Year

2010

Degree Name

Doctor of Philosophy

Department

School of Health Sciences

Abstract

This thesis reports on food insecurity in the community and explores food insecurity perspectives among food insecure people. Food security is the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing, while food insecurity is limited or uncertain ability to acquire good nutritious food in socially acceptable means.

The aim of this study was to develop processes and instruments that can be used to measure and describe food insecurity. The processes and instruments would be useful for local planners and health services to assess and monitor food insecurity in their area and use as a basis for programs and policies development.

This study employed a mixed methods research approach using both quantitative and qualitative methods for data collection. A telephone survey was conducted among 296 households from the population in postal area 2502 and 2505, two socioeconomically disadvantaged areas located in the Illawarra region NSW. The instrument for the telephone survey was adapted from the US Food Security Survey Module (FSSM). Results from the survey were also plotted on digital maps, together with other relevant social data such as location of local shops. Two of the telephone survey participants were further engaged in face-to-face interviews. Four focus group discussions were conducted involving a total of 22 participants. The focus group participants were selected from the Warrawong Community Kitchen, a food aid program which provided free meals at lunch time.

Survey results indicated that 8.4% of the survey participants were food insecure, with 7.4% classified as food insecure without hunger and 1.0% as food insecure with hunger. Housing tenure status, language spoken at home and time taken to get to shops were found to be significantly associated with food insecurity. Renting and paying mortgage were found to affect food security status. People speaking other languages besides English at home were more likely to become food insecure, suggesting that some ethnic groups or immigrants are more at risk of food insecurity. Food insecure people were also found to take more time to get to the shop. Identification of these predictors can facilitate the determination of social indicators that need to be considered in the local policy and planning.

The qualitative data indicated that cost of food was the major factor for food insecure people in obtaining enough food. Being food insecure was reported as affecting the quantity and quality of food they had, as well as having implications for mental and social health. A range of coping strategies were employed to deal with the situation, including budgeting, searching for cheap food, receiving food in exchange for services, food aid, or in extreme cases, going without food. The study also indicated that food insecure people were at risk of health and food safety problems resulting from their coping strategies. The participants believed that others in the community had a negative social attitude towards them. They held the view that resorting to food aid services was an acceptable coping strategy, but they perceived that some people in their circumstances would not hold this same perception. In addition, addiction to cigarettes, alcohol and drugs were mentioned as barriers to having enough food in the households as money was preferentially directed to these substances. Understanding of the perspectives and concerns as well as barriers they face provide important information to guide local program planning and implementation, especially for professionals working with food insecure people.

An outcome of this study was the development of a draft short form instrument containing four food insecurity items to determine the prevalence of food insecurity. This is an important advance on the single food security question currently used in the state and national level food and health surveys in Australia. This study also demonstrated that data can be presented and information delivered very effectively using digital maps to complement standard methods for data presentation. It is anticipated that the instrument developed and information gained through this study will be beneficial for local planners and health services professionals to manage local food insecurity programs and policies development.

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