Predictors of chronic food insecurity among adolescents in Southwest Ethiopia: a longitudinal study

BMC Public Health

Patrick Kolsteren²  Lieven Huybregts²  Carl Lachat²  Megan Klein Hattori⁴  Challi Jira¹  Abebe Gebremariam³  David Lindstrom⁴  Tefera Belachew⁵ 

[1] Department of Health Planning and Health Services Management, College of Public Health and Medical Sciences, Jimma University, PO.Box:378, Jimma, Ethiopia;Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium;Department of Population and Family Health, College of Public Health and Medical Sciences, Jimma University, PO.Box:1104, Jimma, Ethiopia;Department of Sociology, Brown University, Box 1916, Providence, RI, 02912, USA;Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, B- 9000 Ghent, Belgium

关键词: Longitudinal;    Ethiopia;    Buffering;    Adolescent;    Chronic food insecurity;   

Others  :  1163371
DOI  :  10.1186/1471-2458-12-604

 received in 2011-12-17, accepted in 2012-07-17,  发布年份 2012

【 摘 要 】

Background

Evidence on the differential impacts of the global food crisis as it translates into chronic food insecurity locally is essential to design food security interventions targeting the most vulnerable population groups. There are no studies on the extent of chronic food insecurity or its predictors among adolescents in developing countries. In the context of increased food prices in Ethiopia, we hypothesized that adolescents in low income urban households are more likely to suffer from chronic food insecurity than those in the rural areas who may have direct access to agricultural products.

Methods

This report is based on data from the first two rounds of the Jimma Longitudinal Family Survey of Youth (JLFSY). Both adolescents and households were selected using a stratified random sampling method. A total of 1911 adolescents aged 13-17 years were interviewed on their personal experiences of food insecurity both at baseline and at year two. Multivariable logistic regression analyses were used to compare chronic adolescent food insecurity by household income, household food insecurity, and socio-demographic variables after one year of follow-up.

Results

Overall, 20.5% of adolescents were food insecure in the first round survey, while the proportion of adolescents with food insecurity increased to 48.4% one year later. During the one year follow up period, more than half (54.8%) of the youth encountered transient food insecurity – that is, either during the first or the second round survey. During the follow up period, 14.0% of adolescents had chronic food insecurity (i.e. were food insecure at both rounds). Multivariable logistic regression analysis showed that adolescents in the urban households with low (OR = 1.69, P = 0.008) and middle (OR = 1.80, P = 0.003) income tertiles were nearly twice as likely to suffer from chronic food insecurity compared with those in high income tertile, while this was not the case in rural and semi-urban households. Female sex of adolescents (P < 0.01), high dependency ratio (P < 0.05) and household food insecurity (P < 0.001) were independent predictors of chronic adolescent food insecurity in urban, semi-urban, and rural areas, while educational status of the adolescents was negatively associated with chronic food insecurity (OR = 0.047, P = 0.002) in urban areas.

Conclusions

In the context of increased food prices, household income is an independent predictor of chronic food insecurity only among adolescents in the low income, urban households. Female gender, educational status of primary or less and being a member of households with high dependency ratio were independent predictors of chronic food insecurity in urban, semi-urban, and rural areas. The fact that the prevalence of chronic food insecurity increased among adolescents who are members of chronically food insecure urban households as income tertiles decreased suggests that the resilience of buffering is eroded when purchasing power diminishes and food resources are dwindling. Food security interventions should target urban low income households to reduce the level of chronic food insecurity and its consequences.

【 授权许可】

   
2012 Belachew et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Brinkman HJ, de Pee S, Sanogo I, Subran L, Bloem MW: High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health. J Nut 2010 Jan, 140(1):153S-61S.
• [2]Sanogo I: Global food price crisis and household hunger: a review of recent food security assessments findings. Humanitarian Exchange Magazine 2009., 42From: http://www.odihpn.org/humanitarian-exchange-magazine/issue-42/the-global-food-price-crisis-and-household-hunger-a-review-of-recent-food-security-assessments webcite [accessed on March 10, 2011]
• [3]Global Food Insecurity and Price Increase. 2008. From: http://reliefweb.int/sites/reliefweb.int/files/resources/22968633DA7681E2852575BE005B4D9B-Full_Report.pdf webcite [accessed on April 23, 2011]
• [4]Global monitoring report: a development emergency. The International Bank for Reconstruction and Development 2009. Available from http://siteresources.worldbank.org/INTGLOMONREP2009/Resources/5924349-1239742507025/GMR09_book.pdf webcite [accessed on March 25, 2011]
• [5]Minot N: Transmission of food price changes from world markets to Africa: food price transmission and welfare impact in Sub-Saharan Africa. International Food Policy Research Institute, summary, APRIL 2010. 2011. http://www.ifpri.org/sites/default/files/publications/ifpridp01059.pdf webcite. [Accessed on March 24,2011]
• [6]Ulimwengu JM, Workneh S, Paulos Z: Impact of soaring food price in Ethiopia: does location matter?. IFPRI,  ; 2009. http://www.ifpri.org/sites/default/files/publications/ifpridp00846.pdf webcite [Accessed on 24 March 2011)
• [7]Food security and vulnerability in selected towns of Oromia Region, Ethiopia, Vulnerability Assessment and Mapping (VAM). 2009b. From: http://home.wfp.org/stellent/groups/public/documents/ena/wfp221387.pdf webcite [Accessed on March 20, 2011].
• [8]Food security and vulnerability in selected towns of Tigray Region, Ethiopia, Vulnerability Assessment and Mapping (VAM). 2009a. From: http://home.wfp.org/stellent/groups/public/documents/ena/wfp221389.pdf webcite [Accessed on April 20, 2011]
• [9]Devereux S: Distinguishing between chronic and transitory food insecurity in emergency needs assessments, World Food Programme, emergency needs assessment branch (ODAN). January 2006. From: http://www.livestock-emergency.net/userfiles/file/assessment-review/Institue-Development-Studies-2006.pdf webcite [Accessed on: March 21, 2011]
• [10]Tarasuk V, McIntyre L, Li J: Low-income women's dietary intakes are sensitive to the depletion of household resources in one month. J Nutr 2007 Aug, 137(8):1980-1987.
• [11]An introduction to the basic concepts of food security. Information for action, practical guides. 2008. Available from http://www.fao.org/docrep/013/al936e/al936e00.pdf webcite [Accessed on March 25, 2011]
• [12]Tarasuk VS: Household food insecurity with hunger is associated with women’s food intakes, health, and household circumstances. J Nutr 2001, 131:2670-2676.
• [13]Oldewage-Theron WH, Dicks EG, Napier CE: Poverty, household food insecurity and nutrition: coping strategies in an informal settlement in the Vaal Triangle, South Africa. Public Health 2006 Sep, 120(9):795-804.
• [14]Sarlio-Lähteenkorva S, Lahelma E: Food insecurity is associated with past and present economic disadvantage and body mass index. J Nutr 2001 Nov, 131(11):2880-2884.
• [15]Norhasmah S, Zalilah MS, Mohd Nasir MT, Kandiah M, Asnarulkhadi AS: A qualitative study on coping strategies among women from food insecurity households in Selangor and Negeri Sembilan. Mal J Nutr 2010, 16(1):39-54.
• [16]Hadley C, Lindstrom D, Tessema F, Belachew T: Gender bias in food insecurity experiences of adolescents in Jimma Zone. Soc Sci Med 2008, 66:427-438.
• [17]Sustainable Development and Poverty Reduction. May 2002. Addis Ababa. From: http://siteresources.worldbank.org/INTPRS1/Resources/073102.pdf webcite on April 23, 2011]
• [18]Hadley C, Belachew T, Lindstrom D, Tessema F: The forgotten population? Youth, food insecurity, and rising prices: implications for the global food crisis. NAPA Bull 2009, 32:77-91.
• [19]Belachew T, Haley C, Lindtsrom D, GebremariaM A, Getachew Y, Lachat C, Kolsteren P: Gender differences in food insecurity and morbidity among adolescents in southwest Ethiopia. Pediatrics 2011, 127(2):e397-e404.
• [20]Kish L: A procedure for objective respondent selection within the household. Jam Stat Assoc 1949, 44:380-387.
• [21]Coates J, Frongillo EA, Rogers BL, Swindale A, Bilinsky P: Measuring household food insecurity: why it’s so important and yet so difficult to do? J Nutr 2006, 136:1404S-1408Sa.
• [22]Coates J, Frongillo EA, Rogers BL, Webb P, Wilde PE, Houser R: Commonalities in the experience of household food insecurity across cultures: what are measures missing? J Nutr 2006 May, 136(5):1438S-1448S.
• [23]Frongillo EA, Nanama S: Development and validation of an experience-based measure of household food insecurity within and across seasons in northern Burkina Faso. J Nutr 2006 May, 136(5):1409S-1419S.
• [24]Belachew T, Hadley C, Lindstrom D, Gebremaria A, Lachat C, Kolsteren P: Food insecurity, school absenteeism and educational attainment of adolescents in Jimma Zone Southwest Ethiopia: a longitudinal study. Nutr J 2011 Apr, 10:29. BioMed Central Full Text
• [25]Summary of food security and vulnerability in selected urban centers of Ethiopia. 2009. From: http://documents.wfp.org/stellent/groups/public/documents/ena/wfp221386.pdf webcite [Accessed on April 24, 2011]
• [26]Rose D: Economic determinants and dietary consequences of food insecurity in the United States. J Nutr 1999, 129:S517-S520.
• [27]Hamelin AM, Beaudry M, Habicht J-P: Characterization of household food insecurity in Quebec: food and feelings. Soc Sci Med 2002, 54:119-132.
• [28]Hamelin AM, Habicht JP, Beaudry M: Food insecurity: consequences for the household and broader social implications. J Nutr 1999, 129:S525-S528.
• [29]Harrigan J: Food insecurity, poverty and the Malawian Starter Pack: Fresh start or false start? Food Policy 2008, 33:237-249.
• [30]Devereux S: Livelihood insecurity and social protection: a reemerging issue in rural development. Development policy 2001, 19(4):507-519.
• [31]McIntyre L, Glanville T, Raine KD, Dayle JB, Anderson B, Battaglia N: Do low-income lone mothers compromise their nutrition to feed their children? Can Med Assoc J 2003, 168:686-691.
• [32]Dowler E, Calvert C: Nutrition and diet in lone-parent families in London. Family Policy Studies Centre, London; 1995.
• [33]Power EM: Economic abuse and intra-household inequities in food security. Can J Public Health 2006, 97:258-260.
• [34]Vozoris NT, Tarasuk VS: Household food insufficiency is associated with poorer health. J Nutr 2003 January, 133:120-126.
• [35]Stuff JE, Casey PH, Szeto KL, Gossett JM, Robbins JM, Simpson PM, Connell C, Bogle ML: Household food insecurity is associated with adult health status. J Nutr 2004 Sep, 134(9):2330-2335.
• [36]Lee JS, Frongillo EA: Nutritional and health consequences are associated with food insecurity among U.S. elderly persons. J Nutr 2001 May, 131(5):1503-1509.
• [37]Seligman HK, Laraia BA, Kushel MB: Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr 2010 Feb, 140(2):304-310.
• [38]Biros MH, Hoffman PL, Resch K: The prevalence and perceived health consequences of hunger in emergency department patient populations. Acad Emerg Med 2005, 12:310-317.
• [39]Cook JT, Frank DA, Berkowitz C, et al.: Food insecurity is associated with adverse health outcomes among human infants and toddlers. J Nutr 2004 Jun, 134(6):1432-1438.
• [40]DeRose LF, Das M, Millman SR: Does female disadvantage mean lower access to food? Popul Dev Rev 2000, 26(3):517-547.
• [41]Haddad L, Reardon T: Gender bias in the allocation of resources within households in Burkina Faso: a disaggregated outlay equivalent analysis. J Dev Stud 1993, 29(2):260-276.
• [42]Senauer B, Garcia M, Jacinto E: Determinants of the intra-household allocation of food in the rural Philippines. Am J Agric Econ 1988, 70(1):170-180.
• [43]Behrman J: Intra-household allocation of nutrients in Rural India: are boys favored? Do parents exhibit inequality aversion? Oxf Econ Pap 1988, 40(1):32-54.
• [44]Situational analysis on population, reproductive health and gender in Ethiopia. Addis Ababa, Ethiopia; 2006.
• [45]De Muro P, Burchi F: Education for rural people. Cross-country analysis, FAO. 2007. From: ftp://ftp.fao.org/docrep/fao/010/a1434e/a1434e.pdf webcite [Accessed on April 21, 2011]
• [46]Idrisa YL, Gwary MM, Shehu H: Analysis of food security status among farming households In Jere Local Government of Borno State, Nigeria. J Trop Agric Food Environ Ext 2008, 7(3):199-205.
• [47]Jones SJ, Jahns L, Laraia BA, Haughton B: Lower risk of overweight in school-aged food insecure girls who participate in food assistance: results from the panel study of income dynamics child development supplement. Arch Pediatr Adolesc Med 2003 Aug, 157(8):780-784.
• [48]Devereux S: Can social safety nets reduce chronic poverty? Dev Policy Rev 2002, 20(5):657-675.