Food insecurity affects nearly 1 in 5 US adults and is associated with barriers to preventive health care. Whether food insecurity is associated with lower national cancer screening adherence and whether Supplemental Nutrition Assistance Program (SNAP) participation is associated with attenuation of these disparities remain unclear. To evaluate the association between food insecurity and guideline-concordant colorectal, breast, and cervical cancer screening and to assess whether SNAP participation was associated with attenuation of screening disparities among food-insecure adults. This cross-sectional study used 2022 Behavioral Risk Factor Surveillance System data, a nationally representative survey of noninstitutionalized US adults. The study took place from May 22 to July 21, 2025. Data analyses were conducted from June 3 to July 7, 2025, and included respondents with complete food insecurity, SNAP participation, covariate, and age- and sex-eligible cancer screening data. Self-reported food insecurity during the past 12 months; SNAP participation served as the primary effect modifier. Guideline-concordant colorectal, breast, and cervical cancer screening based on US Preventive Services Task Force recommendations. Of 251 107 adults included in the analytic cohort, 47 453 (18.9%) reported food insecurity; food-insecure respondents were more often younger than 65 years (35 031 [73.8%] vs 118 063 [58.0%]) and female (27 690 [58.4%] vs 106 203 [52.2%]) compared with food-secure respondents. Screening adherence was lower among food-insecure than food-secure adults for colorectal (10 115 [51.6%] vs 59 825 [63.8%]), breast (1459 [61.2%] vs 7457 [72.5%]), and cervical cancer screening (1124 [39.8%] vs 4682 [50.3%]). In adjusted analyses stratified by SNAP participation, food insecurity was associated with lower odds of colorectal (adjusted odds ratio [aOR], 0.78; 95% CI, 0.74-0.83), breast (aOR, 0.69; 95% CI, 0.60-0.79), and cervical cancer screening (aOR, 0.63; 95% CI, 0.49-0.81) among respondents not enrolled in SNAP. Among food-insecure respondents, adjusted probabilities of being up to date with screening were higher among SNAP participants than nonparticipants for colorectal (48.2% [95% CI, 46.1%-50.2%] vs 46.3% [95% CI, 44.1%-48.4%]; difference, 1.9 [95% CI, 0.5-3.6] percentage points), breast (56.1% [95% CI, 54.0%-58.3%] vs 52.7% [95% CI, 49.7%-55.8%]; difference, 3.4 [95% CI, 1.3-5.6] percentage points), and cervical (51.3% [95% CI, 48.9%-53.8%] vs 45.2% [95% CI, 42.5%-47.4%]; difference, 6.1 [95% CI, 3.8-8.4] percentage points) cancer screening. In this cross-sectional study of 251 107 US adults, food insecurity was associated with lower likelihood of guideline-concordant colorectal, breast, and cervical cancer screening. Among food-insecure adults, SNAP participation was associated with higher adjusted screening probabilities than nonparticipation.

The National School Lunch and Breakfast Program, a US program that addresses food insecurity, requires children with higher household incomes to pay for meals. It is unclear whether universal school meals (USM) policies, which make all meals free, further alleviate food insecurity, particularly for students who would otherwise pay. This study estimates the association between statewide USM policies and food insecurity. A difference-in-differences study using a nationally representative sample of US households with 6- to 17-year-old children from 2012 to 2021 and 2023 to 2024. The exposure was maintaining statewide USM policy after 2022, determined based on state of residence. The primary outcome was household food insecurity; the secondary outcome was child food insecurity. Analyses were stratified by household income. The sample included 75 122 households. Households with the highest incomes in USM-maintaining states experienced a 1.3-percentage-point (95% CI: -2.1, -0.5) differential decrease in household food insecurity and a 0.9-percentage-point (95% CI: -1.4, -0.5) differential decrease in child food insecurity. Households with low-middle income in USM-maintaining states experienced a 3.2-percentage-point (95% CI: -6.1, -0.3) differential decrease in household food insecurity but no differential change in child food insecurity. Households with lowest income in USM-maintaining states experienced no differential change in household food insecurity and a 3.8-percentage-point (95% CI: -6.2, -1.5) decrease in child food insecurity, although caution is required because the parallel trends assumption was violated. Implementing statewide USM policies could contribute to decreased food insecurity among households with school-aged children.

Food insecurity and verbal aggression toward children: Income-differentiated pathways through parental psychological distress.

Objectives. To examine associations between (1) food insecurity and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP), and (2) ultraprocessed food (UPF) consumption and Healthy Eating Index-2020 (HEI) score among US pregnant women. Methods. We analyzed data from pregnant women (n = 1286) across 9 waves of National Health and Nutrition Examination Surveys, from 2001 to 2018. We assessed UPF consumption, as percentage of energy from Nova Group 4 classification, and HEI. Multivariable regressions estimated associations of food insecurity and WIC or SNAP participation with UPF consumption and HEI. Results. Food insecurity affected 20% of women and was associated with lower HEI (B = -3.8; SE = 1.4; P = .01) but not UPF consumption. UPF consumption did not differ by WIC or SNAP participation status (P > .05). WIC participants had higher HEI while SNAP participants had lower HEI (P = .01). Conclusions. Food insecurity was linked to lower prenatal HEI but not UPF consumption. WIC may improve otherwise low prenatal HEI; unchanged UPF consumption, irrespective of nutrition assistance beneficiary status, warrants public health and nutrition education strategies to reduce UPF consumption and scale access to affordable, less-processed, nutritious foods. (Am J Public Health. 2026;116(7):971-980. https://doi.org/10.2105/AJPH.2026.308507).

Protocol for the sequential multiple assignment randomized trial to reduce food insecurity and improve adherence in patients with hypertension (SMART-FI).

Youth mental health problems are rising nationally. Virginia ranks among the lowest states in youth mental health access and has concentrated pockets of food insecurity (FI), underscoring the urgency of policy responses. FI is a known risk factor, yet surveillance often relies on single-item measures. We introduce a multidimensional Food Insecurity Index (FII) to examine associations with adolescent mental health. We analyzed 2023 Youth Risk Behavior Surveillance System data from Virginia (n = 1866) and the United States (n = 10,724). The FII combined five indicators capturing acute scarcity and chronic dietary compromise. Survey-weighted logistic regression estimated adjusted odds ratios (AORs) for persistent sadness or hopelessness. Each 1-point increase in FII was associated with higher odds of persistent sadness or hopelessness in Virginia (AOR = 1.066, 95% CI: 1.005-1.130) and nationally (AOR = 1.087, 95% CI: 1.062-1.112). Female students had higher odds than males, and bullying was a strong correlate. A dose-response pattern was observed. Integrating FI screening with nutrition and behavioral health supports may help identify and address overlapping risks. Multidimensional FI is consistently associated with poorer mental health among high school students.

School-based food relief (SBFR) programs respond to students' immediate food needs by alleviating hunger. In Queensland, Australia, SBFR was expanded during the COVID-19 pandemic emergency response to address a perceived increase in food insecurity. This paper reports on an evaluation of programs supported by the Y Queensland, which aimed to highlight successful delivery practices and determine whether food insecurity improved. An explanatory mixed-method, multi-case study methodology was used to explore the effects of the program across four schools from the perspectives and experiences of the school staff. A descriptive survey supplemented the case study methodology to collect information from all other schools receiving SBFR support regarding program operations, types of SBFR provided, perceived program impact, and continued need for support. A total of 56 surveys and six in-depth interviews were collected from staff working in 46 schools supported by the program. The evaluation identified five key characteristics of effective program delivery: welcoming physical environments, relationships that promote social connection, inclusion of all to reduce stigma, adaptability to feedback and observation, and collaboration with the community. Programs with strong delivery characteristics improved food security and school connectedness, impacts that were especially valuable during COVID-19 disruptions. This study demonstrates how successful SBFR programs can operate as adaptable, equity-focused interventions that create supportive environments, reduce stigma, and strengthen social connectedness while addressing food insecurity during a public health emergency.

Liver transplant (LT) recipients are at risk of post-transplant diabetes mellitus (PTDM), and the incidence varies by region. We explored the relationship between county-level food environment and PTDM and whether food insecurity mediates regional variation. First-time LT recipients from July 2004 to December 2022 without pre-existing diabetes were identified in the UNOS SRTR database. Data on 3 measures of healthy food access at the county level were obtained: population experiencing food insecurity, low-income population with low access to grocery stores (food deserts), and ratio of unhealthy to healthy food options (food swamps), all expressed by quartile. The primary endpoint was PTDM. Subdistribution hazard models were used to estimate associations, adjusting for demographic and clinical characteristics and county-level social vulnerability. Mediation analyses quantified the extent to which the food environment explained regional variation in PTDM. A total of 68,273 LT recipients met the inclusion criteria; 15.5% developed PTDM. All 3 food environment measures were independently associated with higher PTDM risk, even after adjustment for recipient, donor, and county-level factors. These measures were also significant mediators of regional variation in PTDM. Food insecurity mediated 48% of regional variation in PTDM, while food deserts and food swamps mediated 20% and 23%, respectively. LT recipients in counties with decreased access to healthy foods were significantly more likely to develop PTDM. Food environment accounted for a meaningful proportion of regional differences in PTDM. Identifying and addressing food insecurity among LT recipients may represent a modifiable pathway to improve long-term outcomes.

Understanding household economic influences on child stunting: A cross-sectional study in Eastern Uganda.

Feeding resistance: Intersectional paths to food justice, health, and emancipation.

Sanctions, Food Insecurity, and the Mitigating Role of Foreign Investment

• The paper examines how conflict disrupts social assistance and whether humanitarian aid can fill gaps during crises. • The analysis uses household panel data from Amhara to show how conflict and climate shocks affect poverty and food security. • When the PSNP was curtailed by conflict, humanitarian aid filled the gap, highlighting benefits of coordinated support. • The study assesses how social and humanitarian aid mediate conflict and climate shocks on income, food security, and poverty. Little is known about how conflict interacts with social assistance to affect poverty and livelihoods outcomes. Even less is understood about how conflicts disrupt government- and donor-provided social assistance, and whether humanitarian emergency assistance can fill provision gaps in situations of acute crisis. This paper draws on an exceptional and bespoke household panel dataset collected in Ethiopia’s Amhara region, just before and after the conflict in the neighbouring Tigray region spilled over into the study area in 2021 In addition to the impacts of conflict spillovers into Amhara, climate variability and drought have been hallmarks of vulnerability and food insecurity in the region for decades. Our data provides a rare opportunity to study the interaction between conflict and assistance, whilst controlling for drought which has long shaped vulnerability in the study area. The paper provides new evidence of how social assistance and humanitarian assistance can complement each other to mediate the impacts of conflict on food security and poverty in climate-stressed environments. The results demonstrate that, as the PSNP was curtailed and conflict erupted and intensified, humanitarian assistance supported many people including those no longer served by the PSNP – a heartening dynamic. This demonstrates a promising picture of what coordination across historically fragmented sectors can achieve.

Objectives. To summarize and present a visual representation of the complex implementation context of cardiovascular disease prevention interventions and identify opportunities to increase an emphasis on equity. Methods. From May to October 2021, we conducted 24 interviews with people knowledgeable about cardiovascular disease prevention activities in the Denver, Colorado, metropolitan area, guided by the framing of a resource generator network analysis and the levels (clinical, behavioral support, health promotion/access, and regulatory/taxes) of the Prevention Impacts Simulation Model. We selected 4 program examples to demonstrate how subsets of the network carry out cardiovascular disease prevention activities. Results. There were 82 active and 7 inactive programs. We categorized organizations into 10 types. We identified the following health equity topic areas: tracking metrics, making referrals to basic needs services, offering non-health care services, addressing hunger and food insecurity, focusing programs on low-income and minoritized groups, and regulating industry. Conclusions. We recommend increasing the use of systems science methods in public health to reorient efforts toward prevention and equitable allocation of resources and to increase links across levels. (Am J Public Health. 2026;116(S3): S152-S161. https://doi.org/10.2105/AJPH.2026.308537).

Excessive rainfall anomalies during the dry season (harvest period) and their impact on rainfed crop yields in Ethiopia.

SWAP IT is a school-based nutrition programme that promotes healthier lunchbox choices for children in Australia. As part of the programme scale-up, ensuring that implementation responds to the social and cultural determinants that shape food and nutrition practices for Aboriginal and Torres Strait Islander communities is important for equitable impact. To inform the cultural adaptation of SWAP IT, this study aimed to explore the experiences and perspectives of Aboriginal school staff regarding the implementation of SWAP IT in schools with high Aboriginal and/or Torres Strait Islander enrolments. An exploratory qualitative study was conducted within the Hunter New England (HNE) region of NSW Australia-a large and geographically diverse area (132 000 km2) and one of 15 Local Health Districts in NSW. The study was led by an Aboriginal Program Manager from the Population Health Unit of HNE Local Health District, with further cultural oversight provided by programme governance groups. Grounded in Indigenous methodology, data were collected using yarning (an Aboriginal communication method and data collection tool) through individual and group yarns with 11 staff from seven SWAP IT schools. Data were analysed using Thematic Analysis and group yarns to inductively identify and refine key themes. Eight themes were identified. Four themes captured participants' direct experiences and perspectives of SWAP IT, including positive perceptions of its value (1A), and opportunities to strengthen cultural responsiveness in programme processes (1B), resources and content (1C) and distribution methods (1D). A second set of four themes reflected broader contextual considerations that emerged through the yarns and were seen to influence implementation, including preferences for culturally responsive materials and methods (2A), food access and insecurity as a significant challenge (2B), potential barriers to family engagement (2C) and sustainability concerns (2D). Incorporating surface level adaptations (e.g., Aboriginal artwork) and deep-level adaptations (e.g., cultural food practices) will enhance the programme's cultural responsivity for equitable delivery. Additional implementation strategies that account for the broader considerations may maximise impact for Aboriginal children and communities. Co-designing and piloting an adapted programme with Aboriginal communities is a critical next step. SO WHAT?: These findings highlight opportunities to strengthen cultural responsivity in programme design and delivery to better support Aboriginal and Torres Strait Islander communities.

BackgroundEnvironmental and social hazards shape HIV vulnerabilities in Sub-Saharan Africa. Although older adults (>55) have an HIV prevalence higher than the national average in Tanzania, they are understudied in HIV research. To address this knowledge gap, we examined associations between extreme weather event exposure, mobility, resource insecurities, and HIV vulnerabilities among older adults in Moshi, Tanzania.MethodsWe conducted a cross-sectional survey in Moshi with adults aged ≥50 randomly sampled from the Prospective Urban Rural Epidemiology cohort. We conducted multivariable linear and logistic regression analyses to examine associations between environmental (past-year extreme weather events; recent [past 6- and 1-month] seasonal/weather-related mobility) and social (food, water, and/or sanitation insecurity) hazards, protective factors (social support, resilience), and HIV vulnerabilities (condom use self-efficacy; sexual relationship power; lifetime intimate partner violence). Models were adjusted for age, gender, education, and relationship status.ResultsAmong participants (n = 250; mean age: 60.6 years, SD = 11.1; 72.8% women), over half (56.0%) reported >1 past-year extreme weather. Past-year extreme weather exposure (adjusted beta [aβ] = -1.09, 95% Confidence Interval [CI]: -2.08 to -0.10), past-month mobility (aβ = -2.25, 95%CI: -3.45 to -1.06), past 6-month mobility (aβ = -1.83, 95% CI: -3.17 to -0.48), and low food security (vs high/marginal) (aβ = -0.94, 95% CI: -1.72 to -0.15) were associated with lower condom use self-efficacy. Social support (aβ = 0.11, 95% CI: 0.06- 0.16) and resilience (aβ = 0.28, 95% CI: 0.12-0.44) were associated with increased condom use self-efficacy. Past-month (aβ = -5.03, 95% CI: -7.04 to -3.02) and 6-month (β = -2.59, 95% CI: -4.72 to -0.48) mobility were associated with lower sexual relationship power. Past-month mobility (aOR = 12.31, 95% CI: 2.67-56.80) and sanitation insecurity (aOR = 1.20, 95% CI: 1.10-1.32) were associated with higher intimate partner violence odds.ConclusionsExtreme weather event exposure, seasonal/weather-related mobility, and resource insecurities were associated with HIV vulnerabilities among older adults in Moshi. HIV programs in climate-affected contexts can include older populations and integrate social and environmental hazards.

Insufficient access to healthy food has been linked to poor health outcomes in under-resourced communities. The relationship between neighborhood-level food insecurity and diabetes in pregnancy remains understudied, with previous studies reporting inconsistent results. This study examined the association between living in a low-income, low access (LILA) census tract and the prevalence of pregestational type 2 diabetes (T2D) and gestational diabetes (GDM) among pregnant individuals. This cross-sectional study included patients who delivered a singleton pregnancy at ≥20 weeks' gestation at Henry Ford Hospital between January 2014 and December 2019 and resided within Detroit city limits at the time of delivery. Residence in a LILA census tract, as designated by the USDA Food Access Research Atlas, was the exposure, and prevalences of pregestational T2D and GDM were the outcomes, which were collected retrospectively from patient records. A total of 117 census tracts were designated as LILA. Covariates that were adjusted for included maternal age at delivery, race, body mass index (BMI), insurance status, and substance use during pregnancy (drug, alcohol, and tobacco). Multivariate logistic regression models were used to analyze the data. Of the 3,897 patients included in this study, 1,377 (35.3%) resided in LILA tracts and 2,520 (64.7%) resided in non-LILA tracts. When individuals residing in LILA and non-LILA tracts were compared, there were no significant differences in the prevalences of pregestational T2D (4.8 vs. 4.6%, adjusted prevalence odds ratio [aPOR] = 1.00, 95% CI: 0.72-1.38, p = 0.99) and GDM (11.3 vs. 13.7%, aPOR = 0.96, 95% CI: 0.78-1.20, p = 0.74). Maternal age at delivery, maternal BMI, race, and insurance status were all significantly associated with the prevalences of GDM and pregestational T2D. Our results suggest that a LILA tract is not significantly associated with the prevalences of T2D and GDM during pregnancy. · Living in a LILA tract was not linked with GDM or T2D in pregnancy.. · Age and BMI were significantly associated with T2D and GDM.. · Race and insurance status were significantly associated with T2D and GDM..

Recovery centered perinatal care: A retrospective cohort study evaluating a scalable prenatal care model to improve outcomes for birthing people with opioid use disorder and their newborns.

Substantial gains have been made in school nutrition over the last 2 decades. The COVID-19 pandemic highlighted the impact of food insecurity on child and adolescent nutrition, underscoring the value of school meal programs. Federal, state, and local regulations have improved the nutritional quality of school meal programs, including updated school meal guidelines from the US Department of Agriculture. Advocacy for universal school nutrition is needed to promote policies that prioritize continuous access to meals and snacks of high nutritional value and variety, experiential (hands on, practical, reflective) learning, and positive eating environments.

Cardiovascular diseases remain the leading cause of global morbidity and mortality. Strategies centered on individual risk factors have been insufficient to reduce population-level cardiovascular burden or to address persistent health inequities. This review is timely given the increasing emphasis on cardiovascular health (CVH) metrics, particularly the American Heart Association (AHA) Life's Essential 8 (LE8), and the growing recognition of social determinants of health (SDOH) as fundamental drivers of cardiovascular outcomes. CVH, as defined by AHA frameworks, remains suboptimal across populations being a strong predictor of cardiovascular and all-cause mortality. Emerging evidence highlights food insecurity and other adverse SDOH as major contributors of poor CVH, acting primarily through modifiable behavioral domains such as diet, physical activity, nicotine exposure, and sleep. LE8 mediates a substantial proportion of the link between social disadvantages and adverse cardiovascular outcomes, underscoring its potential utility as both risk assessment and intervention framework. Collectively, current evidence supports a paradigm shift in cardiovascular prevention strategies that integrate CVH metrics with SDOH. LE8 provides a practical and scalable framework to assess CVH and target modifiable pathways linking social disadvantages to CVD. Future research and interventions should adopt multilevel, equity-focused, and life-course-oriented approaches to effectively reduce cardiovascular morbidity and mortality.