Coping with food Insecurity

E.M. Berry

The need to eat food is arguably the most important biological drive in all living species. It is even more essential / significant that the drive to reproduce since when food is scarce, women lose their menstrual cycles and men their libido. If there are not enough energy stores to maintain a successful pregnancy, then nature will delay the process.

Food and Nutrition Security

Food and nutrition security exists “when all people at all times have physical, social and economic access to food, which is safe and consumed in sufficient quantity and quality to meet their dietary needs and food preferences, and is supported by an environment of adequate sanitation, health services and care, allowing for a healthy and active life”[i]. In this scheme food production, food systems and socio-economic aspects which are the basis for the concept of food security are complemented by the biological approach in which the human being is considered as the starting point and not at the end of the food chain. Food Security is best considered as a causal, linked pathway from production to consumption. A number of domains are recognized in Food Security. 1) Availability of food produced and imported; 2) Accessibility. The food can reach the consumer and the latter has enough money for purchase. To such physical and economic accessibility is added socio-cultural access to ensure that the food is culturally acceptable and that social protection nets exist to help the less fortunate. 3) Utilization. The individual must be able to eat adequate amounts both in quantity and quality in order to live a healthy and full life to realize his or her potential. Food and water must be safe and clean, and thus adequate water and sanitation are also involved at this level. A person must be physically well to be able to digest and utilize the food consumed. A fourth domain is called Stability. This deals with the ability of the nation/ community / person are able to withstand shocks to the food chain system whether caused by natural disasters (climate, earthquakes) or those that are man-made (wars, economic crises). Thus, it may be seen that Food security exists at a number of levels. Availability - National; Accessibility – Household; Utilization – Individual; Stability – may be considered as a time dimension that affects all the levels. All four of these dimensions must be intact for full food security. It is also of note that food losses from the farm or port to the shop and food waste thereafter may account for up to one third of total food availability. Reducing these amounts is a major challenge  for securing world food availability in the future. More recent developments emphasize the importance of sustainability which may be considered as the long-term time dimension to food security. Sustainability involves indicators at a supra-national / regional level of ecology, biodiversity and climate change[ii]. These will affect the food security of future generations. There are many methodologies and indicators by which to measure food security which depend on the analysis of data from primary (expert opinion and community perspectives) and secondary (owned by governments) sources[iii]. However, the people with the most problems with FS are rarely included. These are the marginalized members of society: unemployed, homeless, special needs, elderly, single parents, mentally frail and more. Much more efforts need to be made to reach out to and help these sectors in the population.

Food Insecurity

Food Insecurity, on the other hand, will occur when there are problems at any level in the food production – consumption pathway. The definition of food insecurity is “whenever the availability of nutritionally adequate and safe foods, or the ability to acquire acceptable foods in socially acceptable ways, is limited or uncertain”[iv] When this happens a number of compensatory coping mechanisms / strategies come into play[v] [vi]. To try and understand better the coping strategies of households and individuals, I wish to introduce a concept called the sociotype [vii] [viii]. The sociotype is a framework synthesis of the factors that determine an individual’s resilience across the life trajectory from birth to old age. It is considered to be made up of three inputs: - Individual health; Relationships and Environment. Individual factors include physical and mental health, personality and life philosophy. Relationships cover all interactions within the family, friends/ lovers and at work. The Environmental factors include education, employment, socio-economic and of course where one lives and under what political system. The interactions between these three areas will determine how a person will cope with any adverse situation such as the life events of marriage, divorce and bereavement and aging. A person’s sociotype and that of his family will be challenged by chronic disease situations such as diabetes, cancer, dialysis post transplant and many other conditions.  Work in progress (unpublished data) on a survey on over 1200 adult respondents shows that coping and mastery skills are independent of age and increase with educational achievements. Individuals who are less healthy and wealthy have poorer coping scores. However since this is a cross-sectional study these findings represent associations and not causality, Thus, one cannot know whether a person is less healthy because of poorer coping abilities or vice-versa. Only a longitudinal study will answer such a question.

In coping with Food Insecurity a number of questions arise in each of the sociotype domains as shown in Table 1. The answers to these questions (and there are many more) cannot be tackled through randomized controlled trials and require a more qualitative type of methodology. In practice when food insecurity occurs the household and individual go through a series of coping strategies. This process has been described in a number of stages. Firstly there is worry and concern. Then comes a decrease in the quality and diversity of the food purchased. Next occurs a decrease in the amounts eaten and meal skipping. Lastly there is a resort to non-sociable activities such as begging and stealing. Attempts have been made to document these behaviours but this has proven to be rather difficult, especially in capturing the last coping stages about which people are understandably reluctant to admit and talk.

Table 2 shows the various strategies for coping with food security within the three domains of the sociotype. According to four types of strategies: 1. Dietary Change; 2. Increase Short-Term Household Food Availability; 3. Decrease Numbers of People Eating Together and 4. Rationing Strategies[ix]

Food insecurity is time dependent. If it is only transient such as after a temporary economic / unemployment shock, then the family will return to being food secure, but not necessarily at the same degree as before the crisis. Thus, there may be different levels of food security relating to the quality and quantity of food eaten, whether at home or outside of it. Such a concept of levels of food security requires further clarification and will be useful in the future for assessing responses to different scenarios of food insecurity.

Future Challenges

Can one teach coping skills for food insecurity? This question has to be tackled at different stages depending on the country or region involved. Nationally there must be policies for emergency situations including international aid, storage and distribution facilities. At the household level it probably can only be dealt with over the short time scale. Where possible, households should have stores of food and money. Also home grown produce (rural only) and cooperation and food sharing between family and neighbors will be helpful.[x] A surrogate marker for chronic food insecurity is chronic hunger. Ideally, no child should go to bed hungry. If this happens, then there is a breakdown in family duties, public health monitoring and national values. Food is a human right which is recognized in article 25 of the Universal Declaration on Human Rights and in article 11 of the International Covenant on Economic, Social and Cultural rights: long-term sustainable food security will ensure it[xi]. Ensuring Food security is everyone’s interest and responsibility.

Table 1 Questions arising when tackling Food Insecurity by domain of Sociotype

INDIVIDUAL HEALTH

 How to keep up food quality and prevent malnutrition?

How to deal with constant hunger?

How to eat previously unacceptable food – culture / religious taboos?

RELATIONSHIPS

How to decide to whom to distribute the food?

How to cope if someone falls ill?

ENVIRONMENT

How to borrow or get credit?

How to beg? / steal

Consequences of economic hardship?

Table 2. Coping Strategies to Food Insecurity by Coping Domains