Search Results (596)

South Africa has implemented an extensive social grant system to improve the wellbeing of vulnerable households. However, evidence remains limited regarding the pathways through which social grants are associated with household food insecurity and whether these relationships vary across geographical contexts of South Africa. Understanding these mechanisms is essential for designing more effective and spatially targeted social protection policies. This study examined the relationship between social grant receipt and household food insecurity, hypothesizing that household income serves as the principal pathway linking social grants to food insecurity. This study used nationally representative data from the 2024 General Household Survey. A latent food insecurity index was constructed using a two-parameter logistic Item Response Theory model, and a moderated-mediation structural equation model was employed to decompose the association between social grant receipt and food insecurity into direct and indirect components while accounting for geographic heterogeneity. The results indicate that social grants are strongly targeted toward households with higher levels of food insecurity and lower incomes, confirming that grant recipients are among the most vulnerable households in South Africa. Household income was negatively associated with food insecurity and mediated 55.4% of the total association between social grant receipt and household food insecurity. This underscores income as the main transmission pathway. High geographic heterogeneity was observed. The indirect income-mediated association was strongest in commercial farming areas, followed by urban and rural areas administered by local leaders. The direct association was significant in urban and rural areas administered by local leaders. These results show that the effectiveness of income transfers depends on the household’s demographic and socioeconomic conditions. The findings suggest that although social grants play an important role in reducing household vulnerability, cash support alone is insufficient to address household food insecurity among disadvantaged households in South Africa. Therefore, strengthening income support provided through social grants should be complemented by location-specific interventions that expand employment opportunities, improve market access, promote productive asset accumulation, and strengthen local food systems, particularly in rural areas where constraints continue to limit household food security. Full article

Background/Objectives: Household food insecurity (FI) impacts child health and development. Children have distinct and unique experiences of FI, and child self-report measures are increasingly used. However, there is limited reporting of children’s comprehension and engagement with these measures within local settings. The Child Food Insecurity Experiences Scale (CFIES) is a 10-item child self-report tool that is widely used, despite limited validity evidence. This study aimed to explore the face and content validity of the CFIES in an Australian context. Methods: We used cognitive interviews with 25 children aged 8–12 years to document CFIES comprehension. Data were analyzed using inductive and deductive approaches. Results: Children demonstrated awareness of FI (even when food secure themselves) and displayed sophisticated understanding of its social ramifications. While the overall perception of the tool was generally positive, we uncovered that not all key terms or emotion words were universally understood, potentially impacting validity. Similarly, conditional clauses or question modifiers were sometimes overlooked. In addition, the 12-month response timeframe and the answering categories (“many times”, “one or two times” or “never”) proved challenging for some children. In addition to the item-specific impressions, children provided nuanced ideation across four broader themes, which may impact item interpretation and willingness to answer: perceptions of hunger; micro and macroeconomics affecting households; social identity and comparison; and caregiver protection dynamics. Children indicated the need to consider survey modality and ensure privacy. Conclusions: A global tool that reflects children’s cross-cultural conceptualization of FI represents a pragmatic and feasible way to monitor change in FI across regions and may aid advocacy efforts. However, this study suggests the need for further modifications to the CFIES and the necessity to build rapport with communities and organizations that allow for the interpretation of the data within the contextual considerations. Full article

Background: Food insecurity and water insecurity are increasingly recognized as interconnected social determinants of health; however, their co-occurrence remains underexplored in U.S. populations. SNAP households with children experience a high prevalence of both food and water insecurity. This study estimated the prevalence of food insecurity and water insecurity and examined their co-occurrence among SNAP households with children in the Southern U.S. Methods: A cross-sectional, web-based survey was conducted among 683 SNAP participants residing in households with children. Food insecurity was assessed using the 10-item USDA Adult Food Security Survey Module, and water insecurity was measured using the Household Water Insecurity Experiences (HWISE) scale. Descriptive statistics estimated prevalence, and regression analyses assessed associations. Results: Food insecurity (75.1%) and water insecurity (53.9%) were highly prevalent among surveyed SNAP households with children. Nearly half of households (48.6%) experienced both conditions, while 19.6% were secure in both. Food insecurity alone was reported by 26.5% of households, and water insecurity alone by 5.3%. Higher food insecurity scores were associated with increased odds of water insecurity (AOR = 1.33, 95% CI: 1.26–1.40, p < 0.001). Conclusions: Food insecurity and water insecurity frequently co-occur among SNAP households with children. Integrated public health strategies addressing both food and water access are needed to reduce disparities and improve household well-being. Full article

Background: Food insecurity remains a major public health challenge in many low- and middle-income countries, where environmental and socioeconomic conditions influence household access to adequate, safe, and nutritious food. Objectives: This study aimed to evaluate the associations between environmental and socioeconomic factors and household food security in Riobamba, Ecuador. Methods: A cross-sectional survey was conducted among 382 households using the Latin American and Caribbean Food Security Scale (ELCSA), complemented by structured and Likert-scale questions addressing agricultural production practices, food handling, waste management, and food choice and dietary diversity. Household food security status was classified according to the standard ELCSA scoring procedure and subsequently grouped into categories representing adequate or inadequate household food access and consumption. Binary Logit and Probit models were estimated to identify factors associated with household food security. Results: The Probit model showed slightly better predictive performance (classification accuracy = 73.56%; Pseudo R² = 0.2729; LR χ² = 143.94; p < 0.01). Household income was the strongest predictor of food security status (Logit coefficient = 1.1977; p < 0.01). Among the environmental variables, agricultural production practices (β = 0.8649; p < 0.01), food handling practices (β = 0.3714; p < 0.05), and food choice and dietary diversity (β = 0.6479; p < 0.01) were positively associated with adequate household food access and consumption, whereas waste management practices were not significantly associated. Household size and gender were also significantly associated with food security outcomes. Conclusions: These findings indicate that household food security in urban Ecuadorian settings is associated with both environmental and socioeconomic conditions. Policies promoting sustainable agricultural practices, safe food handling, dietary diversity, and socioeconomic well-being may contribute to strengthening household food security and nutrition. Full article

This paper examines the vulnerability and adaptive capacity of mountain communities in South and Central Asia, with specific reference to the Himalayas and the Central Asian highlands. Using a comparative framework, the study combines the Livelihood Vulnerability Index (LVI), LVI-IPCC, and the Livelihood Equity/Endowment Index (LEI) to measure multidimensional vulnerability. A mixed-methods approach combining household surveys and qualitative field evidence is used to analyze primary data from 600 households across four mountain regions: Leh (India), Sindhupalchok (Nepal), Batken (Kyrgyzstan), and Urgut (Uzbekistan). The results show that vulnerability is not explained only by climatic exposure; it is also associated with socio-economic conditions, institutional access, and livelihood assets. Leh and Sindhupalchok show higher vulnerability associated with water insecurity, food dependence, weak infrastructure, and climate variability, whereas Batken’s vulnerability is mainly linked to limited adaptive capacity. Urgut shows greater resilience associated with stronger adaptive capacity, despite persistent structural inequalities. The paper identifies financial access, social networks, and knowledge systems as important factors in strengthening resilience. It concludes that context-specific, inclusive, and asset-based policy interventions may help strengthen adaptive capacity and reduce vulnerability in fragile mountain ecosystems. Full article

Background: Child malnutrition is a major public health problem worldwide, but the pathways through which socioeconomic status (SES) affects nutritional outcomes differ markedly between economic and welfare regimes. Differentiating whether these impacts are direct or through behavioural and structural factors is key to focused policy intervention. Objective: This study aimed to investigate the effects of socioeconomic inequalities, maternal knowledge and feeding practices, and food insecurity on preschool undernutrition in Hungary and Indonesia. Methods: The study employs a cross-national comparative design. Respondents were households with children 36 to 59 months old; the sample comprised 128 households in Budapest, Hungary and 535 households in Surabaya, Indonesia. The instruments were designed to fit within a survey for data collection. Data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) with Multi-Group Analysis (MGA). Results: In Hungary, SES and food insecurity are positively associated with malnutrition, whereas in Indonesia, SES and biological factors drive malnutrition. Intermediate factors such as maternal feeding practices (Hungary) and health coverage (Indonesia) did not directly affect malnutrition. Although the model identified significant socioeconomic pathways, its very low explanatory and predictive power for child malnutrition in both urban Hungary (R² = 0.024) and Indonesia (R² = 0.062), and the predictive relevance (Q² Hungary: −0.009); (Q² Indonesia: 0.016), which remained close to zero or negative, indicate that these variables only partially capture the complex, multifactorial mechanisms driving nutritional status. Conclusions: These findings indicate that a more targeted approach to food insecurity and behavioural screening within the Hungarian welfare system would be necessary to address malnutrition effectively. Findings in Indonesia underline the potential benefits of prioritising equity in health coverage and income support. Full article

Background/Objectives: Food insecurity remains a major public health challenge in Guamote Canton, Ecuador, particularly in areas characterized by high levels of poverty and limited educational attainment. This study examined the association between household income, educational level, and food insecurity in Guamote Canton. Methods: A cross-sectional survey based on the Latin American and Caribbean Food Security Scale (ELCSA) was administered to 368 households, allowing food insecurity to be classified into four categories: food security, mild insecurity, moderate insecurity, and severe insecurity. An Ordinal Logistic model was applied to identify the socioeconomic factors associated with food insecurity. Results: The results showed that household income and educational level were significantly associated with lower probabilities of food insecurity (β = −0.639, p = 0.001; β = −0.366, p = 0.008, respectively). Gender, Area of residence, and Access to nutrition information were also significantly associated with food insecurity. Conclusions: Households located in rural areas and those headed by women were more likely to experience moderate or severe food insecurity. Overall, the findings highlight the importance of improving income opportunities, educational attainment, and structural living conditions, which may contribute to lower levels of food insecurity. Full article

Background/Objectives: Many individuals facing food insecurity make tradeoff decisions between spending money on food or other basic needs. In addition, many engage in coping strategies to stretch food budgets or make food last longer. There is limited data on how participation in food assistance programs is associated with use of tradeoffs or coping strategies among households experiencing food insecurity. Methods: A secondary analysis of 2021, 2022 and 2023 cross-sectional state-wide survey on food access, including questions on use of tradeoffs and coping mechanisms, and participation in food assistance programs (Special Supplemental Nutrition Program for Women, Infants, and Children, Supplemental Nutrition Assistance Program, school meals or food pantries). Prevalences of tradeoffs and coping strategies by food assistance use were determined. Multivariable logistic regression models determined odds of tradeoffs and coping strategies reported by food-insecure households. Results: Overall, 85% of respondents reported making any tradeoffs and 90% reported any coping strategy use in the prior year. Any food assistance program participation was associated with higher prevalences of making any tradeoff compared to not participating in food assistance programs (89% vs. 78%, p < 0.001) and a higher prevalence of engaging in any coping strategy (92% vs. 84%, p < 0.001). Food assistance participation was associated with increased odds of making any tradeoff (OR 1.82 95% CI 1.39, 2.39) or any coping strategy (1.85, 95% CI 1.22, 2.80). Conclusions: Meeting food assistance program income eligibility requirements is likely a marker of poverty that extends beyond food insecurity. Food assistance is necessary but insufficient to meet family needs. Full article

Background/Objective: Parental feeding practices play an important role in shaping children’s dietary intake, eating behaviours, and long-term health outcomes. Although several questionnaires assess feeding practices, few have been validated among socioeconomically disadvantaged populations, despite these groups being disproportionately affected by food insecurity and diet-related health inequities. This study assessed the structural validity and internal consistency of the Feeding Practices and Structure Questionnaire—Solid Feeding version (FPSQ-S)—among socioeconomically disadvantaged mothers and fathers of young children. Methods: Two cross-sectional online surveys were conducted with 178 mothers and 94 fathers of children aged 5–35 months living in disadvantaged households. Confirmatory factor analysis was used to examine the structural validity of the FPSQ-S. Internal consistency was assessed using Cronbach’s alpha and Hancock’s H coefficients. Results: The original six-factor FPSQ-S structure was retained and demonstrated acceptable overall model fit in this disadvantaged sample (CFI = 0.846, TLI = 0.821, RMSEA = 0.070). Internal consistency ranged from acceptable to excellent across subscales (Cronbach’s α = 0.63–0.93; Hancock’s H = 0.64–0.93). Most items loaded satisfactorily onto their intended constructs; however, two items within the Feeding on Demand construct demonstrated weak factor loadings, and this construct showed lower reliability than the remaining subscales Conclusions: This is the first study to evaluate the FPSQ-S among socioeconomically disadvantaged mothers and fathers of children aged 5–35 months. The FPSQ-S demonstrated acceptable structural validity and reliability. While the six-factor structure was largely supported, further refinement of the Feeding on Demand construct and additional psychometric evaluation are warranted. Full article

Background/Objective: Achievement of Sustainable Development Goals SDG 2 (child nutrition) depends upon SDG 6 (water insecurity) and SDG 13 (climate action) in multiple ways. However, the current climate–nutrition literature mostly considers water’s effects on nutrition through agriculture and food production. Here, we identify the climate’s impact on child nutrition through its effect on both household food and water security and on their interaction across varying environmental contexts. Methods: Using nationally representative data from India, we estimate the climate’s direct association with household water access (time spent fetching water), and both direct and indirect association with household food security (women’s dietary diversity), and child’s dietary diversity and nutrition (HAZ score). Data from 42,567 women and 39,667 children (6–23 months) are analyzed using linear regression and structural equation modeling. Results: A unit increase in rainfall is linked to an 18 percent decrease in time to water and an 8.3 percent increase in women’s dietary diversity score. A temperature increase is associated with an increase in time to water and decreased women’s dietary diversity. Time to water mediates the association of temperature and rainfall with women’s dietary diversity, child’s dietary diversity and child’s HAZ score. Households in regions of higher water availability are associated with increased dietary diversity, increased HAZ, and decreased time to water; however, the interaction between climate and regional water availability shows varying effects. Conclusions: Climate is associated with household food and water security, which together mediate its association with nutrition. These findings call for broadening the climate action framework to explicitly recognize the multidimensional linkages between SDG 6 and SDG 2. Full article

Female empowerment in post-conflict rural contexts is strategic for food security and socioeconomic resilience. This study analyzed the relationship between women’s productive empowerment and food security in 40 rural women involved in pig production in Santa Rosa del Sur, Bolívar, Colombia. A mixed approach with a descriptive–exploratory design and longitudinal scope was used. Data collection employed adapted versions of the Women’s Empowerment in Agriculture Index (A-WEAgI) and the Household Food Insecurity Access Scale (HFIAS), alongside participant observation and reflective thematic analysis. Quantitative data were analyzed via descriptive statistics and Spearman correlation. The baseline revealed low empowerment regarding income, resources, technical capacities, and time. The global A-WEAgI reached 21%, while HFIAS showed moderate food insecurity in 52% of households. Spearman analysis (CS) indicated moderate negative correlations between food insecurity and income (CS = −0.56), access to resources (CS = −0.51), and technical capacities (CS = −0.49), suggesting that greater women´s empowerment was associates with lower food insecurity. Post-intervention, improvements occurred in technical skills, leadership, and organizational participation. Qualitative findings showed increased confidence in Agroindustry activities, though limitations in economic autonomy, commercialization, and domestic workloads persisted. Gender-focused rural strategies enhance productive capacities and food resilience; however, structural barriers related to economic autonomy and gender inequality persist. Full article

Background: Early childhood nutrition is strongly associated with neurodevelopmental outcomes, particularly in socially vulnerable settings. Limited evidence is available describing the relationship between nutritional status, food security, and neurodevelopment among preschool children in low-income urban areas of Colombia. This study aimed to evaluate nutritional status, household food insecurity, and neurodevelopmental outcomes in children attending early childhood centers in El Codito, Bogotá, and to explore the association between anthropometric indicators and neurodevelopmental performance. Methods: A cross-sectional study was conducted in children enrolled in community childcare centers. Nutritional status was assessed using anthropometric indicators according to World Health Organization growth standards, including weight for age, height for age, and body mass index for age. Neurodevelopment was evaluated using the Escala Abreviada de Desarrollo (EAD). Household food insecurity was measured through a validated questionnaire. Descriptive statistics were performed, and associations between variables were analyzed using correlation tests and group comparisons according to data distribution. Results: Most participants presented adequate nutritional status; however, a proportion of children showed risk of stunting or excess weight. Neurodevelopmental scores were generally within expected ranges, although variability was observed across developmental domains. Significant associations were identified between certain anthropometric indicators and neurodevelopmental outcomes. Moderate to severe household food insecurity was identified in 21.4% of participating households. Conclusions: Nutritional status and household food insecurity represent important contextual factors for child health in vulnerable urban populations. These findings highlight the importance of integrated nutritional and developmental monitoring strategies within early childhood programs. Further longitudinal studies are required to clarify causal pathways and to guide targeted public health interventions in similar contexts. Full article

Background/Objectives: Household food insecurity is a modifiable social determinant of health with important implications for diet quality and health outcomes. Dietitians are well positioned to identify and respond to food insecurity; however, little is known about how this is addressed in routine dietetic practice across Europe. This exploratory study examined food insecurity screening and response practices among dietitians practicing in Europe and examined associated correlates using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B). Methods: An online cross-sectional survey informed by the COM-B framework was distributed through the European Federation of Associations of Dietitians’ institutional communication channels between February and June 2024. Participants were recruited using a voluntary, convenience-based sampling strategy through professional networks and social media dissemination. A total of 148 dietitians practicing in European countries responded. The questionnaire assessed routine food insecurity screening practices, COM-B correlates, perceived barriers, actions taken following identification, and learning needs. Quantitative data were analysed descriptively, and open-ended responses were used illustratively to contextualise reported practices. Results: Food insecurity screening was not systematically embedded in routine dietetic practice, with 11.6% of respondents reporting routine screening and 30.2% not asking about food insecurity. Identification of food insecurity did not consistently translate into follow-up action, and responses were predominantly referral-based rather than involving direct material support. While capability and motivation to address food insecurity were generally high, opportunity-related factors—such as time constraints, limited organisational support, and unclear referral pathways—emerged as the main barriers shaping professional behaviour. Substantial heterogeneity was observed across practice settings. Conclusions: In this sample of dietitians practicing in Europe, food insecurity screening and response were variable and often constrained by organisational and contextual factors. These findings highlight the need for system-level support and practice-oriented training to facilitate the integration of food insecurity into routine dietetic care. Full article

Background/Objectives: Excess weight and dyslipidemia are health conditions growing worldwide in children, including indigenous populations. The concern is their related comorbidities, which could appear at an early age. Given limited information on Seri children, this study aimed to evaluate the prevalence of excess weight and dyslipidemia, and to identify factors associated with BMI-for-age Z-score and dyslipidemia. Methods: This cross-sectional study was conducted among Seri children aged 3–11 years. For prevalence analysis, the BMI-for-age Z-score was calculated as an indicator of excess weight. Dyslipidemia was assessed only in school-age children. Information was collected on potential associated variables, including maternal nutritional status, children’s sleep behaviors, physical activity, diet, and cardiovascular health, as well as household characteristics such as the modernity index and food insecurity. Results: A total of 154 Seri children were evaluated. Among preschoolers, 18.8% were classified at risk of overweight. In school-age children, the combined prevalence of overweight and obesity was 32.8%. Maternal BMI and weight, the modernity index, and being a boy were positively associated with the BMI-for-age Z-score, whereas having food insecurity, cardiovascular health score, and sleep time were negatively associated. Dyslipidemia prevalence was 46.1% among school-age Seri children. Having dyslipidemia was positively associated with maternal BMI, percentage of energy intake from ultra-processed products, paternal occupation as a merchant, and child age, and negatively associated with the number of remunerative maternal economic activities. Conclusions: These findings provide evidence on the prevalence of excess weight and dyslipidemia and their associated factors among Seri children and may inform future research and health strategies in Seri and other vulnerable populations. Full article

Background: Household food insecurity (HFI), defined as the lack of reliable access to adequate food because of limited money or resources, may influence children’s nutritional status. This study aimed to examine the association between HFI risk, based on a single screening item, and underweight and obesity among kindergarten children in Nevada. Methods: Cross-sectional data from the Kindergarten Health Survey (KHS) collected across three school years (2022–2023, 2023–2024, and 2024–2025) were analyzed using a pooled sample of 7267 children. HFI risk was assessed using one item from the Hunger Vital Sign. Weight status was determined using Body Mass Index (BMI) guidelines from the Centers for Disease Control and Prevention (CDC). Descriptive statistics and multinomial logistic regression examined associations between HFI risk and underweight and obesity, adjusting for confounders. Results: Across the pooled sample, 16.3% were at risk for HFI, 16.0% were underweight, and 21.9% had obesity. In pooled analysis, HFI risk was associated with higher odds of obesity (Adjusted Odds Ratio [AOR] 1.29; 95% Confidence Interval [CI]: 1.05–1.59), but not underweight, compared with food-secure children. In year-specific analyses, higher odds of underweight were observed in 2023–2024 (AOR 1.74; 95% CI: 1.14–2.66) and 2024–2025 (AOR 1.58; 95% CI: 1.04–2.38). Conclusions: HFI risk was associated with obesity among kindergarten children in Nevada, while associations with underweight were observed only in certain school years and should be interpreted cautiously. These findings suggest HFI risk as an important early childhood health concern and support the need for nutrition support, family assistance, and longitudinal research. Full article