Prevalence Of Severe Food Insecurity Research Articles

Food insecurity and dietary diversity among food aid recipients in urban and rural areas at the covid‐19 outbreak: An exploratory study

AbstractThe covid‐19 pandemic has affected food aid. This paper reports an exploratory study to estimate the prevalence and degree of food insecurity, household dietary diversity score (HDDS), and the association with demographic, social, and economic characteristics of health status in a sample of food aid recipients in urban and rural areas of Catalonia, Spain. Cross‐sectional data on food insecurity, dietary diversity, household income, health, and sociodemographic characteristics were obtained from the survey taken at seven different food aid distribution points from urban and rural locations. Sixty‐six percent of the participants identified as new users since the covid‐19 crisis. Only 12.5% of the sample lived in households where all adults were unemployed, and 44.8% were employed. Almost a third of the sample (32.3%) reported having someone in their household who suffered from a diet‐related illness or disease. The prevalence of severe food insecurity was 52.1%, followed by 28.1% suffering moderate food insecurity. New food aid users due to covid‐19 pandemic showed a significantly higher prevalence of food insecurity. No significant differences were found in terms of HDDS. This paper provides evidence that much of the gap in food insecurity is related to dietary diversity and children in households considering different urban or rural areas.

Mental distress, food insecurity and university student dropout during the COVID-19 pandemic in 2020: evidence from South Africa.

Student dropout has been a key issue facing universities for many years. The COVID-19 pandemic was expected to exacerbate these trends; however, international literature has produced conflicting findings. Limited literature from Africa has investigated the impact of COVID-19 on student dropout trends, despite the documented devastation, including increased risk of food insecurity and mental distress, caused by the pandemic. This work seeks to understand the impact of food insecurity and mental distress on student dropout during the COVID-19 pandemic. Using a cross-sectional research design, first-year undergraduate students from a large South African university were recruited via email to participate in a survey between September and October 2020. The Household Food Insecurity Access Scale (HFIAS) was used to measure food insecurity and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) was used to measure mental distress. Multivariate regression was used to investigate factors associated with student dropout. The student dropout rate was 10.5% (95% CI: 8.2-13.2). The prevalence of severe food insecurity was 25.7% (95% CI: 22.3-29.4) and the prevalence of severe mental distress symptoms was 26.7% (95% CI: 23.3-30.4). Dropout rates and levels of food insecurity were highest among students residing in remote areas during the lockdown at 19.2% and 43.6%, respectively. The multivariate logistic regression revealed that being male increased the probability of dropout almost three-fold (odds ratio (OR) = 2.70; 95% CI: 1.48-4.89, p =0.001)). Being moderately food insecure increased the odds of dropout more than two-fold (OR=2.50; 95% CI:1.12-5.55, p=0.025), and experiencing severe mental distress symptoms increased the odds of dropout seven-fold (OR=7.08; 95% CI:2.67-18.81, p<0.001). While acknowledging that various factors and complexities contribute to student dropout, the increased vulnerability to food insecurity and mental distress, stemming from issues such as widespread job losses and isolation experienced during the pandemic, may have also had an impact on dropout. This work reiterates the importance of directing additional support to students who are food insecure and those who are experiencing mental distress in order to mitigate university student dropout.

Has food security in the EU countries worsened during the COVID-19 pandemic? Analysis of physical and economic access to food.

The aim of the paper is to provide an ex-post assessment of the impact of the COVID-19 pandemic on food insecurity in the EU-27 countries expressed by physical and economic food access. We analysed trade and price effects, together with food insecurity and malnutrition indicators. Actual levels of the indicators were compared with their pre-pandemic magnitudes and/or with counterfactual levels derived from predictive models. We also aimed to compare the objective statistics with the subjective consumers' perception of their households' food security. Our research indicates that the EU food trade was more resilient to COVID-19 impacts than the trade in non-food products, while food trade decreases were of a temporary nature. This did not affect the trade balance significantly; however, the import reduction threatened the physical food access in most EU countries. Regarding economic food access, the results indicate that the increase in food prices was offset by the increase in disposable income. It may suggest that the COVID-19 pandemic did not significantly affect the deterioration of economic access to food in the EU countries. However, the prevalence of severe food insecurity in the total population or the proportion of households reporting inability to afford a meal with meat, chicken, fish, or a vegetarian equivalent increased in 2020-2021 compared to 2019. This means that the comparative analysis of the real data on prices and households' income, as well as consumer financial situation and food consumption affordability, does not offer a clear answer concerning the impact of the COVID-19 pandemic on the food security of EU households.

Effect of a comprehensive nutrition education program on nutritional behavior and food security of female-headed households who receive welfare support in Zanjan Province, Iran

BackgroundIn recent years, the food security and dietary quality of many Iranian families have deteriorated due to unprecedented inflation. Nutrition education programs can be an effective and inexpensive method to improve food quality and security. The present study aimed to investigate the effect of a comprehensive nutrition education program for low-income women who are heads of households and are covered by the Zanjan province’s welfare.MethodsThe food security of 2600 female-headed households covered by the Welfare of Zanjan province was evaluated using a standard 6-item questionnaire. A total of 600 women with the highest food insecurity scores were selected for the comprehensive nutrition education program. The participants received six sessions of 1.5 h of courses about how to improve the quality of their diets and manage their budgets and be physically active. At the beginning of the study and one month after the completion of the intervention, the participants were asked to complete a questionnaire designed and validated by the investigators. The scores of each section before and after the intervention were compared using paired t-test method and p values ​​of < 0.05 were considered statistically significant.ResultsThe prevalence of severe food insecurity among female-headed households who receive welfare support in Abhar, Khodabandeh, and Zanjan cities was 59.5%, 75%, and 62%, respectively. A total of 505 participants successfully completed the courses. After completion of the educational intervention, diet quality, physical activity, budgeting, and food safety scores of the participants increased by 6%, 4%, 4%, and 5%, respectively, which were statistically significant (p < 0.001). However, no significant difference was observed in the food insecurity scores.ConclusionThe comprehensive nutrition education program without financial or nutritional support can have a small but significant impact on the improvement of the nutritional behaviors and dietary quality of low-income people.

Dietary Diversity, Household Food Insecurity and Stunting among Children Aged 12 to 59 Months in N'Djamena-Chad.

Household food insecurity is increasingly recognized as a global health problem, particularly in sub-Saharan Africa. This study aimed to contextualize the associations between household food insecurity, dietary diversity and stunting in N'Djamena. This study is a community-based cross-sectional study, and the SMART (Standardized Monitoring and Assessment of Relief and Transitions) methodology was used to calculate the sample size. A total of 881 households were selected for the survey. A 24-h recall evaluated the dietary diversity score (DDS), the Household Food Insecurity Access Scale (HFIAS) made it possible to assess household food insecurity (HFI), and stunting among children aged 12 to 59 months was assessed by anthropometric measurements. Logistic regression was constructed to determine the association between household food insecurity, dietary diversity, and stunting. The study was conducted from January to March 2022. The prevalence of severe food insecurity was 16.6%, and that of stunting was 25.3%. The mean DDS was 6.5 ± 1.6. Severe food insecurity (OR 2.505, CI: 1.670-3.756) was significantly associated with stunting. The association between DDS and stunting was not significant. This study's prevalence of household food insecurity and stunting was very high. Household food insecurity and household size were significantly associated with stunting.

Consideraciones sobre la seguridad alimentaria en hogares mexicanos durante la pandemia de Covid-19

This study determined the level of food security in Mexican households in the COVID-19 pandemic according to the characteristics of the members. To this end, the harmonized version of the Latin American and Caribbean Food Security Scale was applied between May and August 2020. It was detected that 16.0% of households had food security (FS), FS was higher in households with persons aged 26 to 64 years (16.2%) and 65 years and older (15.2%). The prevalence of severe food insecurity was higher (26.3%) in households where three or more persons under 15 years of age lived and in households where the number of economic contributors decreased. These results provide useful information on the HS situation prevailing during COVID-19. They suggest that the most vulnerable households in post-pandemic times will be those in which there are more minors and in which the number of economically active persons decreases.

A Comparison of Food Insecurity Among Two Communities, Family Types and Genders During the COVID-19 Pandemic in the Oforikrom Municipality, Ashanti Region of Ghana

ObjectivesThis study aimed to compare food insecurity among two different communities (Ayeduase and Kotei), family types and genders over a six months period during the COVID-19 pandemic at Oforikrom Municipality, Ashanti Region of Ghana.MethodsA Longitudinal study was conducted using a semi-structured questionnaire and a two-stage sampling technique among 160 respondents.ResultsThe overall prevalence of food insecurity was 49.4%, 29.4% and 21.2% for mild, moderate and severe food insecurity respectively at baseline. Severe food insecurity was higher among respondents in the Kotei community (22%) than those in the Ayeduase community (20%) at baseline, whiles at end-line, severe food insecurity among respondents in the Ayeduase community was higher (11.2%) than Kotei (8.7%). There was a significant association between respondents in Kotei and Ayeduase (p < 0.0001). The prevalence of severe food insecurity at baseline and end-line was higher in women (37.5%) than in men (24.6%) (p < 0.0001) Also, there was a negative correlation (B = −2.26, 95% CI: −3.67, −0.86) between respondents who had some level of tertiary education at baseline and food insecurity (p = 0.002). Respondents with no level of formal education were significantly associated and negatively correlated with food insecurity at baseline (p = 0.005) (B = −2.39, 95% CI: −0.04, −0.74) and at end-line, there was a positive correlation (B = 0.58, 95% CI: 0.19, −2.97) [p = 0.003] between respondents with no level of formal education and food insecurity. Easy access to water at baseline and end-line were also significantly associated with food insecurity (p = 0.015) and (p = 0.045) respectively.ConclusionsCOVID-19 has not only affected fragile livelihoods but has also had a huge effect on food security among families with women being mostly affected during the pandemic than men.Funding SourcesIt was funded by Rahel Nyarko-Morrison.

Validity of the Food Insecurity Experience Scale and prevalence of food insecurity in The Bahamas.

Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.

Food Insecurity and Sleep Disturbance Among 223,561 Adolescents: A Multi-Country Analysis of Cross-Sectional Surveys.

This study was to investigate the association between food insecurity (FI) and sleep disturbance among adolescents. Based on the cross-sectional data of the Global School-based Student Health Survey, this study analyzed self-reported data from adolescents in 68 countries. Multivariate logistic regression and meta-analysis were used to evaluate the association between FI and sleep disturbance. The final sample included 223,561 adolescents. The prevalence of severe FI and sleep disturbance was 6.4% and 8.0%, respectively. Severe FI was significantly associated with a higher risk of sleep disturbance in 48 of the 68 countries after adjusting for covariates, with a pooled OR (95% CI) of 1.94 (1.79–2.09). Overall, the association between FI and sleep disturbance was similar across countries and gender, though a large level of heterogeneity existed across upper- and middle-income countries. Identifying adolescents suffering from FI and remedying the FI severity may be important to improve sleep quality in global adolescents.

Household Food Insecurity and Dietary Diversity Among Kenyan Households During the COVID-19 Pandemic

ObjectivesThis study compares 1) household food insecurity and 2) household dietary diversity before and during the COVID-19 pandemic, and 3) examines self-reported coping strategies among three communities around Lake Victoria, Kenya.MethodsWe conducted in-person home interviews with 90 randomly selected households in March 2020 prior to the first reported case of COVID-19 in Kenya and followed up with 88 of these same households by phone in June 2020 during COVID-19. We assessed household foodinsecurity status using the Household Food Insecurity Access Scale (HFIAS) and assessed dietary diversity using the Household Dietary Diversity Score. We compared differences in household food insecurity scores and prevalence across time using the paired T-test and McNemar's test, respectively. We compared household dietary diversity scores and the proportion of households consuming each food group across time using the Wilcoxon signed rank test and McNemar's test for paired samples, respectively.ResultsThe prevalence of severe food insecurity increased from 82% before COVID-19 to 91% during COVID-19 (P = 0.03) and household dietary diversity scores fell from 9.5 ± 1.5 to 8.6 ± 1.5 (P < 0.001). Households coped by reducing their food intake at mealtimes, borrowing money from family and friends, and purchasing food on credit.ConclusionsThese findings demonstrate a high and growing level of vulnerability faced by these communities. Strategies to address food insecurity and access to diverse foods during the COVID-19 pandemic are urgently needed.Funding SourcesCornell Atkinson Center for Sustainability

Prevalence and Covariates of Food Insecurity Across the First 1000 Days Among Women of Mixed HIV Status in Western Kenya: A Longitudinal Perspective.

Food insecurity (FI) is common globally and can have lifelong consequences. However, few studies have longitudinally examined how FI varies across gestation and the postpartum period ("the first 1000 days"); none have explored this in sub-Saharan Africa or in the context of HIV. To assess the prevalence and covariates of FI in the first 1000 days among Kenyan women. All pregnant women attending 7 clinics in western Kenya (n = 1247) were screened for HIV and FI (Individual Food Insecurity Access Scale) between September 2014 and June 2015. A subset of women (n = 371) was recruited into an observational cohort study and surveyed 11 times through 2 years postpartum (NCT02974972, NCT02979418). Data on FI, sociodemographics, and health were repeatedly collected. Severe FI was modeled using multilevel, mixed-effects logistic regressions (n = 346). Of the 1247 pregnant women screened, 76.5% were severely food insecure in the prior month. Further, the prevalence of severe FI was higher among women living with HIV than those without (82.6% vs 74.6%, P < .05). In the cohort, the odds of being severely food insecure decreased monotonically after delivery. Each point higher on the Center for Epidemiologic Studies-Depression scale was associated with 1.08 times greater odds of being severely food insecure (95% CI: 1.05-1.10); each point higher on the Duke/UNC Functional Social Support Scale was associated with 0.97 lower odds of severe FI (95% CI: 0.94-0.99). Severe FI is prevalent during the first 1000 days in western Kenya. Services to mitigate the far-reaching consequences of this modifiable risk should be considered.

Prevalence of food security in the UK measured by the Food Insecurity Experience Scale.

BackgroundMeasurement of UK food insecurity has historically been inconsistent, making it difficult to understand trends. This study contributes by reporting and analysing data from a national survey conducted in line with UN Food and Agriculture Organization (FAO) recommendations and standard methods, providing an internationally comparable pre-coronavirus disease 2019 (COVID-19) snapshot of food insecurity.MethodsData came from a nationally representative 2019 UK sample (N = 2000) surveyed by Ipsos-Mori. Prevalence of food insecurity was assessed using the UN FAO Food Insecurity Experience Scale. Logistic regression was used to model food insecurity in relation to geographic and socio-demographic variables.ResultsSevere food insecurity was reported by 3% of the sample, an increase of 66.7% over the last directly comparable UK analysis (Gallup World Poll data from 2016 to 2018). Indication of some degree of food insecurity was reported by 14.2% of the sample and tended to be higher amongst younger age groups, those on lower incomes, and home renters (as opposed to owners). No geographic variables were significantly associated with food insecurity prevalence.ConclusionsThe finding that prevalence of severe food insecurity was already increasing before the COVID-19 pandemic, across all areas of the UK, is cause for concern. Our results provide an important benchmark for assessing the impact of COVID-19 on food insecurity.

Validity of the Food Insecurity Experience Scale (FIES) for Use in League of Arab States (LAS) and Characteristics of Food Insecure Individuals by the Human Development Index (HDI).

ABSTRACTBackgroundThe Food Insecurity Experience Scale (FIES) is a UN FAO Voices of the Hungry (FAO-VoH) experiential metric of food insecurity (FI). It was pilot tested in some countries but not in Arab speaking ones and validated using global data. Yet, its psychometric properties may vary in the League of Arab States (LAS) due to cultural and linguistic differences.Objectives 1) assess the validity of FIES for use in the LAS region, 2) determine the prevalence of FI, by gender, age group, and the human development index (HDI), and 3) examine sociodemographic characteristics of severe FI individuals.MethodsTo assess the psychometric properties of FIES, Rasch modeling was applied to the 2014–2015 Gallop World Poll (GWP) in the LAS. Prevalence and characteristics of severely FI individuals were assessed using the 2014–2017 GWP data of 62,261 respondents.ResultsOverall, FIES met the Rasch model assumptions of equal discrimination and conditional independence. Infit statistics for FIES items, in most LAS countries, were <1.3, indicating good internal validity. In Syria and Sudan, the item “worried about not having enough food to eat” had infits >1.3. Outfit statistics >2.0, indicating erratic responses, were noted in 26% of the LAS countries. Significant correlations were found (≥0.4) between items in Algeria, Tunisia, and Lebanon. The overall prevalence of severe FI was 15.7%. At highest risk were those aged ≥50 y compared with younger adults (16.5% versus 15.5%, respectively, P <0.02), women compared with men (17.6% versus 14.1%, respectively, P <0.0001), and those in countries with low HDI compared with high HDI (24.9% versus 8.3%, respectively, P <0.0001).ConclusionsOverall, FIES is valid for measuring FI in the LAS. Cognitive testing of items with high outfit statistics and omission of correlated ones may improve the scale. Populations vulnerable to severe FI include older adults and women. These populations should be examined further.

ECONOMIC DIVERSIFICATION AND AGRO-FOOD TECHNOLOGICAL SOLUTIONS IN NIGERIA: LESSONS FROM MALAYSIA

The paper x-rayed the various aspects of the agro-food economic diversification in Malaysia to draw lessons for Nigeria’s agricultural economic growth and development. A descriptive statistical method was employed in the presentation. With a total population of 31.6 million people, Malaysia has been able to harness the factor endowments for its people such that its GDP per capita (USD, PPP) grew from 18,577 in 2005 to 25,669 in 2016, whereas Nigeria’s GDP per capita (USD, PPP) grew from 4,149 in 2005 to 5,435 in 2016. Nigeria failed in its capacity utilization of the available factor endowments. In 2016, the percentage of prevalence of undernourishment of Malaysian people was 2.9, while Nigeria’s data was 11.5%. Furthermore, there was no prevalence of severe food insecurity in Malaysia, but Nigeria recorded 24.8% in its prevalence of severe food insecurity, within the period under consideration. The paper concluded that Nigeria’s economic performances are dwindling. It was recommended that to enhance stable and viable sustainable and economic growth for its people, Nigeria’s mono-economy must give way to the productive development of all sectors of the economy, particularly the agro-technology.

Improved on-farm storage reduces seasonal food insecurity of smallholder farmer households – Evidence from a randomized control trial in Tanzania

Ending hunger is a key goal of the 2030 Agenda for Sustainable Development, adopted in 2015. This goal notwithstanding, the prevalence of severe food insecurity of the world’s population has increased. It is highest in Sub-Saharan Africa, where the seasonality of harvests leads to fluctuations in food insecurity, particularly in the lean season, the time before the harvest is brought in. We posit that addressing seasonal food insecurity requires not only increased food production, as is commonly argued, but also consideration of post-harvest losses during storage. Here we present the results of a randomized control trial on the effects of improved on-farm storage on seasonal food insecurity. Our intervention provided farming households from two districts in Tanzania with hermetic storage bags that can help reduce storage losses. Seasonal food insecurity was measured via multiple rounds of SMS-based surveys. The results show that the intervention reduced the proportion of severely food insecure households by 38% on average in the lean season, and by 20% in the full seasonal cycle. These findings demonstrate that a simple and inexpensive technology could contribute strongly to reducing seasonal food insecurity and improving smallholder farmers’ year-round access to food.

Food Insecurity Among Older Adults: A Multilevel Analysis of State-Level Interventions.

Objective: To analyze whether state-level social programs for older adults (OAs) in Mexico are associated with a reduction: (a) in the prevalence of severe food insecurity (SFI) and (b) in the magnitude of the effect of municipal marginalization on SFI. Method: Cross-sectional study based on urban OAs (65-100 years) from the 2010 census. Three-level logistic multilevel regression models were estimated to explain SFI. Results: Controlling for individual and municipal characteristics, states with social programs for OAs are generally associated with lower SFI prevalences (odds ratio [OR] = 0.68 [0.48, 0.95]) and mitigate the effect of marginalization on SFI when compared with states with no programs. Compared with in-kind food programs and voucher-based programs, monetary transfers are associated with a significant reduction in SFI prevalence (OR = 0.68 [0.46, 0.99]). Conclusion: States with programs for OAs, mainly monetary transfers, are associated with lower SFI prevalences.

Food Access Deficiencies in Sub-saharan Africa: Prevalence and Implications for Agricultural Interventions

Our understanding of food security in sub-Saharan Africa (SSA) has been hampered by limitations in the temporal and spatial representativeness of data. Food balance sheets provide scalable estimates of per capita food availability, but fail to represent food access, stability and their causal linkages. In contrast, rural household surveys represent detailed conditions for one or multiple points in time, but are influenced by survey timing and are often limited in geographical coverage. This study draws on a large sample of rural land-holding households in SSA (n = 6,353) to identify household level food access deficiencies and to understand the associations with rural livelihoods and food sourcing behavior throughout the year. Food access deficiencies were identified using food security of access and diet diversity indicators. Dietary diversity and channel of access (farm or purchased) were enumerated for the “flush” and “lean” periods and food security of access was enumerated for the lean period only - making the results of this study independent of survey timing. As many as 39% of households were classified as severely food insecure (in terms of food access) and as many as 49% of households were likely to be deficient in micronutrients in the lean period. Vulnerability to food insecurity and micronutrient deficiencies differed by household composition, agricultural livelihood characteristics and agro-ecological zone. Dairy, fruit and vitamin A-rich produce were predominantly accessed through the farm channel. Households with a livestock component to their farm had a lower prevalence of severe food insecurity and higher diet diversity scores. These findings have implications for the development of nutrition-sensitive and nutrition-specific interventions. Interventions need to be tailored to agro-ecological zone, household composition, scale of operation and production mix. Increasing income will not necessarily result in improved diet diversity or healthy dietary choices. Interventions focused on income generation should monitor and promote crop and livestock production diversity and provide nutrition education.

Effect of the Affordable Care Act's Medicaid Expansions on Food Security, 2010-2016.

Objectives. To examine whether the expansion of Medicaid under the Affordable Care Act (ACA) decreased the prevalence of severe food insecurity.Methods. With data on adult respondents to the Food Security Supplement to the Current Population Survey in US states for the years 2010 to 2013 and 2015 to 2016, I used a difference-in-difference design to compare trends in very low food security (VLFS) among low-income childless adults in states that did and did not expand Medicaid in 2014 under the ACA.Results. Among low-income, nonelderly childless adults, VLFS rose from 17.4% before ACA to 17.5% after ACA in nonexpansion states, and fell from 17.6% to 15.9% in expansion states. In difference-in-difference analysis, Medicaid expansion was associated with a significant adjusted 2.2-percentage-point decline in rates of VLFS, equivalent to a 12.5% relative reduction.Conclusions. The improvement in food security after the ACA's health insurance expansion suggests that health insurance provision has spillover effects that reduce other dimensions of poverty.Public Health Implications. Providing free or low-cost health insurance coverage may free up household funds, reducing food insecurity and improving this important social determinant of health.

Food insecurity (hunger) and suicide attempts among 179,771 adolescents attending school from 9 high-income, 31 middle-income, and 4 low-income countries: A cross-sectional study

BackgroundData on food insecurity and suicide attempts in adolescence are scarce. Thus, the aim of the current study was to assess the association between food insecurity (hunger) and suicide attempts in adolescents from 44 countries. MethodsCross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day food insecurity (hunger) were collected. Multivariable logistic regression, meta-analysis, and meta-regression were conducted to assess the associations. ResultsThe final sample consisted of 179,771 adolescents attending school. The prevalence of moderate (rarely/sometimes hungry) and severe (most of the time/always hungry) food insecurity were 46.7% and 7.0%, respectively. After adjustment for potential confounders, severe food insecurity (vs. no food insecurity, i.e., no hunger) was significantly associated with higher odds for suicide attempts in 31 of the 44 countries studied with the pooled OR (95% CI) being 1.90 (1.77–2.04) (I2 = 45.2%). The associations were similar across country-income levels. However, meta-regression analysis by country showed that stronger associations were related with lower population prevalence of severe food insecurity. The pooled OR (95% CI) for moderate food insecurity (vs. no food insecurity) was 1.26 (1.21–1.32) (I2 = 29.7%). LimitationsCausality cannot be established due to the cross-sectional study design. ConclusionsFood insecurity (hunger) is a global problem and is associated with suicide attempts. The identification of children suffering from food insecurity (hunger) and remedying this condition may be important to improve mental health among adolescents worldwide.

Does social support modify the relationship between food insecurity and poor mental health? Evidence from thirty-nine sub-Saharan African countries.

The present study aimed to determine the relationship among food insecurity, social support and mental well-being in sub-Saharan Africa, a region presenting the highest prevalence of severe food insecurity and a critical scarcity of mental health care. Food insecurity was measured using the Food Insecurity Experience Scale (FIES). Social support was assessed using dichotomous indicators of perceived, foreign perceived, received, given, integrative and emotional support. The Negative and Positive Experience Indices (NEI and PEI) were used as indicators of mental well-being. Multilevel mixed-effect linear models were applied to examine the associations between mental well-being and food security status, social support and their interaction, respectively, accounting for random effects at country level and covariates.ParticipantsNationally representative adults surveyed through Gallup World Poll between 2014 and 2016 in thirty-nine sub-Saharan African countries (n 102 235). The prevalence of severe food insecurity was 39 %. The prevalence of social support ranged from 30 to 72 % by type. In the pooled analysis using the adjusted model, food insecurity was dose-responsively associated with increased NEI and decreased PEI. Perceived, integrative and emotional support were associated with lower NEI and higher PEI. The differences in NEI and PEI between people with and without social support were the greatest among the most severely food insecure. Both food insecurity and lack of social support constitute sources of vulnerability to poor mental well-being. Social support appears to modify the relationship between food security and mental well-being among those most affected by food insecurity in sub-Saharan Africa.