Child Food Security Research Articles

Spanish adaptation and validation of the Child Food Security Survey Module (CFSSM-S).

The present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables. A cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively. A secondary school (grades 7-10) in the city of Terrassa in Catalonia, Spain. Participants included adolescent boys and girls (n 426) aged 12-17 years. The cross-validation design with EFA and CFA captured a single factor, 'food insecurity'. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker-Lewis index=0·979) and internal consistency (ω=0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure. The CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.

A Summer Nutrition Benefit Pilot Program and Low-income Children's Food Security.

Federal summer meals programs serve less than one-sixth of children that receive free or reduced-price meals during the school year. To address this gap in food assistance for school-aged children, the Summer Electronic Benefits Transfer for Children (SEBTC) Demonstrations provided summer food assistance in the form of electronic benefits transfer cards to households with school-aged children certified for free or reduced-price meals during the school year. Over 2011-2013, the SEBTC demonstrations were evaluated by using a random assignment design. Households were randomly assigned a monthly $60-per-child benefit, a monthly $30-per-child benefit, or no benefit, depending on the study year. Key outcomes included children's food security and consumption of foods and food groups related to a healthful diet (diet quality). At baseline (in the spring) and again in the summer, the evaluation surveyed ∼52 000 households over the course of the 3 years of the impact study. SEBTC reduced the prevalence of very low food security among children by one-third. It also had positive impacts on 6 of the 8 child nutrition outcomes measured (amounts of fruits and vegetables; whole grains; dairy foods; and added sugars). SEBTC is a promising model to improve food security and the dietary quality of low-income school-aged children in the summer months.

Skeletal growth, body composition, and metabolic risk among North Sudanese immigrant children.

Children of immigrants and refugees from developing countries are at risk for poor growth that could contribute to adult chronic disease. This study describes the physical growth, bone growth, body composition, metabolic risks, physical activity, and food security of Sudanese children living in the United States. Cross-sectional descriptive study of 64 Sudanese children age 5-18. Bone mineral content (BMC), bone density (aBMD), and body composition (fat, lean mass, percent body fat) were measured using DXA. Lipids, insulin, glucose, and hs-CRP were analyzed using standardized laboratory methods. Food security was assessed with the U.S. Household Food Security Survey. Physical activity was measured through self-report questionnaire and pedometers. About 1/3 of children had low BMC and aBMD. Lean mass was low in 46%, and 32% were obese. Cholesterol, triglycerides, and HOMA-IR were elevated in 23.4%, 32.8%, and 15.6% of children, respectively; only 22% of children were physically active and 40% experienced food insecurity. Sudanese children may have unique risks related to low bone mass low muscle mass, high percent body fat metabolic biomarkers, inactivity, and food insecurity potentially contributing to adult osteoporosis, diabetes, and cardiovascular disease.

Do Walmart Supercenters Improve Food Security?

This paper examines the effect of Walmart Supercenters, which lower food prices and expand food availability, on household and child food insecurity. Our food insecurity-related outcomes come from the 2001-2012 waves of the December Current Population Study Food Security Supplement. Using narrow geographic identifiers available in the restricted version of these data, we compute the distance between each household’s census tract of residence and the nearest Walmart Supercenter. We estimate instrumental variables models that leverage the predictable geographic expansion patterns of Walmart Supercenters outward from Walmart’s corporate headquarters. Results suggest that closer proximity to a Walmart Supercenter improves the food security of households and children, as measured by number of affirmative responses to a food insecurity questionnaire and an indicator for food insecurity. The effects are largest among low-income households and children, but are also sizeable for middle-income children.

Influence of Sociocultural Practices on Food and Nutrition Security in Karamoja Subregion of Uganda

ABSTRACTThe study determined the influence of sociocultural practices on food and nutrition security of children and women in Karamoja subregion, located in northeastern Uganda. Sixteen focus group discussions were conducted among 133 participants. Data were analyzed using qualitative content analysis. Findings indicate that cultural norms, myths, and taboos restrict consumption of animal-sourced foods and some green vegetables by women. Sociocultural practices promoted prelacteal feeding, affecting the implementation of World Health Organization’s recommendations for exclusive breast feeding. In conclusion, sociocultural practices influence food and nutrition security, exposing women and children to the risk of malnutrition and associated consequences.

Nutritional Status of Pupils Attending Public Schools with and without School Feeding Programme in Hohoe Municipality, Ghana

At-school lunch provision through the Ghana school-feeding programme (GSFP) is a child survival, health promotion and food security intervention implemented in selected schools in all 216 districts nationwide with the nutrition objective of reducing short-term hunger and malnutrition. The study assessed the impact of the Ghana School Feeding Programme (GSFP) on the nutritional status of participants. School-based cross-sectional survey using multi-stage sampling to select 417 pupils aged 3-12 years enrolled in 14 public basic schools with (n=133) and without (n=304) school feeding programme in the seven sub-districts of the Hohoe municipality, Ghana. Data was collected between January-April 2015 through face-to-face interviews using a semi-structured questionnaire with assistance from teachers/guardians. Weight, height and mid upper-arm circumference were measured and used to generate underweight, stunting, thinness and obesity using WHO Antroplus and STATA 12.1. Mutually-adjusted simple and multinomial logistic regressions were done to determine association between the explanatory and dependent variables. Overall, 15.6% underweight, 9.8% stunting, 4.3% thinness and 5.5% overweight prevalence were observed. Between beneficiary and non-beneficiary pupils, there were no statistically significant differences in underweight (12.4% vs. 16.8%), stunting (13.3% vs. 8.6%), thinness (1.8% vs. 5.3%) and overweight (3.5% vs. 5.6%) respectively. Most of the explanatory variables including provision of schools meals were not significantly associated with the nutritional status indicators. Pupils in lower primary had increase odds for underweight (AOR; 3.0, 95% CI; 1.4-6.6, p=0.006) while those residing in rural areas were five folds more likely to be stunted (AOR; 5.3, 95%CI; 1.3-21.6, p=0.021). Prevalence of malnutrition was lower among beneficiaries but there were no statistical significant differences in anthropometry between schools with and without feeding programme. Findings suggest that the school feeding programme could marginally improve nutritional status of beneficiaries.

Spatial analysis of food insecurity and obesity by area-level deprivation in children in early years settings in England

Backgroundwe assessed manager perceptions of food security and obesity in young children attending nurseries across England, assessing spatial differences by area-level deprivation. Methodswe conducted an adjusted multinomial logistic regression and an adjusted geographically weighted logistic regression examining the odds of a manager perceiving obesity, food insecurity, or both as a problem among children in care measured via a mailed survey. Results851 (54.3%) managers returned the survey. A nursery being in the highest tertile of area-level deprivation was associated with a 1.89 (95% CI 1.00, 3.57) greater odds of perceiving obesity as a problem, a 3.06 (95% CI 1.94, 4.84) greater odds of perceiving food insecurity as a problem, and a 8.39 (95% CI 4.36, 16.15) greater odds of perceiving both as a problem, compared with the lowest tertile. Conclusionswe observed differences in manager perception by area-level deprivation, but the relationship was especially pronounced for food insecurity.

A qualitative study on the intersectional social determinants for indigenous people who become infected with HIV in their youth

BackgroundIndigenous young people are currently highly overrepresented in the HIV epidemic in Canada, especially in the Prairie Provinces, such as Manitoba. Understanding HIV-vulnerability in Indigenous peoples must begin with understanding that social determinants are intersectional and linked to the historical legacy of European colonization. In this paper findings that detail the influence of the intersectional social determinants on Indigenous people who become infected with HIV in their youth are presented.MethodsThe qualitative research design of phenomenology was used as it afforded the opportunity to understand Indigenous young people from their frames of reference and experiences of reality, resulting in a phenomenological understanding of their perspectives and experiences of the early years of living with HIV. A total of 21 Indigenous young people took part open-ended interviews.ResultsThe stories that the Indigenous young people shared revealed their deeply interconnected social worlds, and how social determinants including abuse, trauma, being part of the child welfare system, and housing and food security were connected throughout various stages of their lives. Such stages included childhood, adolescence and young adulthood (the time of HIV infection), and later adulthood for older participants with the social determinants having multiple influences on their health trajectories.ConclusionsThe findings highlight the need for policies and programs that are broadly focused, addressing multiple social determinants together. Overall, there needs to be more emphasis on the multiple social determinants in the life situations of all Indigenous youth. Reducing the health and social disparities in Indigenous youth is key to reducing the number of young Indigenous people diagnosed with HIV. The findings also shed light on the importance of listening to young Indigenous people who have experienced HIV diagnosis and life following diagnosis.

Food security in a remittance based economy

We interviewed 395 subsistence farming households from Chitwan, Nepal in order to identify the impact of remittances and other explanatory variables on child, adult, and household food security. The highest category of the IV - ordered probit regression models with cluster robust standard errors indicated that the food security status of households, adults and children was explained by gender and age of household head, adoption of conservation agricultural technology, number of fruit trees, and income from agricultural and livestock sources. Additional variables affecting only children’s food security were the adoption of hybrid rice or maize varieties and the wage income or salary earned within the district, whereas an additional variable affecting only household and adult food security was the wage income earned outside the district. Households receiving international remittances were more food secure than those households that did not receive such remittances.

Application of Noninferiority Tests to Examine the Food Insecurity–Obesity Relationship in Children

ABSTRACTThis study applies noninferiority testing to assess the relationship between child weight and food security status in a sample of 808 children between 3 and 5 years old who were attending an urban, state-funded preschool program. Most families were African American (72.3%). Analyses were conducted using noninferiority testing to evaluate the overweight–food security association. Odds of being overweight in the food insecure (FI) group were 0.643 (95% confidence interval [CI], 0.525 to 0.788) and odds from the food secure (FS) group were 0.570 (odds ratio [OR] = 1.127, 95% CI, 0.464 to 0.697, p = 0.004). These findings held across subgroups of gender, race, and family conflict. Children whose parents indicated education beyond high school showed a reversal with FI odds of overweight less than FS odds (OR = 0.663). As illustrated in this study, noninferiority testing provides an alternative analytic approach to examining the association between FI and weight in children.

Lean-Season Food Transfers Affect Children's Diets and Household Food Security: Evidence from a Quasi-Experiment in Malawi

Background: There is evidence that social transfers increase food consumption, improving the quantity and quality of food consumed by poor households. Questions remain on how to improve the effectiveness of social programs.Objective: The aim was to assess the impact of a lean-season food transfer on household food security, diet, and nutrition status of young children during the lean season in Malawi and to understand processes through which transfers operated.Methods: This was a longitudinal, quasi-experimental study based on 2 survey rounds in the Zomba district in Malawi. Data were collected from 60 communities randomly selected among food-insecure villages. Twenty households were randomly selected for interviews within each community. Study outcomes included household expenditures and food consumption (measured by using 7-d recall) and child-level dietary diversity (measured by using 24-h recall) and nutritional status (anthropometric measurements). We followed a mixed-methods approach involving child- and household-level assessments, as well as interviews with community stakeholders. We estimated program impact by combining propensity score matching and difference-in-difference methods.Results: The per capita effect of food transfers on food expenditure was estimated at 36 Malawian kwachas/d, corresponding to an increase of 19% from baseline. There was evidence of increased iron availability in household intake. Highly significant effects were found on children's dietary diversity score, corresponding to an increase of 15%, as well as a positive effect on weight-for-height z scores (WHZs) of >0.25 SDs. Effects on food expenditure and dietary diversity were robust to alternative matching specifications, although the effect on WHZs was not. Examination of the targeting of the transfer showed evidence of large errors of inclusion and exclusion.Conclusion: During the lean season in food-insecure settings, where important declines in food insecurity, diet quality, and nutrition status are present, food transfers may have a protective effect on household food security and diets of young children.

The Effects the Summer Electronic Benefits Transfer for Children Demonstration has on Children’s Food Security

AbstractDuring the summers of 2011 through 2013 in selected demonstration locations, the Summer Electronic Benefits Transfer for Children (SEBTC) Demonstration randomly assigned levels of additional food assistance to school‐age children in low‐income households in order to improve children’s food security in the summer, when many children lose access to federal school meals programs. The findings are simple and dramatic: a $60 per‐child monthly SEBTC benefit reduces very low food security among children by one‐third (a 3.0 percentage‐point decline from a control group level of 9.1%) and food insecurity among children by one‐fifth (an 8.3 percentage‐point decline from a control group level of 43.0%). Additional benefits also improve food security for the adults in the household. There is some evidence of larger impacts among those households that were more disadvantaged at baseline. These results suggest that an SEBTC‐like program would have substantial impacts on child, adult, and household food security. More broadly, they suggest that a moderate (e.g., $100 per household per month) increase in more general food assistance would also have substantial impacts on food security.

Food Security and Weight Status in Children: Interactions With Food Assistance Programs

It is unclear whether Supplemental Nutrition Assistance Program (SNAP) or National School Lunch Program (NSLP) participation modifies the relationship between food insecurity and obesity in children. Data were included for 4,719 children aged 9-17 years who participated in the National Health and Nutrition Survey between 2003-2004 and 2011-2012. Linear regression was used to examine the relationship between household food security (full, marginal, low, and very low) and BMI percentile. Adjusted models were also stratified by SNAP and NSLP participation. There was no significant overall relationship between household food security and BMI percentile. In SNAP non-participants, there was no apparent overall relationship between BMI percentile and household food security. However, BMI percentile in children from households with low food security was significantly higher than that of children from fully food-secure households (risk difference [RD]=5.95, 95% CI=1.11, 10.80). Among SNAP participants, there was no significant relationship between household food security and BMI percentile. By NSLP participation category, there was a non-significant trend toward increasing BMI percentile with decreasing household food security in those reporting two or fewer (RD=1.75, 95% CI= -0.79, 4.29) and two to three (RD=1.07; 95% CI= -1.74, 3.89) lunches/week. There was no apparent relationship between household food security and BMI percentile in those reporting four or more lunches/week. Although the overall relationship between household food security and weight status in school-aged children was not statistically significant, there was some evidence that the relationship may differ by SNAP or NSLP participation, suggesting the need for more research.

Improving Nutrition by Increasing Supplemental Nutrition Assistance Program Benefits

The diets of Americans fall far short of recommended dietary guidelines, and those who live in low-income households have even poorer diets than higher-income households. Many low-income Americans rely on the Supplemental Nutrition Assistance Program (SNAP). The program's dual goals are to improve food security and nutrition. Among the possible strategies to address dietary shortfalls among low-income Americans is to increase the SNAP benefit. This article uses data from the random assignment evaluation of the Summer Electronic Benefit Transfer for Children demonstration to add new insights on the impact of SNAP on diet quality for households receiving SNAP who also received SNAP-like benefits through Summer Electronic Benefit Transfer for Children. Households received $60 each month per eligible school-aged child. The objective of the evaluation was to see if Summer Electronic Benefit Transfer for Children improved children's food security and nutrition. The evaluation surveyed these households to collect information about food expenditures, food security, and children's diets. For households receiving SNAP in sites that used the SNAP Electronic Benefit Transfer delivery system, the analysis showed increases in food expenditures and decreases in levels of food insecurity. The analysis also indicates improvements in dietary quality among school-aged children, but the impacts were modest.

Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study.

Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique. Contrary to the expectations, the perceived physical health of mothers and their children was found not to be affected by conflict and displacement, while psychological distress was often reported. A weak healthcare system, Ukraine’s proneness to informal payments, and heavy bureaucracy to register as an IDP were reported in our study. A precarious social safety net to IDP mothers in Ukraine, poor dietary diversity, and a generalized rupture of vaccine stocks, with halted or delayed vaccinations in children were identified. Increasing social allowances and their timely delivery to IDP mothers might be the most efficient policy measure to improve health and nutrition security. Reestablishment and sustainability of vaccine stocks in Ukraine is urgent to avoid the risks of a public health crisis. Offering psychological support for IDP mothers is recommended.

Securing a Stop to the Summer Setback: Policy Considerations in the Future Expansion of the Summer Electronic Benefit Transfer for Children

The Summer Electronic Benefits Transfer for Children (SEBTC) has been proposed as a solution to address the problem of child food security during the summer. Initial SEBTC findings from a demonstration project show promise and the federal government has approved substantial funding for its continuation. This report reviews empirical assessments of SEBTC and Electronic Benefits Transfer research, and presents policy considerations in the program's future expansion.

Seasonal Difference in National School Lunch Program Participation and Its Impacts on Household Food Security.

The National School Lunch Program (NSLP) is one of the most important food assistance programs in the United States to ensure children's food security and healthy development. Previous studies have offered mixed results and challenges in estimating the effects of program participation. This study assesses NSLP's effect on household food security using data from the Survey of Income and Program Participation (SIPP). SIPP collects information on food security that covers four reference months, including both summer (June, July, August) and nonsummer months. The number of summer months in these four reference months varies by SIPP rotation group. These unique features allow this study to address the potential selection bias in the research of NSLP and food security by examining a seasonal difference in program participation. The analysis found that one more summer month in the reference period increases the difference in low food security rates by about 1.5 percentage points between recipients and nonrecipients eligible for free or reduced-price lunch. Findings have important social work and health policy implications for increasing food security among low-income households with children.

Food and nutrition security as gendered social practice

In many parts of the world, the food security of households and the nutrition security of individual household members, in particular that of children, are still at risk, in spite of the progress made in combatting hunger at the global level. The prevailing opinion among scientists and development practioners alike is that women’s empowerment is the key to household food security and good nutrition of children. Similarly, it is thought that gender inequalities manifest themselves in dietary discrimination of women resulting in their lesser access to sufficient and nutritious food. To investigate the credibility of these ‘common truths’, empirical evidence on women’s roles in the social practices that aim at realizing household food security and good family nutrition was reviewed. It can be concluded that women definitely yield and wield power through their involvement in and responsibility for these practices, but that – at the same time – enhancing women’s capabilities by improved access to critical resources would benefit their household’s food security and their children’s nutrition. Furthermore, except for the region of South Asia, gender inequalities do not visibly result in a gender gap in nutrition, although women’s specific dietary needs in relation to pregnancy and motherhood are not always recognized.

Junior Farmer Field Schools, Agricultural Knowledge and Spillover Effects: Quasi-Experimental Evidence from Northern Uganda

We analyse the impact of a junior farmer field school (JFFS) project in Northern Uganda on students’ agricultural knowledge and practices. Assuming that children are induced to transmit their newly acquired knowledge to their parents and guardians, we also test for the presence of spillover effects at household level. The empirical analysis is based on two sources of panel data: a household survey and a dataset containing results of a test on agricultural knowledge administered to treated and control students before and after the program by the project’s staff. We use matching difference-in-differences estimators, comparing the key outcomes across matched samples of treated and non-treated groups before and after the project intervention. We find that the program had positive effects on students’ agricultural knowledge and adoption of good practices and that it produced some spillover effects in terms of improvements of household agricultural knowledge and food security. However, we find no impact on the propensity to introduce new agricultural good practices and on household agricultural production. Overall, our results point to the importance of adapting the basic principles of farmer field schools to children through junior farmer field schools, as they could improve short and long-term food security and well-being of both children and their households.

Improved food quality, quantity and security among Kenyan orphans and vulnerable children: associations with participation in a multisectoral community-based program, age, gender, and sexual risk

The present study evaluates factors associated with improved food quantity, quality and diversity among participants in a 3-year multisectoral program targeting sibling families of orphans and vulnerable children in rural Kenya. This cross-sectional study evaluates food adequacy and diversity using the World Food Programme’s Food Consumption Score, food access over the previous year, and food dependence on outside-household resources among 1060 families of orphan or vulnerable siblings. The primary comparison group was program-enrolled households who had not yet received any program inputs. Mixed effects logistic models were used to assess the association of food quantity, quality and security with program participation, program inputs and respondent characteristics. Increased time in the program was significantly associated with improved food quantity, quality and security. Other covariates significantly predicting improved food quantity, quality and security included using program-funds to cultivate small-holder farms, increased monthly income, self-efficacy and the number of partners in previous year. After adjusting for monthly income and other covariates, duration of program participation remained a significant predictor of improved food consumption, quality and security. The study presents a unique community-based intervention, hybridizing insights from multiple disciplines that warrants further study to improve the food quantity, quality and security of orphans and vulnerable children across sub-Saharan Africa.