This case study aimed to do a critical, intersectional, policy analysis of a disability policy regarding personal assistance support for basic human needs in everyday life. In January 2019, a comprehensive preparatory report about new suggestions was presented by the Swedish Government. This caused many reactions from disability rights organisations. One particular topic became heated and criticized in the debates, namely interpretations of the legal texts about personal assistance support concerning help with breathing and nutrition feeding. I have analysed interpretations of this legal text in the preparatory report, referral response and its result in the Government bill. The analysis shows problematic, normative understandings about the body and how a specific integrity demand have affected whether a person has been entitled to personal assistance to support their basic needs. Cost efficiency, quantification, and measurable goals are increasingly visible in the Swedish welfare society. People with disabilities and their entitlement to assistance have decreased for the sake of productivity and cost reductions. An intersectional perspective of the policy’s legal texts illustrates how it lacks an essential understanding of human values. There is a need for a deeper perspective of empathy to see that basic human needs are non-measurable.

BACKGROUND: Households experiencing "food insecurity" have limited access to food due to a lack of money or resources. Poor nutrition, from food insecurity, can impact physical and cognitive development of children. Study objectives were to document the prevalence of Tennessee child care programs screening for food insecurity, explore differences between programs receiving child and adult care food program (CACFP) funding and those screening for food insecurity, and understand possible burdens food insecurity places on child care families as perceived by child care program directors. METHODS: In this cross-sectional study of licensed Tennessee child care programs, a 10-question survey and four-question follow-up survey were electronically distributed. Analysis included descriptive statistics, a chi-square of programs receiving CACFP funds and screening for food insecurity, and themes analysis of open-ended responses. RESULTS: The average child care program enrollment (N = 272) was 80.16 with programs serving mostly preschoolers (98.53%) and toddlers (91.91%). Over half (56.99%) of programs reported they received CACFP funding, yet only 9.19% screen for food insecurity. Chi-square analysis found that programs receiving CACFP funds differ significantly on whether they screen households for food insecurity [Formula: see text] (1, n = 237) = 16.93, p ≤ 0.001. Themes analysis (n = 41) revealed that many child care program directors do not view food insecurity as a burden for families. CONCLUSIONS: Child care programs receiving CACFP funds are more likely to screen families for food insecurity than programs who do not. Programs indicate a willingness to include food insecurity screening questions on child care paperwork.

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Contexte : Au Canada, de nombreuses personnes issues de la migration sont confrontés à l’insécurité alimentaire (IA), une problématique préjudiciable à la qualité de l’alimentation. Un nombre croissant d’organismes de dépannage alimentaire incluent des programmes visant l’amélioration des compétences alimentaires. Toutefois, la relation entre l’IA et la qualité de l’alimentation des migrants demandeurs d’aide alimentaire et la potentielle modification d’effet par les compétences alimentaires ont été peu étudiés. Objectif : Examiner l’association entre le niveau d’IA, les compétences alimentaires et la qualité de l’alimentation chez les demandeurs d’aide alimentaire issus de la migration. Méthode : Les données sont extraites d’un sous-échantillon de la cohorte PARCOURS, constitué de nouveaux utilisateurs de banques alimentaires migrants au Québec (n=224) au recrutement. Les variables d’intérêt ont été mesurées à l’aide de questions adaptées de l’Enquête sur la santé de collectivités canadiennes. Des analyses linéaires multiples basées sur des familles de modèles ont été menées pour chaque indicateur de qualité de l’alimentation soient la consommation de fruits et légumes (FL) et la variété. Résultats : Au sein de l’échantillon, le score de variété moyen était de 16/20 et la consommation médiane de FL était de 3 fois par jour. Une fois ajusté, le niveau d’IA n’était associé ni à la consommation de FL ni à la variété de l’alimentation. Aucune modification d’effet par les compétences alimentaires a été observée. Conclusion : Chez les migrants demandeurs d’aide alimentaire, leur niveau d’IA n'est pas associé à la qualité de leur alimentation peu importe leurs compétences alimentaires. / Background: Many people with a migrant background in Canada face food insecurity (FI), an issue with detrimental outcomes on diet quality. A growing number of food assistance services, which remain the principal intervention supporting Canadians living in food-insecure households, now include programs aiming to improve food skills. However, little is known about the relationship between FI and diet quality of migrants using food assistance services as well as the potential effect modification of food skills on this association. Objective: To examine the association between FI levels, food skills, and diet quality among migrant food assistance beneficiaries. Method: Data were drawn from a subsample of the PATHWAY study at baseline, including new food bank users with an immigrant background in Quebec (n=224). Variables of interest were measured using questions adapted from the Canadian Community Health Survey. Multiple linear regressions were performed for each food quality indicator, namely fruit and vegetable (FV) consumption and diet variety, based on predefined families of models. Results: Among participants, the median frequency of FV consumption was three times per day, and the mean score for variety reached 16/20. When adjusted, FI levels were not associated with either FV consumption or diet variety among food assistance users with a migrant background. No effect modification by food skills was observed. Conclusion: Among migrants seeking food aid, their FI level is not associated with the quality of their diet, regardless of their dietary skills.

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<p>  </p> <p>Food insecurity describes the lack of access to foods and affects 10.2% of general U.S. households and 27% of low-income households in 2021. Food insecurity is a pervasive public health concern in the United States and has been linked to poor dietary intake and diet quality, overweight and obesity (especially among women), and risk of other chronic diseases, such as diabetes, hypertension and dyslipidemia. </p> <p>To better understand food security status and address its associated health and dietary outcomes among low-income populations, a conceptualized model was built and served as research framework for the dissertation, including 1) internal factors and motivations, such as traits related to self-efficacy and sufficiency that may influence diet and health; 2) external factors of temporary support, such as financial benefits from assistance programs that low-income populations are eligible for that may influence diet and health; and 3) external factors of potentially long-term support, such as nutrition education programs targeting low-income groups that may foster internalized knowledge that could sustain impact and improvement of diet and health in the long-term. Each chapter of this dissertation addresses a component of the model.</p> <p>Cross-sectional analysis of a sample of rural veterans using food pantries quantified psychological traits related to self-motivation and efficacy including grit and help seeking, at the individual and internal factors level of the conceptualized model, and their links to food security and resource use, and revealed an inverse association between grit score and risk of food insecurity. The findings provided evidence for future interventions targeting food insecurity improvement to include education and resources that address traits related to self-efficacy, such as grit, among low-income populations to improve health outcomes directly or through improving food security or use of resources. </p> <p>Using nationally representative data, the second study investigated relationships between food assistance through the Supplemental Nutrition Assistance Program (SNAP) participation, a type of societal level external support, and dietary outcomes among low-income older U.S. adults. There were no differences in dietary quality, usual nutrient intake or risk of inadequacy between SNAP participants and eligible nonparticipants. Furthermore, results revealed a high prevalence of not meeting the Estimated Average Requirement from dietary sources for several nutrients (vitamins A, C, D, E, calcium, and magnesium) but the prevalence was lower when nutrients from dietary supplements were included. The results highlight a need for continued effort to improve nutrient and dietary intake among low-income older adults.</p> <p>External factors of potentially long-term support (e.g. nutrition education and food assistance) were evaluated for relationships with body mass index. A longitudinal sample of low-income women interested in participating in nutrition education through SNAP-Education (SNAP-Ed) was examined to determine the relationship between nutrition education (SNAP-Ed) and food assistance program participation through (SNAP, WIC), separately and in combination, with long-term changes in body mass index. No differences in changes of weight status over time were observed by nutrition education, food assistance, or combination participation. The prevalence of obesity was high among this sample, calling for targeted obesity prevention interventions and further support of healthy lifestyle promotion among low-income populations. </p> <p>The findings shown in this dissertation further reveal a high health burden among low-income groups. The studies filled several research gaps described in the conceptualized model. The results may be used to inform future tailored interventions to address food insecurity, dietary and health outcomes at individual and societal levels, incorporating internal motivation and external support to mediate health and dietary risks among low-income population.</p>