Receiving Food Assistance Research Articles

It’s not “Just poverty”: Educational, social, and economic functioning among young adults exposed to childhood neglect, abuse, and poverty

BackgroundNeglect is the most common allegation in Child Protective Services (CPS) investigations. Researchers and media have questioned whether and how CPS-investigated neglect differs from poverty. Prior studies are limited by self-reported or cross-sectional measures, small samples, and short observation periods. Objective(1) To estimate the “added harm” of CPS-investigated neglect, net of poverty exposure (depth and duration), on high school completion, employment and earnings, incarceration, and teen parenthood; (2) To assess whether abuse is a stronger risk factor for adverse outcomes than neglect. Participants and Setting29,154 individuals born in 1993–1996 from Milwaukee County, WI, who either received food assistance or were reported to CPS before age 16. MethodUsing logistic regression with a rich set of social and demographic controls, we compared individuals with CPS-investigated neglect, abuse, or both abuse and neglect in early childhood or adolescence to those who experienced poverty but not CPS involvement. We calculated cumulative measures of poverty duration and poverty depth between ages 0 and 16 for the full sample using public benefit records. ResultsOutcomes among children with alleged or confirmed neglect were statistically significantly worse in all domains than impoverished children without maltreatment allegations, and similar to children with alleged or confirmed abuse. Effect sizes varied by outcome. ConclusionsOverall, this study suggests that CPS allegations of neglect are distinct from poverty and an important risk factor for adverse outcomes in adulthood.

Exploration of Food-Seeking Behaviour, Food Preparation, and Restrictions to Sufficient Food among the Jahai Sub-Tribe (Indigenous People) in Gerik, Malaysia.

Access to food has been determined to be a factor that strongly influences the dietary intake and eating habit of indigenous people (Orang Asli, OA). This study explored food acquisition and the barriers in obtaining traditional and market foods among the Jahai subtribe (within the Negrito ethnic group) via a qualitative approach. Twenty-eight OA (14 males and 14 females) from Gerik, Perak, Malaysia participated in four focus group discussions (FGDs; two male-only and two female-only groups; seven informants in each FGD). Thematic analysis was adopted to analyse the gathered data. The results found that the Jahai applied both modern (buying and receiving food assistance) and traditional (gathering, farming, fishing, and hunting) methods in obtaining food. The barriers they faced in gathering sufficient food supply included low purchasing power, high demand for food, high transport costs, depletion of food supplies in their surroundings, threats from wild animals on the farm and during food searching activities, and food sharing. Food preparation methods practiced by the OA include roasting and grilling, frying, simmering (gulai), and boiling. In conclusion, this study enhances our understanding of the dietary behaviour of the Jahai subtribe and highlights restricted food access among the OA, which demands urgent attention.

The shift of food value through food banks: a case study in Kyoto, Japan

The aim of this paper is to study the diversion of food waste by food banks through an analysis of how the value of food is transformed by food banks and their recipients, from waste to things of value. Not enough research exists on the recipient’s activity after they have received food assistance from food banks. By tracking food donations from food bank collections to food recipients, this study examines the relation between people and food and how they influence the value of things—in this case, excess or unwanted food that has lost its exchange value. This research was conducted through observation of participants at food banks, food diaries, interviews with members of recipient organizations and final recipients, and a questionnaire with food assistance recipients in Kyoto, Japan. The first main point of this paper is the importance of food literacy to transform and optimize food donations into appreciated food, thereby avoiding food waste through the ingenuity of downstream actors. The second point is to uncover the shift of burden arising from the sorting, repurposing, and even discarding of the unusable portion of food donations. Above and beyond the burden of managing inconsistent and skewed food donations falls to recipient organizations and final recipients, the empirical data show that the recipient organizations and final recipients achieve this with very limited, scarce resources. Despite the difficult situation, their food literacy and creativity contribute to increasing the utilization of food donation and thereby valorizing food donations. In contrast to donor organizations, researchers have a higher standard for realizing value, so it is our critical to measure the actual conditions affecting the ultimate utilization of excess or unwanted food. By providing transparency into the effort of recipients to manage food donations, this paper highlights both the reliance on recipients’ knowledge and skill in food literacy with limited resources but also the limits of shifting the burden of waste diversion to disadvantaged groups.

Patterns of intergenerational child protective services involvement

BackgroundPrior research on Child Protective Services (CPS) involvement among at-risk youth focuses on their roles as parents perpetrating maltreatment against biological offspring. Given family complexity and assortative partnering, measuring all CPS involvement – as perpetrators and non-offending parents of victims – provides new insight into intergenerational maltreatment patterns. ObjectivesOur objective was to investigate the risk of multiple forms of parent or perpetrator CPS involvement (PP-CPS) by age 25, among those exposed to three forms of adversity in their late teens (at ages 14–17): alleged victim on a CPS investigation, out-of-home care (OHC), and poverty. Participants and settingWe used a sample of 36,475 individuals born in 1990–1991 from the Wisconsin Data Core longitudinal administrative database, and tracked their involvement in CPS, OHC, and the food assistance program (SNAP) over time. Our sample consisted of individuals who, at ages 14–17, met one of the following criteria: were in OHC; had CPS involvement as a victim but no OHC (CPSV group), or received food assistance without CPSV or OHC (SNAP group). MethodsUsing logistic regression, we modeled four forms of PP-CPS involvement: parent-perpetrator, resident parent non-perpetrator, nonresident parent non-perpetrator, and non-biological parent-perpetrator. ResultsPredicted risks of any PP-CPS involvement by age 25 were 10 % (SNAP group), 17–22 % (CPSV group), and 26–33 % (OHC group); among OHC youth known to have a biological child, rates exceeded 40 %. The proportion of CPS involvement that involved parent-perpetration varied substantially by sex and adversity type. ConclusionsFocusing only on intergenerational maltreatment in which the parents are the perpetrators may substantially understate the risk of maltreatment recurring across generations.

Economic Security Assessment in Palapag Northern Samar Philippines

This study was conducted to assess the economic security of Palapag in terms of food production, food consumption, livelihood, income, and living conditions of the municipality of Palapag, Northern Samar, Philippines. Analyze the extent of disaster response provided by the government, Non-Government Organizations (NGOs), International Non-Government Organizations (INGO), and concerned groups and individuals to the affected population and how people cope with crises using their local assets or resources after the disaster. Families sometimes received food assistance (26 kg rice and canned goods) from the local government and other concerned NGOs & INGOs good for a few days. There were families who are members of Cash transfer (a government program) who receive cash grants to improve the health, nutrition, and education of children. This will also augment the expenses of the family for the food, health, and education of their children. The family copes with the food shortage of food by reducing the number of meals per day, replacing rice with root crops and vegetables. Borrowing of money from small sari-sari shops in supporting their household (HH). Taking children out of school and rather obliged or forced to help the family to earn income in the form of labor. Selling of productive assets like land or livestock in case of emergencies related to health, education, and death. Migration by both men and women to big cities for applying as domestic, construction, and factory worker.

P38 Gleaning as a SNAP-Ed Public Health Approach to Address Healthy Eating for Low-Income Mainers

Objective Evaluate the success of developing gleaning distribution systems to increase access to local food in settings where low-income individuals live, receive food assistance, obtain clinical services, and congregate for nutrition education. Use of Theory or Research Maine Supplemental Nutrition Assistance Program Education (SNAP-Ed) programming is informed by the United States Department of Agriculture's (USDA) SNAP-Ed Evaluation Framework, aligned with the Social-Ecological Model. Target Audience Mainers eligible for SNAP benefits. Program Description Maine SNAP-Ed implements evidence-based public health approaches to reduce health disparities. At the individual and environmental levels, nutrition educators deliver series-based education and develop organizational partnerships to adopt and promote nutrition-related supports. In response to community need and readiness, Maine SNAP-Ed has seen an increase in educators partnering to develop systems to gather and distribute leftover crops as part of a policy, systems, and environmental change strategy designed to increase access to fresh produce for low-income Mainers. Evaluation Methods A monthly PSE tracking tool measures progress toward outcomes. End-of-year, semi-structured interviews with educators supplement monthly data, summarizing accomplishments and potential reach. Annual data are analyzed to assess whether intended outcomes were achieved using independent and collaborative reviews with a consensus decision-making process. The Framework indicator “MT5-Nutrition Supports Adopted” guides this work. Other methods include use of public data sources to estimate reach, and photo documentation and success story templates to describe outcomes qualitatively. Results Ten gleaning systems were developed in fiscal years 2017 and 2018, impacting more than 38 sites. Partners include local farms and food councils, federally qualified health centers, the Commodity Supplemental Food Program, emergency food agencies, and public schools. Recipient sites include Head Starts, libraries, food pantries, senior and low-income housing, federally-funded summer meal sites, and clinical settings. Conclusions SNAP-Ed can successfully implement and maintain gleaning strategies that maximize local food systems and supplement nutrition education. This work supports community-based food assistance efforts, while addressing obesity prevention and food insecurity for low-income individuals. Funding SNAP-Ed.

P167 Exploring Cooking and Shopping Behaviors in Low-Income African American and Hispanic Participants

Background According to the USDA, 11.8% of US households were food insecure in 2017. The inability to access fresh, healthy food greatly affects diet quality and overall health. Grocery shopping habits, meal preparation methods, and frequency of eating away from home also affect diet quality. Objective To qualitatively explore cooking and shopping behaviors of low-income African American (AA) and Hispanic participants to inform the development of interventions targeting these behaviors. Study Design, Settings, Participants AA (n = 16) and Hispanic (14) participants who identified as the main food preparer in their household were recruited from low-income neighborhoods in Gainesville and Hollywood, Florida. About half (47%) of Hispanic participants and 38% of AA participants reported currently receiving food assistance. Trained focus group moderators used a semi-structured script to ask questions related to food shopping and preparation. Focus groups were conducted in English (n = 3) and Spanish (n = 3). Measurable Outcome/Analysis Focus groups were audio recorded, transcribed verbatim, and coded using thematic analysis. Results The number of weekday and weekend meals differed between AA and Hispanic participants. AA and Hispanic participants reported cooking on average two to three and five days per week, respectively. AA participants cooked more often on weekends. When grocery shopping, both groups consider cost the top factor influencing purchasing decisions. Food preference differed between groups, and even between participants within the Hispanic group, but most participants choose meals that feature familiar foods and take less than one hour to prepare. AA participants frequently reported time and money as barriers to cooking, whereas Hispanic participants did not report any barriers to cooking. Conclusion While there are many similarities between the cooking and shopping behaviors of AA and Hispanic participants, a number of cultural differences also exist. When designing interventions targeting grocery shopping, cooking, and eating behaviors, these cultural distinctions should be addressed, and adaptations should be made based on the target population. Funding Self-funded.

Scurvy Outbreak Among South Sudanese Adolescents and Young Men - Kakuma Refugee Camp, Kenya, 2017-2018.

Scurvy is a relatively rare micronutrient deficiency disease that can occur among refugees dependent on food aid (1). Inadequate access to fresh fruits and vegetables in refugee camps can result in scurvy (2,3). Kakuma Refugee Camp in Kenya's Turkana District is home to 148,000 refugees, mostly from Somalia and South Sudan, who receive food assistance. In August 2017, a number of South Sudanese adolescent and young adult male refugees were evaluated at a health clinic in the camp for calf pain, chest pain, and gingival swelling. Because the symptoms were nonspecific, no diagnosis was made, and some patients received antibiotics and analgesics. All were managed as outpatients, but symptoms did not improve. During subsequent months, more young men with similar symptoms were reported. On January 20, 2018, the United Nations High Commissioner for Refugees (UNHCR) was informed and conducted clinical examinations. Signs and symptoms included lower limb pain and swelling (in some cases involving joints), lethargy, fatigue, gingival swelling and pain, hyperkeratotic skin changes, and chest pain. Based on these clinical findings, micronutrient deficiency, particularly vitamin C deficiency (scurvy), was considered a possible diagnosis, and an investigation of a possible outbreak was conducted. The suspected scurvy cases all occurred in young men from South Sudan who were living and cooking together in one geographic section of the camp. All patients who received treatment with vitamin C noted improvement of symptoms within <1 week. Patients were provided with food and cash assistance, the latter to allow dietary diversification (i.e., fresh fruits and vegetables). However, both forms of assistance were inadequate to allow access to sufficient amount of calories and the dietary diversification needed for intake of micronutrients, such as vitamin C. It is important to consider these needs when determining the amount of food or cash assistance provided to adolescents and young adult male refugees.

An Exploration of the Influences Contributing to Food Insecurity in Chester County, Pennsylvania.

Food security refers to the ideal state or condition of households that have access at all times to enough food for their members to live an active, healthy life. To better understand local food insecurity, a needs assessment was implemented to explore contributing factors and discuss solutions. A qualitative study including nine focus groups with low-income adults who receive food assistance (N = 82) and four focus groups with emergency food providers (N = 21) was conducted. Focus group data were analyzed using phenomenological methods. Five themes emerged from the residents: (1) food accessibility both contributes to and reduces food insecurity; (2) residents understand the need for and practice the act of preserving foods; (3) food shopping behaviors were similar for the residents and stores were well received; (4) benefits and barriers with food insecurity are similar; and (5) variety and quality of food and food safety of emergency foods are concerns. The food provider focus groups indicated that they recognized similar problems faced by the residents, and they stressed the need for education. Food insecure individuals should continue in the conversations around solutions, and a comprehensive look at food insecurity through local food and health care systems might determine additional needs.

Socioeconomic Profiles as Predictors of Glycemic Control in Youth with Type 1 Diabetes

Various measures of socioeconomic status (SES) predict glycemic control in youth and young adults (YYA) with type 1 diabetes; however, rarely have multiple SES factors been considered simultaneously, including parental education and income, food security, health insurance status, and food assistance. The purpose of this study was to identify multidimensional SES profiles in YYA with type 1 diabetes and to assess the association between these profiles and glycemic control. Data from 257 YYA with type 1 diabetes enrolled in the SEARCH Food Insecurity Ancillary Study in South Carolina and Washington between the years 2013 and 2015 were included. We identified SES profiles utilizing latent class analysis and used multivariable logistic regression to compare the profiles’ glycemic control, with HbA1c &amp;gt; 9% defined as poor glycemic control. Two profiles were identified: Profile 1 (74%) included YYA that were of higher parental income and education, and less likely to have government-funded health insurance, to receive food assistance, and to be food insecure. Profile 2 (26%) included YYA who were categorized opposite to that of profile 1. In profile 2, 60% of YYA had poor glycemic control compared to 44% of YYA in profile 1. After adjustment for age, sex, race/ethnicity, site, diabetes duration, and diabetes medication, YYA in profile 2 were significantly more likely to have poor glycemic control relative to YYA in profile 1 (OR = 1.94, 95% CI = 1.01-3.71). Membership to a lower SES profile is associated with poor glycemic control among YYA with T1D. Strategies to improve glycemic control, particularly in YYA who belong to lower SES profiles, are needed. Disclosure M.W. Sutherland: None. X. Ma: None. J.A. Mendoza: None. B.A. Bell: None. B.A. Reboussin: None. A.R. Kahkoska: None. K.A. Sauder: None. C. Pihoker: None. A.D. Liese: None.

Parent and Child Reports of Food Insecurity and Mental Health: Divergent Perspectives.

Food insecurity-the inability to provide adequate food for at least one household member sometime during the year-is linked to negative physical and mental health outcomes. Child reports of experiences in other domains of life are only moderately related to parental proxy reports of the same experiences. The goal of our study was to assess the convergence of parent and child reports of food insecurity and several specific mental health symptoms. Dyads of parents and children attending medical appointments were surveyed. Inclusion criteria consisted of English-speaking adults and their children between the ages of 8 and 17 years. Sixty-two percent of adults and 50% of children self-reported meeting screening criteria for food insecurity, and adult-child dyad reports were significantly correlated. However, when asked about the child worrying about food running out or having eaten less than desired in order to conserve food, adult and child reports diverged significantly, with adults more frequently underestimating worry and conservation behaviors compared to child self-reports. Similar discrepancies were found for items probing specific symptoms of depression, general anxiety, and obsessive-compulsive disorder. Our data show that adults may not accurately perceive the subjective effects of food insecurity on children in their household, particularly in households receiving food assistance, perhaps because of objectively greater need. Because food insecurity may have profound effects on child development, pediatricians should be aware of the mental health risks for children in food-insecure homes.

Policy, System and Environmental Correlates of Fruit and Vegetable Consumption in a Low-Income African American Population in the Southeast.

The current study seeks to identify policy, system and environmental (PSE) correlates of fruit and vegetable consumption among a sample of low-income African Americans in two counties in Alabama (Jefferson and Mobile) and one county in Mississippi (Forrest). A modified Behavioral Risk Factor Surveillance System (BRFFS) survey, which included multi-level ecological factors, was used to evaluate nutritional habits at the pre-intervention stage of a multi-state research study. We surveyed a total of 256 participants between May and August 2015. Local community coalitions established in each of the counties were instrumental in the planning and administration of the baseline survey. Univariate analyses revealed that whether participants met the daily recommendation for fruit/vegetable consumption may be correlated with whether participants had children who attended schools/day care centers with health policies in place, received food assistance, and observed media campaigns related to nutrition. Further, results of multivariate analysis indicated that meeting fruit/vegetable recommendations was correlated with personally participating or having a family member who participated in a health policy meeting in the past two years. These findings suggest that policy-based interventions have the potential to improve health outcomes among priority populations, such as low-income African Americans, who are at high risk of developing chronic diseases.

Food Melt in Consumer Food Environments in Low-income Urban Neighborhoods.

We systematically evaluated changes in availability, price, and quality of perishable food items from the beginning to the end of the month in lowincome, urban neighborhoods. The sample included grocery stores or supermarkets in Cleveland, Ohio, within neighborhoods with >30% of population receiving food assistance. We collected data for 2 sequential months during the first and fourth weeks of each month. Two coders evaluated stores, collecting measures of availability, price, and quality for 50 items. We examined difference in number and proportion of items available at the beginning of the month (BOM) to items remaining available at the end of the month (EOM), as well as quality and price of those items. Across 48 stores, availability at EOM was lower than BOM; as store size increased, reduction in availability (ie, food melt) was significantly (p < .01) less pronounced. Overall, items became less expensive at the EOM whereas quality remained consistent; we noted no statistically significant differences by store type for price or quality. Food melt differentially affects individuals in neighborhoods without grocery stores. Findings reveal composition of food environments is dynamic rather than static, influencing food-purchasing choices among lowincome consumers.

Linking SNAP to Food Security: Exploring Reinstating a Purchase Requirement and Tying Benefits to the Low-Cost Food Plan

Abstract The United States has a food assistance structure that, by design, does not assure that households receiving food assistance will be food secure, is deeply inefficient, and is at financial and structural risk. The two most common forms of food assistance used today are Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) and charitable food assistance in the form of groceries (provided through a network of food banks, food pantries, and other related programs). Approximately 43 million persons participate in SNAP and nearly one-third of them also rely on a food pantry for groceries. The use of charitable food assistance by persons relying on SNAP demonstrates that SNAP’s benefit level and structure does not sufficiently result in food security. The article argues that reinstating a purchase requirement for SNAP and increasing the level of benefits provided to SNAP participants would increase the food security of participants, alleviate the chronic demand for food from food banks and food pantries, and ultimately allow the charitable food assistance network to better accomplish its goal of providing emergency food assistance to the needy.

Receiving Assistance and Local Food System Participation

A body of literature has noted that local food systems (LFSs) may not involve active participation by individuals with lower incomes. This is, in part, a function of racial and class hegemony, as well as physical and financial accessibility of LFSs. LFS institutions, such as farmers’ markets, have been working to facilitate receipt of food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP). Charitable assistance programs, such as food banks, have also been actively working to engage in LFSs, for example, by making local foods available. However, little research has explored the role that receiving public or charitable assistance can play in influencing LFS participation. In this article, I utilize quantitative and qualitative data collected from across the state of Ohio to examine the relationship between receiving assistance and LFS participation for women, who remain predominately responsible for food provisioning in the U.S., including among those who participate in LFSs. Quantitative results suggest that receiving assistance can increase participation in LFSs. Qualitative data provides more nuanced information about the importance of food assistance for women who want to participate in LFSs, and suggest that it is essential that food cooperatives and farmers’ markets are equipped to receive food assistance programs, such as SNAP, in order for women with lower incomes to participate in LFSs.

Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012-2013.

Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans (n = 5862, 20–64 years) using data from the Korea National Health and Nutritional Examination Survey (2012–2013). Household food security status was categorized as “food-secure household”, “food-insecure household without hunger”, and “food-insecure household with hunger”. Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health. A greater proportion of food-insecure participants were nutritionally deficient compared with expectations of the 2015 Korean Dietary Reference Intakes. These deficiencies were generally higher in both “food-insecure household” groups. Both “food-insecure household” groups, particularly the “food-insecure household with hunger” group showed significantly adverse mental health status (ORs: 1.52–3.83) and lower QOL (ORs: 1.49–3.92) than did the “food-secure household” group before and after adjusting for sex, age, education, household income, smoking/alcohol consumption, physical activity, marital status, and receiving food assistance. In conclusion, food insecurity may be significantly associated with adverse mental health indicators and decreased QOL in young/middle-aged Koreans.

How food insecurity contributes to poor HIV health outcomes: Qualitative evidence from the San Francisco Bay Area

RationaleFood-insecure people living with HIV/AIDS (PLHIV) consistently exhibit worse clinical outcomes than their food-secure counterparts. This relationship is mediated in part through non-adherence to antiretroviral therapy (ART), sub-optimal engagement in HIV care, and poor mental health. An in-depth understanding of how these pathways operate in resource-rich settings, however, remains elusive. ObjectiveWe aimed to understand the relationship between food insecurity and HIV health among low-income individuals in the San Francisco Bay Area using qualitative methods. MethodsSemi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance from a non-profit organization. Interviews explored experiences with food insecurity and its perceived effects on HIV-related health, mental health, and health behaviors including taking ART and attending clinics. Thematic content analysis of transcripts followed an integrative inductive-deductive approach. ResultsFood insecurity was reported to contribute to poor ART adherence and missing scheduled clinic visits through various mechanisms, including exacerbated ART side effects in the absence of food, physical feelings of hunger and fatigue, and HIV stigma at public free-meal sites. Food insecurity led to depressive symptoms among participants by producing physical feelings of hunger, aggravating pre-existing struggles with depression, and nurturing a chronic self-perception of social failure. Participants further explained how food insecurity, depression, and ART non-adherence could reinforce each other in complex interactions. ConclusionOur study demonstrates how food insecurity detrimentally shapes HIV health behavior and outcomes through complex and interacting mechanisms, acting via multiple socio-ecological levels of influence in this setting. The findings emphasize the need for broad, multisectoral approaches to tackling food insecurity among urban poor PLHIV in the United States.

Health and Socio-economic Impacts of Livelihoods Programs among People Living with HIV in Cambodia: A Case-Control Study

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in the programs for at least one year. Several indicators in socio-economic situations, food security, health conditions, and psychological well-being of the cases (n= 358) and the controls (n= 329) were compared. Results: The mean of monthly income of the cases who attended the programs for three years or more was 13.6% higher than that of the controls. A significantly higher proportion of the cases reported having three meals per day, while a significantly lower proportion of them received food assistance in the past 12 months. The mean total score for frequency of occurrence also indicated less severity of food insecurity among the cases. Regarding child education, the cases reported a significantly lower rate of out-of-school children. The proportion of the cases who rated their quality of life as good was significantly higher, and they were significantly less likely to report that they felt guilty being HIV-positive persons. Regarding psychological well-being, the mean total score of depressive symptoms for the cases was significantly lower than that for the controls, and the proportion of the cases with a cut-off score smaller than 1.75, which indicated less depressive symptoms, was also significantly higher than that of the controls. Conclusions: Findings from this study portray the positive impacts of KHANA’s livelihoods programs in maintaining and upgrading the livelihoods and quality of life of PLHIV in Cambodia. With these noticeable impacts, the programs should be scaled up to support PLHIV and vulnerable households across the country.

Recent changes in sociodemographic characteristics, dietary behaviors and clinical parameters of adults receiving food assistance in France.

BackgroundIn 2004–2005, a survey carried out on food recipients in France revealed an alarming nutritional situation. In 2011–2012, and using a protocol similar to that of 2004–2005, our objective was to update the description of sociodemographic characteristics, dietary behaviors and clinical parameters of food assistance recipients and to analyze changes since 2004–2005.MethodsBoth surveys included multistage random sampling of adults benefitting from structures that supply food pantries and charitable grocery stores. Data on sociodemographic characteristics and dietary behaviors were collected along with weight, height and blood pressure measurements. Comparisons between the 2004–2005 (n = 883) and 2011–2012 (n = 1,058) survey observations were made, adjusting for socio-demographic changes which had occurred in the meantime.ResultsSince 2004–2005, proportions of food recipients ≥55 years (13.1–19.1 %), born in France (29.2–36.8 %) and employed (5.5–11.7 %) have increased; food insufficiency has decreased (95–74 %). For over half of the recipients, canned (52.4 %) and non-perishable (50.9 %) foods were obtained only from food assistance. Frequency of consumption significantly increased even after adjustment for socio-demographic changes; this was the case for dairy products (for twice a day consumption, 30.2–36.4 %), fruits and vegetables (three times a day, 7.8–13.9 %), and meat, eggs and fish (twice a day, 9.4–19.2 %). In 2011–2012, 15.6 % of men and 36.0 % of women were obese, while 44.5 and 35.1 % had high blood pressure, respectively.ConclusionsBetween 2004–2005 and 2011–2012 in France, consumption of staple foods has been slightly improved in food assistance recipients. However, prevalence of cardiovascular risk factors remains high, which underlines the need for long-term efforts at better quality of foods delivered.

Altered Daily Activities and Shame Resulting from Children Experiencing Food Insecurity in Rural South Carolina and Oregon

Children are cognitively, emotionally, and physically aware of food insecurity and respond to it by participation in adult strategies, initiating their own, and generating resources. Food insecurity is substantially detrimental for children, resulting in behavior problems, disrupted social interactions, compromised school performance, poor diet, less physical activity, and poor health, but we lack empirical data on the possible mechanisms. Data from Venezuela suggest that child experiences of food insecurity result in alterations in child daily activities and shame, and that these in turn result in adverse behavior, social interactions, and school performance. This study investigated this possible mechanism in rural children in South Carolina and Oregon.We conducted a qualitative study in 40 children (9–15 y), with 20 in each state. The children were living in rural poor neighborhoods and ethnically diverse. Their families had low income; children and their families were food‐insecure. Individual in‐depth interviews were conducted with children in private using an interview guide with open‐ended, semi‐structured questions. Interviews were recorded, transcribed, coded, and analyzed using Nvivo 10.Alterations in activities occurred because of not having enough money and/or food. Children were exposed to lack of planning in activities after school, during weekends, and on vacations. Activities were low quality with respect to child health and development (e.g., phoning, texting, watching TV, “messing around”). Almost all children reported having responsibilities of chores at home, meaning less time being sedentary, resting, studying, and learning in after‐school activity. Some children, where one parent was absent, took adult responsibilities, such as taking care of siblings and doing more chores. During episodes of food insecurity, children had less frequent eating times together, disrupted eating pattern, or ate alone, or each member ate in different locations of home. Some rural children did healthy activities like having contacts with animals, gardening, or farming. All children who talked about receiving free lunch, free box of food, or visiting a food bank reported feeling shame; some did not want others to know about their situation. Children felt anger, sadness, frustration, and worry due to lack of food, and shame due to lack of food and receiving assistance. Some children interacted more with others to obtain food; others interacted less, and read, watched TV, did videogames, or slept. Some children missed school because of sleep disruptions or parental illness, which likely affected school performance.Children experienced shame for being food insecure and receiving food assistance, and had altered daily activities, which resulted in changes in behavior, social interactions, and school performance. The shame experienced particularly in receiving food assistance was universal and powerful, suggesting shame as an important mechanism leading to consequences for children and raising concern about detrimental effects of providing food assistance directly to children.Support or Funding InformationEconomic Research Service of the U.S. Department of Agriculture through the RIDGE Center for Targeted Studies at Purdue University