Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

The Development, Implementation, and Evaluation of Innovative Strategies to Reduce Food Insecurity among Children in the United States

The Need for Investment in Rigorous Interventions to Improve Child Food Security

Food Insecurity on College and University Campuses: A Context and Rationale for Solutions

A Consideration of the Evaluation of Demonstration Projects to End Childhood Hunger (EDECH)

Food Insecurity Among Adults With Severe Mental Illness

Obesity and Hunger Threaten the Foundations of Child Health

Access to health care and food in children with food allergy

BackgroundSocial 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).MethodsAdults (≥ 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.ResultsA 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.ConclusionsIn 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.

ABSTRACTObjectives: In 2014, 30% of African-American households with children had low or very low food security, a rate double that of white households with children. A household has low food security if its members experience food shortages and reductions in food quality attributable to a lack of household resources or access and very low food security if its members also experience reductions in food intake and disrupted eating patterns. Households that are either low or very low food secure are known collectively as food insecure. We examined the association between the severity of household food insecurity and reports of lifetime racial discrimination among a sample of food-insecure African-American households in South Carolina.Design: Data were collected from 154 African-American respondents. Food insecurity was measured using the US Department of Agriculture’s Household Food Security Survey Module. Lifetime racial discrimination was measured using the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). We used logistic regression to test the association between severity of food insecurity (low vs. very low food secure), PEDQ-CV score and PEDQ-CV subscales. All models were adjusted for demographic and socioeconomic variables.Results: A one-unit increase in the frequency of lifetime racial discrimination was associated with a 5% increase in the odds of being very low food secure (odds ratio (OR) 1.05, P < .05). More reports of discrimination that were stigmatizing or devaluing (OR 1.16, P < .05), took place at a workplace or school (OR 1.15, P < .05) or were threatening or aggressive (OR 1.39, P < .05) increased the odds of being very low food secure. More reports of racial discrimination that were excluding or rejecting did not significantly increase the odds of being very low food secure (OR 1.07, P > .05).Conclusions: Severity of household food insecurity is associated with lifetime racial discrimination among African-American households in South Carolina.

The Household Food Security Survey Module (HFSSM) is an 18-item scale created and maintained by the US Department of Agriculture (USDA) that measures food insecurity in the United States. The HFSSM includes ten items that reference food hardships among adults in the household and eight items that reference food hardships among children. The scale was created and maintained using a dichotomous Rasch model (Engelhard et al., Educ Psychol Meas 78:1–19, 2017). However, the item responses that are collected for nine of the items are polytomous that are later dichotomized for creating the final scale. In 2006, the Committee on National Statistics (CNSTAT) reviewed the HFSSM and the USDA’s procedures for measuring food insecurity. They suggested modeling polytomous item responses with a polytomous model instead of dichotomizing item responses (Wunderlich and Norwood, Food insecurity and hunger in the United States: an assessment of the measure. The National Academies Press, Washington, DC, 2006). The purpose of this study is to explore modeling polytomous HFSSM items with a partial credit model, building on Nord’s (Assessing potential technical enhancements to the US household food security measures. US Department of Agriculture, Economic Research Service, 2012) work on the partial credit model and the HFSSM. The polytomous Rasch model is compared to the dichotomous Rasch model currently used by the USDA. The data suggest that the polytomous model provides better model-data fit, explaining 62% of the variation as opposed to 58% with the dichotomous model. The use of a polytomous model increases the precision of the estimates of food insecurity.

To measure and describe the prevalence and severity of household food insecurity in a remote on-reserve First Nations community using the Household Food Security Survey Module (HFSSM) and to evaluate the perceived relevance of the HFSSM for this population. Household food security status was determined from the eighteen-item HFSSM following the classifications developed by Health Canada for the Canadian Community Health Survey, Cycle 2·2 Nutrition. One adult from each household in the community was invited to complete the HFSSM and to comment on its relevance as a tool to measure food security for First Nations communities. Sub-Arctic Ontario, Canada. Households (n 64). Seventy per cent of households were food insecure, 17% severely and 53% moderately. The prevalence of food insecurity in households with children was 76%. Among respondents from homes rated as having severe food insecurity, all (100 %) reported worrying that food would run out, times when food didn't last and there wasn't money to buy more, and times when they couldn't afford to eat balanced meals. The majority of respondents felt the HFSSM did not capture an accurate picture of food security for their situation. Aspects missing from the HFSSM included the high cost of market food and the incorporation of traditional food practices. A high prevalence of household food insecurity was reported in this community. On-reserve remote First Nations communities may be more susceptible to food insecurity than off-reserve Aboriginal populations. Initiatives that promote food security for this vulnerable population are needed.

ABSTRACTDespite strong evidence of the prevalence of food insecurity in adults and households with children in different areas of Iran, the prevalence of child-specific food insecurity in Iran and especially in Tabriz has not been evaluated. Therefore, the objective of the current study is to evaluate the prevalence of food insecurity in schoolchildren and to identify its social, demographic, and nutritional determinants in Tabriz, Iran. This cross-sectional study was conducted between April and September 2014 among 330 schoolchildren aged 7–11 years comprising 170 boys and 160 girls from ten public schools in Tabriz, Iran. Demographic and socioeconomic factors had been obtained from participants. Food security status was assessed by an eight-item U.S. Department of Agriculture (USDA) Food Security Module previously validated for use in Iran. Dietary information was obtained by a food frequency questionnaire (FFQ). In our findings, the prevalence of food insecurity among children was 30% with 29.1% being low food secure and 0.9% being very low food secure. Mean weight for age Z-score (WAZ) in the food insecure group was significantly lower than in the food secure group. The prevalence of food insecurity was more prevalent in boys (p = .006). Food insecure children had a significantly lower intake of energy, carbohydrate, protein, and meat (p < .001) and higher prevalence of wasting compared with their counterparts in the food secure group (p = .004). These results suggest a proportionally high prevalence of food insecurity in schoolchildren in Tabriz and its significant association with poor nutritional status and dietary habits. Our findings also ensures the necessity of nutritional support programs and nutritional education in Iranian low-income families to improve their overall health.

ObjectivePrevious research has documented the high prevalence of food insecurity, or uncertain access to healthy foods, and poor dietary intake in emergency food pantry (EFP) users. However, no studies have determined whether there are differences in dietary intake when stratified by food security status within the EFP population. This study evaluated associations between food security status and the intake of key nutrients and food groups among EFP clients.Study Design, Setting and ParticipantsAdult EFP clients (n=445) from a multistate sample of 24 rural, Midwestern EFPs participated at a single time point from September–November 2014.Outcome Measures and AnalysisParticipants completed a characteristics survey, the 18‐item U.S. Household Food Security Survey Module, and up to three National Cancer Institute Automated Self‐Administered 24‐hour dietary recalls (ASA24s). Adult food security status, classified as food secure, low or very low food secure, was the independent variable while mean intake of energy, vitamins, minerals, and food groups were dependent variables. Multiple linear regression models adjusted for energy and other confounders were used to determine associations between food security status and nutrient/food group outcomes.ResultsLow adult food security was significantly positively associated with total energy (kcal) intake (β=245.81 p=0.02) compared with very low food security. Adult food security was significantly positively associated with whole fruit (cup equivalents) intake (β=0.17 p=0.04) compared with low food security.Conclusions and ImplicationsResults suggest that food security, low food security, and very low food security status may be specifically associated with the consumption of key food groups and therefore differences in dietary intake by food security range should be considered in the development of future initiatives that target this population.Support or Funding InformationThis project is supported by the Agriculture and Food Research Initiative competitive grant no. 2013‐69004‐20401 of the USDA National Institute of Food and Agriculture.

The Importance of Screening for Food Insecurity in Children with Sickle Cell Anemia: An Ancillary Study to the Severe Acute Malnutrition Feasibility Trial in Nigeria

Understanding and Addressing Barriers to Healthy Eating among Low-Income Americans