Higher Risk Of Food Insecurity Research Articles

Food insecurity in international and domestic students at an Australian university 2 years into the global COVID-19 pandemic

ObjectivesThe aim of this article is to explore the differences in the prevalence, sociodemographic determinants, and effects of food insecurity between international and domestic students in an Australian university during the COVID-19 pandemic. MethodsThis study uses a cross-sectional online survey. The questionnaire contained the 18-item Household Food Security Survey Module to assess food security status. Logistic regression models were used to analyze the associations between student characteristics and food insecurity. A total of 467 students (376 domestic and 91 international) attending a large university in Sydney completed the survey between October 2021 and May 2022. ResultsCompared with domestic students (13.0% food insecure), international students (18.7% food insecure) had higher odds of being food insecure in our sample (odds ratio = 2.02; 95% CI, 1.01–4.07; P = 0.013). Different risk factors for food insecurity were identified in these two student groups (e.g., being undergraduates and living outside the parental home, for domestic students, and, for international students, living in accommodation that provided meals that did not suit their preferences and experiencing changes in living arrangements due to the pandemic). Lower fruit intake was reported by food-insecure domestic students. Poor well-being was reported by both food-insecure domestic and international students. International students with food insecurity were more likely to use food assistance services than food-insecure domestic students. ConclusionsInternational students experienced a higher risk of food insecurity than domestic students during the pandemic in Australia. More tailored interventions to address food insecurity need to be developed for international and domestic students by considering their different experiences.

Food Insecurity Disparities Among Immigrants in the U.S.

Food insecurity negatively impacts public health and costs the U.S. healthcare system $53 billion annually. Immigrants are at higher risk of food insecurity. We sought to (1) characterize the prevalence of food insecurity among immigrants (i.e., noncitizens and naturalized citizens) and U.S.-born citizens and (2) determine whether Supplemental Nutrition Assistance Program utilization and income-poverty ratio levels impact the relationship between immigration status and food insecurity. Multivariable logistic regression models were used to determine the odds of food insecurity (dependent variables) using nationally representative data from the 2019-2020 National Health Interview Survey. Independent variables included immigration status, Supplemental Nutrition Assistance Program utilization, income-poverty ratio, and other important demographics. AORs with their 95% CIs are reported. Analysis was conducted in 2022. After controlling for independent variables, noncitizens had 1.28 (95% CI=1.02, 1.61) times higher odds of food insecurity than U.S.-born citizens. There was no food insecurity disparity between naturalized citizens and U.S.-born citizens. However, the association between immigration status and food insecurity varied significantly at different levels of Supplemental Nutrition Assistance Program utilization and income-poverty ratio. There were no food insecurity disparities between immigrants and U.S.-born citizens when they utilized the Supplemental Nutrition Assistance Program and when they had an income below 200% federal poverty level. Noncitizens who did not utilize the Supplemental Nutrition Assistance Program or those with an income above 200% federal poverty level were more likely to report food insecurity than their U.S.-born counterparts (AOR=1.32, 95% CI=1.01, 1.73 and AOR=1.88, 95% CI=1.24, 2.86, respectively). Moreover, naturalized citizens with an income above 200% federal poverty level were also more likely to report food insecurity than their U.S.-born counterparts (AOR=1.61, 95% CI=1.21, 2.14). Supplemental Nutrition Assistance Program utilization may likely eliminate food insecurity disparities among immigrants and U.S.-born citizens. However, among non-Supplemental Nutrition Assistance Program utilizers, significant food insecurity disparities remained between noncitizens and U.S.-born citizens after adjusting for independent variables. In addition, among individuals with incomes above 200% federal poverty level, significant food insecurity disparities were observed between immigrants and U.S.-born citizens. More research is needed to further understand the role that fear of deportation, ineligibility or lack of awareness about eligibility for the Supplemental Nutrition Assistance Program, and other factors such as structural racism play in food insecurity disparities between immigrants and U.S.-born citizens.

Risk of financial stressors in patients diagnosed with cancer: Lessons from a nationwide financial navigation program.

e18662 Background: Financial toxicity associated with a cancer diagnosis exacerbates the financial crisis in cancer patients and their families. Financial crisis is associated with poor outcomes due to both non-medical and medical hardships. Family Reach, a US-based nonprofit, is dedicated to removing financial barriers standing between cancer patients and their treatment through comprehensive financial navigation. In this study, we sought to understand the prevalence of medical and non-medical financial stressors in a Family Reach cohort. Methods: Patient application data (provided by patients, caregivers, or case workers) from the Family Reach program received between March 2020 and June 2022 were included in the analysis. Data included patient demographics, clinical attributes, financial attributes, and medical and non-medical financial stressors (described below). Significant associations between stressors and patient characteristics [X2 test and Odds Ratios (OR)] are presented. Results: A total of 10,558 applications representing 50 states and D.C. were processed in the study period. Data was stratified by type of cancer (55% solid vs. 38% hematologic), age of patient (32% pediatric, 32% AYA, & 36% adult), and patient race & ethnicity [41% non-Hispanic White (W), 22% non-Hispanic Black (B), 16% Hispanic/Latinx (H/L)]. Ninety-two percent had annual household income < $70,000 (US median -$70,784 in 2021). Race and ethnicity differences: Eighty-five percent B and 84% H/L patients had an annual household income < $50,000, as compared to 65% W patients (X2p < 0.05), and more likely to belong to single-parent households (59% B, 40% H/L, 30% W, X2 p < 0.05). B and H/L patients were at a higher risk of food insecurity (B vs. W, OR = 1.8, H/L vs. W, OR = 1.9), utility shut-off (B vs. W, OR = 1.9, H/L vs. W, OR = 1.4), phone shut-off (B vs. W, OR = 2.0, H/L vs. W, OR = 1.2) and houselessness (B vs. W, OR = 1.8, H/L vs. W, OR = 1.7), compared to W patients, after adjusting for geography. Age of cancer onset: No income differences were observed between pediatric, AYA, & adult patients. Adult (OR = 3.2) & AYA (OR = 1.9) patients had a higher risk of unpaid medical expenses, as compared to pediatric patients, after adjusting for income & geography. While no significant differences were noted between solid and heme cancers, lung patients were at a higher risk of financial distress from non-medical expenses (e.g., risk of homelessness OR = 1.4) as compared to breast, colon, and prostate combined, after adjusting for income & geography. Conclusions: To our knowledge, this is the first analysis of financial stressors in a US national cohort of cancer patients and receiving financial navigation. The higher prevalence of financial stressors in patients of color in this self-selected group indicates that interventions addressing cancer need to integrate social determinants of health.

Prevalence of food insecurity and its association with depressive and anxiety symptoms in older adults during the COVID-19 pandemic in Mexico: A secondary analysis of ENCOVID-19 survey.

COVID-19 infection has caused high rates of morbi-mortality in older adults (OAs). In addition, conditions such as depression, anxiety, unemployment, and poverty frequently contribute to this population being at higher risk of food insecurity (FI) during the COVID-19 pandemic. This study aimed to analyze the prevalence of FI and its association with depressive and anxiety symptoms in Mexican OAs during the COVID-19 pandemic. This study involved a secondary analysis of the National Survey on the Effects of COVID-19 on the Wellbeing of Mexican Households (ENCOVID-19), a series of cross-sectional telephone surveys conducted between April and October 2020. The OA subsample was 1,065. FI was measured by using the Latin American and Caribbean Food Security Scale (ELCSA), and depression and anxiety symptoms were measured by using the Depression Scale of the Center for Epidemiological Studies (CESD-7) and the Generalized Anxiety Disorder Scale (GAD-2), respectively. Socioeconomic status (SES), occupation, schooling, and pension were also evaluated. ANOVA was used to compare the variables between the different FI groups, and logistic regression was used to analyze the risk between FI and the anxiety and depression variables. The mean age of the participants was 67.31 ± 6.4 years, and FI was classified as mild, moderate, and severe, with prevalences of 38.6, 15.04, and 8.16%, respectively. Overall, 28.01% of the OAs presented symptoms of anxiety and 39.09% of depression. In the comparison between groups, a higher prevalence of depressive symptoms was observed with a higher degree of FI, with 65.75% in moderate-to-severe, 10.39% in mild, and 9.40% without FI, p ≤ 0.000. Regarding anxiety symptoms, 48% of the OAs showed moderate-to-severe, 30.05% showed mild, and 15.38% were without FI, p ≤ 0.000. Using multiple logistic regression, an OR of 5.50 (95% CI 2.74-11.04) was observed for depressive symptoms when moderate-to-severe FI is present. In the case of the risk of anxiety symptoms, it was significant in all degrees of FI, in mild (OR = 2.43, 95% CI 1.66-3.59) and in moderate-to-severe (OR = 5.32, 95% CI 3.45-8.19). There is a high prevalence of FI in Mexican OAs during the COVID-19 pandemic. FI increases the risk of other conditions such as depression and anxiety. It is important to design and implement programs aimed at OAs with these conditions to reduce or prevent FI.

Indigenous knowledge in traditional production of rice: Impact on food security in the upland households in Ifugao, Philippines

Indigenous knowledge is essential to the survival of highland farming across the world. In the Philippines, the Ifugao indigenous people have a long history of rice farming which is intertwined with their indigenous knowledge and cultural identity, particularly the Ifugao Rice Terraces (IRT). Their traditional practices of rice production entails the use of indigenous knowledge. The investigation included a number of conventional processes, ranging from land preparation through harvesting and even the planting season. It is clear that Ifugaos continue to grow native rice in the region in the customary manner. It is noteworthy because Ifugao is having food security challenges, thus 82 percent of people believe that there is a high risk of food insecurity, and 70.20 percent believe that rice output is insufficient based on yearly rice production. 51.2 percent felt that even though there is food insecurity, they would not go hungry.

Do Patients Reporting Fractures Experience Food Insecurity More Frequently Than the General Population?

The economic burden of traumatic injuries forces families into difficult tradeoffs between healthcare and nutrition, particularly among those with a low income. However, the epidemiology of food insecurity among individuals reporting having experienced fractures is not well understood. (1) Do individuals in the National Health Interview Survey reporting having experienced fractures also report food insecurity more frequently than individuals in the general population? (2) Are specific factors associated with a higher risk of food insecurity in patients with fractures? This retrospective, cross-sectional analysis of the National Health Interview Survey was conducted to identify patients who reported a fracture within 3 months before survey completion. The National Health Interview Survey is an annual serial, cross-sectional survey administered by the United States Centers for Disease Control, involving approximately 90,000 individuals across 35,000 American households. The survey is designed to be generalizable to the civilian, noninstitutionalized United States population and is therefore well suited to evaluate longitudinal trends in physical, economic, and psychosocial health factors nationwide. We analyzed data from 2011 to 2017 and identified 1399 individuals who reported sustaining a fracture during the 3 months preceding their survey response. Among these patients, 27% (384 of 1399) were older than 65 years, 77% (1074) were White, 57% (796) were women, and 14% (191) were uninsured. A raw score compiled from 10 food security questions developed by the United States Department of Agriculture was used to determine the odds of 30-day food insecurity for each patient. A multivariate logistic regression analysis was performed to determine factors associated with food insecurity among patients reporting fractures . In the overall sample of National Health Interview Survey respondents, approximately 0.6% (1399 of 239,168) reported a fracture. Overall, 17% (241 of 1399) of individuals reporting broken bones or fractures in the National Health Interview Survey also reported food insecurity. Individuals reporting fractures were more likely to report food insecurity if they also were aged between 45 and 64 years (adjusted odds ratio 4.0 [95% confidence interval 2.1 to 7.6]; p < 0.001), had a household income below USD 49,716 (200% of the federal poverty level) per year (adjusted OR 3.1 [95% CI 1.9 to 5.1]; p < 0.001), were current tobacco smokers (adjusted OR 2.8 [95% CI 1.6 to 5.1]; p < 0.001), and were of Black race (adjusted OR 1.9 [95% CI 1.1 to 3.4]; p = 0.02). Among patients with fractures, food insecurity screening and routine nutritional assessments may help to direct financially vulnerable patients toward available community resources. Such screening programs may improve adherence to nutritional recommendations in the trauma recovery period and improve the physiologic environment for adequate soft tissue and bone healing. Future research may benefit from the inclusion of clinical nutritional data, a broader representation of high-energy injuries, and a prospective study design to evaluate cost-efficient avenues for food insecurity interventions in the context of locally available social services networks. Level III, prognostic study.

Food insecurity and its association with mental health among Syrian refugees resettled in Norway: A cross-sectional study

BackgroundRefugees are at a higher risk of food insecurity than the general population in high-income resettling countries. Simultaneously, the prevalence rates of mental ill health among refugees surpasses the general population in receiving countries both in high- and low-income settings. This study aims to estimate the prevalence of food insecurity and to study the association between food insecurity and mental health among Syrian refugees resettled in Norway. MethodsAs part of the CHART study (Changing Health and health care needs Along the Syrian Refugees’ Trajectories to Norway), 353 Syrian refugees resettled in Norway for approximately one year participated in a structured telephone survey. We assessed food insecurity with the Household Food Security Survey Module (HFSSM) and mental health (symptoms of anxiety and depression) with the Hopkins Symptom Checklist (HSCL-10). We used descriptive statistics to estimate food insecurity overall, and among women, men, and children separately. The association between food insecurity and mental health symptoms was studied using logistic regression. ResultsOne year after resettlement in Norway food insecurity was reported among 22% of adult Syrian refugees and 24% of their children. The most frequently reported problems were that food did not last or that they skipped meals often or sometimes (approximately 15% for each parameter). Respondents also worried that food would run out before they got money to buy more (15%), had not been eating balanced food in the past 12 months (9%), and had been eating less than before (7%). A few participants reported that they had not been eating for a whole day (5%), had been hungry (4%), or had lost weight during the last year (3%). Most of the women did not report any food insecurity among children in their households (76%), some reported that their children were moderate food insecure (13%), and a few that their children were severely food insecure (10%). Among adults, mental ill health was significantly associated with severe food insecurity (odds ratio (OR) 6.6, 95% confidence interval (CI) 2.1-20.5) but not with moderate food insecurity (OR 1.5, 95% CI 0.4-5.8). ConclusionFood insecurity among refugees and their children after resettlement to high-income countries should be acknowledged and systematically targeted. The association with mental health reinforces the need to consider food insecurity in public health strategies towards refugees.

Evaluation of a nutrition education and cooking programme (NEST) in vulnerable adults who are at high risk of food insecurity

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COVID-19 Recession: Young Adult Food Insecurity, Racial Disparities, and Correlates

PurposeThe COVID-19 pandemic has inflicted devastating health, social, and economic effects globally. This study examines the experiences of young adults in the United States with respect to food insecurity during the pandemic and factors associated with higher and lower risk for young adult food insecurity. MethodsUsing the U.S. Census Bureau's Household Pulse Survey, a nationally representative survey collecting information on people's experiences throughout the pandemic, we analyzed prevalence of, and factors associated with young adult food insecurity during the pandemic. ResultsOverall, 13% of young adults aged 18–25 years reported often or sometimes not having enough to eat in the last 7 days at a given time during pandemic, on average, with Black and Hispanic young people facing higher rates of food insecurity (22% and 15%, respectively) than White non-Hispanic peers (11%). Over the observed pandemic period, we find a decline in food insecurity among young adults corresponding with economic policy actions. Factors associated with a higher risk of food insecurity include lower household income, expected job loss, renting as opposed to owning housing, behind on rent or mortgage payment, lack of confidence in an ability to pay next month's rent or mortgage, delayed medical care, and feeling worried or depressed. DiscussionOur analyses reveal alarming levels of food insecurity among young adults, especially Black and Hispanic young people. Policy actions should include multifaceted and sustained interventions with a focus on supporting historically disenfranchised youth and their communities. These should prevent and address food and housing insecurity and mental health needs holistically.

Severity of Food Insecurity among Australian University Students, Professional and Academic Staff.

Assessments of the severity of food insecurity within Australian university students are lacking, and the experience of food insecurity in Australian university staff is unknown. A cross-sectional online survey in March 2022 aimed to characterize the severity of food insecurity in students, professional and academic staff at the University of Tasmania (UTAS). The Household Food Security Survey Module six-item short form assessed food security status in addition to seven demographic and education characteristics for students and six demographic and employment characteristics for staff. Participants were categorized as having high, marginal, low, or very low food security. Multivariate binary logistic regression identified students and staff at higher risk of food insecurity. Among student respondents (n = 1257), the prevalence of food insecurity was 41.9% comprising 8.2% marginal, 16.5% low, and 17.3% very low food security. Younger, non-binary, first-year enrolled, on campus, and international students were at significantly higher risk of food insecurity. Among staff (n = 560), 16.3% were food insecure comprising 3.8% marginal, 5.5% low, and 7.0% very low food security. Professional staff, staff on casual contracts, and staff recently employed, were at significantly higher risk of food insecurity. Our findings suggest a high occurrence of food insecurity in UTAS students and staff, with a large proportion of food insecure staff and students experiencing very low food security. Our findings have implications for efforts towards reducing food insecurity at university campuses through a holistic and integrated approach, advocating for food systems that support healthy, sustainable, and equitable food procurement and provision for both university students and staff.

Quantitative Assessment of Climate Change Impact and Anthropogenic Influence on Crop Production and Food Security in Shandong, Eastern China

Food security plays an important role in maintaining national stability and sustainable development of human society, and its research has become a hot issue at present. Shandong is the main grain producing area in China, and its grain production plays an important role in national food security. Accordingly, this paper is based on the county climate change, grain yield, sown area, fertilizer use, total power of rural machinery, and total population data in Shandong Province from 1995 to 2020. The evolution process of the food security pattern was studied by the methods of spatial analysis and comprehensive evaluation, the influencing factors of food security were quantitatively analyzed, and the adaptive countermeasures to alleviate the food security risks in this region were discussed. The results show that: Grain production increased by 30.62% from 1995 to 2020. The total population and per capita food availability also increased. Since 2000, more than a quarter of counties have experienced a high risk of food insecurity. The spatial agglomeration of grain production was enhanced, and the local agglomeration characteristics were significantly different. The average temperature in the growing season, the sown area, and the total power of agricultural machinery had a significant positive impact on grain production, while the annual average temperature had a significant negative impact on grain production. Improving the food supply system, strengthening the protection of cultivated land, improving the efficiency of fertilizer utilization, and increasing investment in agricultural science and technology can effectively alleviate food security risks.

Food insecurity during COVID-19 in children with end-stage kidney disease: a pilot study

BackgroundFood insecurity, an important social determinant of health among children, has become more common during the COVID-19 pandemic. Children with chronic diseases including end-stage kidney disease (ESKD) are at higher risk of food insecurity due to their complex care needs, medication burden, and dietary restrictions. No data exists describing food insecurity prevalence in pediatric ESKD patients during the COVID-19 pandemic.MethodsFood insecurity was assessed among families of children (age 0–18 years) with ESKD on chronic dialysis at two pediatric academic medical centers. Families were screened in April 2020 using the Hunger Vital Sign, a validated 2-question screening tool. We assessed impact of COVID-19 on food insecurity. We compared serum phosphorus “pre-COVID” (January/February 2020) to “during COVID” (April/May 2020).ResultsA total of 29 families enrolled in this study. 62% (18/29) of children with ESKD lived in food insecure households, and of those, 72% (13/18) reported that COVID-19 had worsened their food insecurity status. During the COVID-19 pandemic, food insecure patients experienced greater rise in their serum phosphorus levels (1.1 mg/dL vs. 0 mg/dL, p = 0.03) and decreased likelihood of having adequate phosphorus control (50% vs. 11%, p = 0.03).ConclusionFood insecurity was common among children with ESKD on chronic dialysis during the COVID-19 pandemic. Children with food insecurity had a greater increase in their phosphorus levels during the pandemic than did food secure children. Further exploration into how food resources such as an onsite food pantry impacts food insecurity and phosphorus control in children with ESKD is essential.

High occurrence of food insecurity in young people attending a youth mental health service in regional Australia.

AimDespite the relationship between food insecurity and poor mental health, food insecurity in young people attending mental health services in Australia remains understudied. This study aimed to determine the occurrence and predictors of food insecurity, and the relationship with dietary factors in young people attending a mental health service.MethodsA cross‐sectional online survey was conducted in a sample of young people (15–25 years) who attended a mental health service in Launceston, Australia. The survey utilised a single‐item food insecurity screening tool and eight demographic, health and service use questions. Five questions determined self‐reported intake of fruit, vegetables, breakfast, water, sugar‐sweetened beverages and takeaway foods. Binary logistic regression determined predictors of food insecurity. Cross‐tabulations determined differences in dietary intake according to food security.ResultsOf survey respondents (n = 48; 68% female), 40% (n = 19) were food insecure. Respondents living out of home or in unstable accommodation were at significantly higher risk of food insecurity (odds ratio [OR]: 4.43; SE: 0.696; 95% CI: 1.13–17.34; p = 0.032) compared to those living with their parents. Those receiving government financial assistance (OR: 5.00; SE: 0.676; 95% CI: 1.33–18.81; p = 0.017) were also at significantly higher risk of food insecurity. Regardless of food security status, self‐reported intake of fruits, vegetables and breakfast were low, and respondents regularly consumed takeaway foods and sugar‐sweetened beverages.ConclusionsThere was a high occurrence of food insecurity and poor dietary intake in young people attending a youth mental health service demonstrating that initiatives to support access to healthy food in this group should be a priority, with potential benefits for mental health outcomes.

Cost and affordability of healthy, equitable and more sustainable diets in the Torres Strait Islands

ObjectivesTo assess the cost, cost differential and affordability of current and recommended (healthy, equitable, culturally acceptable and more sustainable) diets in the Torres Strait Islands and compare with other Queensland locations. MethodsThe Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol was applied in five randomly selected communities in the Torres Strait Islands. ResultsThe current diet was 32% more expensive than that recommended; ‘discretionary’ foods comprised 64% of the current diet cost. Families could save at least A$281.38 a fortnight by switching to recommended diets. However, these cost 35‐40% more than elsewhere in Queensland. Recommended diets would cost 35% of median and 48% of welfare household income in the Torres Straits. ConclusionsWhile less expensive than the current diet, recommended diets are unaffordable for most households. Consequently, many Torres Strait Islander families are at high risk of food insecurity and diet‐related disease. Implications for public healthUrgent policy action is required to further lower the relative price of recommended diets, and also increase household incomes and welfare supplements to equitably improve food security and diet‐related health, and contribute to environmental sustainability in the Torres Strait Islands.

Food insecurity among disabled adults

BackgroundThe relationship between disability and food insecurity is under-researched. Risk of food insecurity may vary by type and number of disabilities. We examine the hypotheses that (i) a higher number of disabilities increases risk of food insecurity and (ii) associations of physical disabilities, mental/cognitive disabilities or a combination of both types with food insecurity may differ in strength.MethodsData came from the fifth wave of the UK’s Food Standards Agency’s Food and You survey (2018), which contains detailed information on disability and household food insecurity. We used logistic and multinomial logistic regression to model the number and type of disabilities as predictors for food insecurity outcomes, controlling for socio-demographic factors.ResultsBoth type and number of disabilities predicted food insecurity. Every additional disability was associated with higher odds of food insecurity [odds ratio (OR): 1.60, 95% confidence interval (CI): 1.40–1.83]. Among people with a disability, every additional disability was associated with 19% higher odds of food insecurity (OR: 1.19, 95% CI: 1.05–1.34). People with both physical and mental/cognitive disabilities had increased odds of severe food insecurity (OR: 8.97, 95% CI: 3.54–22.7).ConclusionNumber and type of disabilities are associated with higher risk of food insecurity. A combination of physical and mental/cognitive disabilities, as well as having multiple disabilities are each independently associated with higher risk of food insecurity. Policy-makers may thus consider using targeted and tailored policies to reduce barriers to social and financial inclusion of disabled people to reduce food insecurity.

Household food insecurity in Canada early in the COVID-19 pandemic.

Food insecurity linked to insufficient income is an important determinant of health. Whether the COVID-19 pandemic has exacerbated levels of food insecurity in Canada, particularly among vulnerable groups, is unclear. This study estimated the proportion of Canadians reporting experience of household food insecurity six to nine months into the COVID-19 pandemic, and drew comparisons with pre-pandemic levels. Data on household food security status during the pandemic came from the population-based cross-sectional Canadian Community Health Survey (CCHS) collected from September to December 2020. Analyses were based on 26,831 respondents aged 12 and older residing in the 10 provinces. The Household Food Security Survey Module was used to categorize respondents' household food security status within the previous 12 months as food secure or marginally, moderately or severely insecure. The percentage of Canadians reporting some experience of household food insecurity was estimated for the overall population and for various sociodemographic groups. T-tests were used to draw comparisons with pre-pandemic rates from the 2017/2018 CCHS. In fall 2020, 9.6% of Canadians reported having experienced some level of food insecurity in their household in the prior 12 months, which is lower than the estimate of 12.6% from 2017/2018. Overall estimates were also lower in fall 2020 when examined within levels of household food insecurity (i.e., marginal, moderate or severe). The percentage of Canadians reporting experience of household food insecurity was either unchanged or lower than in 2017/2018 among sociodemographic groups vulnerable to experiencing income-related food insecurity, including renters and those with lower levels of education. During the second wave of the COVID-19 pandemic in fall 2020, about 1 in 10 Canadians aged 12 and older reported experience of food insecurity in their household in the previous 12 months. This proportion was lower compared with 2017/2018, both overall and among several groups at higher risk of food insecurity. Monitoring household food insecurity will continue to be important during the COVID-19 pandemic and throughout the years of recovery ahead.

Regional and social inequalities in food insecurity in Brazil, 2013-2018.

This study aims to analyze the association between social indicators and the worsening of food insecurity in 2013 and 2018 in different regions of Brazil. Data from the Brazilian National Household Sample Survey (2013) and Brazilian Household Budgets Survey (2018) were analyzed, considering nationally representative samples of 110,750 and 57,920 households, respectively. Food insecurity was assessed using the Brazilian Food Insecurity Scale by estimating the percentage changes in food insecurity levels between 2013 and 2018, according to sociodemographic variables. The association between social indicators and food insecurity disaggregated by region was estimated using multinomial logistic regression models. Although North and Northeast regions had higher proportions of food insecurity, the Southeast and Central-West regions had the highest increase in food insecurity in the same periods. Income was the indicator with the highest association with food insecurity both in 2013 and 2018. We also observed the association between the presence of three or more residents aged under 18 in a household and a higher risk of food insecurity in North and South regions. Food insecurity increased unevenly among regions during the Brazilian economic crisis, which reinforced regional inequality. Moreover, food insecurity was greater among households with worse social and economic living conditions, contributing to social inequality in the country. Thus, strengthening public policies to promote food security and nutrition according to regional social inequities is necessary.

The Regressive Costs of Drinking Water Contaminant Avoidance

Up to 45 million Americans in a given year are potentially exposed to contaminated drinking water, increasing their risk of adverse health outcomes. Existing literature has demonstrated that individuals respond to drinking water quality violations by increasing their purchases of bottled water and filtration avoidance, thereby avoiding exposure to contaminants. This paper demonstrates that poorer households, for whom the costs of avoidance comprise a greater share of disposable income, bear disproportionate costs of water quality violations in the United States. Following a health-based water quality violation, poor households' expenditure on nutritious grocery products in a nationally representative panel differentially decreases by approximately $7 per month. This is associated with a decrease of about 1,500 calories per household member per day, placing these individuals at a higher risk of food insecurity. This finding suggests that the indirect costs of drinking water contamination through economic channels exacerbate health disparities associated with poverty.

Longitudinal Trajectories of Food Insecurity in Childhood and Their Associations With Mental Health and Functioning in Adolescence

Household food insecurity has been associated with mental health problems in children independently of family income and other confounders. It is unclear whether food insecurity during childhood is also associated with mental health and functioning during adolescence. To evaluate longitudinal trajectories of household food insecurity during the first 13 years of life, characteristics associated with these trajectories, and the associations of the trajectories with externalizing, internalizing, substance use, and social adjustment problems at 15 years of age. This cohort study included participants from the Québec Longitudinal Study of Child Development, a cohort of 2120 children born in Québec, Canada, in 1997 and 1998 and followed up annually or biannually from 5 months to 15 years of age (1998-2013). Data were analyzed from November 2020 to October 2021. When children were aged 1.5, 4, 8, 10, 12, and 13 years, mothers reported whether a family member experienced hunger because the family had run out of food or money to buy food in the past 12 months. Group-based trajectory modeling was used to identify differential exposure to food insecurity from 1.5 to 13 years according to logit functions of age. At 15 years of age, adolescents completed validated questionnaires assessing externalizing, internalizing, substance use, and social adjustment problems. Associations between trajectories of food insecurity and outcomes were assessed using linear regressions. A total of 2032 individuals were included in the analyses of trajectories of food insecurity (1026 [50.5%] male) and 1441 in the analysis of the association with outcomes at 15 years of age (752 [52.2%] female). Two trajectories of food insecurity were identified between 1.5 and 13 years of age: high risk (73 children [3.6%]) and low risk (1959 children [96.4%]). At 5 months, the high-risk and low-risk groups differed in household characteristics including income insufficiency (58 [80.6%] vs 405 [21.0%]), single parenthood (21 [29.2%] vs 135 [6.9%]), and parental history of depression (mothers: 30 [43.5%] vs 411 [21.7%]; fathers: 12 [32.4%] vs 209 [13.5%]). The high-risk trajectory from 1.5 to 13 years of age was associated with cannabis use (β, 0.47; 95% CI, 0.12-0.81), peer bullying (β, 0.43; 95% CI, 0.08-0.77), and dropout potential (β, 0.38; 95% CI, 0.03-0.68) at 15 years of age after adjustment for sex, household income insufficiency, and parental mental health. In this cohort study, few children experienced a persistent high risk of food insecurity, which was associated with psychosocial problems later in adolescence after adjustment for confounders including low income. Early identification of risk for food insecurity may guide the delivery of tailored interventions to improve functioning in adolescence.

A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland

BackgroundThe first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland.MethodsA qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach.ResultsTwelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house.ConclusionsThe restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.