Household Head Smoking Behavior and Household Food Insecurity in South Africa: Evidence from National Income Dynamics Study Survey

PurposeHousehold food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidemic, and having the largest share of poverty in South Africa, this relationship remains unexamined. This study investigated the association between major depressive episode (MDE) and household food insecurity among individuals with MDR-TB.MethodsWe enrolled and interviewed 141 newly admitted microbiologically confirmed MDR-TB inpatients at a specialized TB hospital in KwaZulu-Natal Province, South Africa. Logistic regression models were fitted to assess the relationship between MDE and household food insecurity, while accounting for socio-demographic status (e.g., age, gender, education, marital status, social grant status, income, and preference for living in one’s community).ResultsThe prevalence of MDE and household food insecurity was 11.35% and 21.01%, respectively. MDE was significantly associated with household food insecurity (aOR 4.63, 95% CI 1.17–18.38). Individuals who are female (aOR 6.29, 95% CI 1.13–35.03), young (aOR 8.86, 95% CI 1.69–46.34), have low educational attainment (aOR 6.19, 95% CI 1.70–22.59) and receive social grants (aOR 7.60, 95% CI 2.36–24.48) were most at risk of household food insecurity.ConclusionsMDE in individuals with MDR-TB was significantly associated with household food insecurity, independent of socio-economic status. Although MDR-TB is not exclusively a disease of the poor, individuals from socio-economically disadvantaged backgrounds (e.g., female, young adults, low education, and social grant recipients) were more likely to experience household food insecurity. Our study underscores the need to address the co-occurring cycles of food insecurity and untreated MDE in South Africa.

Food insecurity in urban South Africa is situated in both historic and contemporary factors. This article argues that there is a need to reimagine and reconceptualise national, socio-ecclesial and theological responses to urban food insecurity in South Africa. We contend that the global and enduring nature of food insecurity is indicative of the violence of hunger and poverty and can be viewed as structural violence. While the church has since its inception been involved in feeding the hungry, the structural and systemic nature of food insecurity requires more nuanced theological responses and reflections. As a prophetic voice, the church and theological reflection and action are important partners in conversations, dialogue, measures and interventions geared towards the eradication of hunger and food insecurity in urban South Africa. A descriptive and evaluative method of enquiry was adopted in order to identify the historic structural and systemic factors that perpetuate food insecurity in South Africa. This article concludes that social inequality, economic disenfranchisement and poverty are as a result of structural inequalities that amount to structural violence inflicted on the most vulnerable of society.

This article maps food insecurity in South Africa and plumbs the data to women-headed households at the municipal level. Local contexts provide a better understanding of people's experiences by studying the impact their geographical location has on their economic status, and the impact their raced and gendered identities have on that experience. Localised information could also ensure that more nuanced policies are developed to address inequalities. Food insecurity is a marker of exclusion and poverty in urban and rural areas across South Africa, but women are more likely than men to be food insecure, especially in the rural areas. Data are combined from Statistics South Africa's Income and Expenditure Survey and Community Survey (both 2008) to arrive at a more accurate assessment of food insecurity at municipal level in South Africa. The National Department of Agriculture places food insecurity at 50%, while this study argues that approximately 64% of households in South Africa are food insecure, a result which has policy implications. Our study also uses data that provide a more nuanced approach that shows provincial and municipal variations that are much higher than the national average, which should support provincial and local government policies that address food insecurity more effectively. The article also argues that due to male-biased economic, cultural and community practices, women-headed households are most food insecure. In light of this information, the article provides a nuanced understanding of women's food insecurity in the country. We offer policy recommendations on how women's food insecurity could be reduced in the areas where it is most prevalent. The importance of gender-sensitive development policies, localised contextual knowledge, and innovative strategies that would assist women in their efforts to become food secure, particularly in rural areas across South Africa, are highlighted.

Food insecurity in South Africa: To what extent can social grants and consumption of wild foods eradicate hunger?

Quantitative Indicators from a Food Expenditure Survey Can Be Used to Target the Food Insecure in South Africa

Although the proportion of people living in slums is increasing in low- and middle-income countries and food insecurity is considered a severe hazard for health, there is little research on this topic. This study investigated and compared the prevalence and socio-demographic associations of household food insecurity in seven slum settings across Nigeria, Kenya, Pakistan, and Bangladesh. Data were taken from a cross-sectional, household-based, spatially referenced survey conducted between December 2018 and June 2020. Household characteristics and the extent and distribution of food insecurity across sites was established using descriptive statistics. Multivariable logistic regression of data in a pooled model including all slums (adjusting for slum site) and site-specific analyses were conducted. In total, a sample of 6,111 households were included. Forty-one per cent (2,671) of all households reported food insecurity, with varying levels between the different slums (9–69%). Household head working status and national wealth quintiles were consistently found to be associated with household food security in the pooled analysis (OR: 0·82; CI: 0·69–0·98 & OR: 0·65; CI: 0·57–0·75) and in the individual sites. Households which owned agricultural land (OR: 0·80; CI: 0·69–0·94) were less likely to report food insecurity. The association of the household head’s migration status with food insecurity varied considerably between sites. We found a high prevalence of household food insecurity which varied across slum sites and household characteristics. Food security in slum settings needs context-specific interventions and further causal clarification.

Although the proportion of people living in slums is increasing in low- and middle-income countries and food insecurity is considered a severe hazard for health, there is little research on this topic. This study investigated and compared the prevalence and socio-demographic associations of household food insecurity in seven slum settings across Nigeria, Kenya, Pakistan, and Bangladesh. Data were taken from a cross-sectional, household-based, spatially referenced survey conducted between December 2018 and June 2020. Household characteristics and the extent and distribution of food insecurity across sites was established using descriptive statistics. Multivariable logistic regression of data in a pooled model including all slums (adjusting for slum site) and site-specific analyses were conducted. In total, a sample of 6,111 households were included. Forty-one per cent (2,671) of all households reported food insecurity, with varying levels between the different slums (9-69%). Household head working status and national wealth quintiles were consistently found to be associated with household food security in the pooled analysis (OR: 0·82; CI: 0·69-0·98 & OR: 0·65; CI: 0·57-0·75) and in the individual sites. Households which owned agricultural land (OR: 0·80; CI: 0·69-0·94) were less likely to report food insecurity. The association of the household head's migration status with food insecurity varied considerably between sites. We found a high prevalence of household food insecurity which varied across slum sites and household characteristics. Food security in slum settings needs context-specific interventions and further causal clarification.

Food insecurity impacts childhood nutritional status, physical and cognitive development, and increases lifetime risk for chronic disease. Previous South African studies have examined hunger at the sub-national level without a specific focus on children and adolescents. This study determines the national prevalence of childhood food insecurity, from birth to adolescence, and identifies factors associated with hunger within the household. Individual and household-level data were extracted from the South African National Health and Nutrition Examination Survey (SANHANES-1). Prevalence of food insecurity was assessed using the Community Childhood Hunger Identification Project (CCHIP) index. Multinomial logistic regression analyses were conducted on all households (with and without children) to determine the predictors of food insecurity, with additional analyses adjusting for child dependency and sociodemographic characteristics of household heads in households with children. Of 5 098 households surveyed, 68.6% had children and adolescents present (0-19 years). Of these households, 32.5% (95% Confidence Interval [CI]: 29.5-35.7) were experiencing hunger and 26.3% (95% CI: 23.9-28.8) were at risk of hunger. Among all the households, significant associations for experiencing hunger were the presence of children and adolescents: Adjusted Odds Ratio (AOR) = 1.68 (95% CI: 1.12-2.53); being female-headed: AOR = 1.53 (95% CI: 1.21-1.94) and informally-located; AOR = 1.6 (95% CI: 1.07-2.43). Of the racial groups, having a non-African household head, Coloured: AOR = 0.29 (95% CI: 0.19-0.44) and White/Indian/Asian: AOR = 0.12 (95% CI: 0.04-0.33) conferred lower odds of experiencing hunger; and, the household head having secondary/tertiary education conferred lower odds of experiencing hunger; AOR = 0.40 (95% CI: 0.28-0.56) as well as being at risk of hunger; AOR = 0.69 (95% CI: 0.52-0.92). Receiving social grants, pensions, or remittances more than doubled the odds of experiencing hunger; AOR = 2.15 (95% CI: 1.49-3.09). After adjusting for child dependency in households with children, having at least one older child (age 15-19 years old) did not change the odds of food insecurity. In summary, only 41% of South African households with children and adolescents were food secure. The associations between household head sociodemographics, household location and size on household food insecurity indicate a need for multi-sectoral interventions to bolster sustainable food systems for households with children and adolescents and to improve public protections for female-headed, African-headed and informally-located households dependent on social grants.

Food insecurity impacts childhood nutritional status, physical and cognitive development, and increases lifetime risk for chronic disease. Previous South African studies have examined hunger at the sub-national level without a specific focus on children and adolescents. This study determines the national prevalence of childhood food insecurity, from birth to adolescence, and identifies factors associated with hunger within the household. Individual and household-level data were extracted from the South African National Health and Nutrition Examination Survey (SANHANES-1). Prevalence of food insecurity was assessed using the Community Childhood Hunger Identification Project (CCHIP) index. Multinomial logistic regression analyses were conducted on all households (with and without children) to determine the predictors of food insecurity, with additional analyses adjusting for child dependency and sociodemographic characteristics of household heads in households with children. Of 5 098 households surveyed, 68.6% had children and adolescents present (0–19 years). Of these households, 32.5% (95% Confidence Interval [CI]: 29.5–35.7) were experiencing hunger and 26.3% (95% CI: 23.9–28.8) were at risk of hunger. Among all the households, significant associations for experiencing hunger were the presence of children and adolescents: Adjusted Odds Ratio (AOR) = 1.68 (95% CI: 1.12–2.53); being female-headed: AOR = 1.53 (95% CI: 1.21–1.94) and informally-located; AOR = 1.6 (95% CI: 1.07–2.43). Of the racial groups, having a non-African household head, Coloured: AOR = 0.29 (95% CI: 0.19–0.44) and White/Indian/Asian: AOR = 0.12 (95% CI: 0.04–0.33) conferred lower odds of experiencing hunger; and, the household head having secondary/tertiary education conferred lower odds of experiencing hunger; AOR = 0.40 (95% CI: 0.28–0.56) as well as being at risk of hunger; AOR = 0.69 (95% CI: 0.52–0.92). Receiving social grants, pensions, or remittances more than doubled the odds of experiencing hunger; AOR = 2.15 (95% CI: 1.49–3.09). After adjusting for child dependency in households with children, having at least one older child (age 15–19 years old) did not change the odds of food insecurity. In summary, only 41% of South African households with children and adolescents were food secure. The associations between household head sociodemographics, household location and size on household food insecurity indicate a need for multi-sectoral interventions to bolster sustainable food systems for households with children and adolescents and to improve public protections for female-headed, African-headed and informally-located households dependent on social grants.

ABSTRACTThis study investigates the prevalence and key risk factors of household food insecurity in the climate‐vulnerable coastal regions of Bangladesh. Primary data were collected through a cross‐sectional survey in three coastal districts, providing comprehensive insights into sociodemographic and economic determinants of food insecurity in this underexplored region. The study included mothers of the children aged 6–59 months from 471 households and selected using a three‐stage cluster sampling procedure. Household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS), and multivariable logistic regression was performed to identify the risk factors of food insecurity. The prevalence of household food insecurity was 28.7%, and a lower chance of experiencing food insecurity was found in households with younger heads (≤ 40 years) [AOR: 0.42; 95% confidence interval (CI): 0.20–0.90] compared to the older group. A lower risk of food insecurity prevalence was observed in households having educated mothers (AOR: 0.22; 95% CI: 0.08–0.58) compared to the noneducated group, higher monthly income (AOR: 0.09; 95% CI: 0.04–0.21) compared to lower income, and households located in the central (AOR: 0.21; 95% CI: 0.10–0.44) and western parts (AOR: 0.15; 95% CI: 0.06–0.34) compared to the eastern coastal region of the country. Household heads engaged in fishing and having mothers with chronic health issues were identified as significant predictors of food insecurity. Our study identified several sociodemographic and economic factors as significant predictors of food insecurity and suggested that effective interventions, including the enhancement of educational opportunities, promotion of income‐generating activities, and support for the fisher community and those with chronic health conditions, are necessary to reduce household food insecurity in this region.

Introduction: Food insecurity and malnutrition among children are common in developing countries including Ethiopia. Food insecurity is probably one of the determining factors of malnutrition in children but results are inconclusive. Objectives: The aim of this study was to assess the magnitude of household food insecurity and its association with the nutritional status of children in Gambella town. Method: A community based cross-sectional study was conducted on children in April 2016 in Gambella town, west Ethiopia. Data including household food insecurity were collected from 284 households having children 6-59 months by the face to face interview using structured questionnaire. Anthropometric measurements were measured using standard procedures to determine nutritional status of children. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed to determine the association between household food insecurity and nutritional status of children. Results: The overall prevalence of household food insecurity was 59.5% with 20.1%, 23.6%, and 15.8% households were mildly, moderately, and severely food insecure, respectively. Prevalence of stunting, underweight and wasting were 23.2%, 12.0% and 13.4% respectively. Household food insecurity was independently associated with stunting, but not with wasting and underweight after adjusting for possible confounders using multivariable logistic regression model. The odds of stunting were highly pronounced in those children who were from severely and moderately food insecure households. Conclusion: The findings from this study suggest high prevalence of both household food insecurity and malnutrition among children in Gambella town. Household food insecurity was significantly associated with stunting. The finding implies nutrition interventions targeting children need to address household food security.

Household food insecurity is associated with CVD risk factors in low-income adults, but research on these associations among adolescents is inconsistent. This study investigates whether household and child food insecurity is associated with CVD risk factors in lower-income adolescents. Cross-sectional. Multivariable linear regression assessed the association between household and child food security and CVD risk factors. Household and child food security was measured using the US Food Security Survey Module. The analyses were adjusted for adolescent's age, sex, race/ethnicity, smoking status, physical activity and sedentary time, as well as household income and the head-of-household's education and marital status. The USA. The sample was comprised of 2876 adolescents, aged 12-17 years, with household incomes at or below 300 % federal poverty line from the National Health and Nutrition Examination Survey cycles 2007-2016. The weighted prevalence of household food insecurity in the analytic sample was 33·4 %, and the weighted prevalence of child food insecurity was 17·4 %. After multivariable adjustment, there were no significant associations between household and child food insecurity and BMI-for-age Z-score, systolic and diastolic blood pressure, HDL-cholesterol, total cholesterol, fasting TAG, fasting LDL-cholesterol and fasting plasma glucose. Despite observed associations in adults, household food insecurity was not associated with CVD risk factors in a national sample of lower-income adolescents. Child food insecurity was also not associated with CVD risk factors. More research should be conducted to confirm these associations.

Recent attention has been focused on means of eliminating food insecurity and hunger worldwide. Food security includes three dimensions, viz, availability, access and utilization. In the absence of any of these conditions, it can be considered as food insecurity. The aim of this study was to identify determinants of food insecurity status of rural households in Sri Lanka, using secondary data from a nationally representative sample data-set, the household income and expenditure survey of the Department of Census and Statistics. The analysis was carried out in two stages. In the first stage, the food insecurity index was determined and in the second stage ordered logistic regression model was executed to estimate the food insecurity status of the households as a function of a set of independent variables. The food insecurity index was determined by using a proxy variable based on the percentage of each household’s total expenditures devoted to food. Descriptive statistic results indicated that the percentages of food insecure and secure households were 54% and 46% respectively. The two-sample t-test and proportion test results suggested that there were significant differences of means in human capital variables between food secure and food insecure households. The results of the ordered logistic regression model revealed that if the household head was a female and educated, it would decrease the vulnerability of household to become food insecure, and if a household has a higher number of members who completed the secondary education, higher number of workers, lower young dependents and old dependents, food insecurity status of rural households in Sri Lanka would be reduced. In conclusion, the findings of this study support the empirical literature on the importance of human capital development in food insecurity status.

The COVID-19 pandemic severely disrupted South Africa’s economy, exacerbating household vulnerabilities. In response, the government established the COVID-19 Social Relief of Distress (SRD) grant in 2020 to support working-age adults facing economic hardship. Although initially conceived as a temporary measure, the grant has been extended multiple times. Despite extensive research on social assistance programs, evidence on their long-term effects on food insecurity in low- and middle-income countries remains limited. This study examines the effect of the COVID-19 SRD grant on household food insecurity in South Africa over a four-year period (2020–2023), using fixed-effects analysis of nationally representative General Household Survey (GHS) data. Contrary to expectations, the findings indicate that receipt of the grant was associated with a significant increase in food insecurity. These results underscore the complexities of cash transfer programs, suggesting that immediate financial relief may not translate into long-term economic stability. The study emphasises the importance of integrated policy interventions, including direct food support, employment initiatives, and sustainable income-generating strategies, in enhancing household food security. Policymakers and stakeholders should consider these unintended consequences when designing future social protection measures to ensure they effectively support vulnerable populations during crises.

Household food insecurity in South African suburban low-income households is a major challenge. Research outcomes that will inform decisions on effective solutions towards reducing household food insecurity in South Africa are essential. The purpose of this study was firstly to determine the food security status of households and the skills of household members in Ward 60 of the Nelson Mandela Bay Municipality in the Eastern Cape Province in South Africa. Secondly, it was also to determine the association between the socioeconomic and demographic variables of the households and their level of food (in-)security. The study employed a mixed method of both qualitative and quantitative methodologies, comprising a qualitative Community-Based Participatory Action Research (CBPAR) methodology and a quantitative household food security survey methodology. A household food security survey was employed using a questionnaire that was based on the Household Food Insecurity Access Scale (HFIAS). The questionnaire was used to collect data from 170 randomly selected households. The data analysis used the HFIAS score and logistic regression analysis. The results show 6.1% of households as food secure, 3.05% as mildly food insecure, 13.4% as moderately food insecure, and 77.4% as severely food insecure. The results also show that a significant unemployment rate, a reliance on social grants, and absence of income seriously impact the extent of household food insecurity. The results show a significant association between the household food security and the variables of unemployment, income, and gender. The regression analysis results suggest that gender, household size, age, employment, and household income influence household food security. The results of the household skills show that the households had a variety of skills. These results can help to inform decisions by the government, local municipalities, NGOs, and other stakeholders towards designing effective solutions for enhancing household food security.