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Section 141 of The Healthy, Hunger-Free Kids Act of 20101 provides funding for a research program on the causes and consequences of childhood hunger and food insecurity, and the characteristics of households with childhood hunger and food insecurity, with a particular focus on efforts to improve the knowledge base regarding contributing factors, geographic distribution, programmatic effectiveness, public health and medical costs, and consequences for child development, well-being, and educational attainment. The Economic Research Service and Food and Nutrition Service of the US Department of Agriculture conducted two outreach efforts to obtain input from the research community and other stakeholders to help focus on areas and methods with the greatest research potential. First, Food and Nutrition Service sought written comments to selected questions through publication of a Federal Register Notice. The second option was to convene a workshop under the auspices of the Committee on National Statistics of the National Research Council and the Food and Nutrition Board of the Institute of Medicine. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger is the summary of that workshop, convened in Fall 2012 to examine research gaps and opportunities to advance understanding of the causes and consequences of child hunger in the United States. This report reviews the adequacy of current knowledge, identifies substantial research gaps, and considers data availability of economic, health, social, cultural, demographic, and other factors that contribute to childhood hunger or food insecurity. It also considers the geographic distribution of childhood hunger and food insecurity; the extent to which existing federal assistance programs reduce childhood hunger and food insecurity; childhood hunger and food insecurity persistence, and the extent to which it is due to gaps in program coverage; and the inability of potential participants to access programs, or the insufficiency of program benefits or services. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger will be a resource to inform discussions about the public health and medical costs of childhood hunger and food insecurity through its focus on determinants of child food insecurity and hunger, individual, community, and policy responses to hunger, impacts of child food insecurity and hunger, and measurement and surveillance issues.
The United States is viewed by the world as a country with plenty of food, yet not all households in America are food secure, meaning access at all times to enough food for an active, healthy life. A proportion of the population experiences food insecurity at some time in a given year because of food deprivation and lack of access to food due to economic resource constraints. Still, food insecurity in the United States is not of the same intensity as in some developing countries. Since 1995 the U.S. Department of Agriculture (USDA) has annually published statistics on the extent of food insecurity and food insecurity with hunger in U.S. households. These estimates are based on a survey measure developed by the U.S. Food Security Measurement Project, an ongoing collaboration among federal agencies, academic researchers, and private organizations. USDA requested the Committee on National Statistics of the National Academies to convene a panel of experts to undertake a two-year study in two phases to review at this 10-year mark the concepts and methodology for measuring food insecurity and hunger and the uses of the measure. In Phase 2 of the study the panel was to consider in more depth the issues raised in Phase 1 relating to the concepts and methods used to measure food security and make recommendations as appropriate. The Committee on National Statistics appointed a panel of 10 experts to examine the above issues. In order to provide timely guidance to USDA, the panel issued an interim Phase 1 report, Measuring Food Insecurity and Hunger: Phase 1 Report. That report presented the panel's preliminary assessments of the food security concepts and definitions; the appropriateness of identifying hunger as a severe range of food insecurity in such a survey-based measurement method; questions for measuring these concepts; and the appropriateness of a household survey for regularly monitoring food security in the U.S. population. It provided interim guidance for the continued production of the food security estimates. This final report primarily focuses on the Phase 2 charge. The major findings and conclusions based on the panel's review and deliberations are summarized.
At some point during 2009, more than 17 million households in the United States had difficulty providing enough food for all their members because of a lack of resources. In more than one-third of these households, the food intake of some household members was reduced and normal eating patterns were disrupted due to limited resources. The Workshop on Understanding the Relationship Between Food Insecurity and Obesity was held to explore the biological, economic, psychosocial, and other factors that may influence the relationship between food insecurity, overweight, and obesity in the United States. Hunger and Obesity examines current concepts and research findings in the field. The report identifies information gaps, proposes alternative approaches to analyzing data, recommends new data that should be collected, and addresses the limitations of the available research.
A review of 120 studies published since 2006 was undertaken to examine the relationship between food insecurity at the household or individual level and the following nutrition indicators: child stunting, child wasting, low birth weight, exclusive breastfeeding of infants < 6 months of age, anaemia in women of reproductive age, child overweight and adult obesity. While there is some evidence of a direct association between food insecurity and stunting for children in lower-middle and upper-middle income countries, evidence of links between food insecurity and either child wasting or overweight is almost absent, with the exception of an association with overweight among girls in middle- and high-income countries. The obesity–food insecurity link is most predominant among women in high-income countries, while it is almost absent in men. In addition, food insecurity increases the risk for low birth weight in infants and anaemia in women. Methodological concerns that pose challenges for valid comparison of results relate to study design, data analysis techniques, use of different indicators of household/individual food security and malnutrition, and the limited availability of high-quality micro-level data from large-scale surveys. Most studies report correlation rather than causal associations between food insecurity and nutrition indicators; longitudinal micro-level data from large-scale surveys can help establish causal association and capture the dynamic nature of food insecurity. Food insecurity emerges as a predictor of undernutrition as well as overweight and obesity, highlighting the need for multisectoral strategies and policies to combat food insecurity and multiple forms of malnutrition.
This salient resource offers clinicians a comprehensive multi-tiered framework for identifying, addressing, and reducing food insecurity among children and their families. Reinforcing the importance of food insecurity as a key social determinant of health, this monograph reviews the epidemiology and presents in-depth guidelines for screening for food insecurity and hunger. Recommendations for screening in a busy clinical setting as well as the strengths and limitations of widely-used instruments are discussed. The monograph also outlines a variety of clinic-level interventions, potential community-based resources, and opportunities for clinical-community partnerships to improve families’ food access and security. Further, contributors provide workable plans for large-scale advocacy through greater engagement with professional and community resources as well as policymakers. The monograph concludes with an outline of the critical steps to implement a food insecurity screening process and the key components to train the next generation of provider-advocates. Included in the coverage: Epidemiology and pathophysiology of food insecurity Screening tools and training Scope of interventions to address food insecurity Creation and evaluation of the impact of food insecurity-focused clinical-community partnerships on patients and populations Development of an action plan to fight food insecurity Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings will find an engaged audience among physicians and other clinicians who want to address food insecurity in their healthcare and/or community setting. Institutions that are starting to address social determinants of health, including food insecurity, will find guidance on screening tools, processes and evaluation of impact.
New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.
Inequalities in the Early Years examines poverty’s effects on children and provides workable solutions for decreasing childhood inequalities through the formal education process. This powerful edited collection explores early childhood inequalities across ten disciplines: earth sciences and geography, life sciences, physical sciences, technology, mathematics, history, society and social institutions, business and economy, the arts, and sports and recreation, following Kipfer’s delineation of broad subject areas of knowledge. The volume reaches beyond the domain of education to include multiple perspectives from scholars in the aforementioned disciplines.