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.

À l’instar des grandes transformations des relations internationales, les notions de la sécurité, d’insécurité et de frontière leurs étude ont été bouleversées par la multiplication des activités qualifiées de terroristes dans maints endroits du monde. Cette thèse se saisit de thème à la frontière entre le Niger et le Nigeria, victime ces dernières années d’une insécurité transfrontalière que lui impose notamment l’organisation Boko Haram qui agit à l’échelle transnationale en s’affranchissant des limites frontalières dans le bassin du Lac Tchad. Ainsi cette crise sécuritaire a fait l’objet d’une panoplie des réactions aussi bien nationales que bilatérales ou encore issues des organisations régionales et internationales. La gestion diversifiée de cet ébranlement met en lumière les contradictions qui animent les relations internationales et la complexité des ressorts d’une insécurité transfrontalière mouvante, mal connue et peu médiatisée. / Like the great transformations of international relations, the notions of security, insecurity and border have been deeply transformed, especially due to the advent of the phenomenon labelled as terrorism in many places of the world. This doctoral dissertation explores this situation at the border between Niger and Nigeria. The region has been subjected to cross-border insecurity imposed inter alia by the organization Boko Haram, which acts on a transnational scale without considering the state borders in the Lake Chad Basin region. Thus, this security crisis has been the subject of a number of reactions at national or bilateral levels or from regional and international organizations. The diversified management of this shock wave highlights the contradictions that animate international relations and the complexity in handling this transboundary insecurity that is shifting, poorly known and poorly publicized.

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.

Food insecurity has long been a global challenge associated with negative health outcomes. The spectrum of food insecurity corresponds to a spectrum of negative health outcomes that range from kwashiorkor and marasmus to obesity and chronic disease. The burden of food insecurity is a stressor that additionally negatively effects mental health. In this study, the relationship between food insecurity and mental health was examined using data from the National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module, and participants were classified into one of four categories based on their responses: (1) full food security (FFS), for households with no concerns related to obtaining adequate food, (2) marginal food security (MFS), for households that occasionally had problems obtaining adequate food, (3) low food security (LFS), for households that had to reduce the quality, variety, or desirability of the food they ate, and (4) very low food security (VLFS), for households where at least one member had their food intake reduced due to a lack of money for food. Food insecurity survey scores were classified as FFS if zero affirmative responses were reported, MFS for 1 or 2 affirmative responses, LFS for 3 to 5 affirmative responses, and VLFS for 6 to 10 affirmative responses. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥ 10 indicating depression. Data were analyzed from 28,448 adults aged 20 and older who participated in NHANES from 2005 to 2016. Food insecurity was present in 19.2% of the sample population (n=5,452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Adults with FFS and VLFS experienced depression at rates of 5.1% and 25.8%, respectively. Participants with VLFS had a significantly greater odds of depression than FFS adults, OR=3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factor for depression among US adults. To address this issue in our citizenry, policy initiatives and public health interventions addressing both food access and mental health should be prioritized.

Thesis advisor: Summer Sherburne Hawkins / Background: The COVID-19 pandemic has exacerbated food insecurity among American households. There is limited knowledge on how university students, who were vulnerable to food insecurity prior to the pandemic, have been impacted by COVID-19. This study aimed to measure the prevalence of food insecurity at a private university during the pandemic and identify student coping strategies. Methods: An online survey was distributed via REDCap to university undergraduates. The U.S. Department of Agriculture’s Food Security Survey was utilized to determine the prevalence of food insecurity during the fall 2021 semester and 2020-2021 academic year. The survey collected information on student demographics and strategies students used to obtain food. Interviews were conducted with 6 survey participants to gather richer information about student experiences. Results: 292 student responses were analyzed. The prevalence of food insecurity during fall 2021 was 36.7%, and 34.6% during the 2020-2021 academic year. The strongest predictors of food insecurity (in fall 2021) were working 11+ hours/week (OR: 4.42, 95% CI: 1.73-11.7), previous participation in the National School Lunch Program (OR: 4.04, 95% CI: 1.43-12.2), and receiving financial aid (OR: 3.79, 95% CI: 1.70-8.86). Themes highlighted in interviews included barriers to accessing food, the impact food insecurity has on overall wellbeing, and programs that students would like implemented. Conclusions: Approximately a third of undergraduates at this university experience food insecurity, with financially disadvantaged students being at highest risk. Barriers to obtaining food for university students needs to be addressed with institutional, statewide, and federal policies. / Thesis (BS) — Boston College, 2022. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Departmental Honors. / Discipline: Biology.

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