A thesis submitted to the Faculty of Arts in fulfilment of the requirements for the Degree of Masters in Social Work in the Department of Social Work at the University of Zululand, South Africa, 2013 / The study “An Investigation of Factors Surrounding Food Insecurity in KwaMthethwa”examines the factors responsible for food insecurity with specific reference to the rural people of KwaMthethwa. The investigation found that many factors coalesce to worsen the problem of food insecurity in the area under study. Mainly but not exclusively, factors that were found to worsen food insecurity in the KwaMthethwa area were: inadequate land supply, unemployment exacerbated by lack of marketable work skills, cultural practices and beliefs that tend to marginalize women away from the profitable work force, the HIV- AIDS epidemic which leaves many children without parents and the colonial mentality of white farm employers who see black labour as an exploitable commodity. In KwaMthethwa area the population group most severely affected by food insecurity was women and children. It was found that the situation of food insecurity could be improved by increasing productive infrastructure such as roads, telecommunication links, clinics, schools and properly equipped libraries.

Magister Artium (Child and Family Studies) - MA(CFS) / Child-headed households (CHHs) are a recent development that has become progressively noticeable not only in South Africa but also internationally. This phenomenon arose as a result of the death of parents or abandonment of children by their primary caregivers. The Acquired Immuno Deficiency Syndrome (AIDS) epidemic has taken away the lives particularly of many adults, leaving children orphaned and having to take on the adults’ responsibilities. In the past, relatives or the extended family would take the responsibility of caring and providing for orphaned children but, with current economic hardships, most families are unable to take the extra responsibility. As a result, older siblings become caregivers to their younger siblings. Unfortunately, when parents die, children often lose access to adequate food, social grants, education and health services. Despite the fact that it is the right of all South Africans, including children, to have access to sufficient food, many households, including CHHs, are living in poverty. As a result, they are vulnerable to food insecurity, leading to developmental, social and emotional challenges. The aim of the present study was to explore and describe the experiences, challenges and coping strategies of CHHs with food insecurity in Ingwavuma, from a bio-ecological perspective. Ingwavuma is a small rural town in KwaZulu-Natal Province, South Africa. The study makes recommendations for social work projects, education and future research regarding CHHs’ experiences of food insecurity. This is a qualitative study that utilised an explorative-descriptive methodological approach. Purposive sampling was used to select 20 children between the ages of 13 and 18 years old from CHHs in Ingwavuma. One-on-one semi-structured interviews were conducted with the participants at their homes in the town.

Achieving food security in its totality continues to be a challenge in developing nationsespecially those in Africa. The root cause of food insecurity in developing countries is theinability of people to gain access to food due to poverty (Pinstrup-Aderesen, 2002). While therest of the world has made significant progress towards poverty alleviation, Africa, inparticular Sub-Saharan Africa continues to lag behind.Karamoja region is not any different from other developing regions battling with foodinsecurity because of poverty and unpredictable rainfall. For quite a long point in time,Karamoja region has suffered prolonged draught due to unpredictable rain failure which hasinflicted a lot of misery to the people by making them food insecure because of little or nofood harvests. In the dawn of climate change, the situation may further deteriorate if urgentsustainable food security strategies are not introduced in Karamoja.The tasks of reverting Karamoja’s food insecurity to the same secure levels of the other partsof the country requires a shift from emergency relief distribution to sustainable selfproduction planning by the people of Karimojong. This research therefore goes out toinvestigate the potential of one sustainable strategy called Permaculture in addressing the foodinsecurity at the household level for the Karamojongs.Permaculture is a practical concept applicable from the balcony to the farm, from the city tothe wilderness. It is a design system for sustainable environments providing food, energy,shelter, material and non-material needs, as well as the social and economic infrastructuresthat support them. Permaculture means thinking carefully about our environment, our use ofresources and how we supply our needs. It aims to create systems that will sustain not onlyour present, but also future generations (PIJ, 1999).The final result of the current paper is that according to the case study, the Karamojongpracticing Permaculture are more food secure than the ordinary Karamojong. It was alsofound that the land in Karamoja is fertile and if sensitization and awareness of this concept iscarried out, Permaculture will help in reverting the current food insecurity in Karamoja in along run.

This paper examines how socioeconomic status and economic insecurity relate to obesity in working-age Canadians between 2000 and 2010. First, I attempt to explain the gender specific gradients in body mass. Second, I test the theory that higher levels of economic insecurity are associated with higher rates of obesity. Data from the Canadian Community Health Survey is used to determine how BMI relates to various measures of income, food insecurity, and stress. My results indicate that low income is associated with higher rates of female obesity and lower rates of male obesity. Economic insecurity measured at the provincial level, such as the employment rate seems to have no significant impact on obesity, which may be due to limitations in the data. Food insecurity is predictive of excess body weight in women, especially mothers.

Food insecurity exists when access to safe, nutritionally adequate foods is limited or uncertain, or when acquisition of these foods occurs in socially unacceptable ways (Anderson, 1990). Considerable research has focused on identifying the risk factors for and potential consequences of household food insecurity; however, few studies have investigated whether and how place of residence might influence household food insecurity. To address this gap in the literature, a mixed methods approach was used to explore the connections between risk factors, household food insecurity, and health in urban and rural settings. This dissertation comprised three studies. In the first study, secondary data were used to identify the household factors that increased the risk for household food insecurity and to examine whether place of residence moderated these relationships. Significant associations were found between household sociodemographics and household food insecurity. In addition, rural households were more likely to report household food insecurity. Although most moderation models were non-significant, a moderation effect was found for educational attainment: secondary school graduation increased the risk for household food insecurity in urban households, yet it was protective in rural households. In the second study, secondary data were used to examine the relationship between household food insecurity and poor general, physical, and mental health, and to test for a moderation effect of place of residence. In the main effects models, household food insecurity was associated with an increased likelihood of poor health on all measures. There was no evidence of urban-rural differences in these relationships. In the third study, qualitative data were used to explore household food insecurity from the perspective of urban and rural residents in Eastern Ontario. Findings revealed that urban and rural residents described similar conditions, processes, and consequences of household food insecurity; however, the unique features of the urban and rural settings influenced how people managed these experiences. In particular, certain aspects of the rural settings added to the complexity of managing household food insecurity. Overall, the results of this dissertation suggest that the urban-rural context, although important, is secondary to the primary contribution of low economic and social resources in household food insecurity.

Abstract Background: Individuals with type 2 diabetes mellitus (T2D) face many challenges in self-management of their current disease state. Nutrition education has been identified as a key component in managing metabolic control in individuals diagnosed with T2D. The purpose of this study is to investigate the effect of a 4-week nutrition intervention on glycated hemoglobin (HbA1c) and nutrition knowledge by food security status in individuals with T2D who attend the Family Health Centers of Georgia (FHCGA) located in West Atlanta. Methods: Subjects enrolled in the study (n=6) completed a nutrition knowledge survey at the beginning of the intervention and had their HbA1c values extracted from the FHCGA medical record. Subjects then entered a 4-week group nutrition intervention program. The program consisted of four lessons that focused on the basic diet for diabetes, food label reading, grocery store shopping and eating out with diabetes. Subjects took a nutrition knowledge survey after the intervention and were asked to return to have a follow-up blood draw for HbA1c levels. Results: Two out of six subjects completed the entire protocol. The HbA1c for this subject was higher after the nutrition intervention. An additional two subjects completed all of the lessons and the post survey, but did not have a follow-up HbA1c drawn. The mean nutrition knowledge score pre-intervention (72.33 + 5.13) was lower than the mean post-intervention score (78.67 + 4.04) but was not significantly different. When subdivided by food security status, subjects with a higher food security status had a lower baseline HbA1c. Conclusion: Nutrition knowledge scores increased after nutrition education but not significantly. The effect of nutrition education on HbA1c by food security status could not be determined due to low participation. Future studies with a larger sample size and incentives for compliance are needed to investigate how group nutrition education influences metabolic control in food insecure and secure people with T2D.

Master of Arts / Department of Communications Studies / Timothy J. Shaffer / Defined by the U.S. Department of Agriculture as “limited or uncertain availability of nutritionally adequate and safe foods,” food insecurity is a symptom of systematic disempowerment and represents one of the most prevalent social ailments to impact first-world countries. In a county where one in eight individuals does not have regular access to meals, food insecurity is far from a problem typically associated with college students. However, Feeding America, the largest emergency food assistance network in the nation, reports that one out of every ten people they serve is a student. In total, half of all students will find themselves unable to afford to eat at least once within their academic career; consequently, 1 in 4 will drop out. This thesis argues that the voices and narratives of food insecure students have been absent from the very research meant to represent them. Consequently, little is known of the situational nuances that accompany student hunger, reifying the dominant discursive structure. This research employs Photovoice, a participant-led methodology which invites members of marginalized groups to photograph places, things, and events representative of, or crucial to, their daily life. This study examines the narratives of seven college students, ranging from their first-year to PhD status, in an effort to fill the gap in the knowledge regarding student hunger and food insecurity. This research found that students who experience food insecurity engage in self-blaming practices and, thus, do not believe they have the right to be hungry or ask for help. Instead, food-insecure students employ several strategies, including face negotiation and disclosure, to minimize the severity of their situation and mitigate tensions between their health, finances, and convenience. This study concludes with a discussion of implications, limitations and areas for future research.

Food insecurity exists when access to safe, nutritionally adequate foods is limited or uncertain, or when acquisition of these foods occurs in socially unacceptable ways (Anderson, 1990). Considerable research has focused on identifying the risk factors for and potential consequences of household food insecurity; however, few studies have investigated whether and how place of residence might influence household food insecurity. To address this gap in the literature, a mixed methods approach was used to explore the connections between risk factors, household food insecurity, and health in urban and rural settings. This dissertation comprised three studies. In the first study, secondary data were used to identify the household factors that increased the risk for household food insecurity and to examine whether place of residence moderated these relationships. Significant associations were found between household sociodemographics and household food insecurity. In addition, rural households were more likely to report household food insecurity. Although most moderation models were non-significant, a moderation effect was found for educational attainment: secondary school graduation increased the risk for household food insecurity in urban households, yet it was protective in rural households. In the second study, secondary data were used to examine the relationship between household food insecurity and poor general, physical, and mental health, and to test for a moderation effect of place of residence. In the main effects models, household food insecurity was associated with an increased likelihood of poor health on all measures. There was no evidence of urban-rural differences in these relationships. In the third study, qualitative data were used to explore household food insecurity from the perspective of urban and rural residents in Eastern Ontario. Findings revealed that urban and rural residents described similar conditions, processes, and consequences of household food insecurity; however, the unique features of the urban and rural settings influenced how people managed these experiences. In particular, certain aspects of the rural settings added to the complexity of managing household food insecurity. Overall, the results of this dissertation suggest that the urban-rural context, although important, is secondary to the primary contribution of low economic and social resources in household food insecurity.

archives@tulane.edu / Hispanic older adults are burdened by obesity, and Body Mass Index (BMI) - a common measure of obesity, has limitations with aging. Further, Food Insecurity (FI) is linked to adverse health outcomes, including obesity. Yet, there is limited knowledge on obesity-related health risk disparities on account of place of birth among Hispanic older adults and the effect of FI. This study examines: 1) the prevalence of obesity {BMI/Waist Circumference (WC) classification} by place of birth and their associations to health risks- cardiometabolic risk factors (CRF) and physical performance (PP), and 2) the impact of FI. First, a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) III with sample population of n= 4,584 participants aged 50 years and older {Non-Hispanic whites (NHW), n=3059; United States born Hispanics (USB-H), n=1170; Foreign-born Hispanics (FB-H), n=355} was done. Measurements include body types created from BMI/WC cut off values; CRFs as defined by the American heart association; PP-time tandem stand, time to complete five-stand and time to complete 8ft walk; sociodemographic (SDF) and behavioral factors (BF). Weighted multivariable logistic regression analyzed associations between body types and health risks controlling for SDF and BF. Second, NHANES 2005-2014 with sample population of (n=5,772; NHW, n=3869; USB, n=613; FBH, n=1,290) was analyzed. Food security status was defined as suggested by the United States Department of Agriculture (food secure-FS, food insecure-FI). Multivariable logistic regressions examined relationships between FI, obesity, and having at least one CRF. The proportion of body types varied across ethnicity-place of birth. NHW and FBH were more likely to have normal BMI/WC, while USB-H were more likely to have high BMI/WC. Body types with high BMI/WC were more likely to have CRFs and poorer PP when compared to those with normal BMI/WC. Stratifying by ethnicity-place of birth, FI persons had 1.60-1.80 odds of having at least one CRF when compared to persons who are FS. This study suggests that regardless of place of birth, Hispanic older adults are at obesity-related health risks. The concurrent use of BMI and WC measures in clinic settings and population-based research may encourage healthy aging. / 1 / Queendaleen Chukwurah

Background: Food insecurity is a major public health concern in most settings where the Human Immunodeficiency Virus (HIV) is prevalent, and it affects women disproportionately. However, the prevalence of food insecurity and associated risk factors for women who are living with HIV (WLH) in South Africa is under researched. Methods: The researcher conducted a secondary, cross-sectional analysis of 346 HIV-infected women aged between 18 and 45, in Gugulethu, Cape Town. All participants were 12 months postpartum and enrolled into the MCH-ART study, a large implementation science study of antiretroviral use in pregnancy. For this study, women completed a 10-item household food security questionnaire that categorised food security status into household-level food insecurity, individual level food insecurity and children hunger. Using this tool, the level of food insecurity was categorised as food insecurity (“yes” to up to four questions), experiencing food insecurity (“yes” to five questions or more) and free from food insecurity (“no” to all questions). Results: Overall, the mean age was 29 years (SD: 5.46); 25 % of the women completed high school; 61 % were unemployed; nearly 66 % were free from food insecurity; and 25 % experienced food insecurity. Women who were employed were less likely to experience food insecurity when compared to those who were not employed (OR=0.54; 95 % CI: 0.32-0.90; p= 0.01). Those who completed high school were associated with food security than the ones who did not complete high school (OR= 0.5; 95 % CI: 0.28-0.97; p= 0.04). After adjusting for maternal age, marital and cohabiting status, education attainment, and parity, employment remained a significant predictor of experiencing food security (AOR= 0.55; 95 % CI: 0.32- 0.95 p=0.03) and educational attainment was no longer associated with food insecurity. Conclusions: The prevalence of food insecurity was relatively low in the urban-based sample of HIV-infected women. However, most of these HIV-infected women were obese and overweight. Thus, there is a clear need for more research to explore issues of food insecurity and nutrition in HIV-infected South African women.