Since 1975, over 1.3 million Southeast Asian refugees have resettled in the United States from the Southeast Asian nations of Cambodia, Laos, and Vietnam (Office of Refugee Resettlement, 2014). Many Southeast Asian refugees fled their home countries after the Vietnam War to avoid political persecution. As a result of forced migration, Southeast Asian refugees experience high levels of psychological distress attributed to premigration trauma and postmigration. Stressors may include adjusting to a new culture, finding housing, establishing employment, financial hardship, learning a new language and the feeling of identity loss of their homeland. In considering these stressors, this study sought to understand how a lack of access to affordable healthy food may be impacting Southeast Asian refugees’ social, mental, and physical health. Using basic qualitative research, nine structured participant interviews were conducted. Findings suggest one way to alleviate some stress for refugees was to increase access to culturally congruent food. Additionally, increasing economic opportunities and transportation services were identified as critical to improving access to healthy food options. The theoretical framework that guided this study was resilience theory. This framework brought to light the hardship and stress experienced by refugees. I then used it to outline ways that community gardens may build individual resilience to overcome personal hardships through social support structures. The findings highlight the importance of resettling refugees in communities close to families to build individual resilience and the need for refugee resettlement practitioners to continue to offer resettlement support beyond initial arrival to the United States and until economic self-sufficiency is achieved. Additionally, four central themes emerged from individual stories of each participant’s perceptions of how food access impacts their social, mental, and physical health. The four themes were: (1) postmigration traumas create hardships among Hmong refugees, (2) poverty and physical and mental health disabilities impact food access, (3) food cultivation is deeply rooted in the Hmong culture, and (4) gardens build social communities and give hope. The study also uncovered two unexpected findings. The first was the strong cultural belief in natural healing using herbal medicine known as “tshuaj ntsuab Hmoob” or Hmong green medicine, and, secondly, the prevalent cultivation of Hmong herbal medicine plants in the gardens. For practitioners developing housing for resettled refugees, creating green space for refugees to cultivate their traditional green medicine is vital to Hmong refugees’ identity and culture. One way to provide such access would be to incorporate green space into resettlement housing arrangements so refugees may cultivate fruits and vegetables native to their home countries. Creating green spaces for refugees may help to preserve their rich culture and empower refugee communities to practice their cultural beliefs and traditions. Lastly, I conclude the study with a proposal for development of a nonprofit community garden called Garden of Hope. My vision for the Garden of Hope is to address findings of this study through program services, which may increase access to culturally congruent food and promote individual resilience through entrepreneurship. The goal is to teach refugees how to grow and market their organic fruits and vegetables to local restaurants and or sell them at local community farmers markets. Addressing postmigration stressors for Southeast Asian refugees through the Garden of Hope may improve individual economic mobility and uplift improvised communities through entrepreneurship.

This thesis focuses on the food environment of Masiphumelele and seeks to understand how mixed-method approaches could be employed to facilitate an advanced understanding of food access in Masiphumelele. Masiphumelele was chosen as the case study for this research project as this work is sponsored by the IDRC-funded Nourishing Spaces project, which works in Masiphumelele. Based on the food-environment framework, this thesis embarked on the valuation of food environment literature to establish the interconnections between the four pillars of food security, food environments, and food systems in the urban context. The findings of this study endorse other work on food environments that issues of access should not only be understood through the physical and socioeconomic lens but also consider related social aspects that shape, enable or constrain food choices and behaviours in urban contexts. The findings of this thesis underscore the need for the reconceptualization of food environments beyond the simplistic physical and economic access framings which dominate earlier food environment work characterized by food deserts. Following the assessment of existing literature on food security, the discourse revealed that adopting the mixed-method approach that integrates participatory and retail mapping is an applicable conceptual framework for exposing socio-spatial dynamics influencing food utilization and food accessibility in the urban context. Building on the growing scholarly and policy interest of mixed methods approaches this thesis endeavours to establish the significance of the mixed-method approach in facilitating an improved understanding of food access in Masiphumelele.

No description available.

Objectif : Examiner la relation entre l’accès aux ressources alimentaires et le degré de l’insécurité alimentaire du ménage parmi les nouveaux utilisateurs des organismes communautaires d’intervention en sécurité alimentaire de Montréal. Méthode : Étude observationnelle transversale. Elle consiste en une analyse secondaire de données (n=785) qui proviennent du premier temps de mesure de l’enquête sur les effets des interventions en sécurité alimentaire à Montréal menée entre 2011 et 2012. La variable dépendante a été l’insécurité alimentaire. Les variables indépendantes ont été le mode de transport utilisé pour transporter les aliments, l’emplacement de l’épicerie la plus fréquentée par le participant, la distance entre l’organisme communautaire fréquenté par le participant et son domicile, la proximité de l’épicerie la plus fréquentée, la satisfaction quant à l’acceptabilité et le caractère abordable des aliments dans l’épicerie la plus fréquentée, et les difficultés d’accès aux aliments. Des régressions logistiques furent effectuées afin d’évaluer la relation entre les variables indépendantes et le degré de l’insécurité alimentaire, en utilisant l’insécurité sévère comme catégorie de référence. Résultats : Nos données suggèrent que la sévérité de l’insécurité alimentaire est associée à la difficulté d’accès aux aliments à cause de la cherté des aliments (pour la sécurité alimentaire, OR=0.13; CI : 0.07-0.25 et pour l’insécurité alimentaire modérée, OR=0.42; CI : 0.28-0.63), au fait de faire l’épicerie à l’extérieur du quartier ou de faire rarement l’épicerie (pour l’insécurité alimentaire modérée, OR=0.50, CI : 0.30-0.84), au fait d’avoir accès au transport collectif (pour l’insécurité alimentaire modérée, OR=1.73; CI : 1.09-2.73), au fait de résider à une distance moyenne (soit entre 1000 et 2000 mètres) d’un organisme communautaire en sécurité alimentaire (pour l’insécurité alimentaire modérée, OR=1.83; CI : 1.14-2.92), et à la difficulté d’accès aux aliments à cause de contraintes de transport (pour la sécurité alimentaire, OR=0.18, CI : 0.06-0.52). Conclusion : L’accès aux ressources alimentaires est associé au degré de l’insécurité alimentaire des nouveaux ménages participant aux interventions en sécurité alimentaire à Montréal. / Objectives: To explore the association between access to food resources and household food insecurity level among new participants in food security interventions in Montreal. Methods: This is a cross-sectional study involving 785 new participants with less than 6 months involvement in community organizations delivering food security interventions. Data were collected through face-to-face interviews and geographic measures. The dependent variable was household food insecurity. While the independent variable was access to food resources, assessed through: location of the most used grocery store, distance between participant’s residence and the community organization used, mode of transportation, walking time to the grocery store most used, satisfaction regarding the acceptability and affordability of food available at the grocery store most used, and self-reported difficulties in access to food. Using the severe food insecurity as reference, multivariate logistic regression models were used to estimate the association between household food insecurity level and each explanatory variable. Results: Our data suggest that the severity of household food insecurity is associated with difficulty accessing food due to food affordability (OR=0.13, CI: 0.07-0.25 for food security and OR=0.42, CI: 0.28-0.63 for moderate food insecurity), doing groceries outside the neighborhoods or not shopping food frequently (OR=0.50, CI: 0.30-0.84 for moderate food insecurity), having access to public transportation (OR=1.73, CI: 1.09-2.73 for moderate food insecurity), residing between 1000 and to less than 2000 meters from the community organization (OR=1.83, CI: 1.14-2.92 for moderate food insecurity), and difficulty accessing food due transportation constraints (food security; OR=0.18, CI 95 % 0.06-0.52). Conclusion: Access to food resources is associated with household food insecurity level among new participants in food security interventions in Montreal.

This study evaluates the public market system in New Orleans, Louisiana by focusing on the history of New Orleans public markets, the privatization of food, and the "greening" of the city with the creation of the Crescent City Farmers Market and other grass roots food activist efforts. Using qualitative methods, ethnographic fieldwork, participant observation and interviewing, issues of food access, food security, food production, food locality, quality, and affordability in New Orleans are explored. The history of public markets in New Orleans and the patterns of market proliferation, regulation, and privatization are significant in the landscape of cultural self-identification, community cohesion, neighborhood networks and economic and ecological development and sustainability. The city's various food shopping arenas and their locations become markers of history, status, rebellion, and of the "other," and become centers for issues of health, economy, politics, and food.

Diet and dietary related health outcomes such as obesity and diabetes are major public health concerns. While personal choice and dietary behaviors are major influences on how an individual eats, the environment influences these choices and behaviors. The nutrition environment is one key influence and its relationship with food choice, behaviors, and socioeconomic influences is complex. Within the structure of the nutrition environment, food access and socioeconomic status compound influencing nutrition behavior and food choice. Food deserts are defined as geographic region of low access to healthy affordable food in low income areas. The USDA developed a system for the analysis of food deserts in the United States. However, the methods the USDA uses do not acknowledge potential geographical barriers present in rural mountainous regions including Appalachia. The purpose of this research is to determine whether the USDA methodology underrepresents food deserts in Appalachia and to develop a modified analysis model for the region. The region was analyzed at the census tract level using methods based on USDA guidelines for low income, rurality, and grocery store identification, then applied in Geographic Information Systems (GIS) to roadway data. Network analysis of drive time from grocery stores to 20 minutes away was performed. Low income, rural census tracts with 33% of their area outside of the 20-minute drive time zone were identified as food deserts. Counties containing tracts were then compared to USDA designated counties, using the dependent variables of obesity and diabetes diagnosis rates and controlled for by county level rurality and economic distress. Of the counties designated as rural, 63 contained food deserts by the modified methods and the USDA model identified 20, there was an overlap in identification of 12 counties. There was no significant difference for 2 methods in health outcomes for the counties. In conclusion, the modified methods do identify a larger food desert region. It is crucial to understand the geographic barriers to regions when addressing nutrition environment concerns. The underrepresentation of food desert areas can leave populations and communities underserved and without much needed resources to improve their access to healthy and affordable foods.

South Africa ranks high among the developing countries with income inequality and household food insecurity is a major concern in the country. The overall objective of the study was to investigate access and practices, which lead to increasing household access to nutritious food by households. The students registered for the one-year course identified households in the Dysselsdorp settlement in the Western Cape, South Africa which they worked closely with in food gardening. Descriptive research methods were used to assess food access and identify the socio-economic and demographic variables for this study. Qualitative and quantitative methods were used to gather data, following the College of Agriculture and Environmental Sciences of the University of South Africa’s ethical protocol and guidelines. Data were collected in the middle and at the end of the coursework (mid-term and end-term). A semi-structured baseline questionnaire was used to interview households and to conduct focus group discussions with the students. The baseline questionnaire consisted of five sections, namely the socio-demographic information, food utilization, food availability, food accessibility and the living standards measurement scores. A stratified random sampling strategy was used to select 30 students to participate in the focus group discussions. The students identified three or four households, which they worked closely with and those households were purposively selected for the baseline interviews. vi Data were analyzed using the Statistical Package for Social Sciences programme (IBM SPSS 24). Descriptive statistics (mean, frequencies and standard deviation) were used to compare the data. The 24-hour recall and 7 days food frequency recall was used to assess the household food consumption patterns. Qualitative data were recorded, transcribed, then themes and connections were used to explain the data and correlated with the objectives of the study. The socio-demographic data showed that most of the respondents were above 50 years old and they had an average number of 5.2 members. Thirty-one percent (31%) of the household heads had reached grade 8 to 12 in school, while 69% were those who had not gone to school and completed up to grade 7. Majority of the households relied on social grants as a source of income. The amount of money spent on food by the households in a month was between 0-R500 (63%) and 37% spent above R500 on food. Women participated more in food-related activities than men and the gardening activities were shared by the members of the households. The HDDS is a qualitative method for food consumption, which reflects household access to a variety of foods. The HDDS consists of food groups that the household has consumed over the past 24-hours and it is calculated based on the 12 food groups from the food consumed which are summed up; the mean score is used to determine diet diversity (Swindale & Bilinsky, 2006). The findings in this study is that the average HDDS increased from 5.6 to 6.4, which is above the recommended cut-off point for dietary quality (Steyn et al., 2006). Both the 24-hour recall and 7 days food frequency reported a high consumption of carbohydrates and meat, and less consumption of other food groups such as milk, vii eggs, fruits and vegetables were noted. The households relied on a variety of coping strategies such as asking for food from family or neighbours, depending on charity/grants, finding other sources of food and collecting wild food. All the households grew their own fruits, vegetables and crops. However, livestock production was practiced by 10% of the participating households. The households used preservation methods such as keeping food in a dry place (26), sun drying (38), canning (6), freezing (53) and refrigeration (11) to keep and store vegetables. The Living Standard Measurement (LSM) is a tool which focuses on household access to services and facilities (Faber et al., 2017). Household characteristics range from level 1 up to level 10, and a score from 1 to 4 are considered to be poor and lack access to services, while scores above 5 have improved access to resources and services. The LSM results of the households indicates that they have improved access to services as all the households scored above five. All the households, had access to land with water, electricity and toilet facilities in the yard. The major constraints experienced by the households were insufficient water, theft, pests, plant diseases and livestock which destroyed the crops. It is recommended that the government provide programmes aimed at developing communities, promoting healthy eating and food production. Workshops on nutrition education should be continuous and focus on basic sanitation, food hygiene. Income generation small-scale businesses, crop production, and livestock rearing will assist in alleviating hunger and unemployment. These initiatives could be extended to other areas of the country as a way to improve food security. / Life and Consumer Sciences / M.C.S.

Philosophiae Doctor - PhD / Type 2 diabetes mellitus (T2DM) and pre-diabetes contribute increasingly to the global burden of disease. Along with other behavioural risk factors, diet plays a key role in the onset and management of the disease, in turn largely determined by what foods are immediately accessible in local food environments. With this in mind, this thesis aims to answer the research question: What role do local food environments play in promoting or inhibiting access to healthy foods as part of the self - management of T2DM in urban and rural communities in South Africa, and what can be learned from an international perspective? Specific research objectives include, to: 1. Understand the current national-level policy context with regard to the observed rise in NCDs, their proximal determinants (specifically an observed change in diet patterns), and contributing environmental factors; 2. Identify the current food-related environmental factors associated with the onset and/or management of T2DM in an urban and a rural setting (as well as in four additional international settings in order to provide an international perspective); 3. Explore community perspectives of the role the local food environment plays in the self-management of T2DM in an urban and a rural setting; and, consequently 4. Recommend intervention- and/or policy-related actions that can be implemented based on study findings. A review of the literature and relevant policies was conducted towards achieving the first research objective. Quantitative data were systematically collected at an urban and rural site in South Africa through the creation of an ‘environmental profile’ in an attempt to achieve the second objective – comparable urban and rural data was also collected as part of a larger study at two other international sites (Kampala, Uganda and Stockholm, Sweden) to provide an international perspective. Included in the third objective is the collection of qualitative data through a community based participatory research method at the same urban and rural sites in South Africa. Finally, intervention and/or policy-related recommendations are developed based on study findings and in consultation with relevant stakeholders through interviews. / 2018-12-14

BScnut / Department of Nutrition

No description available.