Food Insecure Families Research Articles

Food insecurity and adolescent impulsivity: The mediating role of functional connectivity in the context of family flexibility.

Adolescent food insecurity is a salient adversity hypothesized to affect neural systems associated with increased impulsive behavior. Family environments shape how adverse experiences influence development. In this study, hypotheses were tested regarding the conjoint effects of food insecurity and family flexibility on impulsivity via alterations in connectivity between regions within the salience and central executive networks. Such alterations are reflected in resting-state functional connectivity (rsFC) metrics between the anterior insula (AI) and the middle frontal gyrus (MFG). Hypotheses were tested in a longitudinal moderated mediation model with two waves of data from 142 adolescents (Time 1 [T1] Mage = 12.89, SD=0.85; Time 2 [T2] Mage = 15.01, SD=1.07). Data on past-year household food insecurity, family flexibility, and rsFC were obtained at T1. Impulsivity was self-reported by the adolescent at T1 and T2. Findings revealed that high T1 left-to-left rsFC between the AI and MFG was associated with increased impulsivity at T2. The interaction of family flexibility and food insecurity was associated with AI and MFG rsFC. In the context of low family flexibility, food insecurity was linked to high levels of AI and MFG rsFC. Conversely, in the context of optimal family flexibility, food insecurity was associated with low levels of AI and MFG rsFC. Conditional indirect analysis suggests that the links among food insecurity, rsFC, and impulsive behavior depend on family flexibility. RESEARCH HIGHLIGHTS: Adolescent food insecurity was associated with anterior insula and middle frontal gyrus connectivity only at certain levels of family flexibility. High family flexibility attenuated the link between food insecurity and neural connectivity, while low levels of family flexibility increased this risk. High left anterior insula and left middle frontal gyrus connectivity was associated with increased impulsivity 1 year later.

Good Friends and Good Neighbors: Social Capital and Food Insecurity in Families with Newborns

To examine the association between social capital and household food insecurity among US families with newborns. This cross-sectional analysis used enrollment data from 881 newborn-caregiver dyads at six geographically-diverse US academic sites enrolled in the Greenlight Plus Trial, a comparative effectiveness trial to prevent childhood obesity. Ordinal proportional-odds models were used to characterize the associations of two self-reported measures of social capital: 1) caregiver social support and 2) neighborhood social cohesion, with household food insecurity after controlling for sociodemographic characteristics. Among 881 newborn-caregiver dyads (49% Hispanic, 23% non-Hispanic white, 17% non-Hispanic Black; 49% with annual household income <$50,000), food security was high for 75%, marginal for 9%, low for 11% and very low for 4%. In covariate-adjusted analyses, caregivers with a low social support score of 18 had five times the odds (aOR=5.03 95%CI=3.28-7.74) of greater food insecurity compared with caregivers with a high social support score of 30. Caregivers with a low neighborhood social cohesion score of 10 had nearly three times the odds (aOR=2.87 95%CI 1.61-5.11) of greater food insecurity compared with caregivers with a high neighborhood social cohesion score of 20. These associations remained robust when both social capital measures were included in one model. Caregiver social support and neighborhood social cohesion each appear to be inversely associated with food insecurity among US families with newborns. Longitudinal research is needed to determine the directionality of these relationships and whether improving social capital for families with young children reduces household food insecurity.

Women’s coping and adaptation strategies to climate change: a case of the Dodoma Region

ABSTRACT Climate change is escalating in intensity, frequency, and complexity. Its related threats have profound implications for humanity, particularly women. Measures to cope with and adapt to it have been researched in general and does not focus on the role of women in the specific community, who bear the brunt of the strife associated with climate change. It is from this view that this research assesses the effects of women’s coping and adaptation mechanisms to climate change. Data were collected through household surveys, key informant interviews, observation, and documentary reviews. The collected data were descriptively analysed with the aid of SPSS version 20 and Microsoft Excel. Results indicate that communities understood climate change in terms of variability in rainfall patterns and amounts, water availability, increased incidences of drought, and decreased agricultural yields. Such events reduced agricultural productivit and led to the reoccurrence of food insecurity. Women grew drought-tolerant and early-maturing crop varieties, walking long distances to fetch water, crushing pebbles, and engaging in small vending businesses, which had some effects, including falling into family conflicts, diseases, and food insecurity. The study suggested that there is a need for upscaling awareness and capacity building on good agricultural practices, the provision of loans to small vending businesses, and the provision of inputs that assist women to cope with climatic changes smoothly.

Factors Associated with Malnutrition Among Pregnant Women and Lactating Mothers in AJK, Pakistan

Background: Malnutrition during pregnancy and lactation is a major public health issue in developing countries like Pakistan. This study aims to assess the prevalence and factors associated with malnutrition among pregnant women and lactating mothers in Azad Jammu and Kashmir (AJK), Pakistan. Methodology: A cross-sectional study was conducted from January to December 2022 among 300 pregnant women and lactating mothers in the district Poonch of AJK. Data were collected through a semi-structured questionnaire. Anthropometric measurements, including height, weight, and mid-upper arm circumference (MUAC), were taken. BMI and MUAC were used to assess nutritional status. Results: The prevalence of malnutrition was 39% according to BMI (&lt;18.5 kg/m²) and 46% according to MUAC (&lt;21 cm). Significant factors associated with malnutrition included illiteracy (AOR: 2.7, 95% CI: 1.4-5.2), low family income (AOR: 2.1, 95% CI: 1.2-3.8), rural residence (AOR: 3.2, 95% CI: 1.7-6.1), food insecurity (AOR: 4.6, 95% CI: 2.4-8.9), and lack of antenatal care (AOR: 2.3, 95% CI: 1.2-4.5). Conclusion: Malnutrition is alarmingly high among pregnant and lactating women in AJK. Improving female literacy, socioeconomic status, and antenatal care coverage are recommended to address this public health issue.

The Association Between Child Food Allergy and Family Food Insecurity in a Nationally Representative US Sample

ObjectiveTo assess whether child food allergy is associated with family food insecurity, overall, and across different income levels. MethodsWe used the 2011–2018 National Health Interview Survey, a nationally representative cross-sectional survey. The exposure was child food allergy, and our main outcome was odds of family food insecurity, which was calculated using multivariable logistic regression models adjusted for child demographics, family characteristics and survey year. We examined for effect modification by the ratio of family income to the poverty threshold using stratification and tests for statistical interaction. ResultsAmong 83,287 children 6% had food allergy and 22% experienced family food insecurity. Child food allergy was associated with a 1.39-fold (95% confidence interval [CI]: 1.26, 1.53) increased odds of family food insecurity overall. Child food allergy was associated with a 1.46-fold (95% CI: 1.29, 1.66) increased odds of family food insecurity among children whose families lived below 200% of the federal poverty level, and a 1.26-fold (95% CI: 1.05, 1.51) increased odds of family food insecurity among children whose families lived at 200 to 399% of the federal poverty level, with no association among children whose families lived at or above 400% of the federal poverty level (P = .04 for interaction). ConclusionThere is an association between child food allergy and family food insecurity, and this association is modified by the ratio of family income to the poverty threshold. Improved availability and subsidy of allergen-free foods in nutrition assistance programs and food pantries are urgently needed.

Long COVID and the Higher Risk of Food Insecurity Among Participants and Nonparticipants of Food Assistance Programs in the United States

BackgroundIn the aftermath of the COVID-19 public health emergency, it is important to understand the extent of socioeconomic burdens of long COVID, defined as continuation of symptoms after initial infection, including food insecurity. ObjectiveThis study aimed to assess the association between long COVID and family food insecurity among low-income individuals (or any of their family members living with them) who were participants and nonparticipants in public food assistance programs (Supplemental Nutrition Assistance Program [SNAP], Special Supplemental Nutrition Program for Women, Infants, and Children [WIC], and National School Lunch Program [NSLP]) in the United States. DesignThe study used an observational cross-sectional design. Participants/settingData on 7151 adults (aged 18+ years), with family income of < 200% of the Federal Poverty line, from the 2022 National Health Interview Survey, were analyzed. Main outcome measuresLevel of family food security, based on responses to a set of 10 questions measuring family’s food security during the past 30 days. Statistical analyses performedMultinomial logistic regression models were estimated to obtain relative risk ratios of marginal and low/very low food security, relative to the base outcome of high food security, for long COVID status. Multivariable models were estimated separately for the full sample and for subgroups of food assistance participants and nonparticipants. A seemingly unrelated regression (SUR) specification was estimated to assess whether the estimates were different across the participant and nonparticipant subgroups. ResultsCompared with individuals who never had COVID-19, the adjusted relative risks of experiencing marginal and low/very low food security were 1.42 (95% CI, 1.00–2.02) and 1.43 (95% CI, 1.08–1.91) times higher, respectively, for individuals who had long COVID. Although the adjusted risks were not observed to be statistically significant in the participant subgroup, among nonparticipants, adjusted relative risk ratios were 2.34 (95% CI, 1.43–3.82) and 1.56 (95% CI, 1.02–2.39), respectively. SUR results showed that relationships between long COVID and food insecurity were only different for marginal and not low/very low levels of food security between food assistance participant and nonparticipant groups. ConclusionsStudy findings highlight a significantly higher risk of marginal and low/very low- food security among low-income adults who had long COVID, especially those who were nonparticipants in public food assistance programs. Further research is warranted to explore the causal pathways of this relationship for informing policies to mitigate the burden of long COVID.

Impacts of the COVID-19 pandemic on HIV care and treatment services among adolescents attending a tertiary hospital in Dar es Salaam, Tanzania: a qualitative study

BackgroundThe COVID-19 pandemic has caused substantial disruption on HIV care and treatment programmes, especially for adolescents living with HIV (ALHIV) who are known to have poorer health outcomes compared with...

Complex intertwined association between breastfeeding practices and household food insecurity: Systematic review and meta-analysis.

Breastfeeding offers ideal food and nutrition for infants; however, structural barriers may amplify breastfeeding inequities. We aimed to identify whether household food insecurity (HFI) is associated with exclusive and continued breastfeeding (EBF and CBF) as recommended by the World Health Organization/United Nations Children's Fund (UNICEF) Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, literature searches using 'breastfeeding', 'food insecurity' and 'infant' terms were conducted in PubMed/MEDLINE, Embase, CINAHL, Global Health and LILACS from inception through November 2023, without language restrictions, yielding 1382 publications (PROSPERO:CRD42022329836). Predetermined eligibility criteria yielded the 12 included studies (nine cross-sectional and three cohorts). The risk of bias was assessed through the Effective Public Health Practice Project. Meta-analysis was performed for studies assessing EBF (n = 10), and metaregression was used to explore heterogeneity across studies. Prevalence of EBF ranged from 1.6% to 85.3%, with a lower prevalence among HFI. The pooled effect of the association between HFI and EBF presented an odds ratio (OR) of 0.61 (95% CI = 0.49-0.76) with consistent results across marginal (OR = 0.72, 95% CI = 0.55-0.94), moderate (OR = 0.59, 95% CI = 0.41-0.84) and severe HFI (OR = 0.49, 95% CI = 0.32-0.76). High heterogeneity was found only when HFI was dichotomized. The prevalence of CBF ranged from 35.4% to 78.0%, with inconsistent prevalence among HFI; a meta-analysis was not performed due to the low number of studies (n = 3). We concluded that HFI levels are associated with lower odds of EBF. Integrating service and policy-level strategies, such as screening, referrals, skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/UNICEF breastfeeding recommendations among food-insecure families.

Prevalence and socio-economic determinants of growth and developmental delays among Iranian children aged under five years: A cross sectional study

BackgroundThe main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors.ObjectiveThe aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran.MethodsA cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4–60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families’ living and economic status, parents’ behavioral factors, household food security, mother’s general health, and perceived social support. Children’s growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14.ResultsThe prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers’ smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively.ConclusionThere are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers’ smoking, families’ economic status, and household food insecurity as well as history of mothers’ pregnancy complications. The present study’s findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.

The Association Between Early Family Social Stressors and Emotional Well-Being Among Infants and Toddlers

ObjectiveEarly childhood behavioral and emotional disorders are linked to diagnosable mental health problems both later in childhood and into adulthood. However, little work has examined the association between family social stressors and emotional well-being among children under two years of age, including whether differences exist between infancy and toddlerhood. MethodsData come from the nationally representative 2019–2022 National Health Interview Survey, an annual, cross-sectional survey conducted by the National Center for Health Statistics. Separate multivariate logistic regression models estimated associations between family social stressors (stressful life events, family food insecurity, family difficulty paying medical bills) and having a Baby Pediatric Symptom Checklist (BPSC) subscale score of 3 or more (“above the BPSC cutoff”) for poorer emotional well-being among children 2–23 months. Models were additionally stratified by age group (infants, 2–11 months; toddlers, 12–23 months), and adjusted for child and family sociodemographic and geographical characteristics. ResultsChildren who had experienced a stressful life event (AOR=3.83, 95% CI: 2.48–5.92), family food insecurity (AOR=1.69, 95% CI: 1.13–2.51), or family difficulty paying medical bills (AOR=2.10, 95% CI: 1.54–2.87) had higher odds of being above the BPSC cutoff, adjusted for all relevant covariates. Toddlers who experienced a stressful life event (66.5% vs 41.0%) or family difficulty paying medical bills (53.1% vs 29.8%) had higher odds of being above the BPSC cutoff compared with infants. ConclusionsFamily social stressors were linked to poorer emotional well-being among young children. Future research may benefit from the exploration of additional predictors of emotional well-being among this age group.

An optimal variable importance for machine learning classification models using modified simulated annealing algorithm

Abstract Each machine learning model will generate a different importance variable even though the method used is the same. Interpreting the variable significance is confusing. This study proposes combining several variable importance measures using a simulated annealing algorithm with an initial solution of mean and mode. The study uses simulation and empirical data. The simulation data are divided into three scenarios: no correlation, moderate correlation, and high correlation among predictor variables. The empirical data consist of 24 predictor variables. The machine learning models are classification models of random forest, extreme gradient boosting, neural network, and support vector machine. Based on the simulation data study, the combined variable importance will be optimal when predictor variables have low correlation. The simulated annealing algorithms show convergent objective values around the 25th iteration in empirical data. The more predictor variables, the higher the accuracy of this variable importance. Accuracy is optimal when the number of predictors exceeds ten. The five most important variables in explaining family food insecurity are the education of the family head, the floor type of the house, the number of family members who have a savings account, ownership of land, and decent drinking water.

Investigating the Relationship between Family’s Food Security and Social Support Received by Bushehri Mothers with Children Aged 7-12

&#x0D; &#x0D; &#x0D; Introduction: The high level of food insecurity in Bushehr has made it necessary to identify the factors related to food insecurity in families. This study is conducted to determine the relationship between received social support and household food security from the perspective of mothers with 7-12 children.&#x0D; Methods: In this controlled comparative study with a cross-sectional design, 153 mothers with children between 7-12 were selected with quota sampling method. First, First, the 18-item food security questionnaire regarding the United States Ministry of Agriculture was completed by mothers to create two safe and unsafe groups , and then, the social support questionnaire was completed by them.was completed , To analyze the results, the researchers applied logistic regression, descriptive statistics, chi- square and t-test. The level of significance was set at 0.05.&#x0D; Results: Of the 153 mothers who participated in the study, 36/6% had high-school education, and only 22/2% were employed. The families of mothers with higher education tended to be in secure food group (p=0/05, x2=10/22). Moreover, in the families with food security, the children’s average age was less than the families with food insecurity (P-value=0/03, t=-2/13). In 74.5% of the mothers, the amount of the received support was found to be high. Logistic regression showed a relatively insignificant and positive relationship (OR=1/02 and p=0/002) between the received support and food security from the mothers' point of view.&#x0D; Conclusion: Considering the insignificant relationship between household food security and the mothers’ received social support, other factors related to food insecurity, e.g. perceived social support and received social support in families aided by social service organizations should be explored.&#x0D; &#x0D; &#x0D;

Perceived social benefits and drawbacks of sea turtle conservation efforts in a globally important sea turtle rookery

Conservation interventions have wide-ranging social impacts - both positive and negative. Yet a limited understanding of how conservation initiatives affect people’s livelihoods often hinders our ability to learn from past efforts and design more effective and equitable conservation measures. This is particularly needed when there is a high degree of overlap between critical habitats and human activities or a high cultural and economic demand for products derived from the conservation target. Here, we explore the social impacts of sea turtle conservation initiatives implemented on São Tomé Island (Gulf of Guinea) as a case study and consider how these might enhance or hinder future efforts. Semi-structured interviews were conducted with key actors involved in the sea turtle trade in December 2014-February 2015 (prior to the implementation of key initiatives) and February-April 2022. Our findings suggest a clear reduction in the scale of the sea turtle trade and the number of main actors involved. However, most respondents previously involved in the trade had experienced economic displacement and several associated social impacts, such as the reduced ability to support family and friends and food insecurity, due to trade restrictions. Financial capital was the main barrier to transitioning to alternative livelihoods, followed by the lack of skills and peer pressure. Finally, this study highlights the importance of considering human dimensions during the planning and implementation phase of conservation actions and the need for more investment focused on the well-being of communities to ensure the long-term survival of endangered species.

Intergenerational Food Insecurity, Underlying Factors, and Opportunities for Intervention in Momostenango, Guatemala.

Achieving sustainable food security in Guatemala, where nearly half the population is food insecure and 50% of children face chronic malnutrition, is challenging. This mixed-methods study aimed to identify the impacts of climate change on food production, community food security, and household food security. Twelve agricultural group leaders in six communities were interviewed using semi-structured guides. Key informant interview themes included subsistence agriculture, commercial production, challenges related to climate, capital, market, and capacity, as well as sustainable opportunities. Fifty-five mothers from 13 distinct communities around Momostenango were surveyed and interviewed. A significant finding is that 85% of households were food insecure, with 93% relying on agriculture. Food-secure families mostly worked on their own or leased land, whereas food-insecure ones combined farming with day labor. In times of food scarcity, strategies such as altering food consumption and reducing expenses were common. Severely food-insecure families were significantly more likely to reduce portion sizes (72%), whereas food-secure families typically resorted to less preferred foods. Overall, food insecurity was notably linked to larger families, older mothers with limited education, and reliance on agricultural day labor. Food insecurity is a long-term issue in rural areas, deeply rooted in structural socioeconomic constraints, and recurring across generations.

How do children perceive and understand the experience of household food insecurity? A narrative review of the literature

PurposeChildren's food insecurity experiences are largely unrepresented in academic literature. Parents and caregivers cannot always accurately evaluate their children's attitudes or experiences, and even within the same family unit, children and their parents may report differing views and experiences of family food insecurity. The purpose of this narrative review is to identify studies that include children's voices and their perceptions, understanding, and experience of food insecurity in the household.Design/methodology/approachThis narrative review aimed to address the following questions: (1) “What research studies of household food insecurity include children's voices?” and (2) “Across these studies, how do children perceive, understand and experience food insecurity in the household?”. A database search was conducted in October 2022. After inclusion and exclusion criteria were applied, 16 articles remained for review.FindingsThe findings from this review were organised into three themes: Theme 1: Ways children coped with accessing food or money for food; Theme 2: Food-related strategies children used to avoid hunger; and Theme 3: Children attempt to mask food insecurity.Research limitations/implicationsFuture research should further explore the long-term consequences of social pressures and informal economic engagement on children's well-being and social development. By addressing the social determinants of food insecurity, this study can strive to create supportive environments that enable all children to access adequate nutrition and thrive.Social implicationsOverall, the findings of this review demonstrate the significant social pressures that shape children's responses to food insecurity. Results suggest that children's decision-making processes are influenced by the desire to maintain social standing and avoid the negative consequences of being food insecure. As such, this review underscores the need for a comprehensive understanding of the social context in which food insecurity occurs and the impact it has on children's lives. Understanding these dynamics is crucial for developing effective interventions and policies addressing the multifaceted challenges food insecure children face.Originality/value This review has highlighted a need for interventions to incorporate trauma-informed strategies to protect children from and respond to the psychologically distressing experiences and impact of living in food insecure households.

Family meals and food insecurity in Spanish adolescents

The world is not on track to achieve the goal of food security for the global population by 2030. New approaches to understand individuals’ food insecurity are needed, especially insecurity related to children and adolescents, since it is associated with health and psychosocial problems. The study aimed to characterise the family dinners among a representative cohort of schooled adolescents (n = 1017) and their parents (n = 261) in Terrassa (Catalonia, Spain) and how family dinners could be related to household food insecurity. The survey findings revealed that in 2022, 19.2% of the adolescents were experiencing household food insecurity. Adolescents with a lower socioeconomic status and of foreign origin showed the highest likelihood of experiencing household food insecurity. Household food security was also associated with some characteristics of family dinners, such as better quality and a higher frequency (seven or more dinners eaten together per week). Based on this finding, possible ways in which family dinners could offer a beneficial effect, alleviating the consequences of food insecurity in adolescents, are discussed. In line with the 2030 Agenda and the Sustainable Development Goal of guaranteeing food security, the promotion of family dinners and their quality, frequency, and duration to leverage the beneficial effect in states of household food insecurity in Spanish adolescents should be taken into account to design actions and public campaigns in Spain.

Mental Health Among Puerto Rican Adolescents Living in the United States During the COVID-19 Pandemic

ABSTRACT Objectives The present study examined how different family level (family financial stress, family violence) and individual (food insecurity, gender, race) determinants of health were associated with mental health among Puerto Rican adolescents living in the U.S. during the COVID-19 pandemic. Method A sample consisting of 119 Puerto Rican adolescents, aged 13 to 17, was collected via Qualtrics Panels between November 2020 and January 2021. We examined the association between family financial stress experienced during the pandemic and psychological distress. We also evaluated whether the association between family financial stress and psychological distress was moderated by family violence, food insecurity, and the participant’s gender and race. Results Findings showed that food insecurity positively predicted psychological distress. Results also showed that participants’ race moderated the association between family financial stress and psychological distress. Specifically, we found that while there was a significant positive association between family financial stress and psychological distress among Puerto Rican adolescents who identified as a racial minority, this association was nonsignificant among White Puerto Rican adolescents. Conclusion Our research highlights the significant role of COVID-19 related family financial stress and food insecurity on Puerto Rican adolescents’ poor mental health during the COVID-19 pandemic.

Prevalência e fatores associados à Insegurança Alimentar em famílias das comunidades quilombolas de Alagoas, Brasil

ABSTRACT Objective This study aimed identify the prevalence and factors associated with food insecurity in families from the remaining quilombola communities in Alagoas, Brazil. Methods This is a cross-sectional study involving families residing in a random sample of 34 out of the 68 quilombola communities in Alagoas. The dependent variable was food insecurity, defined by the Brazilian Food Insecurity Scale, and its association (prevalence ratio - PR and 95% CI) with the independent variables (socioeconomic, demographic, and environmental) was assessed through multivariable analysis (Poisson regression with robust variance adjustment). Results A total of 2,485 families were evaluated, of which 67.6% were experiencing food insecurity (32.9% mild, 20.1% moderate, and 14.6% severe). Variables associated with moderate + severe forms were: improper waste disposal other than public collection; households with ≤4 rooms; using inadequate water for consumption; households with &gt;4 residents; with residents &lt;18 years old; low educational level of the head of the family (≤8 years); belonging to the lower economic class (D-E); and being a beneficiary of the Bolsa Família Program. Conclusion Food insecurity affects more than two-thirds of quilombola families in Alagoas, constituting an expressive public health problem. In its more severe forms (moderate+severe), it is associated with worse environmental, socioeconomic, and demographic conditions.

The COVID-19 pandemic and food insecurity in households with children: A systematic review.

Food insecurity is defined as not having safe and regular access to nutritious food to meet basic needs. This review aimed to systematically examine the evidence analysing the impacts of the COVID-19 pandemic on food insecurity and diet quality in households with children <18 years in high-income countries. EMBASE, Cochrane Library, International Bibliography of Social Science, and Web of Science; and relevant sites for grey literature were searched on 01/09/2023. Observational studies published from 01/01/2020 until 31/08/2023 in English were included. Systematic reviews and conference abstracts were excluded. Studies with population from countries in the Organisation for Economic Co-Operation and Development were included. Studies were excluded if their population did not include households with children under 18 years. The National Heart, Lung, and Blood institute (NIH) tool for observational cohort and cross-sectional studies was used for quality assessment. The results are presented as a narrative review. 5,626 records were identified and 19 studies were included. Thirteen were cross-sectional, and six cohorts. Twelve studies were based in the USA, three in Canada, one each in Italy and Australia and two in the UK. Twelve studies reported that the COVID-19 pandemic worsened food insecurity in households with children. One study reported that very low food security had improved likely due to increase in benefits as part of responsive actions to the pandemic by the government. Although studies measured food insecurity using different tools, most showed that the pandemic worsened food security in households with children. Lack of diversity in recruited population groups and oversampling of high-risk groups leads to a non-representative sample limiting the generalisability. Food insecure families should be supported, and interventions targeting food insecurity should be developed to improve long-term health.

Global Prevalence of Perinatal Depression and Its Determinants Among Rural Women: A Systematic Review and Meta‐Analysis

Background: Perinatal depression (PND) in low‐resource areas is a significant concern that imposes a substantial burden on both families and societies. Although many studies have explored rural PND, there is a lack of systematic synthesis of the existing research. This study aimed to estimate the global prevalence of PND among rural women and to summarize its determinants.Methods: Comprehensively electronic searches were performed across eight English databases. Two reviewers independently assessed the eligibility of the study and extracted the relevant data. Any inconsistencies were resolved through discussion with a third reviewer. Prevalence estimates were calculated using a random‐effects meta‐analysis model. Subgroup analysis, sensitivity analysis, and meta‐regression were employed to examine the source of heterogeneity. In addition, a narrative synthesis of the influence factors reported in the included studies was provided.Results: The search identified 17,810 studies, of which 86 were included in the analyses. The pooled prevalence of PND in rural areas was 22.1% (95% CI 19.0%–25.3%, p &lt; 0.001, I2 = 99.2%). Subgroup analyses indicated higher PND prevalence in low‐income (24.5%) and lower middle‐income countries (22.8%). Additionally, PND prevalence was greater when assessed using self‐reported screening instruments (22.8%) compared to diagnostic interviews (17.6%). Major risk factors included violence, antenatal psychiatric disorder, low family income, male‐child preference, and food insecurity, while positive social support and higher levels of education were protective factors.Conclusions: Our findings suggest that the prevalence of PND is higher in rural areas compared to global data, particularly in low‐income and lower middle‐income countries. To improve rural maternal mental health, it is essential to develop measures targeting modifiable risk factors for PND, including promoting gender equality, implementing antiviolence initiatives, and strengthening economic support systems. Addressing these factors can help reduce the burden of PND and enhance the well‐being of mothers in rural communities.