High Food Insecurity Research Articles

Exploring Rural, Black Women’s Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population’s specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.

Characterising users of community-based interventions designed to improve the food practices

Abstract Promoting affordable ways to help low-income families improve dietary behaviours and achieve a healthy weight represents a priority for UK public health policy. For such interventions to be appropriately tailored and targeted, it is important to better understand the intended recipients. The present study aimed to assess the dietary practices and psychosocial characteristics of users of Aberdeen City community-based interventions (e.g., food banks, pantries, social cafés) designed to support low-income communities in accessing food and engaging in healthier food practices. From January to June 2023, a cross-sectional survey was conducted employing convenience sampling among users of community-based interventions (N = 105; 73 females). The questionnaire assessed diet quality (SFFQ), household food insecurity (HFIAS), mental health (PHQ-4), well-being (Cantril Ladder), intention and self-efficacy toward healthy eating, and sociodemographic variables. Data were analysed using descriptive statistics, group comparisons, correlations, and regression analyses. Results indicated that community-based food provision users are highly vulnerable to food insecurity. Among participants, 53.3% reported severe food insecurity, and 18.1% reported moderate levels. Service users’ diets were high in discretionary foods and drinks (26% consume daily >1 portion of fizzy juice, 18.2% sweets, 16.7% crisps vs. 11.5% fruits and 10.6% vegetables). The mean dietary quality score was 9.48 (SD = 1.90) from a possible 15. Higher food insecurity and lower diet quality were significantly associated with greater mental distress (r=.41, p<.001; r=-.287, p=.005;) and poorer well-being (r=-.460, p<.001; r=.19, p=.049;). This study is part of a larger project aiming to optimise community-based dietary interventions for low-income populations. The results provide a clearer picture of the intended beneficiaries of such interventions and highlight user needs that can be prioritised in optimisation efforts. Key messages • Community-based food provision users are highly vulnerable to food insecurity and related negative health experiences. • The burden of poor diet and its associated health consequences disproportionately affect those living in the most deprived communities.

Water insecurity may exacerbate food insecurity even in water-rich environments: Evidence from the Bolivian Amazon

Globally, challenges with water and food are two of the most pressing problems people face. Yet hydrologically water-rich environments and rural environments are often overlooked in these discussions due to abundance of natural water resources. Here we test the relationship between water and food insecurity among 270 Tsimane' households in the Bolivian Amazon. Water challenges were evaluated with the Household Water Insecurity Experiences Scale (HWISE), water quality perception, objective water quality analyses, and water access via the JMP drinking water ladder. Food insecurity was measured with the Household Food Insecurity Access Scale (HFIAS), and quantitative measures of food frequency recall were used to further test the water and food insecurity relationship. Using multilevel mixed-effects linear regression, each point increase in HWISE score was associated with 0.47 point (95 % CI: 0.30, 0.62, p < 0.001) higher food insecurity, and households with access to improved water sources had between 1.25 and 1.36 points (95 % CI: −2.61, −0.01, p < 0.05) lower food insecurity compared to households reliant on surface water. These relationships held true independent of quantitative measures of both fish and meat consumption. Using mixed-effects logistic regression analyses, each point increase in HWISE score was associated with 43 % (95 % CI: 1.25–1.66, p < 0.001) increased odds of experiencing severe food insecurity. Households changing what was eaten due to experienced water problems was associated with 2.33 points (95 % CI: 0.41, 4.25, p < 0.05) higher food insecurity. This relationship held true independent of perceived water quality, indicating other structural water problems may be important here in the household water and food insecurity relationship. These results demonstrate that even in water-rich environments, like the Amazon, water and food insecurity are interconnected. Further, despite the challenging conditions, equitable structural interventions, like the development of improved water infrastructure, are critical for the provision of clean drinking water and may simultaneously help alleviate food insecurity.

Dietary Restriction, Socioeconomic Factors, Access to Kidney Transplantation, and Waitlist Mortality.

Dietary restrictions for patients with end-stage kidney disease (ESKD) are burdensome. Kidney transplantation (KT) candidates who lack neighborhood resources and are burdened by dietary restrictions may have decreased access to KT. In our two-center prospective cohort study (2014-2023), 2471 ESKD patients who were evaluated for KT (candidates) reported their perceived burden of dietary restrictions (not at all, somewhat/moderately, or extremely bothered). Neighborhood-level socioeconomic factors were derived from residential ZIP codes. We quantified the association of perceived burden of the dietary restrictions with a chance of listing using Cox models and risk of waitlist mortality using competing risks models. Then we tested whether these associations differed by neighborhood-level socioeconomic factors. At evaluation, 18% of KT candidates felt extremely bothered by dietary restrictions. Those who felt extremely bothered were less likely to be listed for KT (adjusted hazard ratio [aHR]=0.75, 95% confidence interval [CI]: 0.64-0.87); this association did not differ by neighborhood-level socioeconomic factors. Overall, the burden of dietary restrictions was not associated with waitlist mortality (p=0.62). However, among candidates living in high food insecurity neighborhoods, those who felt extremely bothered had higher waitlist mortality (adjusted subhazard ratio [aSHR]=2.07, 95% CI: 1.14-3.75, p[interaction]=0.02). The association between dietary burden and waitlist mortality did not differ by neighborhood-level healthy food access. The perceived burden of dietary restrictions is associated with a lower chance of listing for KT, and higher waitlist mortality only among candidates residing in neighborhoods with high food insecurity. Transplant centers should identify vulnerable patients and support them with nutrition education and access to food assistance programs.

Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study.

Low birth weight (LBW) is a major public health issue associated with increased neonatal morbidity and mortality. This study aimed to examine the association between household food insecurity and LBW in Mashhad, Iran. Study Design: A population-based case-control study. This study involved 6294 mothers (3247 cases and 3247 controls) who visited healthcare centers affiliated with Mashhad University of Medical Sciences for term births between March 2019 and March 2022. Cases included women who delivered neonates weighing<2500 g, while controls delivered babies≥2500 g. Food security was measured using the validated Household Food Insecurity Access Scale. Logistic regression models examined the associations between food insecurity and LBW. Geographic information system techniques mapped LBW distribution in Mashhad. Household food insecurity was significantly associated with higher odds of LBW (adjusted odds ratio [AOR]=1.25, 95% confidence interval [CI]: 1.03, 1.53). Other risk factors included younger maternal age (AOR=1.03, 95% CI: 1.01, 1.04), lower maternal education (AOR=0.55, 95% CI: 0.43, 0.71), cesarean delivery (AOR=1.70, 95% CI: 1.40, 2.06), and exposure to secondhand smoke (AOR=1.68, 95% CI: 1.02, 2.75). Gestational diabetes demonstrated a protective effect (AOR=0.37, 95% CI: 0.15, 0.91). Geographic mapping revealed that regions with higher food insecurity had elevated LBW prevalence. These findings underscore the importance of addressing food insecurity among pregnant women to reduce the risk of LBW and improve newborn outcomes.

The role of SNAP and WIC in the bidirectional relationship between food insecurity and maternal depressive symptoms

BackgroundThe association between food insecurity and maternal depressive symptoms has been established by many cross-sectional and longitudinal studies however the understanding of the reciprocal relationship between them remains unclear. Further, previous research demonstrates that federal nutrition assistance decreases food insecurity and promotes maternal mental well-being but further research is needed to elucidate the moderating role of these programs in the association between food insecurity and maternal depressive symptoms. Therefore, the current study examined the bidirectional associations between maternal depression probability and food insecurity using cross-lagged models and then tested the main and moderating effects of SNAP and WIC. MethodsData were from the Future of Families and Child Wellbeing Study and the sample included 1948 mothers who participated in year 3 and year 5 of data collection. ResultsThe cross-lagged paths show that food insecurity at year 3 predicted maternal depression probability at year 5 and depression probability at year 3 predicted food insecurity at year 5. There was a significant moderating effect of WIC receipt on the association between food insecurity at year 3 and at year 5 such that when mothers with high food insecurity at year 3 received WIC, they were less food insecure at year 5. LimitationsThe study oversampled for unmarried mothers only two waves of data were used for the cross-lagged panel models. ConclusionsResults demonstrate the need to incorporate mental health services with the existing food assistance programs and the need to destigmatize the application process and program structure.

Firearm Homicide Mortality is Linked to Food Insecurity in Major US Metropolitan Cities.

Gun violence disproportionately affects metropolitan areas of the United States (US). There is limited information regarding the influence of social determinants of health, such as food insecurity (FI) on firearm homicide mortality (FHM) in major metropolitan cities in the US. We sought to examine the relationship between FI and FHM. This was a cross-sectional analysis examining the largest 51 US major metropolitan statistical areas (MSAs) using data from 2018. Demographic data, markers of social inequities, and firearm homicide data were obtained from the US Census Bureau, US Department of Education, and the Frey and Brookings Institute. Food insecurity prevalence was obtained from Feeding America. Spearman ρ and linear regression were performed. Using Spearman rho analysis, higher FI (r = 0.55, P < 0.001) was associated with FHM. Other variables associated with FHM included percent Black/African American (AA) (r = 0.77, P < 0.001), poverty rate (r = 0.53, P < 0.001), and percent of children living in single parent households (r = 0.58, P < 0.001). In linear regression analyses, FI was associated with increased FHM, with 1.3 additional FHM events for each unit increase in FI (β = 1.33, 95% CI 0.27-2.39, P = 0.02). The percent of a population that is Black/AA was also associated with FHM, with more than 4 additional cases for each 1% increase in the population (β = 4.32, 95% CI 3.26-5.38, P < 0.001). Food insecurity may influence FHM in major US metropolitan cities. Community- and hospital-based programs that target FI may help combat the gun violence epidemic and decrease gun violence.

Food insecurity and the consumption of plant-centered meals and high sodium foods among students at three large state universities

Objective: To examine the associations between food insecurity and plant-centered meal consumption and other sodium-related dietary behaviors among university students. Methods: A web-based survey of students at three California state universities was conducted between August 2018 to May 2019. Multivariable logistic regressions examined the associations between food insecurity and four sodium-related dietary behaviors. Interaction terms were introduced to assess if race/ethnicity moderated these associations. Results: High food insecurity was associated with increased odds of reporting ‘likely to order’ plant-centered meals (AOR = 1.55, 95% CI = 1.16–2.05). Moderate food insecurity was associated with increased odds of frequently eating processed foods (AOR = 1.40, 95% CI = 1.13–1.74). No moderation effects were found for race/ethnicity. Conclusions: University students with high food insecurity appeared receptive to ordering plant-centered meals, whereas those with moderate food insecurity consumed more processed foods. State universities should encourage and offer more low-sodium, plant-centered meal options in their food venues, on- and off-campus, to promote student health.

Psychological and socio-economic correlates of cardiovascular health among young adults in Puerto Rico

ObjectiveWe aimed to determine the relationship between socioeconomic and psychological factors and overall cardiovascular health (CVH), as defined by the American Heart Association's Life's Essential 8 (LE8), among young adults in Puerto Rico. MethodsParticipants were 2156 young adults, between the ages of 18–29 years, enrolled in the PR-OUTLOOK study. The analysis included survey, laboratory, and physical measurement data collected from September 2020 to November 2023. Assessed socioeconomic indicators included food insecurity, housing instability, economic insecurity, and subjective social standing. Evaluated psychological factors comprised symptoms of depression, anxiety, post-traumatic stress, and overall perceived stress. LE8 scores were calculated and classified as suboptimal (poor/intermediate range) vs. ideal CVH. Logistic regression models estimated associations between each socioeconomic and psychological measure and suboptimal CVH, and dominance analysis assessed the importance of each measure. ResultsParticipants' mean age was 22.6 (SD = 3.1), 60.9 % were female, about one-third (34.2 %) had high school education or less, and over one-third had public or no health insurance (38.4 %). Participants reporting socioeconomic adversity (i.e., high food insecurity, housing instability and economic insecurity, and low subjective social standing) and elevated psychological symptoms (i.e., symptoms of anxiety, depression, post-traumatic stress, and overall perceived stress) had lower CVH scores. However, in the adjusted analysis, only lower subjective social standing (OR = 1.38, 95 % CI = 1.13–1.69) and elevated symptoms of anxiety (OR = 1.63, 95 % CI = 1.25–2.13) and depression (OR = 1.30, 95 % CI = 1.03–1.65) emerged as the primary contributors to suboptimal CVH (vs. ideal). ConclusionEfforts to preserve and enhance CVH among young Puerto Ricans on the island should target these factors.

Functioning and quality of life among treatment-engaged adults with psychotic disorders in urban Tanzania: Baseline results from the KUPAA clinical trial.

There is a treatment gap for those living with severe mental illnesses in low- and middle-income countries, yet not enough is known about those who are currently accessing clinical services. A better understanding of potentially modifiable factors associated with functioning and quality of life will help inform policies and programming. To describe the functioning and quality of life for a psychiatric treatment-engaged population living with psychotic disorders in two urban areas of Tanzania, and to explore their respective correlates. This study analyzed cross-sectional data from 66 individuals enrolled in the Kuwezeshana Kupata Uzima (KUPAA) pilot clinical trial who had a diagnosis of schizophrenia or schizoaffective disorder, recent relapse, and who were receiving outpatient treatment. Baseline functioning (WHO Disability Assessment Schedule 2.0) and quality of life (WHO Quality of Life BREF scale) were measured. Univariable and multivariable regression analyses were conducted to determine correlates of functioning and quality of life. Adjusted analyses indicated that higher disability was associated with higher food insecurity, more symptomatology, more self-stigma, less instrumental support, less hope, lower self-efficacy, and/or lower levels of family functioning. Higher quality of life was associated with higher levels of self-efficacy, more hopefulness, more instrumental support, less self-stigma, and better family functioning. Identification of factors associated with disability and quality of life can help clinicians and policymakers, as well as consumers of mental health services, to better co-design and target psychosocial interventions to optimize their impact in low-resource settings. Trial registration: ClinicalTrials.gov # NCT04013932, July 10, 2019.

Nurturing care assets for food security: a community asset mapping approach

BackgroundZip codes classified by the Food Insecurity Index with moderate and high food insecurity (FI) risk can be a threat to the health and well-being of children during the first 1,000 days (from pregnancy to 2 years). The presence of nurturing care assets (i.e., stable environments that promote health and nutrition, learning opportunities, security and safety, and responsive relationships) can contribute to supporting families and their communities, and ultimately reduce systemic barriers to food security. We aimed to identify and characterize nurturing care assets in under-resourced communities with moderate and high FI risk.MethodsFour steps were used to conduct a Community Asset Mapping (CAM): (1) review of community documents across five zip codes in Clark County, Nevada (2), engagement of community members in identifying community assets (3), definition of the assets providing nurturing care services, and (4) classification of assets to nurturing care components, i.e., good health, adequate nutrition, safety and security, opportunities for early learning, and responsive caregiving. The Food Insecurity Index was used to determine FI risk in each zip code. Analyses explored whether disparities in nurturing care assets across zip codes with moderate and high FI exist.ResultsWe identified 353 nurturing care assets across zip codes. A more significant number of nurturing care assets were present in zip codes with high FI risk. The adequate nutrition component had the most assets overall (n = 218, 61.8%), while the responsive caregiving category had the least (n = 26, 7.4%). Most of the adequate nutrition resources consisted of convenience stores (n = 96), food pantries (n = 33), and grocery stores (n = 33). Disparities in the number and type of good health, early learning, and security and safety assets were identified within zip codes with high FI risk compared to moderate FI risk.ConclusionsThe quantity and type of nurturing care assets can exacerbate existing demographic disparities across zip codes, which are tied to barriers to access to food in under-resourced communities in Clark County, Nevada. Co-creating a nurturing care asset-based zip code strategy to address high FI risk will require strengthening systems across existing nurturing care assets.

Economic freedom, the minimum wage, and food insecurity

AbstractEconomic freedom, a measure of the degree of freedom from government intervention in the economy, has been found to be associated with many positive economic outcomes, such as lower unemployment rates, and higher growth of income, employment, and population. One area that remains unexplored is the relationship with food insecurity. Areas with more government intervention may be expected to have higher food insecurity because those interventions can create greater impediments to people's ability to prosper economically. One specific example of that is the minimum wage, which may make it harder for inexperienced low‐skilled workers to obtain employment. We provide the first state‐level examination of the relationship between food insecurity and economic freedom and find higher values of economic freedom (lower levels of intervention) are associated with lower food insecurity. We also examine one specific component of that economic freedom measure, the minimum wage, and find some limited evidence that higher minimum wages are associated with higher food insecurity.

Effects of Food Insecurity and Dietary Factors on Sleep Quality and Perceived Stress

Food insecurity is a significant concern at a national level, with college students facing a disproportionate impact. Food insecurity is defined as the lack of access to reliable and nutritious food. The link between food insecurity and perceived stress has been documented in prior research; however, its impact on sleep quality has yet to be studied. Food insecurity may reduce the nutritional quality of their diet and increase stress levels, which may negatively impact their sleep. This study aims to assess the impact of food insecurity and diet habits on perceived stress and sleep quality. Our hypothesis is that individuals with high food insecurity and a low quality diet experience higher perceived stress levels and decreased sleep quality. An anonymous survey was distributed through several social media platforms to individuals over the age of 18. The survey included demographic questions and seven validated scales. The scales included the Food Insecurity Experience Scale, Satisfaction, Alertness, Timing, Effciency, and Duration (SATED) Questionnaire, Health Promoting Activities Scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, International Physical Activity Questionnaire, and the Food Mood Questionnaire. These scales measured level of food insecurity, frequency of self-selected health activities, perceived stress, sleep quality, exercise habits, self-esteem, perceived stress, and dietary habits. Data from 561 individuals were analyzed using Pearson’s Correlation Coeffcient in IBM SPSS Version 28.0. The results reveal that feeling worried about having enough to eat was negatively correlated with sleep quality (r= 0-.177, p&lt;0.01), sleeping between 6 and 8 hours a day (r= 0-.181, p&lt;0.01), having confidence handling personal problems (r= -0.201, p&lt;0.01), and consuming dark leafy vegetables (r= 0-.164, p&lt;0.01). Feeling nervous and stressed was positively correlated with sleeping between 2am and 4am (r= 0.088, p&lt;0.05) and negatively correlated with sleep satisfaction (r= 0-.335, p&lt;0.01). Consuming fruits was positively correlated with sleep satisfaction (r= 0.112, p&lt; 0.01), while consuming nuts was positively correlated with staying awake during the day (r= 0.136, p&lt;0.01). The results suggest a strong relationship between food insecurity, diet quality, mental well-being, and sleep quality. Those who are food insecure are less likely to have adequate nutrition, which could raise their stress levels and increase diffculty sleeping. On the other hand, those who consume a well-balanced diet are more likely to have better quality sleep; however, it is worth noting that those who show signs of mental distress are less likely to have a good sleep quality. No funding was provided for this research study. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Nexuses between Food, Energy, and Water Consumption on Urban-Rural Income Gap in South-Eastern Asian Countries Using Difference in Difference in Modelling Technique

South Asian countries are still battling hunger and poverty, especially in rural areas. Empirical evidence attributes the urban-rural income gap to inadequate infrastructure, such as electricity and water supply. This article uses a difference-in-difference model to examine how emerging trends in Food, Energy, and Water (FEW) resources influence the urban-rural income gap. Using data from 2000 to 2019 from China, Indonesia, and India, the results showed that high food insecurity increases income inequality, whereas electricity supply significantly reduces the income gap. Thus, Asians should ensure a sustainable and equitable distribution of FEW resources to improve agricultural productivity and create jobs.

The Impact of Food Insecurity on the Management and Survival of Stage I-III Esophageal Cancer

BackgroundFood insecurity is associated with poor health outcomes; however, the connection with cancer care is not well understood. This study aimed to evaluate the impact of county-level food insecurity on the surgical management and survival of patients with esophageal cancer. MethodsPatients with stage I to III esophageal cancer were identified from Surveillance Epidemiology and End Results data (2010-2016). County-level food insecurity rates were obtained from the Map the Meal Gap data (2010-2016), divided into quartiles: high, marginal, low, and very low. Multivariable and multinomial logistic regression analyses were used to examine the relationship between food insecurity and surgical intervention and the relationship between food insecurity and recommendation and receipt of surgery, respectively. Multivariable Cox proportional hazards modeling was used to evaluate 5-year cancer-specific survival. ResultsA total of 11,114 patients were identified, most of whom were male (78.8%) and non-Hispanic White (77.7%); 44.8% had stage III disease. The odds of undergoing surgical intervention were 27% lower among patients in high–food insecurity counties compared with very low–food insecurity counties (odds ratio, 0.73; 95% CI, 0.64-0.82). The odds of a patient’s being recommended surgery but not undergoing it was 38% higher among patients in high–food insecurity counties compared with very low–food insecurity counties (odds ratio, 1.38; 95% CI, 1.08-1.75). Patients in higher–food insecurity counties had worse survival when compared with patients in very low–food insecurity counties (high: hazard ratio, 1.26; 95% CI, 1.16-1.36). ConclusionsAmong patients with esophageal cancer, significant disparities in surgical resection and survival are associated with high county-level food insecurity. Interventions focused on these communities may help reduce inequities in esophageal cancer care.

Screening for Food and Nutrition Insecurity in the Healthcare Setting: A Cross-Sectional Survey of Non-Medicaid Insured Adults in an Integrated Healthcare Delivery System.

Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity among patients being screened for social risks in the healthcare setting. Data from a 2021 English-only mailed/online survey were analyzed for 2791 Kaiser Permanente Northern California (KPNC) non-Medicaid insured members ages 35-85 years. Sociodemographics, financial strain, food insecurity, acquiring free food from community-based organizations, and nutrition insecurity were assessed. Data from respondents' electronic health records were abstracted to identify adults with diet-related chronic health conditions. Data were weighted to the age × sex × racial/ethnic composition of the 2019 KPNC adult membership. Differences between groups were evaluated for statistical significance using adjusted prevalence ratios (aPRs) derived from modified log Poisson regression models. Overall, 8.5% of participants reported moderate or high food insecurity, 7.7% had acquired free food from community-based organizations, and 13% had nutrition insecurity. Black and Latino adults were significantly more likely than White adults to have food insecurity (17.4% and 13.1% vs 5.6%, aPRs = 2.97 and 2.19), acquired free food from community-based organizations (15.1% and 15.3% vs 4.1%, aPRs = 3.74 and 3.93), nutrition insecurity (22.1% and 23.9% vs 7.9%, aPRs = 2.65 and 2.64), and food and nutrition insecurity (32.4% and 32.5% vs 12.3%, aPRs = 2.54 and 2.44). Almost 20% of adults who had been diagnosed with diabetes, prediabetes, ischemic CAD, or heart failure were food insecure and 14% were nutrition insecure. Expanding food-related healthcare screening to identify and assess food insecurity, nutrition insecurity, and use of community-based emergency food resources together is essential for supporting referrals that will help patients achieve optimal health.

Food insecurity and affective well-being during COVID-19 in the Middle East and North Africa

BackgroundThe COVID-19 pandemic and climate crises have led to unprecedented food insecurity in the Middle East and North Africa (MENA), with ramifications for people's affective well-being. The aim of the study is to explore the relationship between food insecurity and affective well-being in Jordan, Morocco, Tunisia, and Egypt, considering varied social protection responses across these countries. MethodsWe analyzed data from the COVID-19 MENA Monitor Household Panel Survey (2020–2021) and employed hybrid mixed-effects models to differentiate within-person and between-person associations between food insecurity and affective well-being. ResultsThe findings show that higher food insecurity is associated with worse affective well-being, with significant cross-country differences. In Jordan, where extensive social protection was enacted during the pandemic, there is no significant within- or between-person association between food insecurity and affective well-being. By contrast, significant between-person associations are found in Morocco and Egypt, while within- and between-person associations are evidenced in Tunisia. These associations hold strong after controlling for sociodemographic characteristics and household circumstances. LimitationsGiven COVID-19 restrictions, the sample was limited to the universe of working-age (18–64) mobile phone users, a demographic that often corresponds to higher levels of education and income. Therefore, the results of this study likely provide conservative estimates of the association between food insecurity and affective well-being in the full population. ConclusionsThe findings emphasize the critical role of food security in maintaining affective well-being, particularly in non-Western contexts during global crises. They underline the importance of integrating food security considerations into mental health care strategies and interventions.

Influence of selected agricultural technologies on household food security in alego usonga sub county, siaya county, Kenya

This study investigates the impact of agricultural innovations, such as wood ash, irrigation, and hybrid crop varieties, on the food security of households in a region with high food insecurity. The study highlights the role of these technologies in improving food availability, accessibility, utilization, and stability amidst challenges like climate change and low productivity. By focusing on the application of traditional and modern agricultural methods, the study provides insights into how these practices can enhance agricultural output and alleviate poverty in rural areas. The findings underscore the need for region-specific agricultural policies, gender-inclusive extension services, and the integration of traditional and technological solutions to address food insecurity in developing regions.

The double burden of COVID-19 and a major volcanic eruption on local food production and food security in a Small Island Developing State

IntroductionSmall Island Developing States have disproportionately high food insecurity rates, related to complex challenges and vulnerabilities. The COVID-19 pandemic highlighted that within these settings, crises often overlap. We aimed to assess the impact of the concurrent COVID-19 pandemic and volcanic eruption on food production and security in St. Vincent and the Grenadines (SVG).MethodsAn interpretive mixed-methods study was conducted among a convenience sample of consenting adults ≥18 years from 100 households in SVG through a cross-sectional survey and participant interviews (10 households) between September 2021 and March 2022. Food insecurity prevalence over the past year was assessed using the Food Insecurity Experience Scale (FIES; Rasch modeling) and impacts to livelihoods from the pandemic and volcanic eruption was assessed using an adapted Caribbean COVID-19 Food Security and Livelihoods Impact Survey (Caribbean COVID-19 FS&amp;amp;L Survey). Data were analyzed using logistic regression.ResultsDuring the pandemic, 59% of the participants reported decreased income, 63% had no access to markets, 81% had no access to food aid; 34% of the participants had a change in food sources, and 81% reported that food production was negatively impacted by the volcanic eruptions, of which 68% reported decreased food production. The interviews highlighted that access to markets were restricted by fear of leaving home and contracting the COVID-19 virus, and participants who received food aid stated that the number of items were not sufficient for larger families. Almost half of the participants were severely food insecure [48% (95% C.I. 31.2,57.8)]; almost two thirds were moderately to severely food insecure [64% (95% C.I. 50.0, 74.2)]; mean FIES score 5.31 (95% C.I. 5.0,5.6). After adjusting for gender, age, education, and household size, moderate to severe food insecurity was associated with no access to food aid during the pandemic and post-eruptions (odds ratio 3.7; 95% confidence interval 1.5, 9.1; p = 0.004).ConclusionFood insecurity rates were high during the COVID-19 pandemic, exacerbated by volcanic eruptions and insufficient access to food aid. Our results suggest the need for the development of strategies and interventions aimed at increasing the resilience of food systems to mitigate the effects of future disasters.

ANALYSIS OF EQUITABILITY IN HUMANITARIAN AID DISTRIBUTION: A CASE STUDY OF NORTH-EAST NIGERIA

This study examines equitability in humanitarian aid distribution in the context of the North-Eastern region of Nigeria, focusing on food security among host communities and internally displaced persons (IDPs). The North-East has been plagued by a decade-long insurgency, resulting in significant displacement of people and dependence on humanitarian assistance. While numerous aid organizations operate in the region, food insecurity and poverty persist at alarming rates, with over 71.5% of the population living below the international poverty line. Using a cross-sectional dataset from the International Organisation for Migration (IOM), this study employs ordinal probability regression and ordinary least squares regression models to analyse the impact of various factors on food security. The result reveals that a higher proportion of IDPs experience high food insecurity compared to host communities, and asset ownership significantly influences food security, with host community households possessing higher asset values. Interestingly, employed households are more likely to be food insecure, suggesting the need for labour market improvements for both groups. These findings underscore the importance of equitable aid distribution, especially in conflict-affected regions, and calls for targeted interventions to address the varying needs of host communities and IDPs. Further research and policy measures are essential to alleviate food insecurity and poverty in the North-Eastern region.