International Journal of Environmental Research and Public Health

Editorial

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5 pages, 265 KiB

Open AccessEditorial

Addressing Food and Nutrition Security in Developed Countries

by Christina Mary Pollard and Sue Booth

Int. J. Environ. Res. Public Health 2019, 16(13), 2370; https://doi.org/10.3390/ijerph16132370 - 4 Jul 2019

Cited by 13 | Viewed by 4030

Abstract

The guest editors of the special issue on Addressing Food and Nutrition Security in Developed Countries reflect on the 26 papers that were published as part of this issue and the scope of research contained therein. There is an extensive body of work, [...] Read more.

The guest editors of the special issue on Addressing Food and Nutrition Security in Developed Countries reflect on the 26 papers that were published as part of this issue and the scope of research contained therein. There is an extensive body of work, which focuses on topics ranging from the prevalence of food insecurity in developed countries, associations and determinants, measurement and monitoring, to reports of the lived experience and coping strategies of people who are living with food insecurity or and those who are a part of the charitable food sector. Very few solutions to address the problem of food insecurity in developed countries were offered, and many challenges highlighted. Further research is required to find the solutions to address the problem of food insecurity in developed countries, and important principles and values are proposed for those undertaking this work to embrace. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

Research

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15 pages, 306 KiB

Open AccessArticle

Social Assistance Payments and Food Insecurity in Australia: Evidence from the Household Expenditure Survey

by Jeromey B. Temple, Sue Booth and Christina M. Pollard

Int. J. Environ. Res. Public Health 2019, 16(3), 455; https://doi.org/10.3390/ijerph16030455 - 4 Feb 2019

Cited by 54 | Viewed by 11078

Abstract

It is widely understood that households with low economic resources and poor labour
market attachment are at considerable risk of food insecurity in Australia. However, little is known
about variations in food insecurity by receipt of specific classes of social assistance payments that
[...] Read more.

It is widely understood that households with low economic resources and poor labour
market attachment are at considerable risk of food insecurity in Australia. However, little is known
about variations in food insecurity by receipt of specific classes of social assistance payments that
are made through the social security system. Using newly released data from the 2016 Household
Expenditure Survey, this paper reports on variations in food insecurity prevalence across a range of
payment types. We further investigated measures of financial wellbeing reported by food-insecure
households in receipt of social assistance payments. Results showed that individuals in receipt
of Newstart allowance (11%), Austudy/Abstudy (14%), the Disability Support Pension (12%),
the Carer Payment (11%) and the Parenting Payment (9%) were at significantly higher risk of food
insecurity compared to those in receipt of the Age Pension (<1%) or no payment at all (1.3%). Results
further indicated that food-insecure households in receipt of social assistance payments endured
significant financial stress, with a large proportion co-currently experiencing “fuel” or “energy”
poverty. Our results support calls by a range of Australian non-government organisations, politicians,
and academics for a comprehensive review of the Australian social security system
Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

15 pages, 1620 KiB

Open AccessArticle

Household Food Insecurity Narrows the Sex Gap in Five Adverse Mental Health Outcomes among Canadian Adults

by Geneviève Jessiman-Perreault and Lynn McIntyre

Int. J. Environ. Res. Public Health 2019, 16(3), 319; https://doi.org/10.3390/ijerph16030319 - 24 Jan 2019

Cited by 11 | Viewed by 5019

Abstract

The sex gap (i.e., the significant difference in an outcome between men and women) in the occurrence of a variety of mental health conditions has been well documented. Household food insecurity has also repeatedly been found to be associated with a variety of [...] Read more.

The sex gap (i.e., the significant difference in an outcome between men and women) in the occurrence of a variety of mental health conditions has been well documented. Household food insecurity has also repeatedly been found to be associated with a variety of poor mental health outcomes. Although both sex and household food insecurity have received attention individually, rarely have they been examined together to explore whether or how these indicators of two social locations interact to impact common mental health outcomes. Using a pooled sample (N = 302,683) of the Canadian Community Health Survey (2005–2012), we test whether sex modifies the relationship between household food insecurity assessed by the Household Food Security Survey Module and five adverse mental health outcomes, controlling for confounding covariates. Although the sex gap was observed among food secure men versus women, males and females reporting any level of food insecurity were equally likely to report adverse mental health outcomes, compared with those reporting food security. Therefore, household food insecurity seems to narrow the sex gap on five adverse mental health outcomes. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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11 pages, 282 KiB

Open AccessArticle

Healthy Choice Rewards: A Feasibility Trial of Incentives to Influence Consumer Food Choices in a Remote Australian Aboriginal Community

by Clare Brown, Cara Laws, Dympna Leonard, Sandy Campbell, Lea Merone, Melinda Hammond, Kani Thompson, Karla Canuto and Julie Brimblecombe

Int. J. Environ. Res. Public Health 2019, 16(1), 112; https://doi.org/10.3390/ijerph16010112 - 3 Jan 2019

Cited by 19 | Viewed by 7357

Abstract

Poor diet including inadequate fruit and vegetable consumption is a major contributor to the global burden of disease. Aboriginal and Torres Strait Islander Australians experience a disproportionate level of preventable chronic disease and successful strategies to support Aboriginal and Torres Strait Islander people [...] Read more.

Poor diet including inadequate fruit and vegetable consumption is a major contributor to the global burden of disease. Aboriginal and Torres Strait Islander Australians experience a disproportionate level of preventable chronic disease and successful strategies to support Aboriginal and Torres Strait Islander people living in remote areas to consume more fruit and vegetables can help address health disadvantage. Healthy Choice Rewards was a mixed methods study to investigate the feasibility of a monetary incentive: store vouchers, to promote fruit and vegetable purchasing in a remote Australian Aboriginal community. Multiple challenges were identified in implementation, including limited nutrition workforce. Challenges related to the community store included frequent store closures and amended trading times, staffing issues and poor infrastructure to support fruit and vegetable promotion. No statistically significant increases in fruit or vegetable purchases were observed in the short time frame of this study. Despite this, community members reported high acceptability of the program, especially for women with children. Optimal implementation including, sufficient time and funding resources, with consideration of the most vulnerable could go some way to addressing inequities in food affordability for remote community residents. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

17 pages, 602 KiB

Open AccessArticle

What can Secondary Data Tell Us about Household Food Insecurity in a High-Income Country Context?

by Ourega-Zoé Ejebu, Stephen Whybrow, Lynda Mckenzie, Elizabeth Dowler, Ada L Garcia, Anne Ludbrook, Karen Louise Barton, Wendy Louise Wrieden and Flora Douglas

Int. J. Environ. Res. Public Health 2019, 16(1), 82; https://doi.org/10.3390/ijerph16010082 - 29 Dec 2018

Cited by 11 | Viewed by 7001

Abstract

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007–2012) was conducted [...] Read more.

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007–2012) was conducted to calculate weekly food expenditure and its ratio to equivalised income for households below average income (HBAI) and above average income (non-HBAI). Diet Quality Index (DQI) scores were calculated for this survey and the Scottish Health Survey (SHeS, 2008 and 2012). Secondary data provided a partial picture of food insecurity prevalence in Scotland, and a limited picture of differences in diet quality. In 2012, HBAI spent significantly less in absolute terms per week on food and non-alcoholic drinks (£53.85) compared to non-HBAI (£86.73), but proportionately more of their income (29% and 15% respectively). Poorer households were less likely to achieve recommended fruit and vegetable intakes than were more affluent households. The mean DQI score (SHeS data) of HBAI fell between 2008 and 2012, and was significantly lower than the mean score for non-HBAI in 2012. Secondary data are insufficient to generate the robust and comprehensive picture needed to monitor the incidence and prevalence of food insecurity in Scotland. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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12 pages, 677 KiB

Open AccessArticle

Food Reference Budgets as a Potential Policy Tool to Address Food Insecurity: Lessons Learned from a Pilot Study in 26 European Countries

by Elena Carrillo-Álvarez, Tess Penne, Hilde Boeckx, Bérénice Storms and Tim Goedemé

Int. J. Environ. Res. Public Health 2019, 16(1), 32; https://doi.org/10.3390/ijerph16010032 - 24 Dec 2018

Cited by 17 | Viewed by 4899

Abstract

The aim of this article is to present the development of cross-country comparable food reference budgets in 26 European countries, and to discuss their usefulness as an addition to food-based dietary guidelines (FBDG) for tackling food insecurity in low-income groups. Reference budgets are [...] Read more.

The aim of this article is to present the development of cross-country comparable food reference budgets in 26 European countries, and to discuss their usefulness as an addition to food-based dietary guidelines (FBDG) for tackling food insecurity in low-income groups. Reference budgets are illustrative priced baskets containing the minimum goods and services necessary for well-described types of families to have an adequate social participation. This study was conducted starting from national FBDG, which were translated into monthly food baskets. Next, these baskets were validated in terms of their acceptability and feasibility through focus group discussions, and finally they were priced. Along the paper, we show how that food reference budgets hold interesting contributions to the promotion of healthy eating and prevention of food insecurity in low-income contexts in at least four ways: (1) they show how a healthy diet can be achieved with limited economic resources, (2) they bring closer to the citizen a detailed example of how to put FBDG recommendations into practice, (3) they ensure that food security is achieved in an integral way, by comprising the biological but also psychological and social functions of food, and (4) providing routes for further (comparative) research into food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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15 pages, 592 KiB

Open AccessArticle

Testing the Price of Healthy and Current Diets in Remote Aboriginal Communities to Improve Food Security: Development of the Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) Methods

by Amanda Lee and Meron Lewis

Int. J. Environ. Res. Public Health 2018, 15(12), 2912; https://doi.org/10.3390/ijerph15122912 - 19 Dec 2018

Cited by 26 | Viewed by 7814

Abstract

Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised [...] Read more.

Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol to be more relevant to Indigenous groups in assessing one important component of food security. The resultant Aboriginal and Torres Strait Islander Healthy Diets ASAP methods were used to assess the price, price differential, and affordability of healthy (recommended) and current (unhealthy) diets in five remote Aboriginal communities. The results show that the tailored approach is more sensitive than the original protocol in revealing the high degree of food insecurity in these communities, where the current diet costs nearly 50% of disposable household income compared to the international benchmark of 30%. Sixty-two percent of the current food budget appears to be spent on discretionary foods and drinks. Aided by community store pricing policies, healthy (recommended) diets are around 20% more affordable than current diets in these communities, but at 38.7% of disposable household income still unaffordable for most households. Further studies in urban communities, and on other socioeconomic, political and commercial determinants of food security in Aboriginal and Torres Strait Islander communities appear warranted. The development of the tailored method provides an example of how national tools can be adapted to better inform policy actions to improve food security and help reduce rates of diet-related chronic disease more equitably in developed countries. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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14 pages, 340 KiB

Open AccessArticle

Health-Promoting Food Pricing Policies and Decision-Making in Very Remote Aboriginal and Torres Strait Islander Community Stores in Australia

by Megan Ferguson, Kerin O'Dea, Jon Altman, Marjory Moodie and Julie Brimblecombe

Int. J. Environ. Res. Public Health 2018, 15(12), 2908; https://doi.org/10.3390/ijerph15122908 - 19 Dec 2018

Cited by 20 | Viewed by 6876

Abstract

Aboriginal and Torres Strait Islander people living in remote communities in Australia experience a disproportionate burden of diet-related chronic disease. This occurs in an environment where the cost of store-purchased food is high and cash incomes are low, factors that affect both food [...] Read more.

Aboriginal and Torres Strait Islander people living in remote communities in Australia experience a disproportionate burden of diet-related chronic disease. This occurs in an environment where the cost of store-purchased food is high and cash incomes are low, factors that affect both food insecurity and health outcomes. Aboriginal and Torres Strait Islander storeowners and the retailers who work with them implement local policies with the aim of improving food affordability and health outcomes. This paper describes health-promoting food pricing policies, their alignment with evidence, and the decision-making processes entailed in their development in community stores across very remote Australia. Semi-structured interviews were conducted with a purposive sample of retailers and health professionals identified through the snowball method, September 2015 to October 2016. Data were complemented through review of documents describing food pricing policies. A content analysis of the types and design of policies was undertaken, while the decision-making process was considered through a deductive, thematic analysis. Fifteen retailers and 32 health professionals providing services to stores participated. Subsidies and subsidy/price increase combinations dominated. Magnitude of price changes ranged from 5% to 25% on fruit, vegetables, bottled water, artificially sweetened and sugar sweetened carbonated beverages, and broadly used ‘healthy/essential’ and ‘unhealthy’ food classifications. Feasibility and sustainability were considered during policy development. Greater consideration of acceptability, importance, effectiveness and unintended consequences of policies guided by evidence were deemed important, as were increased involvement of Aboriginal and Torres Strait Islander storeowners and nutritionists in policy development. A range of locally developed health-promoting food pricing policies exist and partially align with research-evidence. The decision-making processes identified offer an opportunity to incorporate evidence, based on consideration of the local context. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

15 pages, 870 KiB

Open AccessArticle

Undeserving, Disadvantaged, Disregarded: Three Viewpoints of Charity Food Aid Recipients in Finland

by Anna Sofia Salonen, Maria Ohisalo and Tuomo Laihiala

Int. J. Environ. Res. Public Health 2018, 15(12), 2896; https://doi.org/10.3390/ijerph15122896 - 17 Dec 2018

Cited by 13 | Viewed by 4926

Abstract

Since the economic recession of the 1990s, Finland has experienced the proliferation of charity food aid as a means of helping people who are afflicted by poverty. However, so far little research has been conducted regarding the food aid recipients. This article gives [...] Read more.

Since the economic recession of the 1990s, Finland has experienced the proliferation of charity food aid as a means of helping people who are afflicted by poverty. However, so far little research has been conducted regarding the food aid recipients. This article gives discursive, demographic, and experiential insights into charity food provision and reception in Finland. Drawing on quantitative survey data, online discussion data related to news published on Finnish newspapers’ web pages, and observation and interviews with food aid recipients, this article sheds new light on Finnish food aid recipients from three perspectives. First, public perceptions about food aid often portray food recipients as dishonourable and responsible for their own poverty. Secondly, the survey data shows that the main reason for people resorting to charity food aid is deep economic disadvantage, and further, that there is an unequal accumulation of disadvantage among the food aid recipients, illustrating internal diversity. Third, observational and interview data show that from the food recipients’ perspective, the food aid system has only a limited ability to answer even their immediate food needs, and for the recipients, food aid venues can become not only socially significant, but also socially demanding and emotionally burdening places. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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22 pages, 392 KiB

Open AccessArticle

“A Lot of People Are Struggling Privately. They Don’t Know Where to Go or They’re Not Sure of What to Do”: Frontline Service Provider Perspectives of the Nature of Household Food Insecurity in Scotland

by Flora Douglas, Fiona MacKenzie, Ourega-Zoé Ejebu, Stephen Whybrow, Ada L. Garcia, Lynda McKenzie, Anne Ludbrook and Elizabeth Dowler

Int. J. Environ. Res. Public Health 2018, 15(12), 2738; https://doi.org/10.3390/ijerph15122738 - 4 Dec 2018

Cited by 13 | Viewed by 6090

Abstract

This qualitative study explored frontline service providers’ perceptions of the nature of food insecurity in Scotland in 2015 to inform national policy and the provision of locally-based support for ‘at risk’ groups. A country-wide in-depth interview study was undertaken with informants from 25 [...] Read more.

This qualitative study explored frontline service providers’ perceptions of the nature of food insecurity in Scotland in 2015 to inform national policy and the provision of locally-based support for ‘at risk’ groups. A country-wide in-depth interview study was undertaken with informants from 25 health, social care, and third sector organisations. The study investigated informants’ perspectives associated with how food insecurity was manifesting itself locally, and what was happening at the local level in response to the existence of food insecurity. Data analysis revealed three key themes. First, the multiple faces and factors of food insecurity involving not only increased concern for previously recognised ‘at risk of food insecurity’ groups, but also similar concern held about newly food insecure groups including working families, young people and women. Secondly, respondents witnessed stoicism and struggle, but also resistance amongst some food insecure individuals to external offers of help. The final theme identified community participation yet pessimism associated with addressing current and future needs of food insecure groups. These findings have important implications for the design and delivery of health and social policy in Scotland and other countries facing similar challenges. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

22 pages, 661 KiB

Open AccessArticle

Food Security Experiences of Aboriginal and Torres Strait Islander Families with Young Children in An Urban Setting: Influencing Factors and Coping Strategies

by Leisa McCarthy, Anne B. Chang and Julie Brimblecombe

Int. J. Environ. Res. Public Health 2018, 15(12), 2649; https://doi.org/10.3390/ijerph15122649 - 26 Nov 2018

Cited by 17 | Viewed by 6914

Abstract

Evidence on Aboriginal and Torres Strait Islander peoples’ food security experiences and coping strategies used when food insecurity occurs is limited. Such evidence is important to inform policies that can reduce the consequences of food insecurity. This study investigated factors perceived by Aboriginal [...] Read more.

Evidence on Aboriginal and Torres Strait Islander peoples’ food security experiences and coping strategies used when food insecurity occurs is limited. Such evidence is important to inform policies that can reduce the consequences of food insecurity. This study investigated factors perceived by Aboriginal and Torres Strait Islander families with young children to influence household food security, and coping strategies used, in an urban setting. A qualitative research inductive approach was used. Data were collected through an iterative process of inquiry through initial interviews with 30 primary care-givers, followed by in-depth interviews with six participants to further explore emerging themes. Major topics explored were: influencing factors, food insecurity experiences, impact on food selection, and coping strategies. Food affordability relating to income and living expenses was a major barrier to a healthy diet with large household bills impacting food choice and meal quality. Access to family support was the main reported coping strategy. Food insecurity is experienced by Aboriginal and Torres Strait Islander families, it is largely intermittent occurring especially when large household bills are due for payment. Family support provides an essential safety net and the implications of this are important to consider in public policy to address food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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13 pages, 717 KiB

Open AccessArticle

Using Cross-Sectional Data to Identify and Quantify the Relative Importance of Factors Associated with and Leading to Food Insecurity

by Alison Daly, Christina M. Pollard, Deborah A. Kerr, Colin W. Binns, Martin Caraher and Michael Phillips

Int. J. Environ. Res. Public Health 2018, 15(12), 2620; https://doi.org/10.3390/ijerph15122620 - 22 Nov 2018

Cited by 17 | Viewed by 4840

Abstract

Australian governments routinely monitor population household food insecurity (FI) using a single measure—‘running out of food at least once in the previous year’. To better inform public health planning, a synthesis of the determinants and how they influence and modify each other in [...] Read more.

Australian governments routinely monitor population household food insecurity (FI) using a single measure—‘running out of food at least once in the previous year’. To better inform public health planning, a synthesis of the determinants and how they influence and modify each other in relation to FI was conducted. The analysis used data from the Health & Wellbeing Surveillance System cross-sectional dataset. Weighted means and multivariable weighted logistic regression described and modelled factors involved in FI. The analysis showed the direction and strength of the factors and a path diagram was constructed to illustrate these. The results showed that perceived income, independent of actual income was a strong mediator on the path to FI as were obesity, smoking and other indicators of health status. Eating out three or more times a week and eating no vegetables more strongly followed FI than preceded it. The analysis identified a range of factors and demonstrated the complex and interactive nature of them. Further analysis using propensity score weighted methods to control for covariates identified hypothetical causal links for investigation. These results can be used as a proof of concept to assist public health planning. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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16 pages, 884 KiB

Open AccessArticle

Healthy Diets in Rural Victoria—Cheaper than Unhealthy Alternatives, Yet Unaffordable

by Penelope Love, Jillian Whelan, Colin Bell, Felicity Grainger, Cherie Russell, Meron Lewis and Amanda Lee

Int. J. Environ. Res. Public Health 2018, 15(11), 2469; https://doi.org/10.3390/ijerph15112469 - 5 Nov 2018

Cited by 31 | Viewed by 8917

Abstract

Rural communities experience higher rates of obesity and reduced food security compared with urban communities. The perception that healthy foods are expensive contributes to poor dietary choices. Providing an accessible, available, affordable healthy food supply is an equitable way to improve the nutritional [...] Read more.

Rural communities experience higher rates of obesity and reduced food security compared with urban communities. The perception that healthy foods are expensive contributes to poor dietary choices. Providing an accessible, available, affordable healthy food supply is an equitable way to improve the nutritional quality of the diet for a community, however, local food supply data are rarely available for small rural towns. This study used the Healthy Diets ASAP tool to assess price, price differential and affordability of recommended (healthy) and current diets in a rural Local Government Area (LGA) (pop ≈ 7000; 10 towns) in Victoria, Australia. All retail food outlets were surveyed (n = 40). The four most populous towns had supermarkets; remaining towns had one general store each. Seven towns had café/take-away outlets, and all towns had at least one hotel/pub. For all towns the current unhealthy diet was more expensive than the recommended healthy diet, with 59.5% of the current food budget spent on discretionary items. Affordability of the healthy diet accounted for 30–32% of disposable income. This study confirms that while a healthy diet is less expensive than the current unhealthier diet, affordability is a challenge for rural communities. Food security is reduced further with restricted geographical access, a limited healthy food supply, and higher food prices. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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15 pages, 322 KiB

Open AccessArticle

The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia

by Jeromey B. Temple

Int. J. Environ. Res. Public Health 2018, 15(11), 2333; https://doi.org/10.3390/ijerph15112333 - 23 Oct 2018

Cited by 29 | Viewed by 5377

Abstract

A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. [...] Read more.

A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

15 pages, 336 KiB

Open AccessArticle

You Can’t Find Healthy Food in the Bush: Poor Accessibility, Availability and Adequacy of Food in Rural Australia

by Jill Whelan, Lynne Millar, Colin Bell, Cherie Russell, Felicity Grainger, Steven Allender and Penelope Love

Int. J. Environ. Res. Public Health 2018, 15(10), 2316; https://doi.org/10.3390/ijerph15102316 - 21 Oct 2018

Cited by 49 | Viewed by 11697

Abstract

In high-income countries, obesity disproportionately affects those from disadvantaged and rural areas. Poor diet is a modifiable risk factor for obesity and the food environment a primary driver of poor diet. In rural and disadvantaged communities, it is harder to access affordable and [...] Read more.

In high-income countries, obesity disproportionately affects those from disadvantaged and rural areas. Poor diet is a modifiable risk factor for obesity and the food environment a primary driver of poor diet. In rural and disadvantaged communities, it is harder to access affordable and nutritious food, affecting both food insecurity and the health of rural residents. This paper aims to describe the food environment in a rural Australian community (approx. 7000 km² in size) to inform the development of community-relevant food supply interventions. We conducted a census audit of the food environment (ground truthing) of a local government area (LGA). We used the Nutrition Environment Measurement tools (NEMS-S and NEMS-R) to identify availability of a range of food and non-alcoholic beverages, the relative price of a healthy compared to a less healthy option of a similar food type (e.g., bread), the quality of fresh produce and any in-store nutrition promotion. Thirty-eight food retail outlets operated at the time of our study and all were included, 11 food stores (NEMS-S) and 27 food service outlets (NEMS-R). The mean NEMS-S score for all food stores was 21/54 points (39%) and mean NEMS-R score for all food service outlets was 3/23 points (13%); indicative of limited healthier options at relatively higher prices. It is difficult to buy healthy food beyond the supermarkets and one (of seven) cafés across the LGA. Residents demonstrate strong loyalty to local food outlets, providing scope to work with this existing infrastructure to positively impact poor diet and improve food security. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

19 pages, 368 KiB

Open AccessArticle

Walking the Food Security Tightrope—Exploring the Experiences of Low-to-Middle Income Melbourne Households

by Sue Kleve, Sue Booth, Zoe E. Davidson and Claire Palermo

Int. J. Environ. Res. Public Health 2018, 15(10), 2206; https://doi.org/10.3390/ijerph15102206 - 10 Oct 2018

Cited by 26 | Viewed by 5488

Abstract

There is limited evidence of how Australian low-to-middle income (AUD $40,000–$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised [...] Read more.

There is limited evidence of how Australian low-to-middle income (AUD $40,000–$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised participants according to food security status (the 18-item United States Department of Agriculture Household Food Security Survey Module) and income level to identify and purposefully select participants to qualitatively explore food insecurity and security experiences. Of the total number of survey participants (n = 134), 42 were categorised as low-to-middle income. Of these, a subset of 16 participants (8 FIS and 8 FS) was selected, and each participant completed an in-depth interview. The interviews explored precursors, strategies to prevent or address food insecurity, and the implications of the experience. Interview data were analysed using a thematic analysis approach. Five themes emerged from the analysis: (i) food decision experiences, (ii) assets, (iii) triggers, (iv) activation of assets, and (v) consequences and emotion related to walking the food security tightrope. The leverage points across all themes were more volatile for FIS participants. Low-to-middle income Australians are facing the challenges of trying to maintain or improve their food security status, with similarities to those described in lower income groups, and should be included in approaches to prevent or address food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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18 pages, 1482 KiB

Open AccessArticle

‘Sustainable’ Rather Than ‘Subsistence’ Food Assistance Solutions to Food Insecurity: South Australian Recipients’ Perspectives on Traditional and Social Enterprise Models

by Sue Booth, Christina Pollard, John Coveney and Ian Goodwin-Smith

Int. J. Environ. Res. Public Health 2018, 15(10), 2086; https://doi.org/10.3390/ijerph15102086 - 21 Sep 2018

Cited by 30 | Viewed by 6822

Abstract

South Australian (SA) food charity recipients’ perspectives were sought on existing services and ideas for improvement of food assistance models to address food insecurity. Seven focus groups were conducted between October and November 2017 with 54 adults. Thematically analysed data revealed five themes: [...] Read more.

South Australian (SA) food charity recipients’ perspectives were sought on existing services and ideas for improvement of food assistance models to address food insecurity. Seven focus groups were conducted between October and November 2017 with 54 adults. Thematically analysed data revealed five themes: (1) Emotional cost and consequences of seeking food relief; (2) Dissatisfaction with inaccessible services and inappropriate food; (3) Returning the favour—a desire for reciprocity; (4) Desiring help beyond food; and, (5) “It’s a social thing”, the desire for social interaction and connection. Findings revealed that some aspects of the SA food assistance services were disempowering for recipients. Recipients desired more empowering forms of food assistance that humanise their experience and shift the locus of control and place power back into their hands. Some traditional models, such as provision of supermarket vouchers, empower individuals by fostering autonomy and enabling food choice in socially acceptable ways. Improvement in the quality of existing food assistance models, should focus on recipient informed models which re-dress existing power relations. Services which are more strongly aligned with typical features of social enterprise models were generally favoured over traditional models. Services which are recipient-centred, strive to empower recipients and provide opportunities for active involvement, social connection and broader support were preferred. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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14 pages, 306 KiB

Open AccessArticle

Food Insecurity among Older Aboriginal and Torres Strait Islanders

by Jeromey B. Temple and Joanna Russell

Int. J. Environ. Res. Public Health 2018, 15(8), 1766; https://doi.org/10.3390/ijerph15081766 - 17 Aug 2018

Cited by 23 | Viewed by 9130

Abstract

It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study [...] Read more.

It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study examined the prevalence and correlates of food insecurity among older Aboriginal and Torres Strait Islanders. Using nationally representative data, we employed ordinal logistic regression models to investigate the association between socio-demographic characteristics and food insecurity. We found that 21% of the older Aboriginal and Torres Strait Islander population were food insecure, with 40% of this group exposed to food insecurity with food depletion and inadequate intake. This places this population at a 5 to 7-fold risk of experiencing food insecurity relative to their older non-Indigenous peers. Measures of geography, language and low socio-economic status were highly associated with exposure to food insecurity. Addressing food insecurity offers one pathway to reduce the disparity in health outcomes between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Policies that consider both remote and non-remote Australia, as well as those that involve Aboriginal people in their design and implementation are needed to reduce food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

11 pages, 308 KiB

Open AccessArticle

The Overlooked Burden of Food Insecurity among Asian Americans: Results from the California Health Interview Survey

by Monideepa B. Becerra, Salome Kapella Mshigeni and Benjamin J. Becerra

Int. J. Environ. Res. Public Health 2018, 15(8), 1684; https://doi.org/10.3390/ijerph15081684 - 7 Aug 2018

Cited by 26 | Viewed by 6301

Abstract

Objective: Food insecurity remains a major public health issue in the United States, though lack of research among Asian Americans continue to underreport the issue. The purpose of this study was to evaluate the prevalence and burden of food insecurity among disaggregated [...] Read more.

Objective: Food insecurity remains a major public health issue in the United States, though lack of research among Asian Americans continue to underreport the issue. The purpose of this study was to evaluate the prevalence and burden of food insecurity among disaggregated Asian American populations. Methods: The California Health Interview Survey, the largest state health survey, was used to assess the prevalence of food insecurity among Asian American subgroups with primary exposure variable of interest being acculturation. Survey-weighted descriptive, bivariate, and multivariable robust Poisson regression analyses, were conducted and alpha less than 0.05 was used to denote significance. Results: The highest prevalence of food insecurity was found among Vietnamese (16.42%) and the lowest prevalence was among Japanese (2.28%). A significant relationship was noted between prevalence of food insecurity and low acculturation for Chinese, Korean, and Vietnamese subgroups. Language spoken at home was significant associated with food insecurity. For example, among Chinese, being food insecure was associated with being bilingual (prevalence ratio [PR] = 2.51) or speaking a non-English language at home (PR = 7.24), while among South Asians, it was associated with speaking a non-English language at home was also related to higher prevalence (PR = 3.62), as compared to English speakers only. Likewise, being foreign-born also related to being food insecure among Chinese (PR = 2.31), Filipino (PR = 1.75), South Asian (PR = 3.35), Japanese (PR = 2.11), and Vietnamese (PR = 3.70) subgroups, when compared to their US-born counterparts. Conclusion: There is an imperative need to address food insecurity burden among Asian Americans, especially those who have low acculturation. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

10 pages, 309 KiB

Open AccessArticle

Factors Associated with Continued Food Insecurity among Households Recovering from Hurricane Katrina

by Lauren A. Clay, Mia A. Papas, Kimberly B. Gill and David M. Abramson

Int. J. Environ. Res. Public Health 2018, 15(8), 1647; https://doi.org/10.3390/ijerph15081647 - 3 Aug 2018

Cited by 39 | Viewed by 7507

Abstract

In 2010, 14.5% of US households experienced food insecurity, which adversely impacts health. Some groups are at increased risk for food insecurity, such as female-headed households, and those same groups are often also at increased risk for disaster exposure and the negative consequences [...] Read more.

In 2010, 14.5% of US households experienced food insecurity, which adversely impacts health. Some groups are at increased risk for food insecurity, such as female-headed households, and those same groups are often also at increased risk for disaster exposure and the negative consequences that come with exposure. Little research has been done on food insecurity post-disaster. The present study investigates long-term food insecurity among households heavily impacted by Hurricane Katrina. A sample of 683 households participating in the Gulf Coast Child and Family Health Study were examined using a generalized estimation model to determine protective and risk factors for food insecurity during long-term recovery. Higher income (Odds Ratio (OR) 0.84, 95% Confidence Interval (CI) 0.77, 0.91), having a partner (OR 0.93; 95% CI 0.89, 0.97), or “other” race were found to be protective against food insecurity over a five-year period following disaster exposure. Low social support (OR 1.14; 95% CI 1.08, 1.20), poor physical health (OR 1.08; 95% CI 1.03, 1.13) or mental health (OR 1.13; 95% CI 1.09, 1.18), and female sex (OR 1.05; 95% CI 1.01, 1.10) were risk factors. Policies and programs that increase access to food supplies among high-risk groups are needed to reduce the negative health impacts of disasters. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

18 pages, 3367 KiB

Open AccessFeature PaperArticle

The German Food Bank System and Its Users—A Cross-Sectional Study

by Anja Simmet, Peter Tinnemann and Nanette Stroebele-Benschop

Int. J. Environ. Res. Public Health 2018, 15(7), 1485; https://doi.org/10.3390/ijerph15071485 - 13 Jul 2018

Cited by 20 | Viewed by 7228

Abstract

Although food banks are a well-known resource for low-income people struggling to meet their food needs, they have rarely been investigated on a large scale. This study aims to contribute to the actual debate about the potential and limitations of food banks to [...] Read more.

Although food banks are a well-known resource for low-income people struggling to meet their food needs, they have rarely been investigated on a large scale. This study aims to contribute to the actual debate about the potential and limitations of food banks to decrease the prevalence of food insecurity by providing a representative picture of the German food bank system and its users. Publicly accessible data were used to map residents, public welfare recipients, and food banks. In addition, a comprehensive survey was distributed to all 934 “Tafel” food banks. The results show that nearly all residents and welfare recipients have access to at least one food bank located in the districts in which they reside. Differences in the density of food banks exist between eastern and western Germany. Food banks provide mainly healthy fresh food, but they heavily rely on food donations from local retailers and on volunteer labor. Although changes in the number of user households by income seem to mirror trends in the number of welfare recipients, food bank users appear to represent only a fraction of the food-insecure population in Germany. Food banks might have the potential to improve users’ diet and food security, but they are not able to reach all food-insecure residents in Germany. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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12 pages, 457 KiB

Open AccessArticle

Cost and Affordability of Diets Modelled on Current Eating Patterns and on Dietary Guidelines, for New Zealand Total Population, Māori and Pacific Households

by Sally Mackay, Tina Buch, Stefanie Vandevijvere, Rawinia Goodwin, Erina Korohina, Mafi Funaki-Tahifote, Amanda Lee and Boyd Swinburn

Int. J. Environ. Res. Public Health 2018, 15(6), 1255; https://doi.org/10.3390/ijerph15061255 - 13 Jun 2018

Cited by 28 | Viewed by 9198

Abstract

The affordability of diets modelled on the current (less healthy) diet compared to a healthy diet based on Dietary Guidelines was calculated for population groups in New Zealand. Diets using common foods were developed for a household of four for the total population, [...] Read more.

The affordability of diets modelled on the current (less healthy) diet compared to a healthy diet based on Dietary Guidelines was calculated for population groups in New Zealand. Diets using common foods were developed for a household of four for the total population, Māori and Pacific groups. Māori and Pacific nutrition expert panels ensured the diets were appropriate. Each current (less healthy) diet was based on eating patterns identified from national nutrition surveys. Food prices were collected from retail outlets. Only the current diets contained alcohol, takeaways and discretionary foods. The modelled healthy diet was cheaper than the current diet for the total population (3.5% difference) and Pacific households (4.5% difference) and similar in cost for Māori households (0.57% difference). When the diets were equivalent in energy, the healthy diet was more expensive than the current diet for all population groups (by 8.5% to 15.6%). For households on the minimum wage, the diets required 27% to 34% of household income, and if receiving income support, required 41–52% of household income. Expert panels were invaluable in guiding the process for specific populations. Both the modelled healthy and current diets are unaffordable for some households as a considerable portion of income was required to purchase either diet. Policies are required to improve food security by lowering the cost of healthy food or improving household income. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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17 pages, 639 KiB

Open AccessArticle

Charitable Food Systems’ Capacity to Address Food Insecurity: An Australian Capital City Audit

by Christina M. Pollard, Bruce Mackintosh, Cathy Campbell, Deborah Kerr, Andrea Begley, Jonine Jancey, Martin Caraher, Joel Berg and Sue Booth

Int. J. Environ. Res. Public Health 2018, 15(6), 1249; https://doi.org/10.3390/ijerph15061249 - 12 Jun 2018

Cited by 35 | Viewed by 9284

Abstract

Australian efforts to address food insecurity are delivered by a charitable food system (CFS) which fails to meet demand. The scope and nature of the CFS is unknown. This study audits the organisational capacity of the CFS within the 10.9 square kilometres of [...] Read more.

Australian efforts to address food insecurity are delivered by a charitable food system (CFS) which fails to meet demand. The scope and nature of the CFS is unknown. This study audits the organisational capacity of the CFS within the 10.9 square kilometres of inner-city Perth, Western Australia. A desktop analysis of services and 12 face-to-face interviews with representatives from CFS organisations was conducted. All CFS organisations were not-for–profit and guided by humanitarian or faith-based values. The CFS comprised three indirect services (IS) sourcing, banking and/or distributing food to 15 direct services (DS) providing food to recipients. DS offered 30 different food services at 34 locations feeding over 5670 people/week via 16 models including mobile and seated meals, food parcels, supermarket vouchers, and food pantries. Volunteer to paid staff ratios were 33:1 (DS) and 19:1 (IS). System-wide, food was mainly donated and most funding was philanthropic. Only three organisations received government funds. No organisation had a nutrition policy. The organisational capacity of the CFS was precarious due to unreliable, insufficient and inappropriate financial, human and food resources and structures. System-wide reforms are needed to ensure adequate and appropriate food relief for Australians experiencing food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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Review

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36 pages, 665 KiB

Open AccessReview

Food Insecurity and Mental Health among Females in High-Income Countries

by Merryn Maynard, Lesley Andrade, Sara Packull-McCormick, Christopher M. Perlman, Cesar Leos-Toro and Sharon I. Kirkpatrick

Int. J. Environ. Res. Public Health 2018, 15(7), 1424; https://doi.org/10.3390/ijerph15071424 - 6 Jul 2018

Cited by 180 | Viewed by 21801

Abstract

Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. [...] Read more.

Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. The research databases PubMed, EMBASE, and psycINFO were searched using keywords capturing food insecurity, mental health, and women. Thirty-nine articles (representing 31 unique studies/surveys) were identified. Three-quarters of the articles drew upon data from a version of the United States Department of Agriculture Household Food Security Survey Module. A range of mental health measures were used, most commonly to measure depression and depressive symptoms, but also anxiety and stress. Most research was cross-sectional and showed associations between depression and food insecurity; longitudinal analyses suggested bidirectional relationships (with food insecurity increasing the risk of depressive symptoms or diagnosis, or depression predicting food insecurity). Several articles focused on vulnerable subgroups, such as pregnant women and mothers, women at risk of homelessness, refugees, and those who had been exposed to violence or substance abuse. Overall, this review supports a link between food insecurity and mental health (and other factors, such as housing circumstances and exposure to violence) among women in high-income countries and underscores the need for comprehensive policies and programs that recognize complex links among public health challenges. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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Other

Jump to: Editorial, Research, Review

1 pages, 226 KiB

Open AccessCorrection

Correction: Pollard, C.M.; Booth, S. Food Insecurity and Hunger in Rich Countries—It Is Time for Action against Inequality. Int. J. Environ. Res. Public Health 2019, 16, 1804

by Christina M. Pollard and Sue Booth

Int. J. Environ. Res. Public Health 2020, 17(7), 2343; https://doi.org/10.3390/ijerph17072343 - 30 Mar 2020

Cited by 9 | Viewed by 2547

Abstract

The authors wish to make the following correction to their paper published in the International Journal of Environmental Research and Public Health [...] Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

13 pages, 698 KiB

Open AccessCommentary

Food Insecurity and Hunger in Rich Countries—It Is Time for Action against Inequality

by Christina M Pollard and Sue Booth

Int. J. Environ. Res. Public Health 2019, 16(10), 1804; https://doi.org/10.3390/ijerph16101804 - 21 May 2019

Cited by 150 | Viewed by 30392 | Correction

Abstract

Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches [...] Read more.

Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches have the potential to address the structural causes, not just the symptoms of food insecurity. Despite most developed countries ratifying the Covenant on Economic, Social and Cultural Rights over 40 years ago, food insecurity rates suggest current social protections are inadequate. The contemporary framing of the solution to food insecurity in developed countries is that of diverting food waste to the hungry to meet the United Nations Sustainable Development Goals agenda (Goals 2 and 12.3). An estimated 60 million people or 7.2% of the population in high income countries used food banks in 2013. Although providing food assistance to those who are hungry is an important strategy, the current focus distracts attention away from the ineffectiveness of government policies in addressing the social determinants of food insecurity. Much of the action needed to improve household food security falls to actors outside the health sector. There is evidence of promising actions to address the social determinants of food insecurity in some developed countries. Learning from these, there is a strong case for government leadership, for action within and across government, and effective engagement with other sectors to deliver a coordinated, collaborative, and cooperative response to finding pathways out of food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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16 pages, 294 KiB

Open AccessCommentary

Re-Evaluating Expertise: Principles for Food and Nutrition Security Research, Advocacy and Solutions in High-Income Countries

by Danielle Gallegos and Mariana M. Chilton

Int. J. Environ. Res. Public Health 2019, 16(4), 561; https://doi.org/10.3390/ijerph16040561 - 15 Feb 2019

Cited by 18 | Viewed by 5964

Abstract

Drawing on examples from Australia and the United States, we outline the benefits of sharing expertise to identify new approaches to food and nutrition security. While there are many challenges to sharing expertise such as discrimination, academic expectations, siloed thinking, and cultural differences, [...] Read more.

Drawing on examples from Australia and the United States, we outline the benefits of sharing expertise to identify new approaches to food and nutrition security. While there are many challenges to sharing expertise such as discrimination, academic expectations, siloed thinking, and cultural differences, we identify principles and values that can help food insecurity researchers to improve solutions. These principles are critical consciousness, undoing white privilege, adopting a rights framework, and engaging in co-creation processes. These changes demand a commitment to the following values: acceptance of multiple knowledges, caring relationships, humility, empathy, reciprocity, trust, transparency, accountability, and courage. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

9 pages, 303 KiB

Open AccessProtocol

Protocol for the Development of a Food Stress Index to Identify Households Most at Risk of Food Insecurity in Western Australia

by Timothy J. Landrigan, Deborah A. Kerr, Satvinder S. Dhaliwal and Christina M. Pollard

Int. J. Environ. Res. Public Health 2019, 16(1), 79; https://doi.org/10.3390/ijerph16010079 - 29 Dec 2018

Cited by 18 | Viewed by 5329

Abstract

Food stress, a similar concept to housing stress, occurs when a household needs to spend more than 25% of their disposable income on food. Households at risk of food stress are vulnerable to food insecurity as a result of inadequate income. A Food [...] Read more.

Food stress, a similar concept to housing stress, occurs when a household needs to spend more than 25% of their disposable income on food. Households at risk of food stress are vulnerable to food insecurity as a result of inadequate income. A Food Stress Index (FSI) identifies at-risk households, in a particular geographic area, using a range of variables to create a single indicator. Candidate variables were identified using a multi-dimensional framework consisting of household demographics, household income, household expenses, financial stress indicators, food security, food affordability and food availability. The candidate variables were expressed as proportions, of either persons or households, in a geographic area. Principal Component Analysis was used to determine the final variables which resulted in a final set of weighted raw scores. These scores were then scaled to produce the index scores for the Food Stress Index for Western Australia. The results were compared with the Australian Bureau of Statistics’ Socio-Economic Indexes for Areas to determine suitability. The Food Stress Index was found to be a suitable indicator of the relative risk of food stress in Western Australian households. The FSI adds specificity to indices of relative disadvantage specifically related to food insecurity and provides a useful tool for prioritising policy and other responses to this important public health issue. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

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