Food Insecurity Research Articles

Climate shocks and food insecurity: Are Burkinabè households resilient in the face of various disruptions?

Climate shocks and food insecurity: Are Burkinabè households resilient in the face of various disruptions?

Exploring Drivers of Land Use/Land Cover Transformations in Goang Watershed Ethiopia: Integrating Local Community Perceptions with Remote Sensing Data

Land use/land cover (LULC) changes driven by human activities are major environmental challenges in many developing regions. This study assessed local community perceptions and household-level drivers of LULC change in northwest Ethiopia. The study combined remote sensing analysis of LULC change with household surveys to understand local perspectives and the socioeconomic, biophysical, and institutional factors influencing household engagement in deforestation activities. The household survey data was collected from 384 randomly selected household heads, as well as from focus group discussions and key informant participants. The remote sensing component used ERDAS IMAGINE 2014 software to classify satellite images and assess LULC changes over time. The quantitative socio-economic data was analyzed using descriptive statistics and econometric methods of the multivariate probit (MVP) model, while the qualitative data was presented using content analysis. The study revealed that population growth, poverty, and food insecurity were the major underlying driving factors, while agricultural land expansion, settlement growth, fuelwood collection, overgrazing, and forest fires were the major underlying causes of LULC change. The MVP model result indicated that gender, off-farm income, access to training, family size, educational level, and agroecology were key determinants of households’ participation in deforestation drivers such as forestland clearing for agriculture, fuelwood collection, timber harvesting, and overgrazing. These findings highlight the need for integrated land use policies and programs that address the socioeconomic and biophysical root causes of LULC change. This study recommends supporting alternative livelihoods, promoting fuel-efficient technologies, and tailoring interventions to different social groups and agroecological contexts of sustainable land use planning and natural resource management in the study site. Future studies should compare perceptions and drivers of land use change across different regions to identify common patterns and unique challenges. This approach will enhance understanding and inform targeted interventions for sustainable land management.

The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation

IntroductionFood as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine. MethodsRecipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a ‘Food Farmacy’ (16 weekly produce home deliveries) alone or in combination with a ‘Behavioral Pharmacy’ (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024. ResultsThere was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy. ConclusionsRecipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.

Protecting nutrition in a food crisis.

Food insecurity and malnutrition are rising worldwide due to disruptions in food systems related to interconnected health-, climate- and conflict-related crises. Although governments globally are committed to addressing nutritional challenges, policy responses have increasingly focused on food security and, particularly, on food affordability. However, these short-term measures often overlook the necessity of integrating nutritious foods into the food system to ensure improved long-term nutrition. By drawing on the United Nations Committee on World Food Security's Voluntary guidelines on food systems and nutrition, this article outlines opportunities for policy-makers to integrate nutrition into key elements of the crisis response. Key policy areas where nutrition could be further integrated include social protection, agricultural investment, trade policy and urban planning. Strengthening the focus of nutrition in these measures will be essential to establish long-term incentives that support food systems transformation for improved nutrition. Drawing on theories of the policy process, I propose that stronger governance and cross-sectoral dialogue will be critical to achieve sustained nutritional outcomes. Health policy-makers can play a leadership role in supporting cross-sectoral policy change by carefully framing the policy issues, advocating for institutional structures that promote collaboration across sectors to prioritize nutrition, and strengthening the management of conflicts of interest in food system policy-making.

Potential benefits of incorporating social determinants of health screening on comprehensive medication management effectiveness.

Increasingly, pharmacists are asked to incorporate social determinants of health (SDoH) identification and referral into clinical practice. However, to date, no studies have evaluated clinical changes from embedding SDoH screening into the delivery of comprehensive medication management (CMM) in patients with chronic conditions. To examine the clinical effectiveness of implementing a clinical pharmacist-led SDoH screening and referral process as part of CMM encounters across a network of 7 Federally Qualified Health Centers (FQHCs). We used a retrospective cohort design to evaluate the effectiveness of integrating SDoH screening into CMM across a network of 7 FQHCs. A difference-in-difference approach was used to compare the effectiveness of CMM between patients with and without SDoH needs on the probability of achieving clinical control for blood pressure (<140 systolic/90 diastolic mm Hg) and diabetes (<9% hemoglobin A1c). Among 807 patients receiving CMM in 2023, 595 (74%) were screened for SDoH. 55.1% of patients screened had 1 or more SDoH, most commonly facing barriers related to insurance (22.0%), language (11.3%), transportation (9.1%), health behaviors (7.1%), income/employment (5.9%), and food insecurity (5.6%). Comparing patients with SDoH needs with those without, the proportion of patients controlled at baseline was 66.3% vs 72.3% for hypertension and 39.0% vs 75.4% for diabetes, respectively. Following a CMM encounter, the proportion of patients who achieved blood pressure control increased 7.6% more (P = 0.225) among patients with SDoH needs than in those without SDoH, whereas diabetes control rates increased 13.3% more (P = 0.143). Although not statistically significant, the results of this pilot evaluation suggest the potential for meaningful clinical improvements from screening and referral of SDoH needs as a part of CMM encounters. These results should be corroborated using a larger, more robust study design.

Financial toxicity in gynecologic oncology and its impact on medication access, debt, and food insecurity

Financial toxicity in gynecologic oncology and its impact on medication access, debt, and food insecurity

The impact of a pediatric malnutrition telehealth clinic on anthropometric measurements in children aged 6-59 months in rural Guatemala.

Guatemala, a country with high rates of pediatric malnutrition, has significant challenges including food and potable water insecurity and a lack of health care providers. This study examined the impact of telehealth clinic attendance on pediatric malnutrition scores. A sample of 42 Guatemalan children aged 6-59 months with malnutrition were recruited to participate in eight clinic events, including two in-person and six telehealth clinics. Six telehealth clinics were held at 4- to 6-week intervals, bookended by an initial and concluding in-person event. Nonparametric tests were used to analyze changes between baseline and last visit z-scores for height, weight for length, mid-upper arm circumference (MUAC), and body mass index (BMI) and to examine the relationship between the number of telehealth visits and z-score measurements at baseline and last visit. The number of children with severe malnutrition at baseline by weight for length, BMI, and MUAC decreased by the last visit. A decrease occurred in the number of children with stunted height. Changes in z-scores for height, weight for length, BMI, and MUAC between study onset and last visit did not reach statistical significance. Statistically significant relationships existed between clinic attendance and baseline and last visit weight for height/length z-scores and baseline MUAC z-scores. Positive improvements in nutritional status occurred, especially among children with severe malnutrition. Children with severe malnutrition had significantly better telehealth attendance. Studies with larger sample sizes are needed. Study results indicate that telehealth may be a tool to battle global pediatric malnutrition.

Drivers and magnitude of food insecurity among rural households in southern Democratic Republic of Congo

Drivers and magnitude of food insecurity among rural households in southern Democratic Republic of Congo

Intra- and intergenerational food insecurity: An analysis of Black and White women and children from the NHLBI Growth and Health Study

BackgroundFood insecurity (FI) continues to be a significant public health concern and is associated with myriad physical and mental health consequences. Increased understanding of conditions around its occurrence throughout the life course are needed. However, research has been limited due to inadequate measurement tools and study length. ObjectiveThis study examined the intra- and intergenerational dynamics of FI over time by assessing the transmission of FI from childhood to adulthood, and from mother to offspring using population-specific FI measures, and the influence of sociodemographic factors. MethodsWomen in early midlife (n=624) and their children (n=331) participated in a prospective cohort study between 1987-2019 in Richmond, California. Three validated FI measures were assessed, representing 1) past childhood FI and 2) current adult household FI, reported by the women, and 3) current child FI, reported by the women’s children. Associations between measures were examined using adjusted modified Poisson regression models. Mediation by current adult household FI between past childhood FI and their offspring’s current child FI was assessed. Moderation by sociodemographic factors, including poverty level, parental education, marital status, and race was also assessed. ResultsAmong women, 32.4% reported FI in childhood and 34.5% reported current adult household FI. Among their offspring, 53.2% reported current child FI. Past childhood FI increased the likelihood of current adult FI (RR: 2.18, 95%CI: 1.64, 2.90) and current adult FI increased the likelihood of current child FI (RR:1.49, 95%CI: 1.08, 2.07). Current adult FI partially mediated past childhood FI and their offspring’s current child FI (Natural indirect effect: 1.42, 95%CI: 1.03, 2.24). There was no evidence of moderation by sociodemographic factors. ConclusionsFI measures reported by adults and children capture differing experiences, highlighting the need to use FI measures that are appropriate for their target population. FI may be perpetuated intra- and intergenerationally.

Context-Tailored Food-Based Nutrition Education and Counselling for Pregnant Women to improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi

BackgroundInadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes. ObjectiveTo improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi. MethodsWe performed a two-armed (1:1) cluster-randomized controlled trial in Southern Malawi enrolling pregnant women at gestational age 12-18 weeks. Twenty villages (clusters) were randomized to an intervention or a control group. A nutrition education and counselling (NEC) intervention consisted of education sessions followed by cooking demonstrations and counselling sessions. The women were encouraged to use locally available nutrient-dense foods to enhance dietary adequacy and -diversity. We applied linear programming to identify food combinations which could increase micronutrient-intakes. The control group received standard antenatal health education. ResultsAmong the 311 women recruited, 187 (60%) completed the trial. We found no significant difference in mean birth weights recorded within 1 or 24 hours of birth between the intervention and control groups. Intervention infants had greater birth length (P = 0.043) and abdominal circumference (P = 0.007) compared to controls whereas other birth outcomes did not differ significantly. Notably, a quantile analysis revealed that the NEC intervention favored birth weight among mothers with height below the mean height of the participant sample (156 cm) (P interaction=0.043). ConclusionsTailoring NEC in food insecure communities did not result in significant difference in birth weight among infants of the participating mothers, but mean birth length and abdominal circumference were greater in the intervention group compared to controls. We noted that the NEC intervention favored birth weight among mothers with a lower height than the mean sample height. Our results warrant further investigation into offering tailored NEC early in pregnancy and on a larger scale. The study was registered with Clinical trials.gov ID: NCT03136393.

The role of agriculture for achieving renewable energy-centered sustainable development objectives in rural Africa

Multi-dimensional and overlapping barriers to wellbeing severely affect many areas in rural sub-Saharan Africa. In the region, more than 90% of cropland is rainfed, less than one third of households have electricity, almost 60% of the population reports food insecurity, and more than 35% of the population lives below the international poverty line. Climate change impacts on vulnerable systems with limited adaptive capacity and strong population growth are increasing the magnitude of these challenges, slowing and potentially reversing development. Thus, there is a strong need for multi-sector interventions across multiple levels, from national policies, to regional and river catchment-scale planning, to local planning and investment. To implement such actions, it is key not only to assess technological solutions and their investment needs, but also to appraise their feasibility and implementation potential (from both a policy and a financial point of view). Here, we implement a modelling platform (RE4AFAGRI platform), which soft-links bottom-up process-based water and energy demand and techno-economic infrastructure assessment models (WaterCROP, M-LED, OnSSET) into a multi-node, national Nexus-extended Integrated Assessment Model (MESSAGEix-Nexus) for supply and investment assessment. The results of our analysis shed light on the role of water and energy demand in the agricultural sector for jointly affecting infrastructure and investment requirements for achieving rural sustainable development objectives. We find that scenarios with increased ambition in expanding irrigation and agricultural productivity result in improved diffusion and economic feasibility of infrastructure to provide universal energy access while supporting productive uses of energy. Moreover, we conduct business model analysis to appraise the framework conditions and micro and macro determinants that can ensure feasibility of investment and uptake of small-scale infrastructure, crucial for rural development. Altogether, our research demonstrates how integrated modelling with an explicit focus on Nexus interlinkages can represent the enabling role and the business conditions for renewable energy input in agriculture to become a leverage of rural sustainable development. In turn, important policy and investment-relevant insights can be derived.

Food purchase patterns, food policy recognition, and food environment satisfaction among adults in Jeju, Korea, according to food security: a cross-sectional study

Objectives: Recently, food insecurity has been a major public health issue along with the food crisis caused by COVID-19, climate change, and the polarization of food supply due to socioeconomic disparities. Food insecurity is known to be related to the food choices and environment of the consumer. Therefore, this study aimed to evaluate the food security statuses of adults in Jeju and investigate their food purchase patterns, food policy recognition, and food environment satisfaction.Methods: Based on data from the 2022 Jeju Food Survey, 346 adults aged ≥19 years in Jeju were classified into food security and insecurity groups (quantitatively and qualitatively) using the questionnaire. Food purchase patterns, including purchasing frequency, items, and reasons, were surveyed for local and eco-friendly foods. The recognition and necessity of several food policies and satisfaction with diet and food environment (availability, accessibility, affordability, accommodation, and acceptability) were measured using the Likert scale.Results: Among the total participants, 47.4% were in the food insecurity group. The frequency of purchasing local and eco-friendly foods did not significantly differ by food security status. The insecurity group exhibited a higher recognition rate of basic rights to food (36.0%) than the security group (24.7%, P = 0.023). The recognition and necessity of specific food policies did not significantly differ by food security status, except for the policy of promoting food communities, for which the food security group exhibited higher recognition than the food insecurity group did (P = 0.004). The food insecurity group exhibited significantly lower scores regarding satisfaction toward diet and food environment factors (P &lt; 0.05 for all).Conclusions: Overall, the food security group reported higher satisfaction with their diet and food environment than the food insecurity group. Further in-depth studies to investigate the determinants of food insecurity and effective promotional strategies for food policies are needed.

Food Insecurity Is Common in Patients with Inflammatory Bowel Disease and Is Associated with Increased Ultra-Processed Food Intake.

Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population. This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System. Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least "sometimes" in the last 12 months and 10% reporting decreased food access "often" in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, p = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, p = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support. The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality.

The community food environment as an effect modifier of the relationship between racial discrimination and food insecurity among adults in Southern Brazil

BackgroundRacial discrimination is linked to unhealthy food environments and a higher prevalence of food insecurity. However, no study has explored their interrelated effects. We analyzed the relationship between racial discrimination, community food environment, and food insecurity in adults of different socioeconomic status. We also investigated the potential modifying effect of the food environment on the relationship between racism and food insecurity.MethodsThis was a cross-sectional study of 400 adults aged 20–70 years residing in the central area of ​​Porto Alegre, the capital of Rio Grande do Sul state. Race and racial discrimination were assessed by self-reported race/skin color using the Experiences of Discrimination scale (EOD), respectively. The food environment was assessed using the Nutrition Environment Measures Survey in Stores (NEMS-S) tool. Food insecurity was assessed using the short version of the Brazilian Food Insecurity Scale (EBIA for short, in Portuguese). Poisson regression with robust variance was employed for the multivariate analysis.ResultsThe prevalence of food insecurity was higher in areas with a poorer food environment (areas 1 and 3; 56.6% and 58.8%, respectively). Racial discrimination was associated with food insecurity, where every 1-point increase in the racial discrimination score increased the likelihood of food insecurity by 7% (prevalence ratio [PR] 1.07; 95% CI, 1.03–1.20). When stratifying the analyses by food environment, racial discrimination was associated with food insecurity only in areas with a poorer food environment (PR 1.06; 95% CI, 1.01–1.10).ConclusionsExperiences of racial discrimination were associated with a higher prevalence of food insecurity in the study population. The community food environment was an effect modifier of this relationship, highlighting the relevance of interventions in the food environment focused on areas with a greater presence of Black people as a way of combating racism and food insecurity.

Disparities in Food Insecurity and Academic Achievement Among California Public University Students: An Intersectional Approach.

Background/Objectives: Historically racialized status (HRS) and low socioeconomic position (SEP) are independent risk factors for food insecurity and poor academic achievement among college students. Despite increased enrollment of students from historically racialized groups and low SEP, little is known regarding the intersectional experience of these contemporary student characteristics with food security status or academic achievement. The purpose of this study was to examine the intersections of racialized status and SEP with food insecurity and academic achievement among undergraduate students attending a public university system in California. Methods: This cross-sectional study included 1170 undergraduates who utilized their campus food pantry between June and August 2019 at nine University of California campuses. Racialized status and SEP were used to construct four distinct intersectional positions: (1) White, not low SEP (i.e., traditional students; reference), and three contemporary student groups: (2) White, low SEP; (3) HRS, not low SEP; and (4) HRS, low SEP. Using regression analyses, these intersectional positions were examined with food insecurity and grade point average (GPA), while controlling for other student characteristics. Results: HRS, low SEP students had significantly higher odds of experiencing food insecurity (OR = 2.72; 95% CI: 1.52-4.97) and lower GPA (B = -0.14, p = 0.05) than traditional students, after adjustment. Conclusions: Contemporary students are at increased risk of food insecurity and lower academic achievement compared to traditional students.

Rethinking Food and Nutrition Security: Why Income Alone Isn’t Enough in Coffee-Producing Areas of Ethiopia.

Background Coffee-growing communities in Yayu, Southwestern Ethiopia, are perceived to be food secure due to income from coffee production. However, while income ensures caloric sufficiency, it does not necessarily translate into complete food security, especially in terms of nutrient intake. Our study assessed the food and nutrition security of smallholder farm households in Yayu, with a particular focus on dietary diversity and hidden hunger. We found significant gaps in nutritional intake, especially for vulnerable groups such as women and children under five. Policy and Implications Ethiopia’s Productive Safety Net Program (PSNP) targets food-insecure areas based on economic status, assuming that income ensures food security. However, our findings suggest that this approach may be flawed, as households in coffee-growing regions are often labeled food secure despite significant deficiencies in essential nutrients such as heme iron. This calls for a re-evaluation of food security policies in cash-crop-dominated areas to address not only income but also access to diverse and nutrient-rich foods. Recommendations 1. Enhance Nutritional Education: Implement targeted educational programs focusing on the importance of dietary diversity, particularly in coffee-producing areas. 2. Diversify Agriculture: Encourage smallholder farmers to diversify crops, integrating nutrient-dense foods alongside coffee cultivation. 3. Improve Market Access: Strengthen local markets to ensure that nutrient-rich foods are available and affordable during both surplus and shortage seasons. 4. Revise PSNP Criteria: Use localized food and nutrition data rather than income alone to identify food insecurity in cash-crop regions. Conclusion Income from coffee production in Yayu improves caloric sufficiency but does not guarantee nutritional adequacy. To combat hidden hunger, policies must move beyond income-based indicators of food security and prioritize access to diverse, nutrient-rich foods. This will ensure a more comprehensive approach to food and nutrition security in Ethiopia’s coffee-growing regions.

“When you have stress because you don’t have food”: Climate, food security, and mental health during pregnancy among Bakiga and Indigenous Batwa women in rural Uganda

Climate change exerts wide-ranging and significant effects on global mental health via multifactorial pathways, including food insecurity. Indigenous Peoples and pregnant women inequitably experience the harms associated with climate change and food insecurity. This study explores food security and maternal mental health during pregnancy among rural Ugandan Bakiga and Indigenous Batwa women in the context of climate change. Using a community-based research approach, we conducted a series of focus group discussions about climate, food security, and health during pregnancy in four Indigenous Batwa communities and four Bakiga communities in rural Kanungu District, Uganda, as well as longitudinal follow up interviews later in the year. Data were evaluated using a qualitative thematic analysis. Women consistently identified mental health as an important factor affecting maternal-fetal wellbeing during pregnancy. Many women identified that weather and climate extremes, such as prolonged droughts and unpredictable weather events, have made it more difficult for them to obtain sufficient food for themselves and their families during pregnancy, resulting in significant mental distress. More extreme weather conditions have made physical labour difficult or impossible during pregnancy, and resultant hunger further decreased ability to obtain food—a vicious cycle. Women described how anxiety was compounded by worry about future famine, as they anticipated further decreases in crop yields and rising food prices in a changing climate. Indigenous Batwa women experienced additional distress around their lack of access to Indigenous lands and its nutritious food sources. Overall, mothers in rural Uganda described food insecurity and climate extremes as major sources of stress during pregnancy, and they anticipate challenges will worsen. Interventions to enhance adaptive capacity to climate change are needed and should have a focus on the intricate connections with food insecurity and mental health as drivers of overall maternal health.

Women’s Leadership in Sustainable Agriculture: Preserving Traditional Knowledge Through Home Gardens in Santa Maria Jacatepec, Oaxaca

Rural communities in Oaxaca face challenges such as food insecurity, economic instability, and the loss of traditional agricultural knowledge. Home gardens, once essential for food production and income generation, have declined due to migration, environmental degradation, and modern agricultural pressures. This study evaluated how community-driven models, supported by crowdfunding, can revitalize home gardens to improve food security, build community resilience, and promote economic empowerment. A mixed-methods approach, including household surveys, interviews, and focus groups, was used to assess the impact of these gardens. The results showed that over 70% of households experienced improved food security and reduced reliance on external food sources. Home garden production also led to a 20% reduction in food expenses, and the sale of surplus crops provided additional income, enhancing household economic stability. Women’s involvement in agricultural decision-making increased, fostering empowerment within both family and community contexts. Traditional practices, such as seed saving and organic pest control, were maintained, contributing to the ecological sustainability of the gardens. Crowdfunding was an effective tool for financing home gardens, boosting community engagement and strengthening social bonds. The findings highlight the potential of integrating traditional knowledge with modern funding strategies to create resilient, sustainable agricultural systems in rural Oaxaca.

Nutritional Indicators of Bone Nonunion: A Systematic Review.

Background/Objectives: Bone nonunion remains a clinical challenge in orthopedic surgery with significant impacts on mental and physical wellbeing for patients. There are several previously established risk factors of nonunion that are connected to nutrition, but this has yet to be substantially explored. This review seeks to assess all studies that present associations between nutrition and nonunion to understand the potential for clinical relevance in nonunion prevention. Methods: Case-control and cohort studies comparing nonunion risk based on nutritional factors were gathered through PubMed in July 2024. Data were extracted with dual verification through Covidence and assessed for bias using the Newcastle-Ottawa Scale. Results: A total of 21 studies were included in this literature review. Vitamin D deficiency was a significant risk factor of nonunion in six studies and not significant in six other studies. Albumin was significant in three of the five studies addressing this lab value. Iron deficiency anemia was significant in a study assessing its impact on nonunion. Calcium was not significant in the one study mentioned. ICD-10-coded malnutrition was significant in one of the two studies. Sarcopenia, nutritional care plans, and dietitian-diagnosed malnutrition were statistically significant clinical indicators for predicting nonunion, but food insecurity was insignificant. Conclusions: Vitamin D, calcium, albumin, iron deficiency anemia, sarcopenia, and clinically diagnosed malnutrition have all been associated with an increased risk of nonunion in observational studies and should be considered when preventing nonunion development.

Use of a Health Fair to Promote Health Equity of the Hispanic Community in Metro Detroit

This study analyzes the demographics, general health characteristics, and barriers to healthcare of the Metro Detroit Hispanic community through a health fair survey. Data was collected using a descriptive, 25-question self-reported survey in English and Spanish administered to 19 health fair attendees. Of total respondents, 92% identified as Hispanic and 76% Spanish-speaking. Descriptive analysis was conducted on several variables, including prevalence of medical conditions, health behaviors, and barriers to care. Participants reported a high prevalence of serious chronic conditions including diabetes (29%) and hypertension (29%). Significant barriers included a lack of medical insurance (72%), no primary care physician (67%), and language (24%). Other notable barriers were medication and food insecurity (50% and 67%, respectively). Our findings illustrate the power of a health fair in reaching a local, underserved Hispanic population, and underscore the need for targeted efforts in improving Hispanic health equity and access in Metro Detroit.