Measures Of Food Insecurity Research Articles

Food and nutrition security definitions, constructs, frameworks, measurements, and applications: global lessons.

Food security (FS) is a powerful social determinant of health (SDOH) and is crucial for human and planetary health. The objectives of this article are to (i) provide clarity on the definitions of FS and nutrition security; (ii) provide a framework that clearly explains the links between the two constructs; (iii) summarize measurement approaches, and (iv) illustrate applications to monitoring and surveillance, policy and program design and evaluation, and research, mainly based on the ongoing rich experience with food insecurity (FI) scales. A clear and concise definition of FI and corresponding frameworks are available. There are different methods for directly or indirectly assessing FI. The best method(s) of choice need to be selected based on the questions asked, resources, and time frames available. Experience-based FI measures disseminated from the United States to the rest of the world in the early 2000s became a game changer for advancing FI research, policy, program evaluation, and governance. The success with experience FI scales is informing the dissemination, adaptation, and validation of water insecurity scales globally. The many lessons learned across countries on how to advance policy and program design and evaluation through improved FS conceptualization and measurement should be systematically shared through networks of researchers and practitioners.

Food insecurity: Discrepancy within Australian couple households

AbstractFood security remains a global public health priority but there may be bias in the prevalence of household food insecurity, depending upon who answers the questions. Using a cross‐section from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we analysed components of food insecurity reported separately by both partners in 718 households, allowing examination of discrepancies among couples. We modelled discrepancy in reports of food insecurity on 8 items using binary logit models for each question and a binomial regression for the number of questions on which there was discrepancy. Among couples who differed on an item, (conditional) discrepancy rates ranged from 71.75% to 85.86%. Females were more likely than males to report food insecurity on most items. Key characteristics associated with discrepancy were female's and male's age, female's education, being born in Australia, renting and male's employment. Male's age and birthplace were associated with discrepancy on more items while male's higher education and being a homeowner were associated with discrepancy on fewer items. Among couples who differed in responses, females were more likely to report food insecurity if they were older or had a disability, if their male partner was younger or had no disability, or if either person had more education than high school. The prevalence of food insecurity among couple households may be underestimated by 7.4 percentage points due to discrepancies in reporting. Discrepancies can reduce the accuracy of measures of food insecurity, impeding the targeting of responses, and lead to a less efficient allocation of resources to combat food insecurity.

Food insecurity, poor diet, and metabolic measures: The roles of stress and cortisol

Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36–43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.

Understanding Food Insecurity as a Determinant of Health in Pregnancy Within the United States: An Integrative Review.

Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood. The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes. PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists. Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models. Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.

Mental distress, food insecurity and university student dropout during the COVID-19 pandemic in 2020: evidence from South Africa.

Student dropout has been a key issue facing universities for many years. The COVID-19 pandemic was expected to exacerbate these trends; however, international literature has produced conflicting findings. Limited literature from Africa has investigated the impact of COVID-19 on student dropout trends, despite the documented devastation, including increased risk of food insecurity and mental distress, caused by the pandemic. This work seeks to understand the impact of food insecurity and mental distress on student dropout during the COVID-19 pandemic. Using a cross-sectional research design, first-year undergraduate students from a large South African university were recruited via email to participate in a survey between September and October 2020. The Household Food Insecurity Access Scale (HFIAS) was used to measure food insecurity and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) was used to measure mental distress. Multivariate regression was used to investigate factors associated with student dropout. The student dropout rate was 10.5% (95% CI: 8.2-13.2). The prevalence of severe food insecurity was 25.7% (95% CI: 22.3-29.4) and the prevalence of severe mental distress symptoms was 26.7% (95% CI: 23.3-30.4). Dropout rates and levels of food insecurity were highest among students residing in remote areas during the lockdown at 19.2% and 43.6%, respectively. The multivariate logistic regression revealed that being male increased the probability of dropout almost three-fold (odds ratio (OR) = 2.70; 95% CI: 1.48-4.89, p =0.001)). Being moderately food insecure increased the odds of dropout more than two-fold (OR=2.50; 95% CI:1.12-5.55, p=0.025), and experiencing severe mental distress symptoms increased the odds of dropout seven-fold (OR=7.08; 95% CI:2.67-18.81, p<0.001). While acknowledging that various factors and complexities contribute to student dropout, the increased vulnerability to food insecurity and mental distress, stemming from issues such as widespread job losses and isolation experienced during the pandemic, may have also had an impact on dropout. This work reiterates the importance of directing additional support to students who are food insecure and those who are experiencing mental distress in order to mitigate university student dropout.

Prevalence of food insecurity among caregivers of young children during the COVID-19 pandemic in Ireland.

Our objectives were to explore the prevalence of food insecurity in primary caregivers of young children in Ireland and to compare two tools for measuring food insecurity during the COVID-19 crisis. A cross-sectional online survey was conducted among caregivers of children aged <2 years in Ireland in May/June 2020. Relevant survey questions were closed-ended using two established tools for measuring food poverty/insecurity; the Irish Food Poverty Indicator and the Food Insecurity Experience Scale, developed by the Food and Agriculture Organization. Descriptive statistics were used to calculate the prevalence of food poverty/insecurity. To explore agreement in the classification of food insecurity by the Food Poverty Indicator and the Food Insecurity Experience Scale, Cohen's κ was used. Analyses are based on 716 participants; most had a 3rd-level education and were married or in a partnership. Per the food poverty index, Ireland's national measure of food poverty, 3.9% (n = 28) of our sample were experiencing food poverty. This rose to 10.5% (n = 75) experiencing food insecurity when using the Food Insecurity Experience Scale, which also measures worry/anxiety around access to food. There was low agreement between the tools, with 11.3% of the sample classified as food secure by one tool and food insecure by the other. Our current measure of food poverty in Ireland may not be sufficient to describe the food-access struggles or worry/anxiety about food access, experienced by the population, particularly during an emergency like COVID-19.

Impact of Pandemic COVID-19 towards Food Insecurity and Dietary Diversity Among B40 Mothers Living in Urban Areas in Selangor

Introduction: Food security and dietary diversity are critical in ensuring the nutritional and dietary adequacy of mothers. However, since the COVID-19 outbreak, it has become more challenging for mothers to maintain a healthy and varied diet, as more households are reported to be food insecure. Thus, this study aimed to assess food insecurity and its determinants, as well as to determine how it relates to dietary diversity. Methods: A cross-sectional study comprising 200 of B40 mothers with children under the age of two who resided in metropolitan regions of Selangor was conducted. Household Food Insecurity Access Scale (HFIAS) and Minimum Dietary Diversity for Women (MDDW) questionnaires were used to measure food insecurity and dietary diversity, respectively. Results: About 67% of mothers experienced food insecurity and 29.5% experienced dietary monotony. Less than 12 years of education (AOR=4.89, 95% CI=1.87-12.83) and living in a family with six or more people (AOR=3.48, 95% CI=1.20-11.20) were significantly associated with food insecurity. Besides, mothers with a monotonous diet were eight times more likely to be food insecure (AOR=8.03, 95% CI=2.67-24.05). Higher odds of dietary monotony were associated with less than 12 years of education (AOR=2.46, 95% CI=1.13-5.35) and household income contributor of not more than one person (AOR=3.78, 95% CI=1.66-8.60). Conclusion: Food insecurity was associated with an increased chance of dietary monotony among low-socioeconomic women residing in urban community. Therefore, identifying and addressing issues related to poor dietary diversity may allow for preventive and proactive measures to improve their nutritional status and well-being.

Patients with diabetes struggling to afford food and control their HbA1c in food-insecure areas in Bronx, NY.

To characterise the association between risk of poor glycaemic control and self-reported and area-level food insecurity among adult patients with type 2 diabetes. We performed a retrospective, observational analysis of cross-sectional data routinely collected within a health system. Logistic regressions estimated the association between glycaemic control and the dual effect of self-reported and area-level measures of food insecurity. The health system included a network of ambulatory primary and speciality care sites and hospitals in Bronx County, NY. Patients diagnosed with type 2 diabetes who completed a health-related social need (HRSN) assessment between April 2018 and December 2019. 5500 patients with type 2 diabetes were assessed for HRSN with 7·1 % reporting an unmet food need. Patients with self-reported food needs demonstrated higher odds of having poor glycaemic control compared with those without food needs (adjusted OR (aOR): 1·59, 95 % CI: 1·26, 2·00). However, there was no conclusive evidence that area-level food insecurity alone was a significant predictor of glycaemic control (aOR: 1·15, 95 % CI: 0·96, 1·39). Patients with self-reported food needs residing in food-secure (aOR: 1·83, 95 % CI: 1·22, 2·74) and food-insecure (aOR: 1·72, 95 % CI: 1·25, 2·37) areas showed higher odds of poor glycaemic control than those without self-reported food needs residing in food-secure areas. These findings highlight the importance of utilising patient- and area-level social needs data to identify individuals for targeted interventions with increased risk of adverse health outcomes.

Análise exploratória da associação entre estatura, obesidade e insegurança alimentar em adultos no Inquérito Nacional de Alimentação 2017-2018

ABSTRACT Objective Evaluate short stature as a possible explanation for obesity, and identify if consumption of energy, protein, carbohydrate, and lipids were associated to higher risk for obesity in Brazilian adults (20-59 y) living in household food insecurity. Methods Cross-sectional study from 2017/2018 Household Budget Survey (N=28,112). Food insecurity was measured with the Brazilian Household Food Insecurity Measurement Scale. Short stature was used as an indicator of malnutrition at the beginning of life, which characterizes metabolic alterations resulting from the presence of food insecurity (cuts off women ≤149cm; men ≤160cm). Body mass index (kg/m2) was estimated from self-reported weight and body height. The average food intake was estimated from a 24-hr recall. The weighted means and standard error of the food security/insecurity categories were assessed according to height, mean energy intake and protein(g), carbohydrate(g) and lipids(g) intake, stratified by gender and nutritional status. Results Both men and women with obesity and food insecurity had significantly lower average height in comparison with those in food security status (p-value &lt;0.01). The prevalence of obesity 1 (BMI 30-34.9kg/m2) increased significantly with the food insecurity among women. There was a trend towards short stature among obese women from families with food insecurity, as well as lower intake of energy. Among both men and women, the lowest intakes of protein and the highest intake of carbohydrates were observed in the underweight group (BMI &lt;18.5kg/m2). Conclusion In women, the risk of obesity may depend on the metabolic background, since who presents food insecurity and develop obesity have low stature and lower energy intake.

Time living with food insecurity and socio-demographic factors: longitudinal analysis in a city in the semi-arid region of Northeast Brazil.

Food insecurity (FI) is the lack of daily access for everyone to quality food in sufficient quantity. In many populations, it presents as a chronic and persistent condition. This study analysed the association between the length of time living with FI and socio-demographic conditions in households in a semi-arid municipality in the Brazilian Northeast between 2011 and 2019. This is a population-based cohort study among families in the municipality in Northeast Brazil (2011, 2014 and 2019). FI was estimated through the Escala Brasileira de Insegurança Alimentar (EBIA, Brazilian Household Food Insecurity Measurement Scale), and the longitudinal category of time of living with FI was adopted to classify them according to the time they remained in FI during the cohort. The association with the socio-demographic profiles of the population was verified through multinomial logistic regression. Households in semi-arid, Northeast of Brazil. Household respondents interviewed in 2011, 2014 and 2019 (n 274). Sixty-seven percentage (67 %) of families lived in FI in this period. Rural residence, low monthly per capita income and low schooling of the household reference person increased the chances of these families living longer in FI. These overlapping conditions increased the odds of FI in the household. Coping with FI requires intersectoral intervention that improves the socio-demographic conditions of the population.

A reconsideration of food insecurity trends in the United States

AbstractThe food insecurity status of a household in the United States is generally put into the categories of food secure, low food secure, or very low food secure. Substantial differences in the level of need within categories are then ignored. In response, I establish a class of food insecurity measure using the binary measure of food insecurity combined with a measure of “dollars needed to be food secure.” Using data from the 2010 to 2021 Current Population Survey, I examine whether patterns of food insecurity differ by choice of measure. The two most notable findings are, first, that changes in food insecurity are similar across measures up until 2019 when they began to diverge and, second, that while aggregate rates fell from 2010 to 2021 under all measures, groups especially vulnerable to food insecurity saw smaller declines in the food insecurity rate and increases over other measures.

Measuring food insecurity among a national sample of children with recurrent acute otitis media

IntroductionAcute otitis media is one of the most common reasons for pediatric medical visits in the United States. Additionally, past studies have linked food insecurity and malnutrition with increased infections and worse health outcomes. However, there is a lack of information on the risk factors for food insecurity in specific patient populations, including the pediatric recurrent acute otitis media (RAOM) population. MethodsThe 2011 to 2018 National Health Interview Survey (NHIS) datasets were used to obtain a national estimate of the presentation of food insecurity within pediatric patients with RAOM. Relevant sociodemographic information and prevalence were identified. A multivariable logistic regression model was used to determine sociodemographic risk factors. Calculations were conducted using R with the “survey” package to account for the clustering and sampling of the NHIS. ResultsOf 3844 children with RAOM who responded to the food insecurity module, 20.8 % (19.0–22.6 %) were food insecure. Age, race/ethnicity, percentage of federal poverty level status, insurance status, and self-reported health status were significant and were not independent of food insecurity status. Using multivariable regression, this study found the following sociodemographic risk factors: age 6–10 and age > 10 (reference: age 0–2); Black (reference: Non-Hispanic White); 100 % to 200 % and <100 % federal poverty level (reference: >200 % federal poverty level); public insurance or uninsured status (reference: private insurance); and poor to fair self-reported health status (reference: good to excellent). DiscussionChildren with RAOM who were older, Black, less insured, living in lower-income households, and of poorer health had a greater association with being food insecure. Due to the frequency of RAOM pediatric visits, identifying at-risk groups as well as incorporating food insecurity screening and food referral programs within clinical practice can enable otolaryngologists to reduce disparities and improve outcomes in a targeted approach.

Measurement of food poverty (shoku no hinkon) as capability deprivation in high-income countries: operationalisation with single mothers in Japan.

Existing food insecurity instruments are focused largely on the financial constraints associated with acquiring sufficient amounts of food. This narrow focus has resulted in underestimating the true prevalence of food poverty, particularly in high-income countries. Food poverty needs to be defined as capability deprivation, extending from the nutritional to the temporal, spatial, qualitative and affective aspects of eating. In this article, the Alkire-Foster counting approach is evaluated and an alternative method for measuring such multidi-mensional food poverty is proposed. The method is demonstrated by using evidence from interviews with 53 single mothers, the most high-risk social group in Japan. On the basis of an operational definition of food deprivation and poverty cut-offs, 16 mothers (30%) were identified as living in food poverty, followed by a qualitative analysis of their deprivation profiles. The results show that the economically-poor were highly likely to fall into food poverty, but that food poverty also occurred without economic deprivation, notably among the mental or physical illness carriers and long-hour workers. This multidimensional and decomposable measurement tool is effective for identifying food-poor populations not reflected in traditional food insecurity measurement instruments.

Survey Recruitment Bias and Estimates of College Student Food Insecurity

ABSTRACT Having valid measures of college student FI is essential for justifying basic-needs services for students. But college student food insecurity (FI) rates vary significantly across institutions, perhaps partially due to differences in non-response bias resulting from participant recruitment strategies. We tested for effects of recruitment method on measured levels of college student FI at three time points (2020, 2021, 2022). Survey response rates varied dramatically across recruitment modalities. Higher FI rates were estimated in low-response-rate survey deliveries. Emailed surveys appear to inflate estimates of student FI. Efforts to increase response rates likely produce more valid estimates of college student FI.

Food insecurity and associated factors among households with under-5 children in slum communities in Ibadan, Nigeria

IntroductionFood insecurity is a leading cause of childhood morbidity and mortality. This study assessed the prevalence of household food insecurity and its associated factors among under-5 children in Ibadan, Nigeria.MethodsThis was a cross-sectional household survey of 1,027 under-5 children and their caregivers in urban and rural slums in Ibadan. We used an electronic interviewer-administered, semi-structured questionnaire adapted from the Nigeria Demographic Health Survey and Household Food Insecurity Access Scale was used to report sociodemo-economic characteristics, food insecurity, and anthropometric measurement. The household food insecurity scale consisted of nine questions graded from 0 (Never) to 3 (Often) computed to determine the presence of food insecurity. Nutrition indices were computed, and the results were classified according to World Health Organization 2006 cut-off points. Chi-square tests were used to assess associations between food insecurity and the independent variables. Binary logistic regression analyses were conducted to identify the predictors of food insecurity (α = 0.05).ResultsThe mean ages of the caregivers and under-5 children were 31.7 ± 7.47 years and 34.49 ± 15.8 months respectively. Overall, 530 (51.7%) children were females, and 765 (74.5%) had normal weight for height. In all, 195 (19.0%) households had food insecurity, while 832 (81.0%) households had food security (Chi-square = 103.364, p = < 0.001). Under-5 children living in urban slums were seven times more likely to experience household food insecurity compared to those in rural slums (AOR = 6.859, 95%CI = 4.524–10.509, p = < 0.001).DiscussionHousehold food insecurity was more prevalent in urban slums. Strengthening of the school health program would help identify children with nutritional deficits, and improve the overall health status of children living in slum communities.

Material Need Insecurities among People on Hemodialysis: Burden, Sociodemographic Risk Factors, and Associations with Substance Use.

Despite their relevance to health outcomes, reports of food insecurity and housing instability rates among adults on hemodialysis are limited. Their relation to sociodemographic and behavioral factors are unknown for this population. We enrolled a convenience sample of people receiving hemodialysis at Baltimore and Washington D.C. metropolitan area facilities. Participants completed measures of socioeconomic position, food insecurity, housing instability, and substance use disorder. We cross-referenced participant and facility zip codes with measures of area poverty and residential segregation. We examined associations between individual- and area-level sociodemographic characteristics, food insecurity, and housing instability using multivariable logistic regression models. Of the 305 participants who completed study surveys, 57% were men, 70% were Black, and the mean age was 60 years. Thirty-six percent of the sample reported food insecurity, 18% reported housing instability, and 31% reported moderate or high-risk substance use. People on hemodialysis who were younger, with lower educational attainment, with lower incomes or experiencing financial strain were more likely to have material need insecurities (p<0.05 for all). Among participants living in segregated jurisdictions, men had increased odds of food insecurity compared to women (OR 3.7, 95% CI 1.61 - 8.53); younger participants (age <55 years) had increased odds of food insecurity compared to older participants (OR 3.3, 95% CI 1.49 - 7.32). Associations between gender or younger age category and food insecurity were not statistically significant in less segregated counties (p interaction for residential segregation x gender: p = 0.006; residential segregation x younger age category: p = 0.12). Food insecurity, housing instability, and substance use were common among this sample of adults on hemodialysis. Younger adults on hemodialysis, particularly those living in residentially segregated jurisdictions, were at increased risk for food insecurity. Future research should examine whether material need insecurities perpetuate disparities in dialysis outcomes.

Examining the effect of demographic and socioeconomic factors on household food insecurity in Lideta subcity, Addis Ababa, Ethiopia

Food security and vulnerability assessments in Ethiopia have traditionally focused on rural regions. In contemporary policy discussions, urban food security has garnered significant attention. Notably, there is a lack of empirical substantiation of urban food security and its impact on the livelihoods of city dwellers as they grapple with escalating food prices. The present study aims to determine the extent of household food insecurity and identify correlated factors among 692 households in three randomly selected Woredas (districts) within Lideta sub-city, Addis Ababa, Ethiopia. Six Ketenas (villages) were selected using a probability proportional-to-size technique from three Woredas between February and March of 2023. Data were collected through a validated survey administered by trained individuals, and household income and expenditure were used to measure food insecurity access. Chi-square (&amp;chi;2) and logistic regressions were used to identify factors associated with food insecurity in the region. The overall prevalence of household food insecurity in the study area was found to be 66.5%. Regression results indicate that seven of the hypothesized nine demographic and socioeconomic determinants of household food insecurity significantly influence the probability of experiencing food insecurity (p &lt; 0.05). Household food expenditure, household dependency ratio, age, sex, educational status of the household head, access to savings and credit, and the urban productive safety net program were identified as significant determinants of urban household food insecurity. This study underscores that food insecurity in Ethiopia is not limited to rural areas but also affects urban regions, mainly due to high urban poverty rates. Strategies to reduce household size, improve the household dependency ratio, and enhance socioeconomic factors can empower households to build resilience against food insecurity. Policymakers should adopt measures to stabilize the food insecurity improve living standards, and enhance the economic capabilities of urban households.

Gender, skin color, and household composition explain inequities in household food insecurity in Brazil.

It is well known that female-headed households (FHHs) are more likely to experience food insecurity (FI) than male-headed households (MHHs), however there is a dearth of evidence on how gender intersects with other social determinants of FI. Thus, this paper investigated changes in the prevalence of household FI in Brazil from 2004 to 2018 by the intersection of gender, race/skin color and marital status of the household reference person. Data from three cross-sectional nationally representative surveys that assessed the status of FI using the Brazilian Household Food Insecurity Measurement Scale were analyzed (N2004 = 107,731; N2013 = 115,108, N2018 = 57,204). Multinomial logistic regression models were used to examine the relationship between profiles of gender, race/skin color, marital status of the head of the household with household FI stratified by the presence of children <5 years of age. Over time, FHHs had a higher prevalence of mild and moderate/severe FI than did households headed by men. Food security prevalence increased from 2004 to 2013 and decreased between 2013 and 2018 for households headed by men and women. In 2018, households headed by black/brown single mothers with children < 5 years of age were at the highest FI risk. The probability of reporting moderate/severe FI in these households were 4.17 times higher (95% CI [2.96-5.90]) than for households headed by married white men. The presence of children in the household was associated with a higher probability of moderate/severe FI, especially for households headed by black/brown individuals regardless of the reference person's gender. The results suggest that gender inequities combined with darker skin color and the presence of children at home potentiate the risk of moderate/severe FI. Policy makers need to consider the principles of intersectionality when investing in codesigning, implementing, evaluating, and scaling up evidence-based programs to reduce FI.

Day Scholars Food Insecurity Experience Scale-Survey Module (DSFIES-SM): Psychometric Analysis

Background: School feeding programs’ evaluation requires the measurement of food insecurity, a more objective indicator, within school in low-income countries. The Global Child Nutrition Foundation (GCNF) uses subjective indicators to report school feeding coverage rates across many countries that participate in the global survey of school meal programs all year round. Aim: To test the methodological feasibility of measuring a school food insecurity construct as a direct indicator of the effectiveness and efficiency of school feeding programs. Methods: Two-stage sampling was used during the selection of schools and 128 schoolchildren with a mean ( SD) age of 10.5(1.58) were recruited. Item Response Theory (IRT) and Classical Test Theory (CTT) approaches were utilized during DSFIES-SM development. Psychometric analysis was utilized to assess the psychometric properties of the measure of school food insecurity and to establish the construct-level reliability, convergent and discriminant validity of the DSFIES-SM. Results: DSFIES-SM generated acceptable item-level reliabilities, ranging from .75 to .78. The construct-level reliability of the DSFIES-SM was indicated by Cronbach’s α of .78. Composite reliability was at .77. Fit measures and tests of model fitness for confirmatory factor analysis (CFA) (RMSEA &lt; 0.0001; TLI = 1.06; SRMR = 0.043; CFI = 1.00, p = .85) confirmed that the data fitted the model perfectly. Conclusion: DSFIES-SM consists of twelve questions with dichotomous yes/no responses. DSFIES-SM has good convergent and discriminant validity. Findings suggest that the items compose a statistical scale designed to cover a range of severity of school food insecurity. Future replications to establish other forms of validity across different cultural contexts in low-income countries can be of benefit to the present research.

Food insecurity and levels of marginalization: food accessibility, consumption and concern in Mexico

BackgroundFood insecurity continues to be a problem throughout the world. When estimating food insecurity, few studies analyze the contexts where the phenomenon takes place. By bearing in mind levels of marginalization in four states of Mexico, this paper answers two questions: (I) What problems are experienced with access to food, and how these difficulties affect the amount of food consumed in households? and (II) How do households experience the concern of running out of food?MethodsOur qualitative study draws data from urban and semi-urban areas of four Mexican states: Mexico City, Tamaulipas, the State of Mexico, and Oaxaca. Each state presents different levels of well-being. The study’s participants are selected using the snowball method. Eligibility criteria are based on demographic characteristics such as education, age, and gender. A thematic analytical approach is conducted to analyze collected data from a total of 212 semi-structured interviews.ResultsThe study’s findings indicate that concern of food scarcity is a generalized feeling among participants across different levels of marginalization. Individuals with stable jobs living in contexts of low levels of marginalization experience worriedness when their budgets tightened before the end of the payday, a bi-weekly payment format, named the quincena in México. This psychological state of mind changes through the payday cycle, a period when the direct relationship between food accessibility and consumption weakens. In response, individuals develop strategies to cope with the uncertainty of experiencing food insecurity, such as rationing food portions and/or hoarding food supplies. Even when food accessibility exists, interviewees identify insufficient income as the primary issue in contexts of low and very low levels of marginalization.ConclusionsConclusive remarks drawn from our analysis underline the importance of the context of marginalization in influencing households’ experiences with food insecurity. At the quincena’s end, food insecurity increases, even in contexts of very low marginalization. Our study calls for rethinking the scales employed to measure food insecurity, specifically the questions related to fear of food scarcity. Coping strategies are implemented by surveyed individuals to resolve issues and repercussions that emerge from experiencing food insecurity differ by context of marginalization.