Determinants of Food Insecurity in Higher-Income Households in Canada

Food insecurity and its contributing determinants among rural households in the south-western region of Bangladesh, 2021: A cross-sectional study

Introduction

The onset of the COVID-19 pandemic has disrupted food access, resulting in substantial consequences for food insecurity and contributing to adverse individual and public health outcomes. To comprehensively evaluate these challenges and grasp their implications for food security, this study aimed to evaluate the contributing determinants of food insecurity among rural households in the southwestern region of Bangladesh.

Study design

A cross-sectional study was conducted using a validated questionnaire in selected 310 rural household respondents from the southwestern region of Bangladesh.

Methods

Household food insecurity status was the outcome variable for the analysis. Multinomial logistic regression analysis was used to explore and predict risk factors correlated with food insecurity among southwestern Bangladeshi households.

Results

We found that 59 % and 27.5 % of households were suffering from moderate food insecurity and severe food insecurity, respectively. The multinomial regression model revealed that respondents residing in Kusthia (RRR = 5.56 CI:2.67-8.4 and RRR = 6.65, CI:3.37-9.22) aged between 30 and 40 years (RRR = 2.32, 95 % CI:1.84-3.77 and RRR = 1.87, 95 % CI:1.48-3.97) and 40-50 years (RRR = 1.86 95 % CI:1.46-3.82 and RRR = 1.95, 95 % CI:1.75-3.26) were significantly associated with mild-to-moderate and severe food insecurity. Respondents with a monthly family income of <58.96 USD (3.38 times and 2.18 times), had ≥5 family members (2.68 times and 1.89 times), and had poor income during the pandemic (4.25 times and 2.75 times) more likely to be moderate and severe food insecure.

Conclusion

The results emphasized that during the COVID-19 lockdown in Bangladesh, rural households faced diverse levels of food insecurity, ranging from moderate to severe. It suggests that efforts to raise awareness and implement support strategies for those at higher risk should not only focus on income but also consider additional factors such as family size, adults aged 30-40 years, and occupation.

News media framing of food poverty and insecurity in high-income countries: a rapid review

Food poverty and insecurity have become a public health emergency in many high-income countries. News media coverage can shape public and political views towards such issues. This rapid review synthesizes the evidence on how food poverty and insecurity are represented in the news media. Peer-reviewed publications were accessed through three electronic databases, with reference lists of all included studies screened. Primary research studies conducted in high-income countries and published in English since 1995 were included, with no restrictions on study methods. A combination of deductive coding to Entman's framing theory and inductive analysis was used. Ten studies, mostly rated as low quality, were included in the review. Newspapers were the only type of news media examined. The findings showed a largely absent nuanced understanding of food poverty and insecurity, with the problem often defined by food bank use and the consequences mainly focused on physical health. The causes were mostly attributed to structural factors, with the solutions largely focused on charitable food aid. The discourse of recipient (un)deservingness of food aid was evident. Articles often contained views from government officials and charities, with individuals' experiences of food poverty and insecurity largely absent. The findings of this review highlight that a major shift in print media discourse on food poverty and insecurity is required. More balanced and critical news reporting is required to present a more realistic picture of food poverty and insecurity, including its multi-dimensional nature, limitations of food charity and the need for structural solutions to this important issue.

Sexual Orientation and Food Hardship: National Survey of Family Growth, 2011-2019

OBJECTIVE

Given the high rates of poverty observed among sexual minority groups and their social vulnerability, we examined the prevalence and correlation of food hardship, measured as food insecurity, receipt of free or reduced-cost food, and Supplemental Nutrition Assistance Program (SNAP) participation among low-income sexual minority and heterosexual adults using population-level health surveillance data.

METHODS

We used 4 waves of pooled data (2011-2019) from the National Survey of Family Growth for adults aged 18-44 years. We compared the sexual orientation subgroups and used logistic regression to predict the likelihood of food hardship.

RESULTS

Among men, gay and bisexual men had higher odds of experiencing food insecurity than their heterosexual counterparts (adjusted odds ratio [aOR] = 1.97 and 1.83, respectively). Compared with heterosexual men, bisexual men had significantly higher odds of receiving free or reduced-cost food, but gay men did not. The odds of participating in SNAP did not differ significantly among gay, bisexual, and heterosexual men. Among women, only bisexual women were more prone to experiencing food insecurity than their heterosexual counterparts (aOR = 1.81). The odds of receiving free or reduced-cost food did not differ significantly among heterosexual, bisexual, and lesbian women. However, compared with heterosexual women, lesbian women had significantly lower odds (aOR = 0.62) and bisexual women had significantly higher odds (aOR = 1.24) of participating in SNAP.

CONCLUSION

Our findings contribute to the limited literature examining trends in food hardship among sexual minority groups and suggest potentially different patterns of food insecurity, food assistance, and SNAP participation among sexual orientation subgroups, which may call for group-specific, nuanced approaches for lessening food hardship.

Employment Insurance may mitigate impact of unemployment on food security: Analysis on a propensity-score matched sample from the Canadian Income Survey

Food insecurity, the inadequate access to food due to financial constraints, affects one-sixth of Canadian households, with substantial health implications. We examine the impact of unemployment and the mitigating effect of Employment Insurance (EI) on household food insecurity in Canada. Using the Canadian Income Survey 2018-2019, we sampled 28,650 households with adult workers 18-64 years old. We used propensity score matching to pair the 4085 households with unemployed workers with 3390 households with only continuously employed workers on their propensity towards unemployment. Among unemployed households, we also matched 2195 EI recipients with 950 nonrecipients. We applied adjusted logistic regression to the two matched samples. Food insecurity affected 15.1% of the households without unemployed workers and 24.6% of their unemployed counterparts, including 22.2% of EI recipients and 27.5% of nonrecipients. Unemployment was associated with 48% (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.32-1.66; 5.67 percentage points) higher likelihood of food insecurity. This association was significant and similar across income levels, full-time and part-time workers, and household compositions. EI receipt was associated with 23% (aOR 0.77, 95% CI 0.66-0.90; 4.02 percentage points) lower likelihood of food insecurity, but this association was only significant among households with lower income, full-time workers, and children under 18. The findings suggest a broad impact of unemployment on working adults' food insecurity and a substantial mitigating effect by EI on select unemployed workers. Making EI more generous and accessible for part-time workers may help alleviate food insecurity.

Factors influencing low-income households' food insecurity in Bangladesh during the COVID-19 lockdown

BACKGROUND

The COVID-19 pandemic and countrywide lockdown could negatively impact household food insecurity among low-income households. This study aimed to investigate the prevalence of household food insecurity and its influencing factors among low-income people in Bangladesh during the lockdown of COVID-19.

METHODS

This cross-sectional study was conducted through face-to-face interviews from 500 low-income households during the countrywide COVID-19 lockdown. A pretested, structured and validated questionnaire was used to collect socioeconomic characteristics, household income conditions, and food accessibility. Household Food Insecurity Access Scale (HFIAS) and Dietary Diversity Score (DDS) were used to measure food insecurity. Multinomial logistic regression models were estimated to evaluate and predict risk factors that influence food insecurity.

RESULTS

The study found that above 67% of households was mild-to-moderate food insecure while 23% experienced severe food insecurity. Significantly, 88%, 97.4%, and 93.4% of the households had anxiety and uncertainty, inadequate quality, and inadequate quantity of food, respectively. The regression analysis revealed the age 36-50 years (RRR: 4.86; 95% CI: 2.31-7.44, RRR: 4.16; 95% CI: 2.25-6.10) and monthly income <58.3 USD (RRR: 3.04; 95% CI: 1.12-5.14, RRR: 3.26; 95% CI: 1.79-4.71) were significantly associated with food insecurity (p <0.001). Likewise, less-income (RRR: 3.87; 95% CI: 1.37-6.46, RRR: 2.99; 95% CI: 1.16-4.83), increase in food prices (RRR: 1.29; 95% CI: 0.32-2.33, RRR: 1.08; 95% CI: 0.05-1.12), and those who did not have same type of earning as before during the COVID-19 lockdown (RRR: 3.41; 95% CI: 1.33-5.62, RRR: 2.60; 95% CI: 0.99-4.24) were potential risk factor for MMFI and FI.

CONCLUSION

This study found that households become more susceptible to food insecurity during the COVID-19 pandemic and lockdown period. Based on the findings, we suggest some essential food policies and adequate food assistance to mitigate these negative consequences.

Household food security and the COVID-19 pandemic in Nigeria

Pivotal to human development and the sustainable development goals is food security, which remains of substantial concern globally and in Nigeria, particularly during the COVID-19 pandemic despite various palliatives and intervention initiatives launched to improve household welfare. This study examined the food security status of households during the pandemic and investigated its determinants using the COVID-19 National Longitudinal Phone Survey (COVID-19 NLPS). In analysing the data, descriptive statistics, bivariate as well as multivariate analysis were employed. Findings from the descriptive statistics showed that only 12% of the households were food secure, 5% were mildly food insecure, 24.5% were moderately food insecure and over half of the households (58.5%) experienced severe food insecurity. The result from the ordered probit regression identified socioeconomic variables (education, income and wealth status) as the main determinants of food security during the pandemic. This study indicates that over two-thirds of households were threatened by food insecurity in Nigeria. The finding indicates the gross inadequacy of government palliative support and distribution. Thus, regarding policy implication, interventions and palliatives should be well planned and consistent with household size and needs.

Household food security and the COVID-19 pandemic in Nigeria

Pivotal to human development and the sustainable development goals is food security, which remains of substantial concern globally and in Nigeria, particularly during the COVID-19 pandemic despite various palliatives and intervention initiatives launched to improve household welfare. This study examined the food security status of households during the pandemic and investigated its determinants using the COVID-19 National Longitudinal Phone Survey (COVID-19 NLPS). In analysing the data, descriptive statistics, bivariate as well as multivariate analysis were employed. Findings from the descriptive statistics showed that only 12% of the households were food secure, 5% were mildly food insecure, 24.5% were moderately food insecure and over half of the households (58.5%) experienced severe food insecurity. The result from the ordered probit regression identified socioeconomic variables (education, income and wealth status) as the main determinants of food security during the pandemic. This study indicates that over two-thirds of households were threatened by food insecurity in Nigeria. The finding indicates the gross inadequacy of government palliative support and distribution. Thus, regarding policy implication, interventions and palliatives should be well planned and consistent with household size and needs.

Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey

Background

Food insecurity (FI) is alarmingly high in developing countries including Pakistan. A quarter of Pakistan’s population consists of adolescents yet there is no information on their experience of FI. FI at adolescent age have long term effect on mental and physical health hence we aimed to determine the prevalence of food insecurity (FI) among adolescents and compare it with household FI, and assess social determinants of adolescent FI.

Methods

A cross-sectional survey on 799 households with unmarried adolescents was conducted from September 2015 to June 2016 in three union councils of Hyderabad, Pakistan. Unmarried 10–19 years old girls and boys were interviewed regarding their FI status using Household Food Insecurity Assessment Scale (HFIAS). Household-level FI was also assessed by interviewing mothers of adolescents, and it was compared with adolescent’s FI. Association of adolescent’s FI with socio-demographic determinants was explored through Cox regression using STATA version 14.0. and prevalence ratios were estimated.

Results

FI was found among 52.4% of the adolescents compared to 39% of the households. Thirty percent of the adolescents were food insecure within the food secure households. Female adolescents were found to be less food insecure (Adjusted Prevalence Ratio (APR) 0.4 95% CI [0.3, 0.5]) compared to males. Social determinants like socioeconomic status (SES), crowding index or education of parents were not associated with adolescents’ FI.

Conclusion

Half of the adolescents were found to be food insecure which raises concerns regarding their health in the long run. Gender is an important social determinant of FI among adolescents which suggests an in-depth exploration of social dynamics of adolescent FI. We recommend the mixed-methods study to develop contextually relevant interventions to reduce FI among this group and improve their health status.

Determinants of Food Insecurity in Rural Households: The Case of the Paute River Basin of Azuay Province, Ecuador

Eliminating food insecurity is one of humanity’s greatest global challenges. Thus, the purpose of this research was to analyze the factors that determine food insecurity in households in the rural area of the Paute River Basin, Azuay Province, Ecuador. Stratified sampling was used as the sampling method, with proportional affixation. Moreover, we employed the Latin American and Caribbean Household Food Security Measurement Scale (ELCSA). We estimated the main determinants of household food insecurity using two binomial logit models and one ordered logit model. For the analysis of the data, the respective statistical and econometric tests were employed. The results show that housing size and access to food security information are the most important determinants of food insecurity in the three predictive models applied in this research. This research contributes to the existing literature on food insecurity and provides important information for policymakers, especially regarding food insecurity in rural areas, which has profound economic and social implications.

Food insecurity and socio-demographic characteristics in two UK ethnic groups: an analysis of women in the Born in Bradford cohort

Background

The use of foodbanks has risen sharply in the UK; however, the epidemiology of UK food insecurity is undeveloped. This study contributes to the field by analysing socio-demographic risk factors for food insecurity in a female, ethnically diverse population.

Methods

Data from the Born in Bradford (BiB) cohort were matched with data on food insecurity from the nested BiB1000 study (N = 1280). Logistic regression was used to model food insecurity in relation to ethnicity and socio-demographic factors.

Results

Food insecurity, reported by 13.98% of the sample, was more likely among White British than Pakistani women (crude Odds Ratio (OR) 1.94, 95% CI: 1.37; 2.74, adjusted OR 2.37, 95% CI: 1.57; 3.59). In fully adjusted analyses, food insecurity was associated with a range of socio-economic measures, particularly the receipt of mean-tested benefits (adjusted OR 2.11, 95% CI: 1.41; 3.15) and perception of financial insecurity (adjusted OR 8.91, 95% CI: 4.14; 19.16 for finding it difficult/very difficult compared to living comfortably).

Conclusions

The finding that food insecurity prevalence may be higher than previously thought and that food insecurity is highly associated with socio-economic status, notably benefit receipt, is a cause for concern necessitating an urgent policy response.

Examining the Association between Food Literacy and Food Insecurity

Poor food literacy behaviours may contribute to food insecurity in developed countries. The aim of this research was to describe the apparent prevalence of food insecurity in adults at enrolment in a food literacy program and to examine the relationship between food insecurity and a range of independent variables. Individuals attending the Food Sensations^® for Adults program in Western Australia from May 2016 to April 2018 completed a pre-program questionnaire (n = 1433) indicating if they had run out of money for food in the past month (food insecurity indicator), frequency of food literacy behaviours, selected dietary behaviours, and demographic characteristics. The level of food insecurity reported by participants (n = 1379) was 40.5%. Results from multiple logistic regression demonstrated that behaviours related to planning and management, shopping, preparation, and cooking were all statistically independently associated with food insecurity, in addition to soft/soda drink consumption, education, employment status, and being born in Australia. The results are salient as they indicate an association between food literacy and food insecurity. The implications are that food insecure participants may respond differently to food literacy programs. It may be necessary to screen people enrolling in programs, tailor program content, and include comprehensive measures in evaluation to determine effect on the impact of food literacy programs on different subgroups.

Moderating Effects of Components of Resilience on Obesity Across Income Strata in the National Survey of Children's Health

OBJECTIVE

This study examined whether components of resilience at the family or child level are associated with a decreased risk of obesity in children after accounting for community-, family-, and individual-level stressors associated with an increased risk of obesity.

METHODS

Data are from the 2016 National Survey of Children's Health, using the subset of children 10 to 17 years of age with weight data. We examined whether or not components of family- or child-level resilience were associated with weight status. Community-, family-, and individual-level risk factors for obesity were examined within each income stratum. We used multinomial logistic regression to evaluate if components of resilience are associated with lower overweight or obesity.

RESULTS

The sample included 24,405 10- to 17-year-old children. Child-level but not family-level resilience components were associated with a decreased risk of child obesity across income strata. Food security and adverse childhood experiences (ACEs) were only associated with obesity within higher income strata; bullying was consistently associated across strata. Physical activity was strongly associated with increased emotional resilience. The association between higher emotional resilience and lower obesity remained after adjusting for community-level factors (parks), family-level factors (ACEs), and individual-level factors (bullying). Better maternal health was associated with increased emotional resilience and lower risk of obesity.

CONCLUSIONS

Resilience, specifically emotional resilience, may be a protective factor against obesity in children regardless of income stratum. Physical activity of the child is associated with greater emotional resilience, and better maternal health may mediate the association between this component of resilience and weight.

The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia

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.

Walking the Food Security Tightrope-Exploring the Experiences of Low-to-Middle Income Melbourne Households

There is limited evidence of how Australian low-to-middle income (AUD $40,000⁻$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised participants according to food security status (the 18-item United States Department of Agriculture Household Food Security Survey Module) and income level to identify and purposefully select participants to qualitatively explore food insecurity and security experiences. Of the total number of survey participants (n = 134), 42 were categorised as low-to-middle income. Of these, a subset of 16 participants (8 FIS and 8 FS) was selected, and each participant completed an in-depth interview. The interviews explored precursors, strategies to prevent or address food insecurity, and the implications of the experience. Interview data were analysed using a thematic analysis approach. Five themes emerged from the analysis: (i) food decision experiences, (ii) assets, (iii) triggers, (iv) activation of assets, and (v) consequences and emotion related to walking the food security tightrope. The leverage points across all themes were more volatile for FIS participants. Low-to-middle income Australians are facing the challenges of trying to maintain or improve their food security status, with similarities to those described in lower income groups, and should be included in approaches to prevent or address food insecurity.

Utilising a multi-item questionnaire to assess household food security in Australia

Issue addressed

Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed to underreporting of the problem. The purpose of this study was to investigate food security using the short form of the US Household Food Security Survey Module (HFSSM) within an Australian context; and explore the relationship between food security status and multiple socio‐demographic variables.

Methods

Two online surveys were completed by 2334 Australian participants from November 2014 to February 2015. Surveys contained the short form of the HFSSM and twelve socio‐demographic questions. Cross‐tabulations chi‐square tests and a multinomial logistic regression model were employed to analyse the survey data.

Results

Food security status of the respondents was classified accordingly: High or Marginal (64%, n = 1495), Low (20%, n = 460) or Very Low (16%, n = 379). Significant independent predictors of food security were age (P < 0.001), marital status (P = 0.005), household income (P < 0.001) and education (P < 0.001).

Conclusion

Findings suggest food insecurity is an important issue across Australia and that certain groups, regardless of income, are particularly vulnerable.

So what?

Government policy and health promotion interventions that specifically target “at risk” groups may assist to more effectively address the problem. Additionally, the use of a multi‐item measure is worth considering as a national indicator of food security in Australia.

Are low-to-middle-income households experiencing food insecurity in Victoria, Australia? An examination of the Victorian Population Health Survey, 2006-2009

Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006-09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40000-$80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9-4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.

The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults

PURPOSE

Household food insecurity is related to poor mental health. This study examines whether the level of household food insecurity is associated with a gradient in the risk of reporting six adverse mental health outcomes. This study further quantifies the mental health impact if severe food insecurity, the extreme of the risk continuum, were eliminated in Canada.

METHODS

Using a pooled sample of the Canadian Community Health Survey (N = 302,683), we examined the relationship between level of food insecurity, in adults 18-64 years, and reporting six adverse mental health outcomes. We conducted a probit analysis adjusted for multi-variable models, to calculate the reduction in the odds of reporting mental health outcomes that might accrue from the elimination of severe food insecurity.

RESULTS

Controlling for various demographic and socioeconomic covariates, a food insecurity gradient was found in six mental health outcomes. We calculated that a decrease between 8.1% and 16.0% in the reporting of these mental health outcomes would accrue if those who are currently severely food insecure became food secure, after controlling for covariates.

CONCLUSION

Household food insecurity has a pervasive graded negative effect on a variety of mental health outcomes, in which significantly higher levels of food insecurity are associated with a higher risk of adverse mental health outcomes. Reduction of food insecurity, particularly at the severe level, is a public health concern and a modifiable structural determinant of health worthy of macro-level policy intervention.

Prevalence and covariates of food insecurity among residents of single-room occupancy housing in Chicago, IL, USA

Objective

Emerging 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.

Design

Cross-sectional survey incorporating the Household Food Insecurity Access Scale.

Setting

Ten private SRO residences in the Uptown neighbourhood of Chicago, IL, USA, 2013.

Subjects

SRO residents over 18 years of age who were able to communicate verbally in English (n153).

Results

Food 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).

Conclusions

SRO 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.