What are the determinants of food insecurity in New Zealand and does this differ for males and females?

Regional disparities in food security and depression among single-person households in the Republic of Korea

BACKGROUND

Single-person households constitute over 40% of all households in the Republic of Korea and are more vulnerable to food insecurity and depression than multi-person households. There is a lack of research on examining whether regional characteristics are associated with the degree of food insecurity and depression among single-person households. This study aimed to examine the regional disparities in food security and depression among single-person households in the Republic of Korea.

METHODS

A total of 227,873 adults from the 2019 Korean Community Health Survey was included in the analysis. According to population density and poverty rate, the residence of the participants was classified into four regions: metropolitan areas with high population density were classified into areas with low poverty rates (Region 1) and high poverty rates (Region 2), and provinces with low population density were classified into areas with low poverty rates (Region 3) and high poverty rates (Region 4). Using a single item of household food security, those who had experienced a lack of food due to financial difficulties over the past year were classified as food insecure. Depression was measured using the Patient Health Questionnaire-9. Odds ratios and 95% confidence intervals (CI) for the risk of food insecurity and depression according to regional characteristics were calculated after adjusting for potential confounding variables.

RESULTS

After adjusting for confounding variables, single-person households in regions with high population density, Regions 1 and 2, had 1.16 times (95% CI = 1.04-1.30) and 1.43 times (95% CI = 1.27-1.61) higher odds of food insecurity, respectively, compared to those in Region 4. Single-person households in regions with low poverty rates, Regions 1 and 3, had 1.54 times (95% CI = 1.34-1.77) and 1.21 times (95% CI = 1.01-1.46) higher odds of depression, respectively, than those in Region 4. Among those who lived alone, the middle-aged, having low income, receiving livelihood benefits, or having a low educational attainment had higher odds of experiencing both food insecurity and depression than their counterparts.

CONCLUSIONS

As the risk of food insecurity and depression in single-person households differs according to regional characteristics, local governments need to implement policies for single-person households in consideration of these distinct characteristics.

Pacific Islands Families Study: Household Food Security during Pregnancy and Secondary School Educational Achievement

Nutritional environment in early life is a key factor for brain development and function. It is important to understand the relationship between nutrition in early life and academic achievement in adolescence. The birth cohort of the Pacific Islands Families (PIF) study was born in the year 2000. When their child was six weeks old, mothers were asked questions concerning food security over the past year. Two binary measures of food security were derived as previously used in PIF and also by the Ministry of Health (MOH). In 2020, records of academic achievement from the National Certificate of Educational Achievement (NCEA) for 649 (317 female, 332 male) cohort members showed progressive achievement at levels 1, 2, and 3 of NCEA and allowed University Entrance (UE) to be assessed. The prevalence of food insecurity was not different for sex but high at 29% and 42% using the PIF and MOH definitions of food insecurity, respectively. More females (27%) than males (18%) achieved UE as their highest qualification, and more males (40%) than females (31%) achieved NCEA levels 1 or 2 as their highest qualification. UE was achieved by 25% of those born into food-secure households and 17% from food-insecure households. Logistic regression demonstrated that the odds of achieving UE were 1.8-fold (95% CI 1.2, 2.6, p = 0.003) higher in females than males and, independently, 1.6-fold (95% CI 1.1, 2.5 p = 0.026) higher if the household was food secure. This work emphasises the importance of maternal and early-life food security for subsequent academic achievement and the well-being of future generations.

"I just wanted money for food": a qualitative study of the experiences of Australians during the COVID-19 pandemic

Aim

The social and economic impacts that have occurred during the COVID-19 pandemic can disproportionally affect those already experiencing poverty or at risk of poverty. Therefore, this study sought to explore the relationship between well-being and social determinants of health among Australian adults during the pandemic.

Subject and Methods

Semi-structured interviews were undertaken with 20 participants, aged 21-65 years, from various socioeconomic areas.

Results

Three main themes emerged from the analysis of the data: food security; housing outcomes; and psychological and emotional impact. Participants in low socioeconomic areas struggled with food security, having to access food banks, which was precipitated by employment loss during the pandemic. Some female participants experienced worsening inequalities and lack of financial and housing stability, affecting their overall well-being.

Conclusion

This study identified that there was a clear social divide between adults living in low socioeconomic areas compared with those living in high socioeconomic areas, with participants in low socioeconomic areas faring worse in terms of exacerbated social determinants of health and consequent impacts on well-being.

Prevalence of nutrition risk and associated risk factors among New Zealand pre-school children

AIM

To determine the prevalence of nutrition risk using the validated, Nutrition Screening Tool for Every Pre-schooler (NutriSTEP) among pre-school children in New Zealand (NZ) and to identify socio-demographic factors associated with nutrition risk.

METHODS

Parents/caregivers of NZ pre-school children (aged 2-5 years) completed an online survey including NutriSTEP, both parent and child height and weight, as well as socio-demographic characteristics. The 17-item NutriSTEP responses were scored between 0 and 4; where item scores ≥2 indicate risk, and the maximum score is 68. Participants were stratified into low-risk (score ≤ 20) and moderate to high-risk (score > 20) groups. Strength of associations between nutrition risk and socio-demographic characteristics were explored using binary regression analysis.

RESULTS

Of 505 pre-school children, 96 (19%) were at moderate to high risk (median interquartile range NutriSTEP score 24 [22-26]) and 409 (81%) were at low risk (score 13 [10-16]). Pre-school children at highest risk were non-NZ European (P = 0.002), with solo parents (P = 0.002), from households with incomes ≤$50 000 (P ≤ 0.021) and with non-university educated parents (P ≤ 0.0001). More than 30% of pre-schoolers were at high risk for inadequate consumption of fruit, vegetables, grains, milk products, meat and meat alternatives, as well as exposure to screens during meals and overuse of supplements.

CONCLUSIONS

A fifth of NZ pre-school children were at moderate to high nutrition risk and may not have met the nutrition guidelines. Economic and ethnic disparities were apparent. Using NutriSTEP may assist to identify NZ pre-school children at highest nutrition risk who may benefit from appropriate nutrition support.

The effect of non-participation on the prevalence of food insecurity in a population-based cohort in Portugal

Non-participation can be a source of selection bias. We evaluated the effect of non-participation on food insecurity prevalence among 2942 young adults from the EPITeen cohort (Portugal), which we have followed since assembling the cohort in 2003-2004. We conducted a cross-sectional study when the cohort participants were 26 years old. To examine the effect of non-participation, we statistically imputed the missing data on food security status using multivariate imputation by chained equations based on characteristics associated with food insecurity, specifically household income perception, education and household structure from 21 or 24 years of age follow-ups. In our cohort, non-participation caused ~ 2% difference in the food insecurity prevalence: 11.0% (95% CI 9.0-13.0) for 954 participants and 12.6% (95% CI 11.1-14.1) after imputation. These estimates are close to evidence from other European countries and sustain the relevance of developing public health interventions to promote food security, especially considering the negative nutritional and health outcomes associated with food insecurity.

Food insecurity in Dutch disadvantaged neighbourhoods: a socio-ecological approach

Food insecurity is an important public health concern; however, research into this phenomenon within the Netherlands is limited. Food insecurity is not solely related to individual factors, but can also be influenced by various factors in the social and physical environment. Therefore, this study aimed to identify determinants of food insecurity within the personal, social and physical environment, based on the social ecological model (SEM), and to identify their relative importance for experiencing food insecurity. The study population consisted of 307 participants living in disadvantaged neighbourhoods of the Dutch city The Hague, of which approximately one-quarter were food insecure. Participant characteristics showing bivariate associations P < 0⋅20 were placed in a predetermined level of the SEM, after which a multivariate logistic regression was performed for each level and the Nagelkerke pseudo R ² was presented. Determinants of food insecurity were BMI, gross monthly income, highest educational attainment, smoking status, diet quality, employment status, marital status and religion (P < 0⋅05). The results showed that 29⋅7 % of the total variance in food insecurity status was explained by all included determinants together. The personal, social and physical environment explained 20⋅6, 14⋅0 and 2⋅4 % of the total variance, respectively. Our findings suggest that determinants within the personal environment are most important for explaining differences in experienced food insecurity. The present study contributes to furthering the knowledge about the relative importance of the personal, social and physical environment, indicating that determinants within the personal environment may be most promising for developing targeted interventions to reduce food insecurity.

Simulating Potential Associated Socio-Economic Determinants With Sustainable Food Security (A Macro-Micro Spatial Quantitative Model)

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.

Socioeconomic risks of food insecurity during the Covid-19 pandemic in the UK: findings from the Understanding Society Covid Survey

BACKGROUND

We estimated socioeconomic factors associated with food insecurity during the first year of the Covid pandemic in the UK and explored potential mechanisms explaining these associations.

METHODS

Data were from the April, July, and September 2020 waves of the UK Understanding Society Covid Survey. Food insecurity was measured as 'not having access to healthy and nutritious food' and 'reporting being hungry but not eating'. Logistic regression estimated the relationship between socioeconomic factors and food insecurity. A decomposition approach explored if financial vulnerability and having Covid-19 explained associations between socioeconomics factors and food insecurity.

RESULTS

Single parents and young people aged 16-30 years had a higher odds of reporting both measures of food insecurity. Financial insecurity explained 5% to 25% of the likelihood of reporting being food insecure for young people and single parents depending on the food insecurity measure used. Experiencing Covid-19 symptoms explained less than 5% of the likelihood of being food insecure for single parents but approximately 30% of not having access to healthy and nutritious food for young people.

CONCLUSION

Policies providing additional financial support may help to reduce the impact of Covid-19 on food insecurity in the UK.

Depression and food insecurity among patients with rheumatoid arthritis in NHANES

Background

Social determinants of health (SDH), including food insecurity, are associated with depression in the general population. This study estimated the prevalence of depression and food insecurity and evaluated the impact of food insecurity and other SDH on depression in adults with rheumatoid arthritis (RA).

Methods

Adults (≥ 18 years) with RA were identified from the 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey (NHANES). Depression was defined as a score of ≥ 5 (mild depression: 5–9; moderate-to-severe depression: 10–27) using the Patient Health Questionnaire-9 (PHQ-9). Food insecurity was assessed with the 18-item US Household Food Security Survey Module. Adults with household-level marginal-to-very-low food security were classified as experiencing food insecurity. The prevalence of depression and food insecurity among participants with RA were estimated. Weighted logistic regression was used to evaluate the association between depression and participants’ characteristics including SDH. Penalized regression was performed to select variables included in the final multivariable logistic regression.

Results

A total of 251 and 276 participants from the 2013–2014 and the 2015–2016 NHANES, respectively, had self-reported RA. The prevalence of depression among these participants was 37.1% in 2013–2014 and 44.1% in 2015–2016. The prevalence of food insecurity was 33.1% in 2013–2014 and 43.0% in 2015–2016. Food insecurity was associated with higher odds of having depression (OR 2.17, 95% CI 1.27, 3.72), and the association varied by depression severity. Compared with participants with full food security, the odds of having depression was particularly pronounced for those with very low food security (OR 2.96, 95% CI 1.48, 5.90) but was not significantly different for those with marginal or low food security. In the multivariable regression, being female, having fair/poor health condition, any physical disability, and ≥ 4 physical limitations were significantly associated with depression.

Conclusions

In adults with self-reported RA, the prevalence of depression and food insecurity remained high from 2013 to 2016. We found that depression was associated with SDH such as food insecurity, although the association was not statistically significant once adjusted for behavioral/lifestyle characteristics. These results warrant further investigation into the relationship between depression and SDH among patients with RA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41927-021-00236-w.

Household food insecurity before and during the COVID-19 pandemic in Chile

Objectives

To compare food insecurity (FI) in Chile before and during the COVID-19 pandemic according to different household types and vulnerability indicators.

Study design

Longitudinal study based on two population-based surveys in Chile (CASEN 2017 and COVID 2020).

Methods

Descriptive analysis and multinomial regression models for FI through the Food Insecurity Experience Scale (FIES).

Results

FI levels increased significantly (P < 0.001) between 2017 (30%) and 2020 (49%). There was increased FI in all households, but especially in those with economically dependent persons (i.e. children, adolescents and older adults). Household vulnerability indicators showed a statistically significant relationship with FI both before and during the pandemic. The pandemic has resulted in new population groups experiencing FI.

Conclusions

The COVID-19 pandemic has led to a significant increase in FI, which has also been seen in new population groups.

Spatial analysis of food security in Iran: associated factors and governmental support policies

This study analyzes caloric intake in Iran as a proxy for food security to determine factors associated with caloric intake that could be impacted by policies. We modeled regional heterogeneity by analyzing a complete countrywide dataset disaggregated for rural intra-provincial areas using unique data from the Iranian Statistical Centre for 2007-2016. We applied logistic regression modeling and likelihood ratio tests to assess the association between socio-economic determinants and caloric intake among rural areas of all provinces. National policies (nation-wide food subsidies and a cash equivalent for food for each adult regardless of residence or income) had significant negative associations with caloric intake among all provinces. The detected spatial diversity suggests policies specific to each area could be more effective than a centralized national policy for food security. Rather than implementing one-size-fits-all policies, such as across-the-board cash food subsidies, the government should take a differential spatially targeted approach to directly support low-income households.

Sociodemographic Factors Associated with Adherence to Dietary Guidelines in Women with Gestational Diabetes: A Cohort Study

Dietary advice is the cornerstone of care for women with gestational diabetes mellitus (GDM). However, adherence to this advice is variable. We aimed to identify the proportion of women with GDM who adhere to the New Zealand nutrition guideline recommendations and assess the sociodemographic factors linked to dietary adherence. We assessed dietary intake at 36 weeks’ gestation in a cohort of 313 women with GDM and compared this with the dietary recommendations for the management of GDM. Associations between maternal characteristics and dietary adherence were assessed using ANOVA, chi square, logistic regression, and linear regression tests. Women with GDM had an average adherence score of 6.17 out of 10 to dietary recommendations, but no one adhered to all the recommendations. Adherence to recommendations was lowest for saturated fat, and wholegrain breads and cereals. While 85% visited a dietitian, only 28% of women achieved their recommended weight gain. Maternal factors associated with lower dietary adherence were primiparity, no previous history of GDM, being underweight, and smoking. Adherence to the dietary recommendations by women with GDM in New Zealand for the management could be improved. Further research is needed to identify ways for women with GDM to improve their dietary adherence.

Snacking patterns throughout the life span: potential implications on health

Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.

Examining Factors Related to the Food Insecurity-Obesity Paradox in Low-Income Mothers and Fathers

BACKGROUND

Prior research has indicated a varying relationship of food security and obesity risk between men and women yet factors affecting this relationship are unclear.

OBJECTIVE

The objective of this study was to examine factors related to the gender disparity in the food insecurity-obesity paradox within a sample of low-income parents.

METHODS

Low-income cohabiting mother and father pairs (n = 25) living with their child were interviewed individually using the United States Department of Agriculture Household Food Security Module, Center for Epidemiological Studies Depression Scale, and Coping Strategies Index to examine gendered factors related to the food insecurity-obesity paradox.

RESULTS

There was a significant (P = .003) difference in report of adults in the household sacrificing consumption to feed young children between mothers (2.91 ± 0.92) and fathers (3.59 ± 0.73), with mothers reporting greater sacrifice and compromised diet quality to feed their children, but no significant correlation among body mass index, depression, and food insecurity was detected.

CONCLUSIONS

Food insecure mothers may be more likely to compromise their diet quality to feed their children than fathers. This could help explain why the food insecurity-obesity paradox is significant only in women, and this work gives insights into gender-based differential consequences of food insecurity.

Stunting at birth and associated factors among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital

Background

Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from February 26^th to April 25^th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association.

Results

About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted.

Conclusion

Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.

A qualitative investigation of body weight and weight loss-related attitudes of mothers and fathers in the context of food insecurity

PURPOSE

To examine attitudes about body weight and weight loss among low-income parents of young children experiencing household food insecurity.

METHODS

One-on-one interviews were conducted with 25 dyads of cohabitating low-income mothers and fathers who lived with their child aged 2.5-10 years old. Basic inductive analysis was conducted using NVivo to identify emerging themes related to body weight.

RESULTS

Three main themes emerged including (1) weight loss as a "Blessing in Disguise," (2) trouble with losing weight, and (3) the impact of compromised diet quality. Some differences existed in themes between mothers and fathers, but both placed value on weight loss resulting from food insecurity.

CONCLUSION

This research underscores the importance of sufficient nutrition assistance for limited resource families. A lack of money for food was a barrier towards maintaining a healthy weight but the value our culture places on weight loss even in times of despair was undeniably present.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Food Insecurity in Europe: A Gender Perspective

Food insecurity is the limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire foods in socially acceptable ways. The study presents a comparison of the principal determinants of individual food insecurity in Europe and other Continents, with particular regard to gender, since the literature clearly states the importance of women in the administration of food in the household. The study of gender related differences in food insecurity is particularly important in Europe, since women experience food insecurity at a larger extent than men, but with a variability related to the geographical distribution and with complex relationships with economic and social drivers. Using a large international sample of individual level data, that allows the analysis for developed Countries for the first time, and the first experiential measure of food insecurity comparable at the global level, the paper analyses the principal determinants of gender differences in food insecurity. In order to verify if women's vulnerability in food insecurity is moderated by specific factors, the modelling approach allows gender to vary by education, poverty, place of residence. The results suggest that the driver that could most mitigate women disadvantage is education: people with a university degree present a lower probability of experiencing food insecurity, both for men and for women. On the contrary, familial characteristics, such as the number of children in the household, present a higher impact on women's food insecurity than on men's.

Sociodemographic factors associated with food insecurity: data from the 2003-2014 New South Wales Population Health Survey

OBJECTIVE

To determine the prevalence and sociodemographic factors associated with food insecurity in the state of New South Wales (NSW), Australia.

DESIGN

Cross-sectional analysis of food insecurity data collected by the NSW Population Health Survey between 2003 and 2014. Multiple logistic regression was used to examine associations with key sociodemographic variables.

SETTING

NSW, Australia.

PARTICIPANTS

212 608 survey participants responded to the food insecurity survey question between 2003 and 2014. 150 767 of them were aged ≥16 years. The survey sample was randomly selected and weighted to be representative of the NSW population.

RESULTS

On average 6 % of adults aged ≥16 years experienced food insecurity in NSW. The odds of food insecurity appeared to increase from one survey year to the next by a factor of 1·05. Food insecurity was found to be independently associated with age, sex, marital status, household size, education, employment status, household income, smoking status, alcohol intake and self-rated health. The association with income, smoking status and self-rated health appeared to be the strongest among all covariates and showed a gradient effect. Food insecurity appeared to increase significantly between the age of 16 and 19 years.

CONCLUSIONS

The prevalence of food insecurity appears to be rising over time. Given the negative health consequences of food insecurity, more rigorous measurement and monitoring of food insecurity in NSW and nationally is strongly recommended. The findings provide support for interventions targeting low-income and younger population groups.

Association between unemployment and the co-occurrence and clustering of common risky health behaviors: Findings from the Constances cohort

Background

Unemployment is associated with a high prevalence of risky health behaviors. Mortality increases with the number of co-occurring risky behaviors but whether these behaviors co-occur with a greater than expected frequency (clustering) among unemployed people is not known.

Methods

Differences according to unemployment status in co-occurrence and clustering of smoking, alcohol abuse, low leisure-time physical activity and unhealthy diet (marked by low fruit and vegetable intake) were assessed in 65,630 salaried workers, aged 18 to 65, who were participants in Constances, a French population-based cohort. Among them, 4573 (7.0%) were unemployed without (n = 3160, 4.8%) or with (n = 1413, 2.1%) past experience of unemployment.

Results

Compared to the employed, unemployed participants without or with past experience of unemployment were similarly overexposed to each risky behavior (sex and age adjusted odds-ratios ranging from 1.38 to 2.19) except for low physical activity, resulting in higher rates of co-occurrence of two, three and four behaviors (relative risk ratios, RRR 1.20 to 3.74). Association between behavior co-occurrence and unemployment did not vary across gender, partnership status or income category. Risky behavior clustering, i.e., higher than expected co-occurrence rates based on the prevalence of each behavior, was similar across unemployment status. The same observations can be made in employed participants with past experience of unemployment, although overexposure to risky behaviors (ORs 1.15 to 1.38) and increased rates of co-occurrence (ORs 1.19 to 1.58) were not as pronounced as in the unemployed.

Conclusions

Co-occurrence of risky behaviors in currently and/or formerly unemployed workers is not worsened by behavior clustering. Engagement in each of these behaviors should be considered an engagement in distinct social practices, with consequences for preventive policies.

Prevalence and associated factors for rural households food insecurity in selected districts of east Gojjam zone, northern Ethiopia: cross-sectional study

Background

Food insecurity is a pressing social and public health issue that varies in degree and impact on individuals and social groups, requiring immediate attention for policymakers and decision-makers. This study was conducted to identify the prevalence and associated factors of food insecurity of rural households particularly in the Shebel Berenta and Machakel districts of East Gojjam zone.

Methods

A cross-sectional study design was conducted, in the fall of March 2017 among 504 households. Households are selected using a systematic sampling technique through multistage cluster sampling technique (two stage cluster sampling). The data were collected using a structured interviewer-administered questionnaire covering a range of topics including 18 core food security modules (CFSM) question series, socioeconomic, demographic and related variables. Multivariable Partial proportional odds model (PPOM) was employed to identify the factors associated with food insecurity in rural households.

Result

Of a total of 504 households considered in the study, 54 (10.71%) were highly food secure, 75 (14.88%) were marginally food secure, 157 (31.15%) were low food secure, and 218 (43.25%) were severely food insecure. District (Machakel) (AOR = 3.28 95% CI: 1.73, 6.24), household head education status, illiterate (AOR = 113.4, 95% CI:7.02,1832.02), read and write (AOR = 169.29, 95%CI:11.64, 2461.39), and elementary completed (AOR = 119.75,95%CI:8.43,1700.74), agro-ecological zone, Woina Dega (AOR = 0.0021,95% CI: 0.00009,0.0514), Dega (AOR = 0.0323, 95%CI: 0.002, 0.5209), family size (AOR = 1.18, 95%CI: 1.01, 1.36), landholding (AOR = 0.767, 95% CI: 0.605, 0.972), TLU (AOR = 0.151, 95% CI: 0.0716, 0.3189), access to toilet (no) (AOR = 7.63, 95% CI: 1.459, 39.78), practicing irrigation (yes) (AOR = 0.121, 95% CI: 0.037, 0.38), loan (no) (AOR = 2.83, 95% CI:1.36, 5.89), access to energy, government electric (AOR = 0.468, 95% CI: 0.23, 0.94), solar panels (AOR = 0.45, 95% CI: 0.25, 0.79), soil fertility, moderate (AOR = 0.28, 95% CI: 0.12, 0.87), fertile (AOR = 0.15, 95% CI: 0.032, 0.72) were significant associated food insecurity factors in the study area.

Conclusion

In this study, a high prevalence of food insecurity and various associated food insecurity factors have been identified in the study area. Thus, the concerned stockholders should intervene in food insecure households via different irrigation practices and by considering household size, community-based household head education, and landholding in hectare.

Food Insecurity and Socioeconomic Disadvantage in Australia

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.

Homeownership status and risk of food insecurity: examining the role of housing debt, housing expenditure and housing asset using a cross-sectional population-based survey of Canadian households

BACKGROUND

Household food insecurity is a potent marker of material deprivation with adverse health consequences. Studies have repeatedly found a strong, independent relationship between owning a home and lower vulnerability to food insecurity in Canada and elsewhere, but the reasons for this relationship are poorly understood. We aimed to examine the influence of housing asset, housing debt and housing expenditure on the relationship between homeownership status and food insecurity in Canada.

METHODS

Cross-sectional data on food insecurity, housing tenure and expenditures, home value, income and sociodemographic characteristics were derived from the 2010 Survey of Household Spending, a population-based survey. Multivariable logistic regression models were conducted to estimate odds ratios of food insecurity among households of all incomes (n = 10,815) and those with lower incomes (n = 5547).

RESULTS

Food insecurity prevalence was highest among market renters (28.5%), followed by homeowners with a mortgage (11.6%) and mortgage-free homeowners (4.3%). Homeowners with a mortgage (OR: 0.51, 95% CI: 0.39-0.68) and those without a mortgage (OR: 0.23, 95% CI: 0.16-0.35) had substantially lower adjusted odds of food insecurity than market renters, and accounting for the burden of housing cost had minimal impact on the association. Mortgage-free homeowners had lower adjusted odds ratios of food insecurity compared to homeowners with a mortgage, but differences in the burden of housing cost fully accounted for the association. When stratifying homeowners based on presence of mortgage and housing asset level, the adjusted odds ratios of food insecurity for market renters were not significant when compared to mortgage holders with low housing asset. Mortgage-free owners with higher housing asset were least vulnerable to food insecurity (adjusted OR: 0.18, 95% CI: 0.11-0.27).

CONCLUSIONS

Substantial disparities in food insecurity exist between households with different homeownership status and housing asset level. Housing policies that support homeownership while ensuring affordable mortgages may be important to mitigate food insecurity, but policy actions are required to address renters' high vulnerability to food insecurity.

Food Insecurity in Portugal Among Middle- and Older-Aged Adults at a Time of Economic Crisis Recovery: Prevalence and Determinants

BACKGROUND

To characterize the scenario of food insecurity in Portugal at a time of economic crisis recovery is of the utmost relevance.

OBJECTIVE

This study aimed to estimate the prevalence and to identify the determinants of food insecurity during economic crisis recovery in a population-based urban sample of middle- and older-aged Portuguese adults.

METHODS

A cross-sectional study including 604 participants of the EPIPorto cohort was conducted. Data on sociodemographic characteristics and on food security status were collected. Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Logistic regression models, crude and adjusted for sex, age, education, and household income perception, were performed.

RESULTS

The prevalence of food insecurity was 16.6%. Women (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 1.09-3.54), those less educated (OR = 5.46; 95% CI: 2.84-10.46), and those who had the perception of an insufficient household income (OR = 10.39; 95% CI: 5.00-21.56) were more likely to belong to a food insecure household. Unmarried individuals (OR = 1.79; 95% CI: 1.05-3.06) and lower white-collar workers (OR = 2.22; 95% CI: 1.03-4.77) were also more prone to live within a food insecure household, regardless of sex, age, education, and household income perception.

CONCLUSIONS

The obtained information is valuable for the development of intervention strategies to reduce food insecurity in middle- and older-aged adults, suggesting that women, unmarried, less educated individuals, less skilled workers, and lower income families should be targeted.

Household food insecurity and socio-demographic determinants in young adults: findings from a Portuguese population-based sample

OBJECTIVES

This study evaluated the prevalence and the socio-demographic determinants of food insecurity among young adults at a time of economic crisis recovery.

METHODS

A cross-sectional study including 954 young adults (26 years old) from the EPITeen cohort (Porto, Portugal) was conducted. Food security status was evaluated using the US Household Food Security Survey Module: Six-Item Short Form. Associations between socio-demographic characteristics (sex, education, occupation, household size and structure and household income perception) and food insecurity were estimated using logistic regression.

RESULTS

At a time of economic crisis recovery, 11.0% of young adults experienced food insecurity. A higher odds of belonging to a food insecure household was observed in participants reporting an insufficient household income (OR = 23.3; 95% CI 11.3-47.8), those with less education (OR = 1.7; 95% CI 1.0-2.8), lower white-collar workers (OR = 2.3; 95% CI 1.2-4.2) and those living within a nuclear family including a partner and/or children (OR = 2.0; 95% CI 1.1-3.7).

CONCLUSIONS

Our findings support the need for interventions targeting those from lower income, from nuclear families of young adults with a partner and/or descendants, less educated and with non-manual unskilled occupations, to reduce food insecurity, particularly in economic vulnerable settings.

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.

Infant Food Security in New Zealand: A Multidimensional Index Developed from Cohort Data

Food security (FS) during infancy is associated with lifelong outcomes. New Zealand is a developed economy that reports poor childhood nutrition-related health statistics, particularly among minority children, yet has no measure of FS applicable to infancy. The objective was to develop an FS index for New Zealand infants and examine its association with demographic covariates and health outcomes. Within a large (n = 6853) nationally representative cohort, variables describing infant food consumption, breastfeeding, and maternal food-related coping methods were collected from mothers during late infancy. An FS index was derived using confirmatory factor analysis. Associations were assessed by logistic regressions and described using odds ratios (OR) and ≥95% confidence intervals (CI). Fifteen percent of the cohort was highly FS, 43% tenuously food insecure (FIS), and 16% highly food insecure (FIS). Infants from minority ethnic groups had lower odds of being food secure, as did those born to the youngest mothers, mothers who smoked, or those who lived in low-income households. FIS infants had higher odds of morbidity. Interventions to improve infant FS should focus on improving dietary quality, and should give particular consideration to minority infants. We identified that FIS shows wide ethnic and socioeconomic inequity, and is associated with poorer health. The most important driving factors of FIS included poor quality weaning diets, as well as poverty and its proxies. Any interventions to improve infant FS should focus on increasing fruit and vegetable consumption to recommended intake levels, and should give particular consideration to minority infants.

What can Secondary Data Tell Us about Household Food Insecurity in a High-Income Country Context?

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007–2012) was conducted to calculate weekly food expenditure and its ratio to equivalised income for households below average income (HBAI) and above average income (non-HBAI). Diet Quality Index (DQI) scores were calculated for this survey and the Scottish Health Survey (SHeS, 2008 and 2012). Secondary data provided a partial picture of food insecurity prevalence in Scotland, and a limited picture of differences in diet quality. In 2012, HBAI spent significantly less in absolute terms per week on food and non-alcoholic drinks (£53.85) compared to non-HBAI (£86.73), but proportionately more of their income (29% and 15% respectively). Poorer households were less likely to achieve recommended fruit and vegetable intakes than were more affluent households. The mean DQI score (SHeS data) of HBAI fell between 2008 and 2012, and was significantly lower than the mean score for non-HBAI in 2012. Secondary data are insufficient to generate the robust and comprehensive picture needed to monitor the incidence and prevalence of food insecurity in Scotland.

Exploration of Māori household experiences of food insecurity

AIM

Researchers explored how food insecurity was experienced in Māori households and how this can affect hauora (well-being).

METHODS

This Māori-centred research was conducted in New Zealand by Māori dietetic students with Māori supervision. Kaupapa Māori methodology guided the inductive thematic analysis of observational and discussion data (40+ hours per household) from four Māori households (18 individuals) that participated in a 3-month ethnographic-style investigation in 2011.

RESULTS

Four themes were identified. 'Overcoming socioeconomic hardship' was most clearly observed within the low-income whānau (family), however, all whānau had experienced food insecurity. This experience had short- and long-term impacts on well-being. Other themes identified strategies whānau developed to reduce the severity of food insecurity: sharing food, gardening food, and teaching food and nutrition skills. Selected text for themes revealed expressed Māori values and/or hauora influences. The values of manaakitanga (sharing food/hospitality), whānaungatanga (family relationships) and kaitiakitanga (caring for the environment) were observed and analysed deductively.

CONCLUSIONS

All households had experienced income-related food insecurity, and its short- and long-term impacts on well-being were observed. Whānau had developed many strategies to reduce the severity of food insecurity, relying on support from extended whānau and the wider community, but households remained food insecure. Health and other professionals should advocate for social justice and policy solutions that change systems perpetuating social and health inequity. All households need sufficient income to afford basic needs including food. When basic needs are met, households and individuals can thrive and make meaningful contributions to society.

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.

What Drives Food Insecurity in Western Australia? How the Perceptions of People at Risk Differ to Those of Stakeholders

Food insecurity is considered a “wicked” problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who are actually experiencing the problem. The purpose of this study was to investigate whether there was a difference between the opinions of those “at risk” and stakeholders. A total of seven focus groups (two stakeholder groups n = 10, five “at-risk” groups n = 34) and three interviews (stakeholders n = 3) were conducted to ascertain perceptions. Thematic analysis generated 329 (209 “at-risk” and 120 stakeholder) coded statements related to food insecurity drivers. Respondents were in agreement for the majority of factors, and limited income was considered the primary driver of food insecurity. However, there were notable deviations in the perceived importance of certain drivers, particularly around the price of food and the lack of food literacy. Differences in the perception of causes of food insecurity may in part be attributed to the varied role each group plays in working towards the resolution of the problem, either at the household or system level.

Household Food Insecurity and Mental Health Among Teenage Girls Living in Urban Slums in Varanasi, India: A Cross-Sectional Study

This study was undertaken to investigate the relation between household food insecurity and mental health problems in teenage girls living in urban slums. This community-based cross-sectional study was conducted in 5 urban slums in Varanasi, India, between September 2016 and July 2017. A probability proportion to size (PPS) method was employed to select 5 of 210 urban slums at a first stage, and in the second stage, 418 teenage girls were chosen randomly from selected households. The Household Food Insecurity Access Scale (HFIAS) and mental health inventory tools were employed to assess food insecurity and mental health status. Multivariable logistic regression analysis with at a 95% confidence interval (CI) was used to assess the association between household food insecurity and mental health status. Of 418 respondents, 47.6% were food insecure; 64.1%, 57.7%, and 58.4% had high levels of anxiety, depression, or psychological distress, respectively; and 57.2% exhibited a medium level of loss of behavioral control. Furthermore, teenage girls from food insecure households were more likely to have high levels of anxiety, depression, loss of behavioral control and psychological distress than those living in food secure households. This study shows food insecurity is independently associated with mental health problems among teenage girls. Food insecurity in Indian slums should be addressed by specific public health intervention programs that provide access to sufficient safe, nutritious food.

Drivers of Food Security of Vulnerable Rural Households in Bangladesh

Despite improvements in food production, many rural households in Bangladesh are still food insecure, and this requires urgent policy intervention if the situation is to improve. This article examines the factors influencing food security of vulnerable rural riverine households in Bangladesh. The results reveal that riverine households’ lack of access to many basic necessities and services, such as food, safe drinking water, education and health, results in increased vulnerability to food insecurity which could lead to an unfortunate vicious cycle of poverty. Model results indicate that household heads’ education, household size, adoption of livestock and access to non-farm earnings also affect food security. More importantly, evidence suggests that access to improved health care also needs policy support in parallel with improved access to food to achieve and sustain long-term food security in Bangladesh.

JEL: D130, E230, Q540, Q180

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

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

Household Food Insecurity in Southeastern Iran: Severity and Related Factors

Background

Today, more than one billion people globally suffer from poverty and food insecurity. This study aimed to determine the severity of and factors related to household food insecurity in Zahedan, Southeastern Iran.

Methods

This cross-sectional study was conducted on a total of 2,160 households between November 2014 and December 2015. Demographic and socioeconomic data were collected through interviewing the household mothers. Household food security status was assessed through the USDA 18-item questionnaire. The data were analyzed using chi-square test, one-way ANOVA, and logistic regression model.

Results

Total food insecurity in the households investigated was 58.8%. There were significant associations (P < 0.001) between household food insecurity status and the socioeconomic status of the households, ethnicity, education, age, and employment status of the head of the household and the mother of the household.

Discussion

The results showed that more than half of the households examined suffer from food insecurity. Interventions to improve the food security status of people should be designed and implemented to improve people's knowledge, skills, and attitudes related to healthy eating and food preparation. People's access to healthy foods and knowledge of how to select healthy foods (especially on a limited budget) should also be improved.

Influence of sociodemographic characteristics on different dimensions of household food insecurity in Montevideo, Uruguay

Objective

To determine the factor structure of the Latin American & Caribbean Household Food Security Scale (ELCSA) and to study the influence of sociodemographic characteristics on each of the identified dimensions in Montevideo, Uruguay.

Design

Cross-sectional survey with a representative sample of urban households. Household food insecurity was measured using the ELCSA. The percentage of respondents who gave affirmative responses for each of the items of the ELCSA was determined. Exploratory factor analysis was carried out to determine the ELCSA’s factor structure. A probit model was used to determine the impact of some individual and household sociodemographic characteristics on the identified dimensions of food insecurity.

Setting

Metropolitan area centred on Montevideo, the capital city of Uruguay, April–September 2014.

Subjects

Adults aged between 18 and 93 years (n 742).

Results

The percentage of affirmative responses to the items of the ELCSA ranged from 4·4 to 31·7 %. Two factors were identified in the exploratory factor analysis performed on data from households without children under 18 years old, whereas three factors were identified for households with children. The identified factors were associated with different severity levels of food insecurity. Likelihood of experiencing different levels of food insecurity was affected by individual characteristics of the respondent as well as characteristics of the household.

Conclusions

The influence of sociodemographic variables varied among the ELCSA dimensions. Household income had the largest influence on all dimensions, which indicates a strong relationship between income and food insecurity.

Recent changes in sociodemographic characteristics, dietary behaviors and clinical parameters of adults receiving food assistance in France

Background

In 2004–2005, a survey carried out on food recipients in France revealed an alarming nutritional situation. In 2011–2012, and using a protocol similar to that of 2004–2005, our objective was to update the description of sociodemographic characteristics, dietary behaviors and clinical parameters of food assistance recipients and to analyze changes since 2004–2005.

Methods

Both surveys included multistage random sampling of adults benefitting from structures that supply food pantries and charitable grocery stores. Data on sociodemographic characteristics and dietary behaviors were collected along with weight, height and blood pressure measurements. Comparisons between the 2004–2005 (n = 883) and 2011–2012 (n = 1,058) survey observations were made, adjusting for socio-demographic changes which had occurred in the meantime.

Results

Since 2004–2005, proportions of food recipients ≥55 years (13.1–19.1 %), born in France (29.2–36.8 %) and employed (5.5–11.7 %) have increased; food insufficiency has decreased (95–74 %). For over half of the recipients, canned (52.4 %) and non-perishable (50.9 %) foods were obtained only from food assistance. Frequency of consumption significantly increased even after adjustment for socio-demographic changes; this was the case for dairy products (for twice a day consumption, 30.2–36.4 %), fruits and vegetables (three times a day, 7.8–13.9 %), and meat, eggs and fish (twice a day, 9.4–19.2 %). In 2011–2012, 15.6 % of men and 36.0 % of women were obese, while 44.5 and 35.1 % had high blood pressure, respectively.

Conclusions

Between 2004–2005 and 2011–2012 in France, consumption of staple foods has been slightly improved in food assistance recipients. However, prevalence of cardiovascular risk factors remains high, which underlines the need for long-term efforts at better quality of foods delivered.

Level and determinants of food insecurity in East and West Gojjam zones of Amhara Region, Ethiopia: a community based comparative cross-sectional study

Background

Food insecurity remains highly prevalent in developing countries and over the past two decades it has increasingly been recognized as a serious public health problem, including in Ethiopia. An emerging body of literature links food insecurity to a range of negative health outcomes and causes of a decline in productivity. The objectives of the present study were to determine the level of food insecurity in East Gojjam zone where the productive safety net program is available, and in West Gojjam zone where there is no program, and to identify the determinants of food insecurity in both East and West Gojjam zones of Amhara Region, Ethiopia.

Methods

Community based comparative cross-sectional study design was used from 24 May 2013- 20 July 2013. Multistage sampling technique was implemented. A total of 4110 randomly selected households in two distinct populations were approached to be included in the study. Availability and absence of the productive safety net program between the two study areas was used to categorize them as comparative groups; otherwise the two communities are comparable in many socio-cultural characteristics. The household food security access scale questionnaire, developed by the Food and Nutrition Technical Assistant Project, was used to measure food security level. Socio-demographic and other household level information were collected by using a structured questionnaire. The binary logistic regression model was used to assess factors associated with food insecurity.

Results

From the total 4110 households, 3964 (96.45 %) gave complete responses. The total prevalence of food insecurity was 55.3 % (95 % CI: 53.8, 56.8). To compare food insecurity levels between the two zones, nearly sixty percent, 59.2 % (95 % CI: 57 %, 61.4 %) of the East Gojjam and 51.3 % (95 % CI: 49.1 %, 53.5) of West Gojjam households were food insecure.

Family size (2–4) (AOR = 0.641, 95 % CI: 0.513, 0.801), non-merchant women (AOR = 1.638, 95 % CI: 1.015, 2.643), household monthly income quartiles, 1^st (AOR = 2.756, 95 % CI: 1.902, 3.993), and 2^nd (AOR =1.897, 95 % CI: 1.299, 2.775) were the significant socio-demographic determinants in east Gojjam zone. Illiterate mothers (AOR = 1.388, 95 % CI: 1.011, 1.905), household monthly income quartiles, 1^st (AOR = 3.110232, 95 % CI: 2.366, 4.415), 2^nd (AOR =2.618, 95 % CI: 1.892, 3.622) and 3^rd (AOR = 2.177, 95 % CI: 1.6911, 2.803) were the significant socio-demographic predictors in west Gojjam zone.

Rural residential area (AOR = 3.201, 95 % CI: 1.832, 5.594) and (AOR = 2.425, 95 % CI: 1.79, 3.272), highland agro-ecology (AOR = 2.193, 95 % CI: 1.348, 3.569 and AOR = 3.669, 95 % CI: 2.442, 5.513) and lack of livestock (AOR = 1.553, 95 % CI: 1.160, 2.078 and AOR = 1.568 95 % CI: 1.183, 2.080) were significant environmental predictors in east and west Gojjam zones respectively.

Conclusion

Food insecurity is highly prevalent in both study areas; however, there are different predictor factors. Intervention strategies should give emphasis to women’s education, diversified income generating opportunities, and for each agro-ecological zone, mixed agriculture strategy.

Low maternal education and socio-economic status were associated with household food insecurity in children under five with diarrhoea in Bangladesh

AIM

Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods to meet the dietary needs for an active and healthy life. We examined the prevalence and determinants of HFI in Bangladeshi children under five with diarrhoea.

METHODS

This study included 365 children (55% boys) who had diarrhoea in the two weeks before the 2011 Bangladesh Demographic Health Survey (BDHS-2011). The Household Food Insecurity Access Scale (HFIAS) was used to assess HFI and Pearson's chi-square test and binary logistic regression analysis were used to investigate the association between HFI and multilevel factors.

RESULTS

The prevalence of HFI among children under five with diarrhoea in the two weeks prior to the BDHS-2011 survey was 48%. HFI was significantly higher among the children of uneducated mothers, who were two times more likely to experience HFI, with an adjusted odds ratio (OR) of 2.14 and children who were from the lowest socio-economic status families, who were more than seven times more likely to experience HFI, with an adjusted OR of 7.55.

CONCLUSION

Low maternal education and low socio-economic status were significantly associated with HFI in Bangladeshi children under five with diarrhoea and public health campaigns should take this into account.

Household food insecurity and mental distress among pregnant women in Southwestern Ethiopia: a cross sectional study design

Background

There are compelling theoretical and empirical reasons that link household food insecurity to mental distress in the setting where both problems are common. However, little is known about their association during pregnancy in Ethiopia.

Methods

A cross-sectional study was conducted to examine the association of household food insecurity with mental distress during pregnancy. Six hundred and forty-two pregnant women were recruited from 11 health centers and one hospital. Probability proportional to size (PPS) and consecutive sampling techniques were employed to recruit study subjects until the desired sample size was obtained. The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress and a 9-item Household Food Insecurity Access Scale was used to measure food security status. Descriptive and inferential statistics were computed accordingly. Multivariate logistic regression was used to estimate the effect of food insecurity on mental distress.

Results

Fifty eight of the respondents (9 %) were moderately food insecure and 144 of the respondents (22.4 %) had mental distress. Food insecurity was also associated with mental distress. Pregnant women living in food insecure households were 4 times more likely to have mental distress than their counterparts (COR = 3.77, 95 % CI: 2.17, 6.55). After controlling for confounders, a multivariate logistic regression model supported a link between food insecurity and mental distress (AOR = 4.15, 95 % CI: 1.67, 10.32).

Conclusion

The study found a significant association between food insecurity and mental distress. However, the mechanism by which food insecurity is associated with mental distress is not clear. Further investigation is therefore needed to understand either how food insecurity during pregnancy leads to mental distress or weather mental distress is a contributing factor in the development of food insecurity.

Household food insecurity is associated with less physical activity among children and adults in the U.S. population

BACKGROUND

Household food insecurity and physical activity are each important public-health concerns in the United States, but the relation between them has not been investigated thoroughly.

OBJECTIVE

This study aimed to examine the association between food insecurity and physical activity in the U.S. population.

METHODS

Physical activity measured by accelerometry (PAM) and physical activity measured by questionnaire (PAQ) data from the NHANES 2003-2006 were used. Individuals aged <6 y or >65 y, pregnant women, individuals with physical limitations, and individuals with family income >350% of the poverty line were excluded. Food insecurity was measured by the USDA Household Food Security Survey Module. Adjusted ORs were calculated from logistic regression to identify the association between food insecurity and adherence to the physical-activity guidelines. Adjusted coefficients were obtained from linear regression to identify the association between food insecurity with sedentary/physical-activity minutes.

RESULTS

In children, food insecurity was not associated with adherence to physical-activity guidelines measured via PAM or PAQ and with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity than food-secure children (adjusted coefficient = -5.24, P = 0.02). In adults, food insecurity was significantly associated with adherence to physical-activity guidelines (adjusted OR = 0.72, P = 0.03 for PAM; and OR = 0.84, P < 0.01 for PAQ) but was not associated with sedentary minutes (P > 0.05).

CONCLUSIONS

Food-insecure children did less moderate to vigorous physical activity, and food-insecure adults were less likely to adhere to the physical-activity guidelines than those without food insecurity.

Social determinants and lifestyle risk factors only partially explain the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in the Australian state of Victoria: a cross-sectional study

BACKGROUND

The prevalence of food insecurity is substantially higher among Australians of Aboriginal or Torres Strait Islander descent. The purpose of this study is to explain the relationship between food insecurity and Aboriginal and Torres Islander status in the state of Victoria.

METHODS

Data were obtained from the 2008 Victorian Population Health Survey; a cross-sectional landline computer-assisted telephone interview survey of 34,168 randomly selected Victorians aged 18 years and older; including 339 Aboriginal and Torres Strait Islanders. We categorised a respondent as food insecure, if in the previous 12 months, they reported having run out of food and not being able to afford to buy more. We used multivariable logistic regression to adjust for age, sex, socioeconomic status (household income), lifestyle risk factors (smoking, alcohol consumption and obesity), social support (ability to get help from family, friends or neighbours), household composition (lone parent status, household with a child, and household size), and geographic location (rurality).

RESULTS

Aboriginal and Torres Strait Islanders (20.3%) were more likely than their non-Aboriginal and Torres Strait Islander counterparts (5.4%) to have experienced food insecurity; odds ratio (OR) = 4.5 (95% CI; 2.7-7.4). Controlling for age, SES, smoking, obesity and inability to get help from family or friends reduced the odds ratio by 38%; OR(adjusted) = 2.8 (1.6-5.0).

CONCLUSIONS

Social determinants and lifestyle risk factors only partially explained the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in Victoria. Further research is needed to explain the disparity in food insecurity between the two populations in order to inform and guide corrective action.

Social determinants and lifestyle risk factors only partially explain the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in the Australian state of Victoria: a cross-sectional study

Background

The prevalence of food insecurity is substantially higher among Australians of Aboriginal or Torres Strait Islander descent. The purpose of this study is to explain the relationship between food insecurity and Aboriginal and Torres Islander status in the state of Victoria.

Methods

Data were obtained from the 2008 Victorian Population Health Survey; a cross-sectional landline computer-assisted telephone interview survey of 34,168 randomly selected Victorians aged 18 years and older; including 339 Aboriginal and Torres Strait Islanders. We categorised a respondent as food insecure, if in the previous 12 months, they reported having run out of food and not being able to afford to buy more. We used multivariable logistic regression to adjust for age, sex, socioeconomic status (household income), lifestyle risk factors (smoking, alcohol consumption and obesity), social support (ability to get help from family, friends or neighbours), household composition (lone parent status, household with a child, and household size), and geographic location (rurality).

Results

Aboriginal and Torres Strait Islanders (20.3%) were more likely than their non-Aboriginal and Torres Strait Islander counterparts (5.4%) to have experienced food insecurity; odds ratio (OR) = 4.5 (95% CI; 2.7-7.4). Controlling for age, SES, smoking, obesity and inability to get help from family or friends reduced the odds ratio by 38%; OR_adjusted = 2.8 (1.6-5.0).

Conclusions

Social determinants and lifestyle risk factors only partially explained the higher prevalence of food insecurity among Aboriginal and Torres Strait Islanders in Victoria. Further research is needed to explain the disparity in food insecurity between the two populations in order to inform and guide corrective action.

Food insecurity among Dutch food bank recipients: a cross-sectional study

OBJECTIVE

To determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security.

SETTING

11 of 135 Dutch food banks were selected throughout the Netherlands.

PARTICIPANTS

251 Dutch food bank recipients participated in the study (93 men and 158 women). Inclusion criteria for participation were: (1) at least 18 years of age, (2) sufficiently fluent in Dutch to participate in oral and written interviews, (3) recipient of a Dutch food bank for at least 1 month and (4) collect own food parcel at the food bank. A single member per household was included.

PRIMARY OUTCOME

Level of food security.

RESULTS

The prevalence of food insecurity was 72.9% (N=183), of which 40.4% (N=74) reported very low food security. Of the very low food secure participants, 56.8% (N=42) reported they were ever hungry but did not eat because they could not afford enough food in the previous 3 months. Adjusted multinomial logistic regression analyses showed that households without children were less likely to experience low food security (OR 0.39 (95% CI 0.18 to 0.88)) and men (OR 0.24 (95% CI 0.11 to 0.51)) were less likely to experience very low food security, while low-educated recipients (OR 5.05 (95% CI 1.37 to 18.61)) were more likely to experience very low food security. Furthermore, recipients with high satisfaction with overall food intake (OR 0.46 (95% CI 0.27 to 0.78)), high perceived healthiness of overall food intake (OR 0.34 (95% CI 0.19 to 0.62)) or high self-efficacy of eating healthy (OR 0.62 (95% CI 0.40 to 0.96)) were less likely to experience very low food security.

CONCLUSIONS

Our study showed high prevalence rates of food insecurity among Dutch food bank recipients, and identified subgroups at increased risk of food insecurity. More research is urgently needed on the underlying determinants of food insecurity and the effectiveness of food assistance by food banks.

Optimising locational access of deprived populations to farmers' markets at a national scale: one route to improved fruit and vegetable consumption?

Background. Evidence suggests that improved locational access to farmers’ markets increases fruit and vegetable (FV) consumption, particularly for low-income groups. Therefore, we modelled potential alternative distributions of farmers’ markets in one country (New Zealand) to explore the potential impact for deprived populations and an indigenous population (Māori).

Methods. Data were collected on current farmers’ markets (n = 48), population distributions, area deprivation, and roads. Geographic analyses were performed to optimize market locations for the most deprived populations.

Results. We found that, currently, farmers’ markets provided fairly poor access for the total population: 7% within 12.5 km (15 min driving time); 5% within 5 km; and 3% within 2 km. Modelling the optimal distribution of the 48 markets substantially improved access for the most deprived groups: 9% (vs 2% currently) within 12.5 km; 5% (vs 1%) within 5 km; and 3% (vs 1%) within 2 km. Access for Māori also improved: 22% (vs 7%) within 12.5 km; 12% (vs 4%) within 5 km; and 6% (vs 2%) within 2 km. Smaller pro-equity results arose from optimising the locations of the 18 least pro-equity markets or adding 10 new markets.

Conclusion. These results highlight the potential for improving farmers’ market locations to increase accessibility for groups with low FV consumption. Given that such markets are easily established and relocated, local governments could consider these results to inform decisions, including subsidies for using government land and facilities. Such results can also inform central governments planning around voucher schemes for such markets and exempting them from taxes (e.g., VAT/GST).

Foods and dietary patterns that are healthy, low-cost, and environmentally sustainable: a case study of optimization modeling for New Zealand

OBJECTIVE

Global health challenges include non-communicable disease burdens, ensuring food security in the context of rising food prices, and environmental constraints around food production, e.g., greenhouse gas [GHG] emissions. We therefore aimed to consider optimized solutions to the mix of food items in daily diets for a developed country population: New Zealand (NZ).

METHODS

We conducted scenario development and linear programming to model 16 diets (some with uncertainty). Data inputs included nutrients in foods, food prices, food wastage and food-specific GHG emissions.

FINDINGS

This study identified daily dietary patterns that met key nutrient requirements for as little as a median of NZ$ 3.17 per day (US$ 2.41/d) (95% simulation interval [SI] = NZ$ 2.86 to 3.50/d). Diets that included "more familiar meals" for New Zealanders, increased the cost. The optimized diets also had low GHG emission profiles compared with the estimate for the 'typical NZ diet' e.g., 1.62 kg CO2e/d for one scenario (95%SI = 1.39 to 1.85 kg CO2e) compared with 10.1 kg CO2e/d, respectively. All of the optimized low-cost and low-GHG dietary patterns had likely health advantages over the current NZ dietary pattern, i.e., lower cardiovascular disease and cancer risk.

CONCLUSIONS

We identified optimal foods and dietary patterns that would lower the risk of non-communicable diseases at low cost and with low greenhouse gas emission profiles. These results could help guide central and local government decisions around which foods to focus policies on. That is which foods are most suitable for: food taxes (additions and exemptions); healthy food vouchers and subsidies; and for increased use by public institutions involved in food preparation.