Address Food Insecurity Research Articles

Correlates of food insecurity among university students in a low socioeconomic area

Abstract Background The prevalence of food insecurity (FI) is high and suggested to be growing among university students, with potential detrimental effects on their health status and academic performances. This cross-sectional study aims to identify the socioeconomic, demographic and lifestyle factors associated with FI among university students in a disadvantaged area. Methods An anonymous online survey was conducted from Nov 2022 to Jan 2023 among students enrolled at University Sorbonne Paris Nord, located in a low socioeconomic area in France. FI was assessed with one question distinguishing 2 levels of FI: quantitative (i.e. not having enough to eat) and qualitative (i.e. not having the desired food). This abstract focused on quantitative FI. To improve the representativeness of the sample compared to the total student population of the university, sample weights were used according to gender, study level and speciality, whether they were undergoing initial training or not, or obtained their baccalaureate abroad or not. Multivariable multinomial logistic regression models were used to identify factors associated with FI. Results A total of 5068 students provided valid answers (20% of the target population), 66% of whom were women, and 12% and 36% reported quantitative and qualitative FI, respectively. Being a man, an undergraduate, having obtained a baccalaureate abroad, not living in the family home, not receiving food from family, having no household food-heating facilities, reporting financial difficulties, relying on food charity and eating alone on a regular basis were positively associated with quantitative FI (P < 0.0001). Those reporting quantitative FI were more likely to report academic difficulties. Conclusions This study shows a high prevalence of FI in this student population and identifies several associated factors. Identifying students at greater risk of FI is an important first step to design and evaluate public health interventions. Key messages • The different socio-economic backgrounds of university students imply important food insecurity disparities among them. • University students present several factors associated with food insecurity, which should be considered when addressing food insecurity in this population.

The future of nutrition education for health systems capacity building

Abstract In the ever-evolving landscape of global health, nutrition education plays a pivotal role in shaping the well-being of populations. The future of nutrition education encompasses a holistic understanding of health, considering not nutritional adequacy in health and disease, but also cultural, social, and environmental factors. Tomorrow’s health professionals must also be equipped to address the interconnectedness of nutrition with mental health, sustainability, and community dynamics. Nutrition education will increasingly involve collaboration across disciplines. Health professionals, educators, policymakers, and community leaders must work together to create a comprehensive ecosystem that fosters nutrition literacy. This collaboration extends beyond traditional healthcare settings to schools, workplaces, and local communities. Furthermore, digital transformation will also revolutionise nutrition education. Online platforms, mobile apps, and virtual simulations will enhance learning experiences whilst interactive modules, webinars, and gamified content will engage learners and facilitate continuous professional development. Moreover, telehealth and tele-nutrition will bridge geographical gaps, ensuring access to quality education globally. Cultural sensitivity in nutrition education is also needed across geo-demographic boundaries to appreciate diverse dietary practices, food taboos, and traditional knowledge. Nutrition education should also empower health professionals to advocate for policy change across food systems, promote sustainable practices, and address food insecurity and therefore understanding policy frameworks and participating in advocacy efforts will be key. Finally, embracing the future requires a commitment to lifelong learning to remain at the forefront of nutrition science and its cutting edge as the questions may remain the same but the answers vary significantly as we garner new evidence to navigate evolving global challenges.

Accommodating Seed Libraries into Public Libraries: A Platform to Address Food Insecurity in India

ABSTRACT There are several initiatives adopted by public libraries to address issues on food insecurity which includes public food programs, community-based agricultural programmes, community food gardens, and seed libraries. The need of a seed library in the community is not just about promoting agricultural practices, it also helps to address the rising food insecurity and hunger issues prevailing in the society. This paper explores how seed libraries could be incorporated within public libraries and their scope in Indian context. For the purpose of the study, previous articles on seed libraries were analyzed to understand its functions and operations. The “Annapurna Seed Library” in Assam is selected to provide insight on the scope for seed libraries in India and how it could be implemented in other states as well.

Magnitude and predictors of obstetric complications during delivery among postpartum women in Ethiopia: evidence from PMA Ethiopia longitudinal survey

IntroductionThe majority of pregnancy-related complications were preventable. However, the magnitude of complications during pregnancy and childbirth was high in sub-Saharan Africa. There was limited evidence on the magnitude of obstetric complications during childbirth and its predictors among postpartum women in Ethiopia.Methods and materialsThe research used secondary data sources based on performance monitoring for action in Ethiopia’s second cohort longitudinal survey. It was a national survey that was conducted in three large, predominantly agrarian regions (Oromia, Amhara, and SNNP) and one urban region (Addis Ababa) of Ethiopia between 2021 and 2023. It was conducted to track pregnant women’s use of essential maternal and newborn health services. It involved the enrollment of pregnant women and tracking them at six weeks, six months, and one year after giving birth. The data collected at the beginning of the survey and six weeks after childbirth were used for the analysis. Sample weights were applied to account for differences in sample allocation and response rates across regions and urban/rural areas. Multi-collinearity and intra-cluster correlation were assessed before fitting the multilevel models to ensure the accuracy of the estimates. A multi-level logistic regression model was used to assess the magnitude and predictors for the occurrence of obstetric complications during delivery. The model fit was evaluated using Akaike’s Information Criterion and Bayesian Information Criterion. Adjusted odds ratio with its 95% confidence interval was used to measure the strength of association for this study.ResultsThe magnitude of obstetric complications during delivery was found to be 33.86% with 95% CI (31.56, 36.24. Among the obstetric complications that occurred during delivery, about 15.73%with 95% CI(14.02, 17.61) of women experienced bleeding, 4.14% with 95% CI (3.30, 5.17) had their membrane rupture but labor did not start within 24 h, 2.29% with 95% CI(1.67, 3.13) had their membrane rupture before 9 months, 3.95% with 95% CI(3.16, 4.93) had faced malpresentation or malposition of the baby, 12.70% with 95% CI (11.18, 14.39) had prolonged labor lasting more than 12 h, and 12.40% with 95% CI (10.83,14.17) had convulsions. The odds of occurrence of obstetric complication during delivery among women from severely food insecure households were 1.88 times [AOR = 1.88; 95% CI (1.22, 2.90)] more likely to occur than women from food secure households. Moreover, the odds of occurrence for obstetric complications during delivery among women who had complications during their pregnancy were 2.39 times [AOR = 2.39; 95% CI (1.81, 3.16)] more likely to occur as compared to those women who had no complication during their pregnancy. On the other hand, women’s who had 1–4 live births given before this delivery were 0.61 times [AOR = 0.61; 95% (0.43, 0.88)] less likely to develop complications as compared to those women’s who had no prior live birth.Conclusion and recommendationDelivery-related obstetric complications during delivery in Ethiopia were high. Approximately one-third of postpartum women in Ethiopia experienced obstetric complications during delivery. Based on this study, women’s from severely food insecure households, those women’s who had no prior live birth, and women’s who had complications during their pregnancy were more likely to develop delivery-related obstetric complications. Thus, policy makers and program implementers who were working on maternal and newborn health should give special attention for women’s from severely food insecure households, women’s who had no prior live births, and those women’s who encountered obstetric complications during their pregnancy to decrease the occurrence of obstetric complications during delivery. In Ethiopia, various governmental organizations, such as the Ministry of Health and the Ministry of Agriculture, are dedicated to addressing food insecurity and improving nutritional access. The country has launched several effective nutritional programs, including the Productive Safety Net Program, the Targeted Supplementary Feeding Program, and the National Nutrition Program, aimed at alleviating food insecurity and enhancing nutrition. Ongoing efforts are crucial to tackle the food insecurity experienced by women, which can help to reduce obstetric related complications of women’s during delivery. It is crucial for everyone involved in maternal and newborn health to prioritize addressing the factors that lead to obstetric complications during delivery in women in order to reach the goal of ending all preventable maternal and newborn deaths by 2030.

Rethinking Freshwater Cage Aquaculture: A Case in Ghana

Lakes around the world, including Ghana’s Lake Volta, are facing insidious threats from pollutants due to high dependency on aquatic ecosystems. Cage aquaculture is expanding across Africa because of its potential to address food insecurity, provide livelihoods, and boost local economies. However, the uncontrolled expansion of cage aquaculture can have significant negative impacts on water resources, including environmental footprints that threaten biodiversity. Given the intensification of cage aquaculture for tilapia farming on Lake Volta, we advocate for a transition to inland-integrated aquaculture systems that promote circularity. Strengthening stakeholder collaboration is essential for enhancing competence in mapping inland aquaculture areas, identifying eco-friendly alternatives and reinforcing aquaculture regulations, with particular emphasis on cage culture on Lake Volta. These strategies can reduce the pressures imposed by tilapia cage farms on the lake while promoting best management practices. Additionally, capacity building must be an ongoing process to address knowledge gaps, including the development of effective preparedness plans executed during emergencies. The ongoing pollution from illegal mining in the Black Volta River, a tributary of Lake Volta, along with endemic diseases in the lake, further compounds fish health and welfare issues. This underscores the urgent need to implement inland transition strategies to protect the lake, mitigate disease spread, and ensure safe fish food production.

Randomized pilot trial of an unconditional cash transfer intervention to address food insecurity in oncology.

Screening for food insecurity and other social determinants of health is being integrated into oncology practice. We performed a pilot randomized trial to investigate whether an unconditional cash transfer (UCT) could be used to address food insecurity among female breast and gynecologic cancer survivors. Food insecure cancer survivors completed a baseline survey and were randomized to receive $100/month for three months (UCT) or usual care (UC). Participants (n = 14) completed a follow-up survey after 3-months and we compared changes in health-related quality of life, indicators of food insecurity, diet quality, and whether a participant had to forgo, delay, or make changes to medical care because of cost. The UCT was associated with higher physical health scores, fewer indicators of food insecurity, better diet quality, and a lower likelihood of forgoing medical care than those who received UC. Our results suggest that UCTs can improve outcomes for food insecure cancer survivors.

Teachers' perception of their students' dietary habits in Addis Ababa, Ethiopia: a qualitative study.

Poor dietary choices and consumption of unhealthy foods are major determinants of malnutrition among adolescents in Ethiopia. The school food environment is a valuable setting for exploring adolescents' eating habits. Teachers have an important role in understanding factors that impact students' dietary choices. The aim of this study is to explore secondary school teachers' perceptions towards adolescents' dietary habits in Ethiopia. The study employed a qualitative research design. Four focus group discussions, involving a total of 13 teachers, were conducted at governmental and private schools in Addis Ababa, Ethiopia. Additionally, observations of the food environment in these four schools. The transcripts from the focus group discussions and photographs from observations were analyzed using thematic analysis. Triangulation of data sources and persistent observation of the data were employed to enhance the study's trustworthiness. The study was approved by the Norwegian Center for Research Data and the Addis Ababa Health Bureau, and all participants provided informed consent. Teachers perceived adolescents' dietary habits as unhealthy, characterized by the consumption of unsafe foods, limited variety, and reliance on processed foods. Factors negatively influencing adolescents' dietary habits include a lack of awareness about a healthy diet among both students and parents. Low familial income levels were also identified as a barrier to eating a healthy diet. The unavailability of healthy foods and the advertising of unhealthy and processed foods as well as peer influence were hindrances to a healthy diet both at school and home. This study provides additional evidence of the nutrition transition which is linked to the double burden of malnutrition among adolescents in low-income countries. Factors affecting adolescent diets at school are multileveled. Incorporating nutrition education into the school curriculum will likely improve dietary awareness mitigating peer influence. Regulating the school food environment and enforcing advertisement laws targeting adolescents can promote healthier school food environments. Providing short term nutrition trainings for biology or science teachers and strengthen their role in delivering nutrition education to children and their families, along with implementing measures to address food insecurity and restricting availability of unhealthy food at school need to be regarded as priorities.

The right to food: A fundamental human right and its imperatives

In an age of unprecedented global wealth and technological advancement, the persistence of hunger and food insecurity remains one of the most glaring contradictions of our time. The right to food is a fundamental human right enshrined in various international treaties and national constitutions. Yet, despite this recognition, millions of people across the globe continue to suffer from malnutrition and starvation, highlighting a critical need for holistic action to uphold this fundamental right. Available statistics reveal that Africa bears a disproportionate burden of malnutrition and food insecurity accounting for 20 percent and 61 percent2 of the population respectively. There is a link between access to food in the right quantity and quality and the cognitive development of children which has a spillover effect on the productivity of nations [2, 3]. It is time to reaffirm our commitment to ensuring that this basic right is upheld for all. This right is essential not only for ensuring that individuals lead healthy and productive lives but also for promoting broader social and economic stability. This editorial explores the dimensions of the right to food, its implications, and the urgent need for a coordinated effort to address food insecurity.

An exploration of community food pantries in Scotland: strategic and operational perspectives on addressing food insecurity and health inequalities

Introduction: Food insecurity and health are inextricably linked. Since 2008, Scotland has witnessed a proliferation of both food insecurity and emergency food provision. There is a recognised commitment from Scottish Government to ‘end the need for food banks’, however, the food aid landscape was ‘turbo-charged’ during COVID-19 leading to intense expansion and diversification of food-based projects, including the development of community food pantries (CFPs). These ‘new’ models are relatively under-researched, meaning we do not adequately understand their potential or realised impacts on food insecurity and health. This study aims to fill that gap.MethodsA qualitative methodology was used to collect and analyse data from in-depth interviews with 10 representatives from both operational and policy settings related to food insecurity in Scotland. In addition, we conducted an analysis of policy documentation from Scottish Government related to tackling food insecurity to understand how CFPs fit into its overall strategy to transition away from food bank use.ResultsWe found there were variations in conceptualisations of CFPs and how they operate, challenges related to addressing food insecurity at a community level and varied narratives around the role of community level interventions in tackling health inequalities. Choice and access to services were viewed as central components to the pantry model. However, there were significant challenges faced by CFPs, including territorialism, funding and food supply. Articulations of health were often multi-layered and complicated with strong recognition of the social determinants as well as acknowledgement of the limitations of tackling food insecurity and health inequalities solely at the community level.ConclusionsDespite a commitment to transition away from emergency food provision, CFPs in Scotland appear to face many of the same issues as food banks, particularly those which impact health. Urgent critique of their reliance on surplus food redistribution is required alongside investigation of how these ‘new’ models are experienced by the people who access them. Further expansion of these models should be viewed with caution and in the same vein as traditional emergency food provision: a symptom of, rather than a solution to, the problem of food insecurity.

Uncovering the drivers of food insecurity in Cameroon: insights from a nationwide cross-sectional analysis

BackgroundDespite global efforts to achieve zero hunger, food insecurity remains a critical challenge in several African countries, including Cameroon. This study aims to identify sociodemographic predictors of food insecurity across Cameroon through a comprehensive, nationwide cross-sectional analysis.MethodsData for this study were drawn from the 2018 Cameroon Demographic and Health Survey (CDHS). Food insecurity levels were evaluated using the Food Insecurity Experience Scale (FIES). To estimate the probabilities of moderate and severe food insecurity among different sociodemographic groups, logistic regression models were applied, with results expressed as average marginal effects (AME).ResultsThe findings reveal that approximately 24.86% of participants experienced moderate food insecurity, while 28.96% faced severe food insecurity. Among men, the proportion experiencing severe food insecurity was 38.8%, compared to 24.3% for women. Multivariable regression analysis showed that severe food insecurity was less likely among women [AME = 0.84, 95% CI = 0.83,0.86], Muslims [AME = 0.91, 95%CI = 0.90,0.93], individuals with higher education levels (secondary education: AME = 0.93, 95%CI = 0.90,0.95; higher education: AME = 0.87, 95%CI = 0.85,0.90), those owning land (either alone or jointly) [AME = 0.92, 95%CI = 0.89,0.96], wealthiest households (moderate food insecurity: AME = 0.91, 95%CI = 0.88,0.93; severe food insecurity: AME = 0.73, 95%CI = 0.70,0.75), female-headed households [AME = 0.97, 95%CI = 0.96,0.99], and rural residents [AME = 0.97, 95%CI = 0.95,0.98].ConclusionsThese findings underscore that food insecurity affects a substantial portion of the Cameroonian population, with certain sociodemographic groups more vulnerable than others. This study proposes targeted policy recommendations to address food insecurity in Cameroon, including social assistance programs for at-risk groups, investments in socioeconomic empowerment, improvements in agricultural productivity, and ongoing research to guide evidence-based interventions.

"It's Really About Those Social Determinants of Health that Drive It": Addressing Food Insecurity in Rural Veterans.

The Department of Veterans Affairs (VA) employs numerous strategies to address food insecurity among rural veterans. This manuscript discusses findings from a quality improvement project examining factors impacting food insecurity among rural veterans. Qualitative interviews were conducted with VA expert informants (n = 30) who worked in national program offices addressing veteran food insecurity, site visit participants (n = 57) at three VA Medical Centers (VAMCs), and rural veterans who screened positive for food insecurity at the VAMC sites (n = 10). Interviews were analyzed with analysis matrices. Current VA programming includes a national food insecurity screening initiative and connecting veterans with local community resources. Veteran participants provided suggestions for addressing veteran food insecurity, including outreach and education. In addition, these interviews demonstrate that rural veteran food insecurity is intrinsically interwoven with other social determinants of health. Addressing rural veteran food insecurity must include strategies for understanding and supporting interconnected veteran needs.

Unpacking “the surprise chain”: the governance of food security during the COVID-19 pandemic in Melbourne, Australia

AbstractFood systems are being affected by multiple shocks related to climate change, the COVID-19 pandemic and geopolitical events. Food prices and food insecurity are rising globally as a result, raising questions about the effective governance of food security during shocks. This paper critically examines the governance of food security in Melbourne, Australia during a major food system shock, the COVID-19 pandemic. It draws on document analysis and 34 stakeholder interviews with 41 participants from government, industry and civil society between May 2020 and March 2021. The paper examines the role of these actors in governance mechanisms for two important aspects of food system governance during the COVID-19 pandemic, continuity of food supply and delivery of emergency food relief. Clark et al.’s (2021) “governance engagement continuum” is used to show how civil society groups were excluded from these formal governance mechanisms, instead establishing their own spaces of “self-governance”. The resilience aims associated with these governance mechanisms are also analyzed using Zurek et al.’s (2022) “three R’s” (robustness, recovery and reorientation) framework. Our study highlights the significant role of food industry actors in the continuity of food supply and delivery of emergency food relief, and it shows the vulnerabilities of emergency food relief that depends on industry food “surpluses” as a model for addressing food insecurity during food system shocks. We conclude that greater government leadership is needed in the governance of food security during food system shocks, and in implementation of legislative and policy approaches that are grounded in the human right to food.

Participation in artisanal diamond mining and food security: A case study of Kasai Oriental in DR Congo

Abstract The high prevalence of food insecurity and malnutrition in Kasai Oriental, Democratic Republic of the Congo, prompted an investigation into the complex relationship between household livelihood activities and food security. Despite many rural households relying on subsistence farming, this alone may not ensure improved food security in Kasai Oriental. Consequently, non-farm sectors like artisanal mining offer a potential solution to address food insecurity among rural households. The aim of this study is to explore the association between engagement in artisanal diamond mining, food insecurity, and children’s nutritional status in Kasai Oriental. The research utilizes household cross-sectional data collected between November and December 2022. Fixed effects and Instrumental variable models were employed to address household heterogeneity and potential endogeneity related to participation in artisanal diamond activities. The regression results reveal a significant relationship between participation in artisanal diamond mining and food security. This implies that participation increases households’ cash, enabling them to access sufficient food and potentially mitigating the risk of falling into food insecurity. However, involvement in artisanal mining has not shown a significant association with children’s malnutrition. These findings call for further research on “hidden hunger.” Policies aiming to encourage and formalize artisanal diamond mining should integrate specific extension services and inform rural households about hidden hunger.

Food insecurity and substance use among young adults in the United States

PurposeThe purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18–25 in the U.S. MethodsA cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January–April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination. ResultsNearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors. ConclusionFood insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.

Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study.

Low birth weight (LBW) is a major public health issue associated with increased neonatal morbidity and mortality. This study aimed to examine the association between household food insecurity and LBW in Mashhad, Iran. Study Design: A population-based case-control study. This study involved 6294 mothers (3247 cases and 3247 controls) who visited healthcare centers affiliated with Mashhad University of Medical Sciences for term births between March 2019 and March 2022. Cases included women who delivered neonates weighing<2500 g, while controls delivered babies≥2500 g. Food security was measured using the validated Household Food Insecurity Access Scale. Logistic regression models examined the associations between food insecurity and LBW. Geographic information system techniques mapped LBW distribution in Mashhad. Household food insecurity was significantly associated with higher odds of LBW (adjusted odds ratio [AOR]=1.25, 95% confidence interval [CI]: 1.03, 1.53). Other risk factors included younger maternal age (AOR=1.03, 95% CI: 1.01, 1.04), lower maternal education (AOR=0.55, 95% CI: 0.43, 0.71), cesarean delivery (AOR=1.70, 95% CI: 1.40, 2.06), and exposure to secondhand smoke (AOR=1.68, 95% CI: 1.02, 2.75). Gestational diabetes demonstrated a protective effect (AOR=0.37, 95% CI: 0.15, 0.91). Geographic mapping revealed that regions with higher food insecurity had elevated LBW prevalence. These findings underscore the importance of addressing food insecurity among pregnant women to reduce the risk of LBW and improve newborn outcomes.

Child and Adult Care Food Program: Family Childcare Home Providers’ Perceptions of Impacts of Increased Meal and Snack Reimbursement Rates during the COVID-19 Pandemic

Introduction: The U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for healthy foods for children at participating family childcare homes (FCCH). Higher tier 1 reimbursements are for providers who operate in low-income communities or who are themselves living on a low income. All FCCHs received a higher rate to address food insecurity during the COVID-19 pandemic. Methods: A survey was administered in the spring of 2023 to a randomly selected sample of licensed California FCCHs to assess the perceived impacts of the increased reimbursement on CACFP participation and anticipated challenges with reinstated tiered rates. A total of 518 surveys (261 tier 1, 257 tier 2) were analyzed using linear or logistic regression, adjusting for confounders. Results: Among tier 1 and tier 2 providers combined, over half reported lowering out-of-pocket spending for food (59%) and serving greater variety (55%) and quality (54%) of foods. Tier 2 providers reported experiencing more benefits (p &lt; 0.05) and tended to be more likely to implement optional CACFP best practices (although not significantly different between tiers). Most FCCH providers found reimbursement rates were inadequate before (83%) the pandemic; this amount decreased to 54% post-pandemic for tier 1 and tier 2 providers combined. Conclusions: The temporary CACFP reimbursement positively impacted the perceived quality and variety of foods served to children, especially among tier 2 providers. Increased reimbursements for all FCCHs may ensure children have access to the healthy meals and snacks provided by the CACFP.

Abstract PR002: County-level food insecurity and hepatocellular carcinoma risk: A cross-sectional analysis

Abstract Background: Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, is the sixth most common cancer and third leading cause of cancer deaths worldwide. Hepatitis B and/or C virus, alcohol use, and obesity are main drivers of HCC incidence and prognosis, with risk higher among Black and Hispanic individuals and those with lower socioeconomic status. HCC etiology recently shifted from viral to non-viral-related causes, with up to 40% of HCC cases unexplained by known risk factors. Food insecurity (FI) is associated with several known and emerging HCC risk factors, including poor diet quality, obesity, and diabetes. However, there is limited data on whether FI is in fact a social determinant of HCC risk. In this study, we conducted a county-level cross-sectional analysis to examine whether FI is associated with HCC risk in the United States. Methods: We used the Surveillance Epidemiology and End Results 22 database to obtain county-level counts of HCC cases from 2018-2021 stratified by age (20-64, ≥65 years), sex (female, male), and race and ethnicity (non-Hispanic White, non- Hispanic Black, non-Hispanic Asian or Pacific Islander, non-Hispanic American Indian or Alaska Native, and Hispanic). We obtained county-level FI rates for the years 2018-2021 from Feeding America’s Map the Meal Gap and calculated the average rate over these years. FI rates were calculated using imputation methods that consider state- and county-level sociodemographic variables associated with FI. We obtained additional county-level variables from the Behavior Risk Factor Surveillance System for the years 2018-2021. We used multi- level Poisson regression models with robust standard errors to estimate the association between FI and HCC risk. Models specified county population size as the offset term, and random effects for states and counties. We examined models adjusted for age, sex, race, and ethnicity (Model 1), and further adjusted for county-level binge drinking, smoking, obesity, and diabetes rates (Model 2). We tested multiplicative effect modification by individual-level factors. Results: We included 38,986 cases of HCC diagnosed in 1,085 counties. The mean county-level FI rate was 12.9% (standard deviation (SD)=3.6%). Overall, a 1-SD increase in FI was associated with a 9% increase in HCC risk in Model 1 (incidence rate ratio (IRR)=1.09, 95% CI=1.04-1.15) and a 5% increase in risk in Model 2 (IRR=1.05, 95% CI=1.02-1.09). When stratified by race and ethnicity, FI was only associated with HCC risk in non-Hispanic Whites in Model 2 (IRR=1.07, 95% CI=1.03-1.11; interaction p-value=.05). When stratified by age, FI was only associated with HCC risk in the &amp;lt;65 years group (IRR=1.13, 95% CI=1.08-1.18; interaction p-value &amp;lt;.001). The association did not differ by sex. Conclusion: This study provides some of the first data linking FI to increased HCC risk, in particular early onset HCC. If confirmed in other studies, these findings support the need for interventions that screen for, prevent, and address FI in populations at increased risk for HCC. Citation Format: Rebecca D. Kehm, Chrystelle L. Vilfranc, Jasmine A. McDonald, Hui Chen Wu. County-level food insecurity and hepatocellular carcinoma risk: A cross-sectional analysis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr PR002.

Conference Report: Leveraging the Global Malnutrition Composite Score for Quality Improvement, Health Equity, and Better Patient Outcomes

Effective January 2024, the United States Centers for Medicare &amp; Medicaid Services (CMS) for the first time has included a nutrition-focused quality measure in the Hospital Inpatient Prospective Payment System (IPPS) Inpatient Quality Reporting (IQR) Program: the Global Malnutrition Composite Score (GMCS). The GMCS is an electronic clinical quality measure (eCQM) that hospitals can choose to report voluntarily to meet the requirements for IPPS IQR payments. The GMCS can help improve hospital malnutrition care and help advance hospital health equity goals. This conference report summarizes a panel discussion at the Academy of Nutrition and Dietetics Food and Nutrition Conference &amp; Expo in October 2023. During the panel, four health and nutrition experts described strategies for integrating the GMCS into hospital electronic health records (EHRs). They also outlined how GMCS data can be used to facilitate successful patient transitions to post-acute care through addressing food insecurity and other reasons for malnutrition. Such strategies can serve to help avoid preventable complications and readmissions, improve patient outcomes and health, and meet quality and health equity objectives, while helping reduce overall healthcare costs.

Food Delivery Apps and Their Potential to Address Food Insecurity in Older Adults: A Review.

The proportion of older adults is increasing globally, yet many of them experience food insecurity. Technological innovations, such as increased access to internet- and mobile-based food delivery apps (FDAs), may help mitigate food insecurity. However, this topic has been understudied. This scoping review searched for publications and online technical reports from around the world using interdisciplinary databases like ScienceDirect and internet sources like government websites, respectively. Eligible references were published recently (2019-present) and focused on general technology use, including apps, among older adults (≥50 years) or FDAs for food insecurity or nutritional health generally or specifically among older adults. The search identified 19 studies from 10 countries and extracted relevant information for summary tables. A limited number of studies supported the idea that FDAs can help address food insecurity, but there are important equity considerations for older adults living in rural areas or with constrained physical abilities. Consistently, customized app features and functions increased the intention to use FDAs. In addition, FDAs may have health and environmental impacts, such as food waste and increased access or promotion of ultraprocessed foods. Additional research is needed to elucidate the potential of FDAs to address food insecurity generally and specifically among older adults.

Equity-oriented food supports: Learnings from the Nova Scotia COVID-19 pandemic response.

Public health measures enacted during the COVID-19 pandemic significantly impacted Nova Scotians experiencing food insecurity. Public Health (PH), Nova Scotia Health, created a provincial Housing Isolation Program (HIP) which addressed barriers to isolation, including food access, for COVID-19 cases and contacts being followed by PH. HIP worked with partners to coordinate and respond to urgent food needs of isolating clients by providing grocery and meal delivery options. HIP also made referrals to government and community partners for income and food supports. This program was intended to minimize the spread of COVID-19 by facilitating isolation while meeting basic needs for people with no other means of support. From December 2020 to March 2022, HIP completed grocery and meal deliveries for 579 clients, 1351 referrals to a provincial Income Support Program, and 231 referrals to external food supports. HIP staff worked with clients to manage potential perceptions of stigma. Challenges reported included the urgency of food needs, lack of social supports, and availability and accessibility constraints in rural communities, as well as difficulty accessing culturally appropriate foods and special diets. This intervention demonstrates the importance of addressing food insecurity during emergency preparedness, planning, and response. During emergencies, planning and mobilizing food access requires an equity-oriented approach to overcome stigma. Broadly, continued reliance on charitable responses creates significant vulnerability during emergencies and addressing root causes of food insecurity through social policy will provide longer-term protection.