The Relationship between Structural Social Determinants of Health and Food Insecurity among Pregnant Women

Abstract

Background: Food insecurity, as a major public health concern, is a useful indicator of an individual’s health and wellbeing. Objectives: This study aimed to identify the relationship between the structural social determinants of health and food insecurity among pregnant women. Methods: This cross sectional study was conducted on 837 pregnant women, using stratified cluster sampling. The number of samples from each city of Ilam Province was determined, based on the proportion of women at reproductive age in every city. Urban healthcare centers were selected from each city, and eligible samples were recruited at 24 - 28 weeks of gestation, based on the inclusion criteria. Data were collected on women’s demographic and obstetric characteristics, socioeconomic status, and food security status. Data were analyzed using SPSS version 19. Results: The results showed that the mean age of women was 28.734.41 years. Overall, 35.1% of samples had food insecurity (mild, moderate, and severe insecurity: 24.9%, 7.5%, and 2.9%, respectively). Food insecurity had a significant relationship with the structural social determinants of health (P < 0.001). The logistic regression analysis revealed that the structural social determinants of health were protective factors against food insecurity, as the probability of household food insecurity was lower in women with college education, employees, and high-income households (OR, 0.118, 0.411, and 0.050, respectively). Conclusions: Food insecurity is a common problem, associated with the social determinants of health. Therefore, establishment of food security requires access to the necessary nutrients for all family members, especially the vulnerable ones.