Measures Of Food Insecurity Research Articles

Confirmatory factor analysis to validate a new measure of food insecurity: perceived and actual constructs

Food crises in 2008 raised the need for more timely and effective policy instruments to monitor and fight food insecurity. FAO developed the Food Insecurity Experience Scale (FIES), based on the individual experience in quantity and quality of food. Compared to the traditional, macro-based indicators, FIES presents important advantages: FIES makes it possible to identify the characteristics of food insecure people and allows to analyse food insecurity also in rich and developed countries. The main purpose of the paper is to validate the FIES, in order to assure policymakers that the tool is what they need to design meaningful development efforts. In this study, the methodological properties of FIES were evaluated on a sample of 150 thousand people, all over the world. The analysis of frequency distributions, the measurement of internal consistency, as well as an exploratory factor analysis and a cluster analysis were conducted. A principal component analysis-multiple linear regression allowed to rate the effect of each item on each factor. A confirmatory factor analysis was applied to test the hypothesis that a relationship exists between the observed variables and their underlying latent constructs. External validity was evaluated by a micro-econometric analysis of FIES in relation to extreme poverty and other relevant socio-economic characteristic of the population. The results show that FIES presents a good level of reliability and internal consistency. However, two distinct latent constructs were identified and analysed: a subscale measuring ‘perceived’ aspects of food insecurity and a subscale related to ‘actually experienced’ activities.

Measuring Food Insecurity Using the Food Abundance Index: Implications for Economic, Health and Social Well-Being.

High levels of food insecurity signal the presence of disparities and inequities in local food access, which have been shown to negatively impact the health and well-being of individuals and communities. However, the approaches used to define and measure high food insecurity, also known as a “food desert”, vary widely across research study and intervention methodology. This paper describes the development and validation of a measurement tool called the “Food Abundance Index” (FAI) which is a scorecard for assessing levels of food insecurity across five key dimensions: access, diversity, quality, density, and affordability. A pilot study was conducted to examine levels of food insecurity in order to test the extent to which the FAI can detect food deserts. Nine neighborhoods were selected based on the demographic characteristics of communities shown to be related to food insecurity. Our findings provide evidence that the Food Abundance Index provides a robust measurement tool to assess the extent of food insecurity within a community or neighborhood. Thus, this multidimensional scorecard can be used in future research to detect levels of food insecurity within urban areas and help to bridge the gap between academics, policymakers and practitioners in this important area.

Food insecurity, health care utilization, and health care expenditures.

ObjectiveTo disentangle the relationships among food insecurity, health care utilization, and health care expenditures.Data Sources/Study SettingWe use national data on 13 465 adults (age ≥ 18) from the 2016 Medical Expenditure Panel Survey (MEPS), the first year of the food insecurity measures.Study DesignWe employ two‐stage empirical models (probit for any health care use/expenditure, ordinary least squares, and generalized linear models for amount of utilization/expenditure), controlling for demographics, health insurance, poverty status, chronic conditions, and other predictors.Principal FindingsOur results show that the likelihood of any health care expenditure (total, inpatient, emergency department, outpatient, and pharmaceutical) is higher for marginal, low, and very low food secure individuals. Relative to food secure households, very low food secure households are 5.1 percentage points (P < .001) more likely to have any health care expenditure, and have total health care expenditures that are 24.8 percent higher (P = .011). However, once we include chronic conditions in the models (ie, high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma), these underlying health conditions mitigate the differences in expenditures by food insecurity status (only the likelihood of any having any health care expenditure for very low food secure households remains statistically significant).ConclusionsPolicy makers and government agencies are focused on addressing deficiencies in social determinants of health and the resulting impacts on health status and health care utilization. Our results indicate that chronic conditions are strongly associated with food insecurity and higher health care spending. Efforts to alleviate food insecurity should consider the dual burden of chronic conditions. Finally, future research can address specific mechanisms underlying the relationships between food security, health, and health care.

Food insecurity & dietary restraint in a diverse urban population

ABSTRACT The primary aim of this study was to investigate self-reported reasons for engaging in dietary restraint (DR) in a food insecure urban population. It also tested whether DR was associated with increased eating disorder (ED) pathology when DR was broadly assessed. The initial sample (N = 503) consisted of adult clients visiting food pantries who completed the Eating Disorder Diagnostic Scale for DSM 5, the Radimer Cornell Food Insecurity Measure, and three items from the DR subscale of Eating Disorder Examination Questionnaire (EDE-Q); EDE-Q items were modified to allow participants to explain why they restricted. Analyses included participants (N = 259) who responded to one of the modified EDE-Q questions. Results indicated that participants engaged in DR for several reasons, including minimizing the effect of hunger for other family members (i.e., children), “stretching” food to make it last longer, and prioritizing medical expenses. Intentional efforts to limit food intake in this sample were correlated with increased ED pathology. Although it is not surprising that adults experiencing food insecurity engage in intentional DR, this study adds important information about why food insecure adults engage in DR and highlights the importance of assessing DR for reasons other than weight and shape concerns.

Biases in self-reported food insecurity measurement: A list experiment approach

Measuring the incidence and intensity of food insecurity has long been a challenge due to its conceptual and practical complexity. Several scholars have proposed objective and subjective measurements to monitor or evaluate food in(security) programs. While the objective measurements such as food caloric intake and food expenditure are data demanding and costly, the subjective measurements such as experience-based food insecurity scales that use direct responses to food shortage questions can be prone to biases and misreporting due to respondents’ unobservable economic and social desirability concerns. This paper reports the biases when food shortage is asked through direct questions and indirect interviews using a list experiment approach—an approach widely used to elicit the true responses of respondents for a sensitive question. The list experiment was conducted on four selected self-reported food insecurity survey questions which represent both the availability (incidence) and access (intensity) dimensions of food security. The sample households were drawn from two districts in Northern Ethiopia where households are chronically food insecure and several projects have been implemented. The results indicate the existence of significant bias in self-reported food insecurity responses when implemented through direct interviews. The results also show that the biases, particularly the ones related to incidence questions, have led to erroneous conclusion about the impact of a food security program—the Ethiopian Household Asset Building (HAB) program. Based on the findings, the paper highlights possible options and precautionary actions for measuring food insecurity using self-reported questions.

Worry About Daily Financial Needs and Food Insecurity Among Cancer Survivors in the United States.

A cancer diagnosis can impose substantial medical financial burden on individuals and may limit their ability to work. However, less is known about worry for nonmedical financial needs and food insecurity among cancer survivors. The National Health Interview Survey (2013-2017) was used to identify cancer survivors (age 18-39 years, n=771; age 40-64 years, n=4,269; age ≥65 years, n=7,101) and individuals without a cancer history (age 18-39 years, n=53,262; age 40-64 years, n=60,141; age ≥65 years, n=30,261). For both cancer survivors and the noncancer group, adjusted proportions were generated for (1) financial worry ("very/moderately/not worried") about retirement, standard of living, monthly bills, and housing costs; and (2) food insecurity ("often/sometimes/not true") regarding whether food would run out, the fact that food bought did not last, and the inability to afford balanced meals. Further adjusted analyses examined intensity measures ("severe/moderate/minor or none") of financial worry and food insecurity among cancer survivors only. Compared with individuals without a cancer history, cancer survivors aged 18 to 39 years reported consistently higher "very worried" levels regarding retirement (25.5% vs 16.9%; P<.001), standard of living (20.4% vs 12.9%; P<.001), monthly bills (14.9% vs 10.3%; P=.002), and housing costs (13.6% vs 8.9%; P=.001); and higher "often true" levels regarding worry about food running out (7.9% vs 4.6%; P=.004), food not lasting (7.6% vs 3.3%; P=.003), and being unable to afford balanced meals (6.3% vs 3.4%; P=.007). Findings were not as consistent for cancer survivors aged 40 to 64 years. In contrast, results were generally similar for adults aged ≥65 years with/without a cancer history. Among cancer survivors, 57.6% (age 18-39 years; P<.001), 51.9% (age 40-64 years; P<.001), and 23.8% (age ≥65 years; referent) reported severe/moderate financial worry intensity, and 27.0% (age 18-39 years; P<.001), 14.8% (age 40-64 years; P<.001), and 6.3% (age ≥65 years; referent) experienced severe/moderate food insecurity intensity. Lower income and higher comorbidities were generally associated with greater intensities of financial worry and food insecurity in all 3 age groups. Younger cancer survivors experience greater financial worry and food insecurity. In addition to coping with medical costs, cancer survivors with low income and multiple comorbidities struggle to pay for daily living needs, such as food, housing, and monthly bills.

Food insecurity, gender, and international migration in low- and middle-income countries

The determinants of migration have been widely studied but research has rarely addressed the roles of food insecurity and gender in the migration decision process. To address these gaps, we examine these relationships for 135,078 individuals across 94 low- and middle-income countries. We use a series of binary-choice models with sample selection and data from the 2014–2015 waves of the Gallup World Poll Survey, which includes the first global measure of individual-level food insecurity. Results, which are robust, indicate that food insecurity is an important determinant of both migration intentions and preparations, and the probability of migration intentions increase monotonically with the severity of food insecurity, and the probability of migration preparations decrease. These relationships also differ significantly by gender and level of gross national income. Evidence suggests a need for increased coordination between the international food security and migration policy agendas.

Effects of Flood on Food Security, Livelihood and Socio-economic Characteristics in the Flood-prone Areas of the Core Niger Delta, Nigeria

The study examined the effects of flood risk levels on food security, livelihood and socio-economic characteristics in the flood-prone areas of the core Niger Delta, Nigeria using a descriptive survey design and 790 respondents were selected with the aid of a multistage stratified sampling technique in Bayelsa, Delta and Rivers States, representing the core Niger Delta. Descriptive statistics were used in the analysis and presentation of data. The findings of the study showed that 75.3% of the respondents agreed that basic food is scarce after all flood incident. However, 69.9% attested to the fact that growth and development of crops are affected when flood washes away farmlands. It can also be seen that flood increases food insecurity, unavailability of staple food and malnutrition as agreed by 78.3% of the total respondents. Furthermore, 77.1% of respondents agreed that flood increases the inability of plants to absorb essential nutrients necessary for proper growth while 71.4% agreed that flooding leads to the erosion or loss of the nutritional status of crops planted in the communities. Also, 69.9% agreed that the washing away of farmlands have led to chronic, long-lasting food insecurity in the communities. Further evidence from the study shows that 75.6% of respondents agreed that the incident of flood leads to acute food insecurity which affects the livelihood of the residents. It is also revealed that flood affects households or residents' investments (64.7%) and losing occupation and source of income from flooding leads to difficulty in caring for the children (60.9%). It is concluded that floods have reduced the efficiencies of farmland in terms of food production causing food insecurity, income reduction and poor livelihood among the residents of the core the Niger Delta States. The study, therefore, recommended that communities should advocate, promote and inculcate the spirit of the commitment of individuals and households towards the continued and holistic development (via social, economic, health, and infrastructural), food security, and increased livelihood in flood-prone communities. The Ministry of Agriculture should ensure that smart agriculture is adopted as a way out to resolve the issues of flood-induced food insecurity and structural measures like dams, culverts, drainages and ditches should be constructed by government and her intervention agencies to accommodate and reduce the runoff or overflow of floodwaters which causes severe social, economic and infrastructural damages or impacts during flooding.

Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal.

BackgroundAdequate nutrition is essential during the lactation period for better maternal and child health outcomes. Although food insecurity and dietary monotony (defined as less diverse diet), two important determinants of undernutrition, are endemic in the rural mountains of Nepal, insufficiently examined and assessed for risk factors in mothers during lactation, a life stage of high nutritional demand. This study aimed to assess the status and factors associated with food insecurity and dietary diversity among lactating mothers residing in the mountains of Nepal.MethodsA community-based cross-sectional study was conducted in an urban municipality in the mountainous Bajhang District of far-western Nepal. The sampling frame and strategy led to 417 randomly selected lactating mothers. Household Food Insecurity Access Scale (HFIAS) and the tool “Minimum Dietary Diversity for Women” developed by the Food and Agriculture Organization were used to measure food insecurity and dietary diversity, respectively. Additional information on socio-demographics and risk factors were collected. Multivariable logistics regression assessed correlates of study outcomes.ResultsOverall, 54% of the households were food insecure, and over half (53%) of the mothers had low dietary diversity. Food insecurity status (mild food insecurity AOR = 10.12, 95% CI = 4.21–24.34; moderate food insecurity AOR = 8.17, 95% CI = 3.24–20.59, and severe food insecurity AOR = 10.56, 95% CI = 3.92–28.43) were associated with higher odds of dietary monotony. Likewise, participants with lower dietary diversity were 8.5 times more likely to be food insecure than those with higher dietary diversity (AOR = 8.48, 95% CI = 3.76–19.14). The monthly income of the family was positively associated with food insecurity. Participants’ (AOR = 3.92 95%CI = 1.76–8.71) or spouses’ (AOR = 2.90, 95% CI = 1.07–7.85) unemployment was associated with higher odds of being food insecure. Likewise, owning a cultivable land (AOR = 0.49, 95% CI = 0.28–0.84) and participant’s unemployment status (AOR = 5.92, 95% CI = 3.02–11.63), were significantly associated with increased odds of dietary monotony.ConclusionThe observed food insecurity and poor dietary diversity among lactating mothers, the correlates associated with these outcomes, may help local stakeholders to identify local health needs and subgroups for targeted interventions. Socioeconomically disadvantaged mothers should be specifically targeted for relevant programs and policies.

Life on the Other Border: Farmworkers and Food Justice in Vermont by Teresa M. Mares

Reviewed by: Life on the Other Border: Farmworkers and Food Justice in Vermont by Teresa M. Mares Megan A. Carney Teresa M. Mares, Life on the Other Border: Farmworkers and Food Justice in Vermont. Oakland: University of California Press, 2019. 240 pp. Anthropologists are increasingly studying the ways that food systems intersect with patterns of human migration. Across sub-fields, such as the anthropology of food and nutrition and medical anthropology, ethnographers have been engaging with questions of food insecurity and human mobility from the macro-contexts of multilateral trade agreements (e.g., Galvéz 2018) and industrial agricultural production (e.g., Holmes 2013) to the intimate spheres of feeding and eating (e.g., Carney 2015). Teresa Mares's Life on the Other Border makes a significant contribution to this literature by utilizing a community-based ethnographic lens to study the experiences of immigrant farmworkers in Vermont's dairy industry. The result is a refreshingly nuanced and complex portrait of the lives of these individuals and the broader transnational social networks to which they belong. Based on more than six years of "community-based ethnographic research" (3), Mares draws on multiple forms of empirical evidence, such as interviews, surveys, and participant observation in community garden settings, farmworkers' homes, and public places of activism. Throughout the text, Mares probes the "politics of visibility." She argues that, "Within agricultural regions, hegemonic whiteness, or more specifically the reproduction of whiteness, is enabled by the exclusion and marginalization of non-white bodies" (4). She demonstrates how a politics of visibility at once shields immigrant farmworkers from the view of consumers, upholds a [End Page 1651] bucolic (and mostly white) depiction of Vermont's agriculture, and makes Latinx people hypervisible and vulnerable to surveillance in a non-traditional migrant destination. Mares brings attention to the injustices incurred by farmworkers whose "labor contributes to the livelihoods of farmers and the well-being of consumers across the food chain" (2) while reminding us that despite Vermont's ostensibly progressive politics, it remains a border state and its status as such threatens those without formal authorization to be in the United States. Rather than perpetuate the invisibility of immigrant laborers in Vermont's dairy industry, Mares foregrounds their struggles and illuminates "examples of resiliency and autonomy within marginalized communities that are typically rendered invisible by those in power" (25). This invisibility also extends into the ways that immigrant farmworkers' daily struggles with food procurement and preparation are obscured through existing survey instruments to measure food insecurity in the United States. Based on her own implementation of the USDA Household Food Security Survey Module with 100 Latinx farmworkers, Mares rightly derides "the assumptions underlying how we define and measure food insecurity" (58). While her critique of this particular survey instrument is not necessarily new, the discrepancies she observes between her qualitative data and survey data further justify existing calls for going beyond the "realm of quantifiable data" in working "for real solutions and opportunities for justice in our food system" (84). In Chapter 1, Mares challenges current thinking that Vermont is a state devoid of Latinx migrants by presenting the lived experiences of farmworkers and the myriad vulnerabilities they face as brown bodies in a border region. Chapter 2 presents Mares's survey findings on food insecurity in farmworker households and compares these results against data collected through interviews and observations. She then pivots from the concept of food security to food sovereignty in Chapter 3 to introduce Huertas, a project that "supports migrant farmworkers in planting home kitchen gardens" (89). Calling for a more expansive definition of food sovereignty that bridges both structural and individual-level actions, Mares draws on her experiences as co-director of Huertas and working alongside farmworkers, student volunteers, and interns to implore us to reconsider the garden as a site of autonomy and resistance. She writes, "In this political climate, it seems that gardens are even more necessary, even as they might seem more trivial amidst the massive threats to immigrant well-being and [End Page 1652] safety" (117). Chapter 4 steers our attention to the roles of service providers in working to improve food access, health, and overall well-being of Vermont...

Food insecurity in the PSID: A comparison with the levels, trends, and determinants in the CPS, 1999–2017

Food insecurity, defined as a condition of limited or uncertain access to adequate food, is a widely used measure of well-being in the U.S. The survey module in the Current Population Survey (CPS) that is used to generate the official U.S. food insecurity measure is also included on multiple waves of the Panel Study of Income Dynamics (PSID), offering the first opportunity to answer key research questions on the persistence of food insecurity within and across generations. We assess the validity of the food insecurity measure in the PSID by comparing it to the CPS. We find that, although estimated food insecurity rates in the PSID are lower than those in the CPS, the trends over time in the two datasets are similar, and the rates converge from the 1999–2003 period to the 2015–17 period. Our findings lend credence to the use of the PSID for food insecurity research.

"Measuring hunger": psychometric scales of food insecurity and indigenous peoples in Brazil

The Brazilian Food Insecurity Scale (EBIA) was validated for the Brazilian context in 2004. Since then, the scale has evaluated and measured the experience of food insecurity in rural and urban households, initially in the Brazilian National Household Sample Survey and later in the Brazilian National Survey of Demographic and Health. However, indigenous peoples have not been examined specifically in these surveys, despite recognition of their food and nutritional vulnerability. In this scenario, we analyze and discuss the application of the EBIA among indigenous peoples in Brazil, based on a set of fundamental questions for understanding and measuring their experience with food insecurity and "hunger". We conduct a sociopolitical and ethnographic analysis of a set of official documents and significant articles on the use of psychometric scales of food insecurity among Brazilian indigenous peoples, compared to international studies on the validation and application of scales in other sociocultural contexts. The initiatives with adaptation and application of the EBIA to indigenous peoples in Brazil indicate that understanding and measuring food insecurity in these peoples poses a major challenge. Particularly complex is the proposal to guarantee comparability of different contexts while taking into account the multiple local singularities. We propose that ethnographic studies should serve as specific components of future initiatives on this topic and that they should cover aspects such as the seasonality of indigenous peoples' food production, different processes of food monetization, and the dynamics of their food systems.

Development and validation of measure of household food insecurity in Northern Rao PDR

AbstractIntroductionLao PDR is one of the poorest countries in the world, ranked the 138th of 188 developing countries. Although household food insecurity has been prevalent in Northern Rao PDR, no valid measurement of household food insecurity exists. Therefore, the study was to develop a household food insecurity questionnaire and verify the validity of the questionnaire in the rural areas of Lao PDR.Materials and MethodsUsing a multistage-sampling cross-sectional study, the sample included 373 households with children under 5 years of age living in Xieng Khouang, Lao PDR. The questionnaire was composed of 18 items based on the US household Food Security Survey Module and partially modified to local circumstances. Internal consistency of questions measured with Cronbach's α was adequate, result of 0.746. External validity was evaluated through comparison analyses between food insecurity levels and household socioeconomic indicators.Results and discussionAmong 373 households, 42.7% were food-insecure and 4.3% were food-insecure with hunger. There were more food-insecure households in those with lower maternal education levels (P &lt; 0.001), greater number of household members (P &lt; 0.001), longer travel time to farmland (P = 0.003), and lower household asset scores (P &lt; 0.001). Households with the residence made of natural material for walls (P &lt; 0.001), roofs (P &lt; 0.001) and floors (P &lt; 0.001) as well as without electricity (P &lt; 0.001), pipe to supply drinking water (P &lt; 0.001), and income other than agriculture (P &lt; 0.001) had higher food insecurity than their counterparts. In addition, inadequate maternal prenatal care and education, child health care, and vaccinations increased household food insecurity. Mothers and children in food-insecure households had lower intakes of various food groups including protein-source foods. This study would provide a valid instrument to assess food insecurity and be used in the future as an evaluation tool for the improvement of nutritional deficiencies as well as a tool for selection of target subjects in Northern Rao PDR.

Model-based estimation of small area food insecurity measures in Ethiopia using the Fay-Herriot EBLUP estimator

In many countries, including Ethiopia, sample surveys are designed to produce estimates of variables of interest at the national and regional levels due to cost and operational considerations. For example, household food insecurity estimates are needed down at least at the zone level in Ethiopia to offer targeted solutions. However, the sample sizes of sample surveys are often not large enough to produce reliable estimates at the small area (zone) level. This paper remedies some of these shortcomings by estimating household food insecurity in each zone of Ethiopia by linking data from the 2015/16 welfare and monitoring survey and the 2007 population census using a small area estimation (SAE) approach. The results show the zonal level household food insecurity estimates generated by SAE were more efficient and precise compared to the survey-based estimates. Besides, accurate and cost-effective food insecurity statistics at the zonal level were produced without more resources through combining the available data sources. Finally, zonal level household food insecurity estimates could be the recommended tools for monitoring the progress of sustainable development goals (SDGs) in Ethiopia. Because, in the final 2030 Agenda, SDG 2 concentrates entirely on food security, recognizing much of its complex and multi-faceted nature.

Relationship between social indicators and food insecurity: a systematic review.

The relationships between the social indicators (SIs) that determine food insecurity (FI) have not been described yet. This systematic review aims to identify which SIs are associated with FI in Brazilian households and how these relationships are explained. The research protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO - CRD42018106527). Three independent researchers performed the search in the Latin American and Caribbean Health Sciences Literature (LILACS) and National Library of Medicine (PubMed) databases (June/2018). The study included articles that used the Brazilian Household Food Insecurity Measurement Scale (Escala Brasileira de Insegurança Alimentar - EBIA) to assess FI and that evaluated the association between SIs and FI. We included 18 articles in this review. The Kappa concordance index between the researchers was 0.72 (95%CI 0.42 - 1.00). Most articles were cross-sectional and used multivariate regression for the statistical analysis. At least one income-related SI had a significant association with FI, and, in most studies, they presented the highest values of association measures. We organized the authors' explanation about the relationships between SIs and FI in a conceptual model. The study identified three possible justifications for the association between SIs and FI: direct relationship, relationship mediated by income, or relationship mediated by another SI and income. Income assumed a central role in the mediation between several SIs and FI. However, the analysis methods of the studies did not allow us to investigate this mediation. Therefore, improving data analysis to isolate and understand the effect of SIs on FI is still necessary.

The Four Domain Food Insecurity Scale (4D-FIS): Development and evaluation of a complementary food insecurity measure

The Four Domain Food Insecurity Scale (4D-FIS): Development and evaluation of a complementary food insecurity measure

Exploratory Factor Analysis on Food Insecurity Experience Scale (FIES): Latest food insecurity measurement tool by FAO

Food insecurity is a known health-related problem worldwide. Recently, FAO releases the latest measurement scale to gauge experiences of food insecurity named as Food Insecurity Experience Scale (FIES), which was designed to have cross-cultural equivalence and validity. We aimed to translate and validate FIES by using exploratory factorial analysis (EFA) and to see its reliability to implement it in Malaysia. This cross-sectional study was conducted among a community in Felda Bukit Cherakah, Puncak Alam Selangor (n=124). Factor analysis FIES items established two underlying structures, while the Cronbach alpha coefficient indicates acceptable internal consistency. FIES is valid and reliable to be used to measure food insecurity situation among our population.

Effects of family income and conditional cash transfers on household food insecurity: evidence from a longitudinal study in Northeast Brazil.

Food insecurity (FI) is a challenge to policy makers worldwide, who need to understand which polices and programmes are effective at overcoming FI. The present study aimed to examine the impact of family income and conditional cash transfers on changes in household FI status in a highly vulnerable municipality in Northeast Brazil. A population-based longitudinal cohort study among families in a municipality in the semi-arid area in Northeast Brazil (2011 and 2014). FI was estimated with the Brazilian Household Food Insecurity Measurement Scale (EBIA). The effects of family income and cash transfer on changes in FI were estimated using logistic regression models and the population-attributable risk fraction. Households in Cuité, Paraíba, Brazil. Household respondents interviewed in 2011 (n 358) and 2014 (n 326). There was a reduction in FI prevalence of 17·5 % across time; 24·5 % of families who were food insecure in 2011 became food secure in 2014. After adjustment, families that did not experience an increase in their total household income or a reduction in the cash transfer amount were at increased risk of persistent FI across time. If the cash transfer programme had not been in place, about 10 % of the families that switched from food insecure to food secure across time would have remained in FI instead. The decrease of FI occurred in an area of extreme climatic and social vulnerability. These changes were more related to the cash transfer than the increase in family income over time.

The Relation Between Household Food Insecurity and Children's Height in Canada and the United States: A Scoping Review

Household food insecurity is a determinant of health and marker of material deprivation. Although research has shown that food insecurity is associated with numerous adverse health, developmental and nutritional outcomes among children in high-income countries, little is known about its impact on children's height, an important marker of nutritional status and physical development. We reviewed evidence on the relation between experience-based measures of food insecurity and the height of children aged 0-18 y in Canada and the United States. The search, conducted in Embase, Medline, CINAHL, ProQuest, Web of Science, and EconLit from the inception of the databases to October 2017, identified 811 records that were screened for relevance. A total of 8 peer-reviewed studies, 2 from Canada and 6 from the United States, met the inclusion criteria and were summarized. Five studies found no association between food insecurity and children's height. One study found that having taller children in the household predicted more severe food insecurity, whereas 2 studies found that more severe experiences of food insecurity were associated with shorter height among children from ethnic minority populations. These results suggest that household food insecurity may not be associated with height inequalities among children in Canada and the United States, except perhaps in certain high-risk populations. However, the few studies identified for review provide insufficient evidence to determine whether food insecurity is or is not associated with children's height in these countries. Given the importance of optimal linear growth for current and future well-being, it is critical to understand how different modifiable environmental circumstances relate to children's height to help establish priorities for intervention. Families with children are disproportionately affected by food insecurity, and more research explicitly designed to examine the association between household food insecurity and children's height in high-income countries is needed.

Child Compared with Parent Perceptions of Child-Level Food Security

ABSTRACTBackgroundThere is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts.ObjectiveThe aim of this study was to compare parent and child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population.MethodsCross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic third- to fifth-grade students and their parents were used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared with an adaption of the 5-item Child Food Security Assessment completed by their child. Levels of association between child and parent perceptions within dyads were calculated using Goodman and Kruskal's γ statistic. A mixed-effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics.ResultsThe child sample was 53% girls, mean age of 9 y, and 63% were Hispanic. The parent sample was 86% women and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak positive association between child and parent perceptions of child-level food security (γ = 0.162, P < 0.001). Children perceived themselves as less food secure than their parents’ perception 70.1% of the time. Household receipt of Supplemental Nutrition Assistance Program benefits was associated with greater odds of discordant food security perceptions, whereas female children, older children, and parents not working were characteristics associated with lower odds of discordant perceptions.ConclusionsResults, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate estimations or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. This trial was registered at clinicaltrials.gov as NCT02668744.