No / Over the last two decades individual capitalists and private corporations have become increasingly involved in philanthropy, often through foundations targeted at helping to reduce social problems associated with poverty, disease and food insecurity. This book questions the political and ideological reasons behind rich individuals and large companies choosing to engage in poverty reduction through philanthropy.

Food insecurity is associated with increased stress, symptoms of mental illness, and persistent health disparities. Women caregivers (referred to as mothers) may be at an increased risk because they often compensate for food shortages by reducing their own intake and make household food decisions. The current literature on the relationship between food security status and mental health in the U.S. lacks a clear framework for the relationship between these two phenomena. This dissertation describes three studies that aimed to explore the relationship between food security and mental health for mothers with low income in Virginia: (1) understanding differences in mental health outcomes by food security status (n=1,029), (2) a path analysis of a conceptual framework of the relationship (n=1,029), and (3) a thematic analysis of mothers' lived experiences with this relationship (n=29). An explanatory, sequential mixed methods design was employed with a cross-sectional survey informing semi-structured interviews. The survey (administered August-October 2021) was developed with previously validated measures of food security status, physical and mental health, symptoms of mental illness, behavioral food coping strategies, and social support. The interview guide was developed based on the findings of the survey and administered in May and June 2022. Collective findings of this series of studies suggested lower food security status was associated with negative mental health outcomes. However, there were no direct pathways from food security status to mental health outcomes. Social support and behavioral food coping strategies mediated the relationship between food security status and mental health outcomes. Mothers reported experiencing managing a variety of stressors associated with food insecurity. Mothers also indicated that stressors and coping strategies associated with managing food insecurity impacted their mental health. Future research should explore additional factors impacting household resiliency and strategies to reduce stigma associated with resource utilization. These findings can be built upon to develop screening tools and interventions to help improve food security and mental health status mothers with low income. / Doctor of Philosophy / Household food insecurity, where a household has insufficient access to safe, nutritious foods, is associated with a number of negative physical and mental health outcomes, including stress for members of the household. Food insecurity is not necessarily felt equally by all members of a household. Mothers may be at a greater risk because they often are responsible for household food decisions. Despite an association between food insecurity and mental health being discussed in the existing literature, there was little evidence to support how that relationship works and the other factors that may affect this relationship. This dissertation details three studies that were conducted to better understand the relationship between food security and mental health for Virginia mothers with low-income: (1) understand differences in mental health outcomes by food security status, (2) develop a framework for how factors are related in this relationship, and (3) explore mother's experiences with the relationship. A survey was developed and administered (August-October 2021) using previously tested measures of food security and mental health. The survey also included measures of factors that may have impacted the relationship, including physical health, social support, and behavioral food coping strategies, which are strategies used by people to stretch their available food resources. Interviews were conducted in May and June 2022. Findings suggest food security acts indirectly on mental health outcomes through social support and behavioral food coping strategies. Mothers reported managing multiple stressors associated with the experience of food insecurity that impacted their mental health. In the future, research should explore strategies to encourage resource utilization and identify ways to improve maternal mental health. Ultimately, interventions to improve food security and mental health for mothers with low income should be developed and implemented.

There were an estimated 11.1% of households experiencing food insecurity in the U.S. in 2018, meaning that they did not have the adequate resources to access safe, nutritious food at some point in the year. In order to support people experiencing food insecurity and related-hunger, national organizations, regional food banks, and local programs operate to recover, organize, and distribute the food available to them. Food recovery work falls into a regulatory grey-area. Should anyone consuming donated food become ill, the food handlers would not be criminally or civilly liable if they distributed it in good faith. There are no federal regulations covering food handling in food recovery, though some states do have such regulations. As a result, safe food handling guidance, education, and training is offered through organized networks and Cooperative Extension. Participating in educational programs increases safe food handling knowledge, however volunteers and employees in food recovery organizations have also been observed to unsafely handle food. Additionally, these resources can be limited in their scope and some are only accessible through membership in pre-existing networks such as Feeding America. The purpose of this work is to further document how food is handled in food recovery and compliment that by collecting the experiences and perceptions of these food handlers as well as Cooperative Extension educators who support them. This work utilized a mixed-methods approach to quantify behaviors and experiences, which compliments qualitatively collected contextual information. Food handlers serving with a university-based student food recovery program, which works to distribute unserved and unsold food from on-campus dining centers, were observed improperly washing their hands, inconsistently keeping records, and using unclean or otherwise contaminated equipment. These behaviors could be addressed through rolespecific education representing their unique operations. Virginia Cooperative Extension (VCE) educators were used as a case study to measure their experiences when supporting food recovery, with 41% of respondents having previously supporting an organization or program. Topics covered ranged from safe food handling, network leadership, financial planning, and farming/gardening. VCE educators expressed a sense of altruism when supporting food recovery organizations, but also experienced challenges such as not having enough time to fully engage or the organization not having adequate equipment to enact their support. VCE educators who had not previously supported these organizations expressed wanting to learn more about food recovery work and how VCE can support them. Employees of food banks believe current food safety education could be improved by offering role-specific information in customizable formats so the food handlers can translate their knowledge into action. Future education should also focus on problemsolving, so food handlers feel empowered to react to expected challenges. Lastly, to account for challenges experienced while conducting this research, future projects within the context of food recovery should consider the limited time available of potential participants, offer compensation for their participation, and maximize pre-existing networks when connecting with them. / Doctor of Philosophy / There were an estimated 11.1% of households experiencing food insecurity in the U.S. in 2018, meaning that they did not have the adequate resources to access safe, nutritious food at some point in the past year. In order to support people experiencing food insecurity and related-hunger, national organizations, regional food banks, and local programs operate to recover, organize, and distribute the food available to them. Food recovery work falls into a regulatory grey-area. Food handlers are not criminally or civilly liable should anyone become ill as a result of consuming food when it is donated in good faith, and guidance in the form of food handling regulations for food recovery varies from state-to-state and is not addressed federally. As a result, safe food handling education and training is offered through organized networks and Cooperative Extension. Participating in educational programs increases safe food handling knowledge, however volunteers and employees in food recovery organizations have also been observed to unsafely handle food. Additionally, these resources can be limited in their scope with some only accessible through membership in pre-existing networks. The purpose of this work is to further document how food is handled in food recovery, which will complement the collection of experiences and perceptions of food handlers and Virginia Cooperative Extension (VCE) educators who support them. Volunteers serving with a university-based student food recovery program, which works to distribute unserved and unsold food from their on-campus dining centers, exhibited a combination of safe and unsafe food handling behaviors which could be addressed through role-specific education representing their unique operations. VCE educators expressed a sense of altruism when supporting food recovery organizations across a range of topics, however they also expressed wanting to know more about their operations and how VCE can support them. Employees of food banks believe current food safety education could be improved by offering role-specific information in a variety of formats paired so the food handlers can translate their knowledge into action. Lastly, to account for challenges experienced while conducting this research, future projects within the context of food recovery should consider limited time potential participants have to serve as well as maximize preexisting networks when recruiting them.

Dollar General has seen massive growth, opening almost 1,000 stores per year for ten years. Executives attribute the company's success to their attention to the expanding poverty class in low-food-access urban and rural areas. Central Appalachia in particular -- which has one of the highest rates of low food access and poverty in the nation -- has been a growth center for Dollar General stores. Has the growth in Dollar General stores in Central Appalachia affected residents' food procurement patterns? Through an analysis of USDA data on food access and by conducting interviews with 11 people living in Central Appalachia, I find that Dollar General stores are most frequently found in low-income and low-food-access counties and that Central Appalachian people perceive the chain as a necessary evil. I argue that the complicated relationship between Dollar General and Central Appalachian people is an example of David Harvey's theory of accumulation by dispossession. Neoliberal globalization created the conditions that allow Dollar General to thrive in the region – in particular, the corporate enclosure of the commons, the decline of the coal industry, and the new economy which has forced many people to travel hours a day for work. / Master of Science / Dollar General has seen massive growth, opening almost 1,000 stores per year for ten years. Executives attribute the company's success to their attention to the expanding poverty class in low-food-access urban and rural areas. Central Appalachia in particular -- which has one of the highest rates of low food access and poverty in the nation -- has been a growth center for Dollar General stores. Has the growth in Dollar General stores in Central Appalachia affected residents' food procurement patterns? Through an analysis of USDA data on food access and by conducting interviews with 11 people living in Central Appalachia, I find that Dollar General stores are most frequently found in low-income and low-food-access counties and that Central Appalachian people perceive the chain as a necessary evil. I argue that the complicated relationship between Dollar General and Central Appalachian people is an example of David Harvey's theory of accumulation by dispossession. Neoliberal globalization created the conditions that allow Dollar General to thrive in the region – in particular, the corporate enclosure of the commons, the decline of the coal industry, and the new economy which has forced many people to travel hours a day for work.

This dissertation is composed of three essays that measure the impact of social programs and policies on the well being of their target populations. The first essay entitled "The Wage Impact of Historically Black College and University Attendance" examines the impact of attending a Historically Black College or University on the wages of Blacks attending HBCUs versus other four year colleges or universities using a sample of Blacks from the National Longitudinal Survey of Youth (1979). The study finds no initial advantage to HBCU attendance for black men, but a 1.4 to 1.6 percentage point higher growth rate in subsequent wages is associated with the attendance of an HBCU as opposed to other four year colleges. This faster growth rate translates in a net discounted HBCU earnings gain of 8.9 to 9.6 percent over a 16 year period following college attendance. The study finds no advantage or disadvantage to HBCU attendance for Black females. The second essay entitled "Transient and Chronic Poverty in the US: The Role of the Food Stamp Program" examines the unique and common determinants of short-term intra-annual transient poverty and chronic poverty, as well as the differential response of each state of poverty to Food Stamp Program (FSP) use. The study employs dynamic expenditure-based poverty measures using quarterly data from the Consumer Expenditure Survey (2001-2004). The major finding is that FSP use reduces transient poverty, but the study finds no significant impact of FSP use on chronic poverty. The common causes of both states of poverty are low human capital, minority status and involuntary unemployment of the household head. Changes in family composition during the year is only associated with higher transient poverty. The third essay entitled "Food Insecurity and the Food Stamp Program" examines the determinants of food insecurity in the US, as well as its response to Food Stamp Program use with data from the Panel Study of Income Dynamics (1995-1999). The study finds that FSP use reduces household food insecurity, and that the program impact is greater for households that experience more severe insecurity. In addition the study finds that higher risk tolerance as well as a preference for smoking cigarettes increase household food insecurity. / Ph. D.

Yes / We report qualitative findings from a study in a multi-ethnic, multi-faith city with high levels of deprivation. Primary research over 2 years consisted of three focus groups and 18 semi-structured interviews with food insecurity service providers followed by focus groups with 16 White British and Pakistani women in or at risk of food insecurity. We consider food insecurity using Habermas’s distinction between the system and lifeworld. We examine system definitions of the nature of need, approved food choices, the reification of selected skills associated with household management and the imposition of a construct of virtue. While lifeworld truths about food insecurity include understandings of structural causes and recognition that the potential of social solidarity to respond to them exist, they are not engaged with by the system. The gap between system rationalities and the experiential nature of lay knowledge generates individual and collective disempowerment and a corrosive sense of shame. / NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH) (Grant Number IS-CLA-0113-10020).

Background: College students experience food insecurity at a rate 3.5 times higher than the U.S. general population, affecting 43% of students. Furthermore, college students consume high amounts of ultra-processed products. NOVA, a food classification system, takes into account food processing and is thought to better fit the modern food environment. Purpose: The purpose of this research project was to examine the impact of CalFresh enrollment on food security status. This study also evaluated the impact of two different nutrition education interventions (MyPlate and MyPlate+NOVA) on participants’ dietary habits and nutrition knowledge. Methods: Food security, dietary habits, and nutrition knowledge were assessed at baseline, three-month, and at six months follow-up. Food security status was measured using the USDA 6-item Short Form Food Security Assessment Module. A 12-week mobile nutrition education intervention providing MyPlate or MyPlate+NOVA nutrition messages was implemented, and dietary habits were assessed using an adapted NHANES 2009-2010 dietary screener questionnaire, while nutrition knowledge questions were created from the nutrition education messages. Results: Food insecurity decreased by approximately 63% among CalFresh participants. There were no differences in dietary habits or nutrition knowledge among any of the intervention groups or the control group.

Background: Nutritional psychiatry is an emerging field of research and it is currently exploring the impact of nutrition and obesity on brain function and mental illness. Prior studies links between obesity, nutrition and depression among women. However, less is known how food insecurity may moderate that relationship. Methods: Data were employed from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. Two logistic regression models were Logistic regression was used to determine the association between obesity, gender, food insecurity, and past year Major Depressive Disorder (MDD). We then stratified by gender, and tested the association between obesity and past year MDD, and if food insecurity moderated the association. Results: Obesity was associated with an increased risk for past year Major Depressive Disorder (MDD) among females (AOR = 1.35; 95% CI 1.17-1.55) and was not associated among males (AOR = 1.07; 95% CI, 0.86-1.32). Women who reported that reported both obesity and food insecurity reported higher odds of past year MDD episode (AOR = 3.16; 95% CI, 2.36-4.21, than women who did not report food insecurity (AOR = 1.08; 95% CI, 1.02-1.38). Conclusion: With rising rates of mental health problems, females should be closely monitored to understand how poor diets, food insecurity, and obesity play a role in mental health outcomes. It is recommended that clinicians and treatment providers consider the patient's diet and access to nutritious foods when conducting their assessment.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18165号 / 医博第3885号 / 新制||医||1003(附属図書館) / 31023 / 京都大学大学院医学研究科医学専攻 / (主査)教授 中山 健夫, 教授 髙折 晃史, 教授 中原 俊隆 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Structural adjustment measures adopted during the early 1990s considerably altered the rural landscape throughout Zambia. Households responded and continue to respond in a variety of ways, although many do so under highly inequitable terms. Poverty rates, food insecurity, and income inequality all remain unacceptably high in Zambia, particularly in rural areas. Using a biocultural and livelihoods approach, this alternate "publication in scholarly journals" format dissertation examines some of the complexities that condition livelihoods and differentially shape biologies in rural Zambia today. Three main problems are explored: 1) the relationship between food insecurity and adult mental health; 2) piecework (casual labor) as a coping strategy and indicator of household vulnerability to food insecurity; and 3) the association between relative deprivation and adult physical health. Research for the dissertation took place in a rural area in Eastern Province, Zambia in 2009. The research employed a mixed methodology, collecting qualitative and household-level survey data during the rainy and dry seasons. Various statistical analyses were utilized in the three papers appended to the dissertation. The results were further explored using the findings from the qualitative data. In paper one, a positive relationship between food insecurity and poor mental health was found. Food insecurity during the dry season had a greater effect on mental health than in the rainy season. In paper two, the results demonstrate the importance of piecework labor as a coping strategy and the need to adopt a multi-period lens to robustly assess whether participation in piecework reflects a household's vulnerability to food insecurity. In the third paper, a negative association was established between relative deprivation and adult nutritional status. Together, the results from the dissertation provide clear evidence that both the material and relative circumstances of people play important roles in patterning variation in mental and physical health outcomes in rural Zambia.