Insecure Conditions Research Articles

The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation

IntroductionFood as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine. MethodsRecipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a ‘Food Farmacy’ (16 weekly produce home deliveries) alone or in combination with a ‘Behavioral Pharmacy’ (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024. ResultsThere was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy. ConclusionsRecipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.

Humanitarian Activism, Social Protection, and Emergent Citizenship in Myanmar

Through the confluent impacts of the Covid-19 pandemic and the 2021 military coup, Myanmar has become a failed state. Deliberate targeting of humanitarian actors by the military junta has severely constrained the activities of international non-governmental organisations and United Nations agencies. In the first three post-coup years, welfare provision to the distressed and displaced were mainly undertaken by local actors who adapted to new conditions of both insecurity and broader economic turmoil. This localised welfare is intertwined with emergent local governance mechanisms, using technology and data analysis to deliver transparent, accountable, and inclusive public service. In the absence of a coherent central state, the social contract of welfare develops at more local levels, generating smaller islands of citizenship from which to build future political communities.

Intertwined precariousness and precarity: Disentangling a phenomenon that characterises Spanish youth

AbstractThe growth of non‐standard employment has emerged as a crucial factor that contributes to delays and difficulties in young people's transitions to adulthood. Previous studies have demonstrated the importance of multidimensional measures of precariousness. This paper aims to investigate the phenomenon of precariousness holistically, using an original database of respondents in Spain from 20 to 34 years of age. Using a mixed‐methods approach, we explore young people's understandings of precariousness and examine its key determinants and consequences. The findings illustrate the multidimensional nature of feelings of precariousness, with economic insecurity and work conditions being core elements. Our results point to precarity stemming from a combination of inextricably intertwined objective and subjective components, as well as work and economic dimensions.

Precarious employment expectancy by history of mental-health-related sickness absence in Finland

Abstract Background Poor mental health may lead to labour market insecurity including precarious employment and vice versa. Less is known of how mental health is associated with cumulative engagement in precarious employment over the working career. We examined how the working career is expected to be distributed into precarious and other types of employment by history of mental-health-related sickness absence. Methods We used a register-based 70% population sample to examine wage-earners living in Finland in 2018. Applying the Sullivan method, we calculated the expectancy of precarious and non-precarious employment between age 25 and 63 (N = 1268666) based on a novel measure (score with items on temporariness, agency employment, multijob holding, underemployment and income level) and limited employment (due to which precariousness could not be assessed) among those with and without compensated (granted after 10 weekdays) sickness absence due to mental disorders in the past five years (mental SA history). Results Precarious employment expectancy was higher among those with than among those without a mental SA history (2.5 vs. 1.5 among men and 3.5 vs. 2.8 years among women). The difference in the limited employment expectancy was in the same direction, but much larger among men (6.5 vs. 3.3 among men and 4.4 vs. 3.4 years among women). Men with a mental SA history were expected to spend almost a fourth of their working career with either precarious or limited employment, whereas for men without such a history the number was 13%. Conclusions Individuals with mental disorders have notable accumulation of precarious employment over the working career. They also spend excessive time with limited employment, which may have similar elements as precarious employment and reflect broader labour market insecurity. Attempts should be made to ensure that insecure employment conditions among people with mental health problems do not further deteriorate their health and work ability. Key messages • People with mental disorders spend a disproportionate part of their working career either precariously employed or facing other insecurities in the labour market. • Interventions aiming to promote health and work ability should take into account the interplay between poor mental health and poor employment conditions.

Farmers’ Willingness to Accept Afforestation in Farming Land and Its Influencing Factors in Fragile Landscapes Based on the Contingent Valuation Method

Afforestation (AF) in farmland has been widely used as an alternative and sustainable land-use practice to address socioeconomic and environmental challenges. The aim of this study is to estimate farmers’ willingness to accept (WTA) compensation and land, both of which are equally significant for policymakers to ensure the effective implementation of AF and achieve desired outcomes. This topic has not been sufficiently explored in previous research. This study focused on areas characterized by insecure farming conditions, backward economies, and fragile landscapes, where farmers are generally unfamiliar with AF or compensation for ecosystem services under payment for ecosystem services programs. It assessed their attitudes towards the WTA AF, compensation, and land as an alternative practice, which remains under-researched. This is crucial for designing effective AF programs in the future to improve livelihood and enhance the quantity and quality of the environment. This study used the contingent valuation method to estimate the minimum WTA compensation and maximum land for the forgone loss and alternative land-use practices. A questionnaire survey was conducted in Hupsekot municipality, Nepal, with 232 farmer households. The ordinal logistic regression model was used to analyze influencing factors of WTA compensation and land. The result showed that farmers’ average WTA compensation was NPR 1268.67 (USD 9.76)/Kattha/year, with 2.64 Kattha land available for AF. The factors, including socioeconomic characters and attitudes toward the environmental situation and forests, significantly influenced WTA values and provided potential target factors to achieve maximum AF land within a lower budget.

Food insecurity and diabetes management among adults of African descent: A systematic review.

This systematic review explores the established causal link between food insecurity and cardiometabolic conditions among adults of African descent. Specifically, this study examined the relationship between food insecurity and the management of type 2 diabetes, highlighting the prevalence of food insecurity among individuals of African descent with type 2 diabetes. Original English papers were meticulously searched in databases including PubMed, CINAHL, PsycINFO, Medline, Cochrane, Embase and Web of Science. The Cochrane Risk of Bias Tool for quantitative studies and COReQ for qualitative studies were employed to assess biases. Three independent reviewers meticulously evaluated and synthesized results, reaching a consensus. Among the 198 studies identified, 14 met the inclusion criteria for data extraction and analysis, which were conducted independently by three reviewers. The findings indicate that individuals of African descent are more likely to experience food insecurity compared to their White counterparts and are also more prone to diabetes risk factors or the presence of diabetes. This study underscores a higher prevalence of food insecurity and type 2 diabetes among adults of African descent, suggesting that ethnicity and food insecurity play significant roles in diabetes management. Future research should prioritize interventions aimed at reducing these disparities.

Effects of Food Insecurity on Health Conditions among Women and Children of Orang Asli Kintak in Pengkalan Hulu, Perak, Malaysia

Growing evidences have shown high overlap between food, well-being and forest conservation. Such circumstances are being faced by indigenous communities, in Peninsular Malaysia that are becoming more vulnerable due to health problems related to malnutrition. In this paper, we address effects of food insecurity and health conditions among Orang Kintak mothers and children in Pengkalan Hulu. A total of 35 mothers and 63 children were sampled using quantitative approach. Using (WHO) reference standards, main finding for BMI classification of women shows (20%) underweight, (60%) normal weight and (20%) obesity. Meanwhile, (86%) children were under weight and only (14%) are of normal weight. Understanding the health problems faced by Orang Kintak following unbalanced and nutritional diet are crucial in order for local authorities and communities to take critical action, such as to set up a basic food source production program in order to avoid over dependent on purchased food sources. Next, increase the productivity of human capital by encouraging involvement in the economic, education and health sectors. In general, policy-makers need to take into account indigenous knowledge, challenges and beliefs system when making a strategic decision so that it is beneficial and suitable for the planned strategy to be successful.

Manifestations and drivers of secondary trauma among service providers working with Syrian refugees: A mixed-methods study from Istanbul, Turkey

This mixed-methods study explores the incidence, manifestations, and drivers of secondary traumatic stress among service providers who work with Syrian refugees in Istanbul, Turkey. A survey of 104 social workers and other providers working in 17 public and civil society agencies in Istanbul in 2018 demonstrates that 54.81% had Secondary Traumatic Stress Scale scores indicating mild to severe secondary traumatic stress. In total, 28 qualitative interviews showed manifestations and possible drivers of secondary traumatic stress including weak supervision, heavy caseloads, and insecure working conditions. The findings suggest supervision and peer-support should be strengthened to address secondary traumatic stress among providers serving refugees.

Food insecurity versus public health? Social resilience.

The health problems of low-income communities and their relationship to food insecurity are a widespread problem worldwide. Understanding the complex relationship between these two conditions of food insecurity and health outcomes is the focus of this study. In addressing these issues, managing food security and adopting comprehensive strategies that consider the broader public health of the poor and socially vulnerable requires a multi-pronged approach that integrates sustainable food systems, social protection interventions, community engagement, and nutrition-specific interventions. This study is useful for improving our understanding of the relationship between food insecurity and health outcomes, which ultimately contributes to better health and social resilience strategies.

Enhancing food access in a comprehensive cancer center area of influence through local partner capacity building.

Food insecurity, an economic and social condition of limited food access, is associated with poor diet quality-a risk factor for several common cancers. The University of Texas MD Anderson Cancer Center supports healthy food access through community-led evidence translation by actively partnering with community-based organizations (CBOs). These partnerships aim to enhance the capacity of food assistance CBOs to effectively implement evidence-based food insecurity mitigation programs in the cancer center's area of influence. This case study aims to describe the cancer center's model for local food access capacity building and detail operationalization in the context of a whole-community cancer prevention effort (Be Well Baytown) in Baytown, Texas. Elements central to the capacity building model include (i) assessment of baseline needs and capacity, (ii) empowering a community champion within a relevant CBO, (iii) mapping inter-sectoral community partnerships, collaborations, and linkages, and (iv) leveraging systems, connections, and resources to provide an enabling environment for overall food access systems growth. Through this process, Be Well Baytown enhanced the capacity of a local food pantry leading to increases in total reach, pounds of food distributed, and number of food distribution events in collaboration with intersectoral partners from 2018 to 2023. This case study highlights the model's implementation as a co-benefit community partnership strategy to maximize the impact of food security programs integrated with comprehensive cancer center prevention efforts.

Findings on dietary characteristics among Haitian immigrants and the threat of food insecurity: A scoping review

ObjectivesThis study aimed to map and describe the available evidence on dietary characteristics and diet-related health conditions among Haitian immigrants across the globe. Study designScoping review. MethodsThis review was based on the international guide Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The searches were conducted in several electronic databases in July 2023. Reports focusing on diet, nutrition, and diet-related health conditions among international Haitian immigrants published in English, Portuguese, French, or Spanish with no year limit were included. The data extracted was tabulated and presented in a narrative summary. ResultsDatabase search retrieved 502 records, of which 30 met the inclusion criteria. The categories that emerged from the analysis were: food consumption patterns and trends, food and nutrition insecurity, cultural identity, and diet-related health conditions. Findings suggest: available evidence underrepresents Latin America and the Caribbean context; research gaps related to adolescents and the elderly and also to noncommunicable diseases except obesity; changes in food consumption after immigration towards less healthy eating; the Haitian immigrant's preference for healthy and traditional eating patterns; many experiences of food insecurity related to poverty, unemployment, and lack of social support, especially in host countries in Latin America and the Caribbean; and a high prevalence of obesity, especially among women. ConclusionsFurther research is required in countries in Latin America, mainly. Diet-related chronic diseases, adolescents, and the elderly should be targeted for further research. We recommend: longitudinal and qualitative research; field action reports describing local and global strategies to manage Haitian migration-related food and nutrition issues; culturally appropriate dietary interventions; and policies to protect and support the most vulnerable Haitian immigrants to have their fundamental right to adequate food guaranteed, reducing health inequalities.

The Co-Ontological Securities of Gated Lifeworlds: Atmospheres and Foamed Immunologies under Late Modernity

Abstract This article returns to the existentialist roots of ontological security theory (OST) and proposes a phenomenological re-reading of ontological security through the theoretical language of spherology and immunology in order to bring OST into a more substantive engagement with the spatial and immunological realities and practices of the globalizing world. Departing from the work of Peter Sloterdijk, the article advances three principal claims. Firstly, it shows that under the spatio-immunological dislocations of late modernity, the processes of ontological security are better understood as matters of “co-ontological security,” reflecting the highly relational and co-dependent character by which human lifeworlds are organized and juxtaposed. Secondly, it explores the ways in which technologies and life-support systems of ontological security may have negative ramifications for the ontological integrities of other neighboring lifeworlds. And lastly, the article investigates the autoimmunological processes that are at work in all immunological systems and that are capable of turning the mechanisms of ontological security into the very sources of insecurity. In exploring these themes, the text examines the retirement community known as The Villages to show how protected living in an expanding and gated lifestyle community produces the very conditions of ontological insecurity for the self and for others.

Collaborative governance model in disaster mitigation in Malang Regency

Indonesia is a country that has a disaster-prone geographic condition. This is because Indonesia is located at a confluence of tectonic plates, and the tropics have two seasons, namely rainy and dry. Disasters tend to occur in vulnerable communities, and will make communities more vulnerable. The vulnerability of a community begins with the unsafe physical, social and economic conditions attached to it. This insecure condition occurs due to internal and external dynamic pressure, for example in the local institutional community that is less developed and lacks the right skills. Disaster Management Policy is an integral part of national development, namely a series of disaster management activities before, during and after a disaster is carried out by the Malang Regency Government in its efforts to deal with frequent disasters which are not easy, in the implementation process many obstacles occur, disaster mitigation should routinely carried out to reduce the impact of disasters, and make people aware of disaster mitigation, one of which is by carrying out routine socialization on disaster mitigation starting from pre-disaster, during disaster and post-disaster, but BPBD Malang Regency rarely conducts outreach related to disaster mitigation, so that when disaster occurs Disaster impacts are far more severe and result in losses and cause casualties. Malang Regency Government needs to strengthen collaboration with other stakeholders for disaster mitigation efforts.

Cross-sectional analysis of the association between household food insecurity and mental health conditions in children aged 5–11 years in Canada

BackgroundChildren living in food insecure households have poorer mental health outcomes compared with their food-secure peers; however, the relationship between the severity of food insecurity and diagnosed mental health conditions...

Household food security and WASH practices in children with undernutrition: a case study in low middle income area in Semarang, Indonesia

Purpose: This study analyzed the correlation between household food security (HFS) and WASH practices toward nutritional status in children with undernutrition. Methods: This type of research was analytically observational with a cross-sectional design. The sample in this study was 55 mothers with children with a history of undernutrition aged 6 to 23 months. The Rank Spearman test was conducted to analyze this study. Results: The prevalence of stunted and severely stunted was 34.55%, respectively; underweight and severely underweight were 36.36%, respectively; and wasted and severely wasted were 30.91 and 16.36% respectively. The percentage of respondents with mild, moderate, and severe food insecurity were 23.6, 7.3, and 12.7% respectively. The average value of WASH practices was rated as good among all respondents. Household food security score was associated with WAZ (p=0.008 and r=0.352) and HAZ (p=0.027 and r=0.299) but was not associated with WHZ (p=0.067; r=0.248). WASH practice was associated with WAZ (p=0.000; r=0.504), HAZ (p=0.000; r=0.455), and WHZ (p=0.000; r=0.334). Conclusion: There were still conditions of severe food insecurity and undernutrition problems that need the focus of attention. There is a need for monitoring by looking at certain aspects, such as HFS and WASH practices in reducing undernutrition.

Countering social exclusion through inclusive homecare provision: Utilising a participatory life-course approach to influence policy

Homecare models can be effective mechanisms in securing wellbeing and ageing-in-place goals prevalent in health policy agendas. However, the relevance and utility of these models for those living in socially and environmentally insecure conditions has rarely been considered. This is marked by an assumption of in-situ care delivery in private dwellings, and the absence of such groups from homecare development processes. This study aims to harnesses the experiences and preferences of older people in homelessness (OH), older Irish Travellers (OT), and professional stakeholders in an evidence-based co-production of policy recommendations for inclusive homecare provision. The study employed a participatory approach involving the integration of lived experience evidence in a multistakeholder co-production process. Methods comprised: five separate focus groups with OH, OT and service providers (n = 30); two consultative forums involving focus group participants together; and 49 life-course interviews with OH (n = 27) and OT (n = 22) and adults. Findings demonstrate that sizeable gaps in care remain for these groups, and that resource constraints and legislative restrictions prevail for professional stakeholders. Co-produced policy recommendations for inclusive homecare provision based on these experiences and group preferences are presented and discussed.

The impact of government policies and regulations on the subjective well-being of farmers in two rural mountain areas of Italy

AbstractThe sustainable development of rural areas involves guaranteeing the quality of life and well-being of people who live in those areas. Existing studies on farmer health and well-being have revealed high levels of stress and low well-being, with government regulations emerging as a key stressor. This ethnographic study takes smallholder farmers in two rural mountain areas of Italy, one in the central Alps and one in the northwest Apennines, as its focus. It asks how and why the current policy and regulatory context of agriculture affects farmer well-being. Interviews and participant observation were conducted with 104 farmers. Three common scenarios emerged that negatively affect farmer well-being. First, policies and regulations designed for lowland areas do not always make sense when applied in the mountains. Second, when subsidies are put into effect at the local level, the reality of their implementation can veer away from the original goals of the funding program and have unintended effects on farmer well-being, agricultural practices, and the environment. Finally, when regulations are implemented on farms in rural mountain areas, the primacy of a techno-scientific knowledge system over other, local and place-based knowledge systems is exposed. These three scenarios affect well-being by eliciting feelings of stress, frustration, and disillusionment; by reducing farmer control over their work; and by fostering the perception that farming is not valued by society. They also create conditions of inequality and insecurity. The ways in which government policies and regulations play out on mountain farms can erode trust in government institutions, lead to an us versus them mentality, and contribute to the further abandonment of agriculture and rural areas.

The Role of Language in Creating Peace and Security within the Countries in the Middle East Region

Why the countries within the Middle East are unstable despite sharing a common Arabic Language among them, which has been based on Phoenician text? There are different theories explaining the insecurity condition in the countries within the Middle East region including poverty, inequality, domestic violence and etc. These theories does provide an understanding about the insecurity as a factor of failure to achieve economic growth or stable social and economic status but these theories failed to provide an understanding that the type of insecurity resulting from the failure of a language to be creative enough based on the international organizations desire or choice. A part of the answer for this failure maybe the possibility of the Arabic language text which had failed to contribute to creativity based on the international organization desire because the Arabic language consisted of symbolic foundation of cuneiform after conversion to the text forms, through the Phoenicians which had close relations to the Latin and Greek languages, the Arabic language could not ensure creativity while the Latin and Greek languages contributed to the creativity while the Arabic language consist of different creativity based on cuneiform. Therefore, the Arabic language in the region is facing the pressure from the Latin and Greek languages or the influence of the different languages in the region, which has creativity foundation, which is not consistent with the type of creativity from the traditional Arabic language but consistent with the type of creativity from the non-traditional Arabic language. As a result, following the non traditional Arabic language and leaving aside the traditional Arabic language causing insecurity difficulty in the countries within the Middle East region. It is important for the international organization to engage in promoting creative activities in the countries within the Middle East based on the traditional Arabic language and non-traditional Arabic language in order to ensure security in the countries within the Middle East region

Demand of Imported Rice in Mozambique (2011 - 2020)

Rice plays an important role in the food and nutrition security of the Mozambican population and has been importing rice to meet growing consumption needs. There are several studies regarding demand of imported rice worldwide. However, it is noted that despite the importance of imported rice in national consumption, the empirical and quantitative studies on the demand for imported rice in Mozambique are scarce. This study results from the need to contribute to filling the information gap by providing the quantification of the impact of income and price on the consumption of imported rice. Based on monthly rice import data from 2011 to 2020, obtained from INE, the Source Differentiated Almost Ideal Demand System (SDAIDS) model and the Seemingly Unrelated Rules (SUR) approach are applied to estimate demand systems for imported rice. The period was chosen due to availability of data. The results of this study show that the national production of rice still does not cover internal needs, so the country resorts to imports to fill the deficit. The elasticities of demand for rice imported into Mozambique show that all income elasticities of demand are statistically significant, except for “other countries” or Rest of the World. The results also show that when income increases by 1%, the demand for rice increases by 1.2% when coming from “Pakistan”, and by 1.1% when coming from “Singapore”, by 1.03% for “Vietnam”; and in for those from “Myanmar” (1.1%), which suggests that rice from these countries can be classified in the luxury goods category. The results also illustrate that when the price increases by 1%, the quantities demanded decrease, on average, by 1.06% for rice coming from “Pakistan”; by 1.06% for those from “Singapore”; 1.22% for those from “Myanmar”; 0.96% for those from “Vietnam”; by 0.89% for “India”; by 0.79% for “China”; in 0.974% for “Thailand” and in 0.56% for those coming from “other countries”. The low levels of production and productivity show that it is still a challenge to guarantee rice self-sufficiency in Mozambique, and efforts to improve supply must continue, since the country&amp;apos;s dependence on imported rice can potentially create conditions of vulnerability and insecurity and adverse market effects have competitive advantages.

Food Insecurity and Ideal Cardiovascular Health Risk Factors Among US Adolescents.

Food insecurity, a social and economic condition of limited availability of healthy food, is a risk factor for adverse cardiovascular health outcomes among adults; few studies have been conducted in adolescents. This study explores the association between food insecurity and cardiovascular health risk factors among a nationally representative sample of US adolescents, adopting the American Heart Association's Life's Essential 8 metric. We analyzed data from 2534 adolescents aged 12 to 19 years from the 2013 to 2018 National Health and Nutrition Examination Surveys. In the sample, 24.8% of adolescents lived in food-insecure households. After multivariable adjustment, food insecurity was associated with a 3.23-unit lower total Life's Essential 8 score (95% CI, -6.32, -0.15) and lower scores on diet quality (β=-5.39 [95% CI, -8.91, -1.87]) and nicotine exposure (β=-4.85 [95% CI, -9.24, -0.45]). Regarding diet, food insecurity was associated with 5% lower Healthy Eating Index-2015 scores [95% CI, -7%, -2%], particularly lower intakes of whole grains and seafood/plant proteins and marginally higher intake of added sugar. Regarding nicotine exposure, food insecurity was associated with ever use of a tobacco product among m (odds ratio, 1.74 [95% CI, 1.20-2.53]). Compared with their food-secure counterparts, food-insecure male (odds ratio, 1.98 [95% CI, 1.07-3.65]) and female (odds ratio, 3.22 [95% CI, 1.60-6.45]) adolescents had higher odds of living with a current indoor smoker. In this nationally representative sample of adolescents, food insecurity was associated with multiple indicators of cardiovascular health risk. These findings underscore the need for public health interventions and policies to reduce food insecurity and improve cardioprotective behaviors during adolescence, with particular efforts targeting diet quality and nicotine exposure.