forchuk
- School of Nursing, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
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Corey J, Lyons J, O’Carroll A, Stafford R, Ivers JH. A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3219. [PMID: 35328907 PMCID: PMC8954292 DOI: 10.3390/ijerph19063219] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023]
Abstract
Persons experiencing homelessness (PEH) are at heightened risk for infection, morbidity, and mortality from COVID-19. However, health consequences of the pandemic extend far beyond those directly caused by the virus. This scoping review aimed to explore the impacts of the COVID-19 pandemic on the health and well-being of PEH in North America and Europe. A systematic search of academic and grey literature was conducted in September 2021. To be included, studies had to include primary data related to the impact of the pandemic on health or well-being of PEH and be written in English. All potentially relevant references were independently screened by two reviewers, and minor conflicts were settled with input of a third reviewer. A total of 96 articles met criteria for inclusion. Data extraction was completed for all included studies, and findings synthesised and presented thematically. Numerous health impacts of the pandemic on PEH were identified, including SARS-CoV-2 infection, morbidity, mortality, and hospitalisation, fear of infection, access to housing, hygiene, PPE, food, as well as mental health, substance use, other health-related outcomes and treatment services. Gaps in the literature relating to persons using alcohol, access to mental health support, and violence were also identified. Implications for future research are discussed.
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Affiliation(s)
- Julia Corey
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | - James Lyons
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | | | - Richie Stafford
- HSE Community Healthcare Organisation Dublin North City & County, D09C8P5 Dublin, Ireland;
| | - Jo-Hanna Ivers
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
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Vilar-Compte M, Burrola-Méndez S, Lozano-Marrufo A, Ferré-Eguiluz I, Flores D, Gaitán-Rossi P, Teruel G, Pérez-Escamilla R. Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review. Int J Equity Health 2021; 20:40. [PMID: 33472636 PMCID: PMC7816472 DOI: 10.1186/s12939-020-01330-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this "urban advantage" does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition. OBJECTIVES This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.'s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis. RESULTS Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition. CONCLUSIONS This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the "urban advantage". A conceptual framework emerging from the existing literature is proposed to guide future studies and policies. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration number: CRD42018089788 .
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Affiliation(s)
- Mireya Vilar-Compte
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico.
| | - Soraya Burrola-Méndez
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Annel Lozano-Marrufo
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Isabel Ferré-Eguiluz
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Diana Flores
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Pablo Gaitán-Rossi
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
| | - Graciela Teruel
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fé, 01219, Mexico City, Mexico
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Xafis V. 'What is Inconvenient for You is Life-saving for Me': How Health Inequities are playing out during the COVID-19 Pandemic. Asian Bioeth Rev 2020; 12:223-234. [PMID: 32427219 PMCID: PMC7229879 DOI: 10.1007/s41649-020-00119-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact globally. Most affected, however, are those individuals and groups routinely disadvantaged by the social injustice created by the misdistribution of power, money, and resources. Simple measures that prevent the spread of COVID-19, such as frequent hand washing and social distancing, are unavailable to millions of people in the wealthiest of nations and in the poorest of nations. Disadvantaged groups are impacted more directly and in disproportionately higher numbers due to existing poor health, and the disruption of services central to securing an income and an education will have lasting consequences for their futures. The unintended effect of exclusionary government policies is that privileged citizens and healthcare systems are also at greater risk. This paper seeks to highlight the impact of COVID-19 on those already suffering health inequities through consideration of some of the social determinants of health on groups in affluent and poorer nations. It also highlights some of the factors that may assist in tackling health inequities as we emerge from this pandemic.
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Affiliation(s)
- Vicki Xafis
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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7
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Food insecurity among formerly homeless youth in supportive housing: A social-ecological analysis of a structural intervention. Soc Sci Med 2019; 245:112724. [PMID: 31838336 DOI: 10.1016/j.socscimed.2019.112724] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 01/02/2023]
Abstract
A growing body of research indicates that structural interventions to provide permanent supportive housing (PSH) to homeless adults within a Housing First approach can improve their health. However, research is lacking regarding the impact of PSH on youth experiencing homelessness. This article seeks to understand how PSH for youth impacts a basic health need-food security- across multiple levels of the social-ecological environment. In January of 2014, San Francisco, California opened the city's first municipally-funded PSH building exclusively designated for transition-aged youth (ages 18-24). We conducted 20 months of participant observation and in-depth interviews with 39 youth from April 2014 to December 2015. Ethnographic fieldnotes and interview transcripts were analyzed using grounded theory. We present our social-ecological assessment regarding food insecurity for formerly homeless youth in supportive housing. We found that although housing removes some major sources of food insecurity from their lives, it adds others. Many of the participating youth were frequently hungry and went without food for entire days. Mechanisms across multiple levels of the social-ecological model contribute to food insecurity. Mechanisms on the structural level include stigma, neighborhood food resources, and monthly hunger cycles. Mechanisms on the institutional level include the transition into housing and housing policies regarding kitchen use and food storage. Interpersonal level mechanisms include food sharing within social networks. Individual level mechanisms include limited cooking skills, equipment, and coping strategies to manage hunger. Although supportive housing provides shelter to youth, effective implementation of the Housing First/PSH model for youth must ensure their access to an affordable nutritious diet.
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Pollard CM, Booth S, Jancey J, Mackintosh B, Pulker CE, Wright JL, Begley A, Imtiaz S, Silic C, Mukhtar SA, Caraher M, Berg J, Kerr DA. Long-Term Food Insecurity, Hunger and Risky Food Acquisition Practices: A Cross-Sectional Study of Food Charity Recipients in an Australian Capital City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152749. [PMID: 31374922 PMCID: PMC6696626 DOI: 10.3390/ijerph16152749] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/18/2019] [Accepted: 07/30/2019] [Indexed: 11/17/2022]
Abstract
Inadequate social protection, stagnant wages, unemployment, and homelessness are associated with Australian household food insecurity. Little is known about the recipients of food charity and whether their needs are being met. This cross-sectional study of 101 food charity recipients in Perth, Western Australia, measured food security, weight status, sociodemographic characteristics and food acquisition practices. Seventy-nine percent were male, aged 21–79 years, 90% were unemployed, 87% received social assistance payments, and 38% were homeless. Ninety-one percent were food insecure, 80% with hunger, and 56% had gone a day or more without eating in the previous week. Fifty-seven percent had used food charity for ≥1 year, and, of those, 7.5 years was the mode. Charitable services were the main food source in the previous week, however 76% used multiple sources. Begging for money for food (36%), begging for food (32%), stealing food or beverages (34%), and taking food from bins (28%) was commonplace. The omnipresence and chronicity of food insecurity, reliance on social security payments, and risky food acquisition suggest that both the social protection and charitable food systems are failing. Urgent reforms are needed to address the determinants of food insecurity (e.g., increased social assistance payments, employment and housing support) and the adequacy, appropriateness and effectiveness of food charity.
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Affiliation(s)
- Christina M Pollard
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia.
| | - Sue Booth
- College of Medicine & Public Health, Flinders University, GPO Box 2100, Adelaide 5000, Australia
| | - Jonine Jancey
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Bruce Mackintosh
- School of Agriculture and Environment, The University of Western Australia, 35 Stirling Highway, Crawley, Perth 6009, Australia
| | - Claire E Pulker
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Janine L Wright
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Andrea Begley
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Sabrah Imtiaz
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Claire Silic
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - S Aqif Mukhtar
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
| | - Martin Caraher
- Centre for Food Policy, City University of London, Northampton Square, London EC1V 0HB, UK
| | - Joel Berg
- Hunger Free America, 50 Broad Street, Suite 1103, New York, NY10004, USA
| | - Deborah A Kerr
- Faculty of Health Science, School of Public Health, Curtin University GPO Box U1987, Perth Western 6845, Australia
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Butcher LM, Ryan MM, O'Sullivan TA, Lo J, Devine A. Food-Insecure Household's Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours. Nutrients 2019; 11:nu11040828. [PMID: 31013699 PMCID: PMC6521285 DOI: 10.3390/nu11040828] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/20/2022] Open
Abstract
Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) or be influenced by product nutrition information (p = 0.002). Convenience (p < 0.001), organic (p = 0.027) and supermarket-branded products (p < 0.001) were more likely to be rated as important by food-insecure respondents when compared to their food-secure counterparts. When asked to rate “how healthy” their diet was, high–marginal FS respondents were twice as likely describe their diet as healthy than very low FS respondents (p = 0.001).
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Affiliation(s)
- Lucy M Butcher
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Foodbank Western Australia, Perth Airport, WA 6105, Australia.
| | - Maria M Ryan
- School of Business and Law, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
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McKay FH, Haines BC, Dunn M. Measuring and Understanding Food Insecurity in Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030476. [PMID: 30736305 PMCID: PMC6388276 DOI: 10.3390/ijerph16030476] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/29/2023]
Abstract
The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health surveys that measure food insecurity, resulting in outdated population-level food insecurity data. This review sought to investigate the breadth of food insecurity research conducted in Australia to evaluate how this construct is being measured. A systematic review was conducted to collate the available Australian research. Fifty-seven publications were reviewed. Twenty-two used a single-item measure to examine food security status; 11 used the United States Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM); two used the Radimer/Cornell instrument; one used the Household Food and Nutrition Security Survey (HFNSS); while the remainder used a less rigorous or unidentified method. A wide range in prevalence and severity of food insecurity in the community was reported; food insecurity ranged from 2% to 90%, depending on the measurement tool and population under investigation. Based on the findings of this review, the authors suggest that there needs to be greater consistency in measuring food insecurity, and that work is needed to create a measure of food insecurity tailored for the Australian context. Such a tool will allow researchers to gain a clear understanding of the prevalence of food insecurity in Australia to create better policy and practice responses.
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Affiliation(s)
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waterfront campus, Geelong, Victoria 3220, Australia.
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11
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Temple JB, Booth S, Pollard CM. Social Assistance Payments and Food Insecurity inAustralia: Evidence from the HouseholdExpenditure Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030455. [PMID: 30720768 PMCID: PMC6388211 DOI: 10.3390/ijerph16030455] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/01/2022]
Abstract
It is widely understood that households with low economic resources and poor labour market attachment are at considerable risk of food insecurity in Australia. However, little is known about variations in food insecurity by receipt of specific classes of social assistance payments that are made through the social security system. Using newly released data from the 2016 Household Expenditure Survey, this paper reports on variations in food insecurity prevalence across a range of payment types. We further investigated measures of financial wellbeing reported by food-insecure households in receipt of social assistance payments. Results showed that individuals in receipt of Newstart allowance (11%), Austudy/Abstudy (14%), the Disability Support Pension (12%), the Carer Payment (11%) and the Parenting Payment (9%) were at significantly higher risk of food insecurity compared to those in receipt of the Age Pension (<1%) or no payment at all (1.3%). Results further indicated that food-insecure households in receipt of social assistance payments endured significant financial stress, with a large proportion co-currently experiencing “fuel” or “energy” poverty. Our results support calls by a range of Australian non-government organisations, politicians, and academics for a comprehensive review of the Australian social security system.
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Affiliation(s)
- Jeromey B Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
| | - Sue Booth
- College of Medicine and Public Health, Flinders University, Adelaide 5000, Australia.
| | - Christina M Pollard
- Faculty of Health Sciences, School of Public Health, Curtin University, Perth 6102, Australia.
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The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112333. [PMID: 30360491 PMCID: PMC6266169 DOI: 10.3390/ijerph15112333] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 11/17/2022]
Abstract
A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.
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Pollard CM, Mackintosh B, Campbell C, Kerr D, Begley A, Jancey J, Caraher M, Berg J, Booth S. Charitable Food Systems' Capacity to Address Food Insecurity: An Australian Capital City Audit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061249. [PMID: 29895801 PMCID: PMC6025598 DOI: 10.3390/ijerph15061249] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
Australian efforts to address food insecurity are delivered by a charitable food system (CFS) which fails to meet demand. The scope and nature of the CFS is unknown. This study audits the organisational capacity of the CFS within the 10.9 square kilometres of inner-city Perth, Western Australia. A desktop analysis of services and 12 face-to-face interviews with representatives from CFS organisations was conducted. All CFS organisations were not-for–profit and guided by humanitarian or faith-based values. The CFS comprised three indirect services (IS) sourcing, banking and/or distributing food to 15 direct services (DS) providing food to recipients. DS offered 30 different food services at 34 locations feeding over 5670 people/week via 16 models including mobile and seated meals, food parcels, supermarket vouchers, and food pantries. Volunteer to paid staff ratios were 33:1 (DS) and 19:1 (IS). System-wide, food was mainly donated and most funding was philanthropic. Only three organisations received government funds. No organisation had a nutrition policy. The organisational capacity of the CFS was precarious due to unreliable, insufficient and inappropriate financial, human and food resources and structures. System-wide reforms are needed to ensure adequate and appropriate food relief for Australians experiencing food insecurity.
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Affiliation(s)
- Christina M Pollard
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Bruce Mackintosh
- School of Agriculture and Environment, The University of Western Australia, 35 Stirling Highway, Crawley, Perth 6009, Australia.
| | - Cathy Campbell
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Deborah Kerr
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Andrea Begley
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Jonine Jancey
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Martin Caraher
- Centre for Food Policy, City University of London, Northampton Square, London EC1V 0HB, UK.
| | - Joel Berg
- Hunger Free America, 50 Broad Street, Suite 1103, New York 10004, NY, USA.
| | - Sue Booth
- College of Medicine & Public Health, Flinders University, GPO Box 2100, Adelaide 5000, Australia.
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14
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Klineberg E, Vatiliotis V, Kang M, Medlow S, Sullivan L, Cummings M, Pringle G, Steinbeck K. Health status of marginalised young people in unstable accommodation. J Paediatr Child Health 2017; 53:995-999. [PMID: 28600859 DOI: 10.1111/jpc.13590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 02/27/2017] [Accepted: 03/14/2017] [Indexed: 11/29/2022]
Abstract
AIM More than 26 000 Australians aged 12-24 years experience homelessness, yet data on the health status of homeless youth remain limited. The aim of this study was to describe the health of young people attending a youth health service in Western Sydney who were experiencing homelessness. METHODS Retrospective case note review for clients aged 12-25 years attending Youth Health Services in Western Sydney. Extracted data included: homelessness status; demographics; physical health issues; mental health issues; involvement with juvenile justice; and disengagement from education or employment. RESULTS Just under half of the 180 clients attending a Youth Health Service in Western Sydney were homeless, and an additional 15 young people who were not currently homeless nominated homelessness as a presenting issue. In comparison with currently domiciled young people, homeless youth were less likely to have a regular general practitioner and more likely to nominate a physical health concern as a presenting issue, although there was no difference between groups in terms of diagnosed mental or physical health conditions. Considered as a whole, the sample showed high rates of acute physical symptoms, physical trauma, psychological distress and self-harm. CONCLUSIONS Youth homelessness is associated with risk of both poor physical and mental health. As much of youth homelessness is hidden, health-care providers need to ensure that they inquire about homelessness status, and have an awareness of potentially complex multi-morbidities in the physical and mental health of young marginalised people presenting to health services.
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Affiliation(s)
- Emily Klineberg
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Veronica Vatiliotis
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Melissa Kang
- Department of General Practice, University of Sydney, Sydney, New South Wales, Australia.,Youth Health Services, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sharon Medlow
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Lucinda Sullivan
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Michael Cummings
- Youth Health Services, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Graeme Pringle
- Youth Health Services, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Katharine Steinbeck
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
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15
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Graham R, Stolte O, Hodgetts D, Chamberlain K. Nutritionism and the construction of ‘poor choices’ in families facing food insecurity. J Health Psychol 2016; 23:1863-1871. [PMID: 27682336 DOI: 10.1177/1359105316669879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The dominant research approach to both food insecurity and charitable meal provision is nutritionistic, deficit-orientated and ignores wider socio-economic issues. This reinforces existing power dynamics and overlooks the agency of people living food-insecure lives. We critique this dominant approach and draw on the everyday experiences of families facing food insecurity to ground an alternative approach that emphasises food as a social determinant of health.
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16
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Abstract
Young adults are gaining weight faster than any age group. This weight gain and the appearance of obesity-related comorbidities often commence in adolescence. Psychosocial distress and mental health issues are common and debilitating, and treatment approaches are likely to be similar to those for adolescents. At the same time, young adults may have physical morbidities which will continue and worsen throughout adulthood, such as hypertension, diabetes and polycystic ovarian syndrome. Health consequences of obesity are challenging to manage in young adults as their symptoms may be minimal, they are less likely to engage with healthcare due to other life priorities and their neurocognitive developmental stage makes therapy adherence difficult. Clinicians who manage young adults with obesity need to be aware of these age-specific challenges, as well as the sexual and reproductive health concerns that are present in this age group.
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Affiliation(s)
- Hoi Lun Cheng
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia
| | - Sharon Medlow
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia
| | - Katharine Steinbeck
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia.
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Cnr Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW, 2145, Australia.
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17
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Campbell S. Let's not forget climate change in the food insecurity conversation: why the homeless are most vulnerable. Health Promot J Austr 2015; 26:161-162. [PMID: 25995129 DOI: 10.1071/he14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/18/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sharon Campbell
- Public Health Services, Tasmanian Department of Health and Human Services, GPO Box 125, Hobart, Tas. 7001, Australia. Email
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18
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Davison J, Share M, Hennessy M, Bunting B, Markovina J, Stewart-Knox B. Correlates of food choice in unemployed young people: The role of demographic factors, self-efficacy, food involvement, food poverty and physical activity. Food Qual Prefer 2015. [DOI: 10.1016/j.foodqual.2015.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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