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.
Objective
Weight‐biased attitudes and views held by health care professionals can have a negative impact on the patient‐provider relationship and the provision of care, but studies have found mixed ...results about the extent and nature of bias, which warrants a review of the evidence.
Methods
A systematic review and random‐effects meta‐analysis were conducted by including studies up to January 12, 2021.
Results
A total of 41 studies met inclusion criteria, with 17 studies providing sufficient data to be meta‐analyzed. A moderate pooled effect (standardized mean difference = 0.66; 95% CI: 0.37‐0.96) showed that health care professionals demonstrate implicit weight bias. Health care professionals also report explicit weight bias on the Fat Phobia Scale, Antifat Attitudes Scale, and Attitudes Towards Obese Persons Scale. Findings show that medical doctors, nurses, dietitians, psychologists, physiotherapists, occupational therapists, speech pathologists, podiatrists, and exercise physiologists hold implicit and/or explicit weight‐biased attitudes toward people with obesity. A total of 27 different outcomes were used to measure weight bias, and the overall quality of evidence was rated as very low.
Conclusions
Future research needs to adopt more robust research methods to improve the assessment of weight bias and to inform future interventions to address weight bias among health care professionals.
Abstract
Objective
This review aims to synthesize the literature describing policy approaches to nutrition-focused food banking in industrialized countries, spanning the period 2000 to October 2021.
...Background
The charitable food system provides food assistance to increasing numbers of people experiencing food insecurity in industrialized countries. Calls to improve the nutrition quality of foods provided by foods banks, pantries, and shelves have increased, yet little is known about the challenges faced when initiating policy in this setting.
Methods
A protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Guidelines was developed and registered with Open Science Framework. Four electronic databases (MEDLINE Ovid, Global Health, ProQuest, and Scopus) were searched for peer-reviewed articles published in English. A gray literature search was conducted using Google Advanced Search.
Results
Of 642 peer-reviewed articles screened, 15 were eligible for inclusion. In addition, 24 gray literature documents were included. These 39 papers were assessed against the Iron Triangle of Hunger Relief and the Campbell et al framework of organizational factors. Six themes were identified: (1) there is a moral imperative to take action to ensure the provision of appropriate and nutritious food for vulnerable clients; (2) nutrition policies are unlikely to be formalized; (3) the unpredictability of donated food is a barrier to providing healthy foods; (4) reliance on donations affects the sector’s willingness to reduce the unhealthy inventory for fear of losing donors, and the challenges of managing donor relationships were emphasized; (5) organizational capacity (volunteer workforce, executive leadership support) must be considered; (6) the existing measure of success is a weight-based metric that does not support food banks’ prioritizing of healthy foods. These, and other characteristics, were incorporated into an adapted framework.
Conclusion
There is a need and opportunity for nutrition-focused food banking. A priority action area is the adoption of an outcome metric that is based on nutritional quality, to reorient the charitable food system.
It is widely understood that households with low economic resources and poor labourmarket attachment are at considerable risk of food insecurity in Australia. However, little is knownabout variations ...in food insecurity by receipt of specific classes of social assistance payments thatare made through the social security system. Using newly released data from the 2016 HouseholdExpenditure Survey, this paper reports on variations in food insecurity prevalence across a range ofpayment types. We further investigated measures of financial wellbeing reported by food-insecurehouseholds in receipt of social assistance payments. Results showed that individuals in receiptof 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 foodinsecurity compared to those in receipt of the Age Pension (<1%) or no payment at all (1.3%). Resultsfurther indicated that food-insecure households in receipt of social assistance payments enduredsignificant 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
This study addresses a critical knowledge gap by exploring the intricate relationship between low birth weight (LBW) and the heightened risk of suboptimal academic achievement during adolescence ...through a comprehensive retrospective cohort design.
In this registry-based cohort study, meticulously linked health and curriculum-based test data for individuals born in New South Wales (NSW), Australia, between 2003 and 2005 were employed. Birth weight data were carefully sourced from the NSW perinatal data collection (PDC). The educational performance of offspring was thoroughly evaluated using the National Assessment Program for Literacy and Numeracy (NAPLAN) during grade 9, approximately at 14 years of age.
After rigorous adjustments for potential confounders, findings revealed a compelling narrative: LBW adolescents demonstrated an elevated susceptibility to not meeting national minimum standards across all domains, encompassing spelling OR, 1.59 (95%CI 1.48–1.69), writing OR, 1.51 (95%CI 1.41–1.61), reading OR, 1.38 (95%CI 1.29–1.48), and numeracy OR, 1.52 (95%CI 1.40–1.63). Notably, LBW boys exhibited a more pronounced inclination towards diminished academic performance compared to their female counterparts.
This comprehensive retrospective cohort study, based on linked data, unequivocally establishes LBW as significantly associated with an increased vulnerability to substandard educational achievement during adolescence. Particularly robust effects were observed in females across all outcomes. Aimed at investigating whether LBW serves as a predictive factor for later academic difficulties, this study underscores the imperative for the adoption and fortification of preventative and early intervention strategies to curtail the prevalence of LBW-associated academic underachievement in later adolescence.
•Limited information exists on LBWs influence on adolescent academic performance.•LBW linked to heightened risk of decreased academic achievements during adolescence.•LBW impact on the academic performance varies, more pronounced in boys.•Vital to implement early intervention strategies to improve educational performance in LBW-exposed offspring.
Identify and assess publicly available local government sponsorship and signage policies related to harmful products in Western Australia (WA).
An audit of WA Local Government Authority (LGAs) ...websites (n=139) was conducted. Sponsorship, signage, venue hire and community grants’ policies were located and assessed against set criterion. Policies were scored for the inclusion of statements regarding the display and promotion of harmful commodities (alcohol, tobacco, gambling products, unhealthy food and beverages).
Across WA local governments, 477 relevant policies were identified. Six percent (n=28) included statements restricting the promotion of at least one harmful commodity via sponsorships, signage, venue hire, and sporting and/or community grants policy. Twenty-three local governments had at least one policy that restricted unhealthy signage or sponsorship.
Most WA local governments do not have publicly available policies that specifically limit the advertising and promotion of harmful commodities in their government-owned facilities.
There is a dearth of research identifying LGA interventions addressing advertising of harmful commodities within council-owned sporting venues. This research indicates opportunities for West Australian LGAs to develop and implement policy to protect public health by restricting the promotion of harmful commodities to their communities, improving the healthfulness of environments.
The aim of this year-long mixed methods research was to examine the intersection between health, health literacy and local government to identify ways to better connect people to place-based primary ...health care (PHC).
Four local government areas located within the Perth metropolitan geographic area provided the setting for the current research. Researchers were co-located into the four local governments over a 10-month period to engage with community stakeholders and services. Two methodologies were used to achieve the objective: eight group model building (GMB) workshops were conducted with N = 148 participants to create causal loop diagrams of the barriers and enablers to people being healthy and well in each of the LGAs and develop potential action ideas from these. Surveys were used to collect health service use and health literacy, as measured using a validated Health Literacy Questionnaire (HLQ), across the four LGAs (N = 409, approximately 100 respondents/area).
The causal loop diagram themes common across LGAs included: (1) mental health; (2) access to services; (3) health system capacity; (4) economics; and (5) physical wellbeing. Health literacy was relatively high for all nine domains of the HLQ. In the five domains rated from one to four the lowest score was 2.8 for 'appraisal of information' and the highest was 3.2 for 'feeling understood and supported by healthcare providers'. In the four domains rated from one to five; the lowest score was 3.7 for 'navigating the healthcare system' and the highest was 4.1 for 'understand health information well enough to know what to do'. Prioritised action ideas recommended increases in practitioners to meet local needs and training General Practitioners and other health staff in culturally sensitive and trauma informed health care. The survey findings and field notes from the GMB were used to construct personas embodied in vignettes highlighting general themes identified in the workshops including those relevant to local areas.
There are many possibilities for health care and local governments to work together to bring services to community members disengaged from the health system. Bringing together people from diverse backgrounds and organisations created synergies that resulted in novel and feasible potential strategies to improve community health.
University students have been identified as a population sub-group vulnerable to food insecurity. This vulnerability increased in 2020 due to the COVID-19 pandemic. This study aimed to assess factors ...associated with food insecurity among university students and the differences between students with and without children. A cross-sectional survey of (n = 213) students attending one university in Western Australia measured food insecurity, psychological distress, and socio-demographic characteristics. Logistic regression analyses were conducted to identify factors associated with food insecurity. Forty-eight percent of students who responded to the survey had experienced food insecurity in 2020. International students who were studying in Australia were nine times more likely to experience food insecurity than domestic students (AOR = 9.13; 95% CI = 2.32-35.97). International students with children were more likely to experience food insecurity than international students without children (
< 0.001) and domestic students with (
< 0.001) or without children (
< 0.001). For each unit increase in depression level, the likelihood of experiencing food insecurity increased (AOR = 1.62; 95% CI = 1.12-2.33). Findings show a higher prevalence of food insecurity among international university students and students with children during the COVID-19 pandemic and that food insecurity was associated with higher levels of psychological distress. These findings highlight the need for targeted interventions to mitigate the risk of food insecurity among Australian university students, particularly among international students, students with children, and those experiencing psychological distress.
Food insecurity is associated with reduced physical, social, and psychological functioning in children. There has been sparse research into child food insecurity that incorporates children's own ...perspectives, as adults are often interviewed as child proxies. While a nuanced, child-centred understanding of food insecurity is needed to inform effective policy and program responses, little is known about Australian children's firsthand understanding or experience of household food insecurity. This study aimed to fill this gap by inviting preadolescent children's perspectives. Eleven participants aged 10-13 years (seven girls and four boys) took part in the study and were recruited from an Australian charity school holiday camp that targets severely disadvantaged youth. Children took part in individual semi-structured interviews that incorporated drawings and emoji scales. Qualitative interviews were audio recorded, transcribed, and analysed using thematic techniques. Four themes emerged from the data analysis, children had: (i) financial understanding; (ii) awareness of food insecurity and coping mechanisms; (iii) sharing, empathy, and compassion for food insecure families; and (iv) described the nature of 'food' preparation. This study provides a child-centric analysis, demonstrating how children's agency is enacted and constrained in food insecure contexts. This child-derived understanding of food insecurity provides a critical basis from which to build effective approaches to assess and respond to this significant social issue.
•Food safety laws regulate food businesses, but in most developed countries they do not regulate the charitable food system.•Ninety-six percent of food donated to an Australian food bank was safe for ...consumption, with supermarkets responsible for 38% of donations.•Four percent of all donated food posed an unacceptable health risk to clients, with supermarkets donating 90% of these unsafe and unsuitable foods.•Given the health vulnerabilities of people accessing food banks and supermarkets’ corporate social responsibility commitments, supermarkets must ensure the safety and suitability of all food donations.•A specific food safety regulatory framework for donated food in Australia is needed to ensure the donation of safe and appropriate food for vulnerable clients experiencing food insecurity.
Food banks play a vital role in addressing the needs of people experiencing food insecurity. Food banks rely on the food industry, particularly supermarkets, for food donations, and on voluntary labor to scrutinize and sort donations for quality and safety. Currently, national food safety laws and policies in Australia regulate food businesses, but do not specifically apply to donations. There are reports of expired, spoiled, and rotten food donations and clients express dissatisfaction with the quality and safety of food provided. This study describes a novel approach to visually identify and assess the safety and quality of food donations at an Australian food bank. Data from an audit of donations to a metropolitan food bank were analyzed. Food safety assessment criterion were developed based on food safety standards and applied to 1217 items (84,996 kg) of donated food. Each product was visually inspected and assessed as ‘safe’, ‘unsuitable’, ‘potentially unsafe’, or ‘unsafe for human consumption’ upon receival. Of the 84,996 kg of donated food, 96 % was categorized as satisfactory and 4 % (3761 kg) was categorized as either unsafe (2024 kg), potentially unsafe (1313 kg) or unsuitable (424 kg) for consumption. Supermarket donations comprised 90 % (by weight) of the unsafe and unsuitable food. The overall proportion of visually unsafe and unsuitable foods was low, but consumption of any unsafe, hazardous and/or damaged products poses a risk to the consumer. Given the vulnerability of clients receiving this food, the public health risk is high. The management of potential risk is problematic too as multiple decisions to determine appropriateness for distribution, places demands on food banks and hampers efficiency. The findings underscore the clear need for a specific food safety regulatory framework for donated food in Australia.
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