Household food insecurity with hunger is associated with women's food intakes, health and household circumstances

This study investigated food intake patterns and contextual factors related to household food insecurity with hunger among a sample of 153 women in families seeking charitable food assistance in Toronto. Women in households characterized by food insecurity with severe or moderate hunger over the past 30 d (as assessed by the Food Security Module) reported lower intakes of vegetables and fruit, and meat and alternatives than those in households with no hunger evident. Women were more likely to report household food insecurity with hunger over the past 12 mo and 30 d if they also reported longstanding health problems or activity limitations, or if they were socially isolated. The circumstances that women identified as precipitating acute food shortages in their households included chronically inadequate incomes; the need to meet additional, unusual expenditures; and the need to pay for other services or accumulated debts. Women who reported delaying payments of bills, giving up services, selling or pawning possessions, or sending children elsewhere for a meal when threatened with acute food shortages were more likely to report household food insecurity with hunger. These findings suggest that expenditures on other goods and services were sometimes foregone to free up money for food, but the reverse was also true. Household food insecurity appears inextricably linked to financial insecurity.     

Position of the American Dietetic Association: Addressing world hunger,malnutrition, and food insecurity

It is the position of the American Dietetic Association (ADA) that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable. The Association is aware that hunger exists in a world of plenty and that poverty, gender inequity, ethnocentrism, racism, and the lack of political will are key constraints to solving the problems of global hunger and malnutrition. Recognizing that simplistic approaches are inadequate, the ADA identifies sustainable development as the long-term strategy to ending world hunger and achieving food security. Sustainable development requires political, economic, and social changes that include empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature. Additionally, because the health status of future generations is related to the well-being of their mothers, achieving food security will also require increased access for women to education, adequate health care and sanitation, and economic opportunities. This position paper reviews the complex issues of global food insecurity and discusses long-term solutions for achieving world food security. Achieving the end of world hunger has been and is now within our grasp. There is sufficient food to feed everyone, and solutions can be realized now that will benefit all of humanity. As noted in the paper, most people who examine the costs of ending versus not ending world hunger are bewildered by the question of why humanity did not solve the problem a long time ago. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, respect local cultures, and are environmentally and economically sustainable. The ADA recognizes that decisions and actions that dietetics professionals make as practitioners and consumers can help reduce the extent of poverty and hunger both here and abroad. This paper provides information, resources, and strategies to assist dietetics professionals in improving the public's understanding of key issues, becoming advocates of the poor, and influencing the political will to end world hunger.     

Position of the American Dietetic Association: food insecurity and hunger in the United States

It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the United States. The Association believes that immediate and long-range interventions are needed, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, to end food insecurity and hunger in the United States. Food insecurity continues to exist in the United States, with over 38 million people experiencing it sometime in 2004. Negative nutritional and nonnutritional outcomes have been associated with food insecurity in adults, adolescents, and children, including poor dietary intake and nutritional status, poor health, increased risk for the development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievement. Dietetics professionals can play a key role in ending food insecurity and hunger and are uniquely positioned to make valuable contributions through provision of comprehensive food and nutrition education, competent and collaborative practice, innovative research related to accessing a safe and secure food supply, and advocacy efforts at the local, state, regional, and national levels.     

Measuring the effect of food stamps on food insecurity and hunger: research and policy considerations

The federal government has estimated the prevalence of household "food insecurity" and "food insecurity with hunger" since 1995. Early observers believed that the new measure could be used to assess and improve the Food Stamp Program (FSP). Ten years of research have tempered the initial optimism. The prevalence of food insecurity with hunger (12.3% of all low-income households in 2004) is much higher among food stamp participant households (18.6% in 2004) than among low-income nonparticipant households (10.1% in 2004), due to strong self-selection effects. Households facing greater hardship are more likely to join the program. This article reviews 6 types of nonexperimental research designs that have been used to address the self-selection problem. The results have been inconclusive and the authors have warned against drawing causal inferences from their research. Ethical random-assignment research designs may be required to satisfy the intense policy interest in measuring the antihunger impact of the FSP. The most promising ethical research designs would test the effects of offering eligibility to households that are currently ineligible or offering increased benefits to households that are currently eligible for small benefit amounts.     

Frequency and duration of food insecurity and hunger in US households

OBJECTIVE: This study examines the extent to which food insecurity and hunger in US households are occasional, recurring, or frequent/chronic. Design/Variables: The federal food security scale measures the severity of food insecurity in surveyed households and classifies households as to their food security status during the previous year. The Current Population Survey Food Security Supplement (CPS-FSS) collects the data elements used to calculate the food security scale. Supplementary data on the frequency of occurrence of the behaviors and experiences comprising the food security scale are also collected by the CPS-FSS, but most of this information is not included in the food security scale. This study analyzes these supplementary data along with the food security scale and its constituent items using data from the Food Security Supplement of the nationally representative CPS conducted in August 1998. RESULTS: About two thirds of households classified as food insecure by the federal food security scale experience the condition as recurring, and around one fifth experience these conditions as frequent or chronic. The monthly prevalence of hunger is about 60% of the annual prevalence, and the daily prevalence is about 13% to 18% of the annual prevalence. CONCLUSIONS AND IMPLICATIONS: Nutritionists can use these findings to enhance the informative value of food insecurity and hunger statistics from national, state, and local surveys when interpreting them to policy makers and to the general public.     

Moving beyond hunger and nutrition: a systematic review of the evidence linking food insecurity and mental health in developing countries

Food insecurity is a significant problem in the developing world, and one that is likely to increase given the current global food crisis spurred by rising oil prices, conversion of food to biofuels, and reduced harvests in the wake of natural disasters. The impacts of food insecurity on nutrition status, growth, and development are well substantiated; less is known about the non-nutritional impacts of food insecurity, such as its effects on mental health. This systematic review assesses current findings regarding the impacts of food insecurity on mental health in developing countries. Both qualitative and quantitative studies are considered. The results of the search reveal that little work has examined these issues directly, and serious methodological flaws are present in many of the existing studies. Gaps in the literature, implications, and research priorities are discussed.     

Intergenerational differences in food, physical activity, and body size perceptions among African migrants

We assessed intergenerational differences in food, physical activity, and body size perceptions among refugees and migrants from the Horn of Africa living in Victoria, Australia. We used a qualitative design and obtained data from 48 participants (18 individual interviews; 3 semistructured focus groups). Three major themes emerged: (a) food and physical activity, (b) preference of body size and social expectations, and (c) perceived consequences of various body sizes. For parents, large body size was perceived to equate with being beautiful and wealthy; slimness was associated with chronic illness and poverty. Parents adopted strategies that promoted weight gain in children. These included tailored food practices and restricting children's involvement in physical activity. For young people, slimness was the ideal body size endorsed by their peers, and they adopted strategies to resist parental pressure to gain weight. Obesity-prevention programs in this subpopulation need to adopt a multigenerational approach.     

I am woman: the impact of social identities on African American women's mental health

We examine the psychological impact of a range of social identities among a sample of African American women. Using data from the National Survey of Black Americans (NSBA), we find that measures of body image, role performance, discrimination, and social class position are related to mental health status. Women of lower social class standing are especially at risk for poor mental health outcomes. Having low educational attainment, low personal incomes, and less prestigious occupations is associated with a poor self-concept (self-esteem and self-efficacy). Women with low self-concepts, in turn, report poorer mental health. We argue that African American women face multilayered realities that may compromise their abilities to handle the stresses of everyday life.     

Feeding inequality: food insecurity,social status and college student health

A growing but limited body of research has identified the college student population as one that is particularly vulnerable to food insecurity. Early estimates of food insecurity prevalence among college students range from 14 to 60 per cent. The present study utilises original survey data collected from a random sample (n = 300) of college students enrolled at an urban university in the Midwest region of the United States of America (USA). This study examines the impact of food insecurity on health outcomes and the mediation of this relationship by subjective social status among college students. Ordinary least squares (OLS) and logistic regression analyses find that food insecurity is related to worse self-rated, physical and mental health among college students, and Sobel-Goodman tests find that subjective social status plays a significant mediating role in the relationship between food insecurity and health among college students. The implications of these findings in a university context are discussed using a psychosocial framework and insights from the stress process model. In doing so, I discuss food insecurity among college students with an emphasis on the social significance of food and food insecurity.     

Domestic and institutional violence in health services: women's experiences

Developed in state capitals Recife, Salvador and Aracaju, in three state maternity hospitals, this quantitative study aimed at identifying the manifestations of domestic and institutional violence suffered by women assisted in subprograms of the Program of Integral Assistance to the Woman's Health. Data collection was performed by using a semi-structured form. The sample featured young women, housewives, and those that are economically dependant on their significant others. Most women experience matrimonial violence, and financial dependency is the most often mentioned reason to bear it. The lack of vacancies characterized institutional violence due to omission. Research showed that experiencing such violence brings health problems to women, or aggravates them.     

Health, health risks and inequalities: an exploratory study of women's perceptions

Recent theoretical and empirical research has highlighted the importance of understanding the relationship between social structure and health beliefs. The empirical study described here explores the relationships between occupational social class and two dimensions of health beliefs which were concepts of health and perception of vulnerability to disease. Both the dimensions are claimed to be associated with decisions to carry out health behaviour and thus one of the aims was to shed some light on the social class gradient in patterns of preventive health behaviour and risk-taking behaviour. The findings showed a more marked social class differentiation in concepts of health when they were defined in the abstract compared with when they were defined in relation to personal health. The concept of personal vulnerability itself was shown to be problematic and theories about vulnerability were similar for both classes. Explanations for the findings are discussed.     

Ties that bind: implications of social support for rural, partnered African American women's health functioning.

Ecological theory was used to explore the pathways through which intimate relationship quality influenced health functioning among rural, partnered African American women. Structural equation modeling was used to analyze data from 349 women in Georgia and Iowa. Women's intimate relationship quality was positively associated with their psychological and physical health functioning. Support from community residents moderated this link, which was strongest for women who felt most connected with their neighbors and for women who believed their neighborhood to have a sense of communal responsibility. Future research should identify other factors salient to health functioning among members of this population.     

Effects of intense sweeteners on hunger, food intake, and body weight: a review

The sweet taste of aspartame, saccharin, and acesulfame-K has been reported to increase ratings of hunger and, after saccharin consumption, to increase food intake. However, most investigators have found that aspartame consumption is associated with decreased or unchanged ratings of hunger. Even if aspartame consumption increases ratings of hunger in some situations, it apparently has little impact on the controls of food intake and body weight. Aspartame has not been found to increase food intake; indeed, both short-term and long-term studies have shown that consumption of aspartame-sweetened foods or drinks is associated with either no change or a reduction in food intake. Preliminary clinical trials suggest that aspartame may be useful aid in a complete diet-and-exercise program or in weight maintenance. Intense sweeteners have never been found to cause weight gain in humans.     

How the media influences women's perceptions of health care

To better understand the effectiveness of media sources that marketers use to channel direct-to-consumer (DTC) campaigns to women, researchers devised a study that segmented the female participants according to their degree of involvement in health care decisions, marital status, age, employment, income, and education. The findings show that women in certain population segments reacted far differently to health care information depending on whether it was presented through the Internet, magazines, newspapers, radio, or TV.     

Household capacities, vulnerabilities and food insecurity: shifts in food insecurity in urban and rural Ethiopia during the 2008 food crisis

The global food crisis of 2008 led to renewed interest in global food insecurity and how macro-level food prices impact household and individual level wellbeing. There is debate over the extent to which food price increases in 2008 eroded food security, the extent to which this effect was distributed across rural and urban locales, and the extent to which rural farmers might have benefited. Ethiopia's food prices increased particularly dramatically between 2005 and 2008 and here we ask whether there was a concomitant increase in household food insecurity, whether this decline was distributed equally across rural, urban, and semi-urban locales, and to what extent pre-crisis household capacities and vulnerabilities impacted 2008 household food insecurity levels. Data are drawn from a random sample of 2610 households in Southwest Ethiopia surveyed 2005/6 and again in mid to late 2008. Results show broad deterioration of household food insecurity relative to baseline but declines were most pronounced in the rural areas. Wealthier households and those that were relatively more food secure in 2005/6 tended to be more food secure in 2008, net of other factors, and these effects were most pronounced in urban areas. External shocks, such as a job loss or loss of crops, experienced by households were also associated with worse food insecurity in 2008 but few other household variables were associated with 2008 food insecurity. Our results also showed that rural farmers tended to produce small amounts for sale on markets, and thus were not able to enjoy the potential benefits that come from greater crop prices. We conclude that poverty, and not urban/rural difference, is the important variable for understanding the risk of food insecurity during a food crisis and that many rural farmers are too poor to take advantage of rapid rises in food prices.     

Relationship of body size,body image,and self-esteem in African American,European American,and Mexican American middle-class women

In this study we examined the influence of ethnicity on weight, body image, and self-esteem among adult women while controlling for socioeconomic status (SES). Fifty women of African American (AA), European American (EA), and Mexican American (MA) descent completed interviews and questionnaires related to body size and self-esteem, and were measured for weight and height. AA women were significantly heavier than EA women, but MA women did not differ materially from either grouping. Regardless of ethnic descent, all reported congruence between real and ideal body size. In addition no differences were found in self-esteem. This new comparative study calls into question variations previously attributed to race or ethnicity. It also provides a view of middle-class women missing from recent research. Based on the outcomes of our research, we suggest that socioeconomic differences could be more important than ethnic background. Health educators and providers may find these data helpful when designing prevention and intervention strategies for middle-class women regardless of their ethnic origin.     

Prevalence of violence and its implications for women's health.

This study estimates the lifetime prevalence of violent experiences and their relationship to health and the use of health services in U.S. women aged 18-64 years. The Commonwealth Fund's 1998 Survey of Women's Health provides a nationally representative sample. Use of weighted data allows projections to be made to the U.S. population. Over four of ten women in the U.S. are likely to have experienced one or more forms of violence, including child abuse (17.8%), physical assault (19.1%), rape (20.4%), and intimate partner violence (34.6%). In multivariate logistic regression models that control for sociodemographic characteristics, violence-particularly intimate sexual violence-is significantly related to poorer physical and mental health and increased problems with access to medical care. Only one-third of women who experience violence have discussed it with a physician. Health care professionals need to initiate the conversation about violence and offer referrals for needed services.