instructor’s note food security in marginalized communities… · food insecurity (again...

This Instructor’s Note and associated Teaching Pack were developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.

This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported

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Instructor’s Note Food Security in Marginalized Communities 2018

Overview This Instructor’s Note is part of a teaching pack designed to introduce students to the concept of food security as a global health risk. The materials in this pack explore the basic concepts of food security as they relate to multi-sectoral health risks and responses, and common inequities that can compromise food security due to social and economic discrimination and conflict. The lessons use both data and narrative resources to consider why food security is important for individual, community, and global health.

The first lesson in the pack introduces fundamental concepts for thinking about food security across populations, social sectors, and health conditions. The second and third lessons focus on identifying and understanding food-related health risks in two distinct geographic settings, among populations shaped by persistent historical trauma: Native American communities in the United States and Ukraine. Both communities face disproportionately higher food security risks compared to the general population; both suffer economic poverty due to a multi-generational history of conflict and discrimination; and both live within nations (the U.S. and Ukraine) typically understood to produce an abundance of sufficient food for their populations. The fourth lesson is an opportunity to compare and contrast the contexts discussed in Lessons 2 and 3, and further discuss potential positive responses that might advance food security in such settings.

The teaching pack was developed by the Global Health Education and Learning Incubator (GHELI) at Harvard University. GHELI curates resource collections and teaching packs to equip students and educators with high-quality, accessible materials on priority topics, drawn from a range of sources and mediums.

The teaching pack is composed of this Instructor’s Note and the following companion materials:

Teaching Materials

• Lesson 1: Food Security: An Introduction • Lesson 2: Grocery Gap: Food Security in Native American Communities • Lesson 3: Broken Breadbasket: Food Security in Ukraine • Lesson 4: Food Security: Connecting Commonalities • Hunger and Food Security: Annotated Bibliography • Hunger and Food Security: Glossary of Terms

2 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported


Food Security: Instructor’s Note

Learner Level

• Undergraduate

Learning Objectives The material in this teaching pack will enable students to:

1. Define food security and name the four essential conditions for it; 2. Understand why and how food security is relevant to health for individuals and communities; 3. Identify risk factors that undermine food security in communities affected by violence and

discrimination; and, 4. Name and discuss ways to improve food security through health sector and non-health sector

approaches.

Lesson Summaries Lesson Plan 1: Food Security: An Introduction

This lesson teaches students about the fundamental concepts of food security. The activity introduces students to multidisciplinary and cross-sectoral factors that play key roles in food resources, practices, and security in any community or culture.

Lesson Plan 2: Grocery Gap: Food Security in Native American Communities

This lesson is the first of two lessons that use stories and graphic literacy resources to understand food security and related health risks among populations for whom health may be compromised by political violence, economic marginalization, and a past and present history of ethnic discrimination and suppression. The goal of this lesson is to draw on these resources and activities to consider food security concerns for Native American tribal communities in the United States.

Lesson Plan 3: Broken Breadbasket: Food Security in Ukraine

This lesson is the second of two lessons that use stories and graphic literacy resources to understand food security and related health risks among populations for whom health may be compromised by political violence, economic marginalization, and a past and present history of ethnic discrimination and suppression. The goal of this lesson is to draw on these resources and activities to consider the practical food security risks for persons living today in war-torn eastern Ukraine, particularly in the context of the region’s history and its current political and economic conflict.

Lesson Plan 4: Food Security: Connecting Commonalities

The goal of this lesson is to facilitate reflective discussion that compares, contrasts, and connects commonalities between food security for Native American tribal communities and residents of Ukraine, and to imagine potential positive responses that may promote health and food security in such settings.




Background This section summarizes background information essential to understanding food security broadly. It also provides the social, historical, and political contexts of the two communities examined in-depth in this teaching pack—Native America and Ukraine. Additional resources on history and data about these two communities are available in the accompanying annotated bibliography.

What is Food Security?

Food security is “a situation that exists when all people, at all times, have physical, social and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”1 The Food and Agriculture Organization of the United Nations (FAO) highlights four conditions that are essential to make food security possible:

1. Safe and nutritious food must be available; 2. People must have the economic and physical capacities to access it; that is, it must be attainable; 3. The nutrients in the available food must be usable to the body (this is known as “food utilization”);

and 4. Food resources must remain stable over time.

When the conditions above are not present, the population affected by this lack faces the risk of food insecurity.

Food insecurity (again according to the FAO) may be temporary, seasonal, or chronic and ongoing. The effect of food insecurity on health depends on how long it lasts as well as on many other different factors, including: age and stage of growth; the type and amounts of essential nutrients that are missing; the type and amounts of foods substituted in their place; disease; and household or community social factors (such as neglect, disability, unemployment, stress, poverty, domestic or armed violence, and other crises) that may further shape the daily experience of food insecurity. Long-term, chronic food insecurity typically leads to malnutrition, which the FAO defines as a bodily condition “caused by inadequate, unbalanced, or excessive consumption of macronutrients and/or micronutrients.” Both underweight and obesity are common signs of malnutrition. Chronic malnutrition is a risk factor that increases a person’s vulnerability to disease and infection, therefore food insecurity (depending on the situation, who is affected, and how long it lasts) can directly increase a person’s risk of developing adverse health conditions.

People from marginalized groups, who suffer social or economic inequities as a result of racial, ethnic, gender, age, or disability-related discrimination, may lack one or more of the four necessary conditions for food security. Such individuals or groups may be at risk even if their neighbors or others in the community are well-fed and healthy. This teaching pack focuses on Native Americans as a marginalized population due to historical discrimination that continues to influence their employment, poverty, and living conditions (Lesson 2), and on persons living in Ukraine, who are marginalized by economic and political conflicts over property and national boundaries (Lesson 3).

The risks that such populations face are sometimes discussed in relation to food sovereignty, meaning “the right of peoples to healthy and culturally appropriate food produced through ecologically sound and sustainable methods, and their right to define their own food and agriculture systems.”2 For example, Native

1 Annex 3: Glossary. The State of Food Security and Nutrition in the World 2017: Building Resilience for Peace and Food Security. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. Page 107. http://www.fao.org/3/a-I7695e.pdf. 2 World Democratic Forum. Declaration of Nyéléni 2007. http://world-governance.org/en/declaration-of-nyeleni.

http://www.fao.org/3/a-I7695e.pdf

http://world-governance.org/en/declaration-of-nyeleni




American tribal communities affected by economic poverty often depend on food aid in government-funded food packages that fail to provide adequate nutrition or support cultural food and agriculture traditions.

Food Security Risks in Food-Rich Nations: Native America

Why are Native American Tribal Communities Food Insecure?

Native American tribal communities across North America today inhabit geographic territorial boundaries that were forced on them as a result of 18th- and 19th-century European colonialization. Collective violence, wars, and discriminatory policies limited Native Americans’ access to traditional hunting grounds, food sources, and food preparation methods, and undermined the power of many communities to preserve and practice food-related cultural customs. Large-scale, forced “internal migration” efforts that relocated and confined Native American property rights to reservation lands also had complex consequences, including poverty and heightened stressors sometimes identified as “intergenerational” or “historical trauma.”3 Certain effects of this history of structural violence and discrimination on food security and related health outcomes are measurable in research data such as that summarized below.

Comparing Native American Food Security Risks with Other U.S. Populations

As instructors introduce students to food security across different populations in the United States, the data in Tables 1 and 2 below may be useful to illustrate both background context and the severity of the inequities that affect health disparities for Native American communities. These tables may be projected on a board, distributed as handouts, or used by the instructor to design a customized handout or introductory discussion.

Table 1 summarizes data on the inequities of poverty and food security in the United States today and as they affect Native Americans. This table illustrates that food insecurity rates differ between different Native American tribal communities, and that the risks are consistently higher within the Native American population compared with national averages and other groups. Table 2 illustrates inequities in one health outcome related to food security—diabetes prevalence—in youth and adults.

3 See, e.g., Evans-Campbell T. Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities. Journal of Interpersonal Violence 2008; 23(3): 316-338. DOI: http://dx.doi.org/10.1177/0886260507312290.

http://dx.doi.org/10.1177/0886260507312290




Table 1. Poverty and Food Insecurity in the United States in 2016

Proportion (percent) Source Poverty

All Americans 12.7 FRAC 20174, 1 Children (all Americans) 18.0 FRAC 2017, 1 Native Americans (average) 26.4 Pardilla5, 58 In the 26 counties with majority Native American population 37.0 Map the Meal Gap 20186 Native Americans: Navajo 42.9 Pardilla, 59

Food Insecurity Adults, all Americans 11.5 FRAC 2017, 3 Children, all Americans 17.5 FRAC 2017, 3 National Average 15.0 Zielinski7 Black non-Hispanic households (all) 25.1 Pardilla, 63 Black, non-Hispanic households below 130 percent poverty

44.0 Pardilla, 63

Food Insecurity among Native Americans: In the 26 counties with majority Native American population 20.0 Map the Meal Gap 20158 On reservations in Montana and South Dakota 43.0 Jernigan9 Native Americans in rural Oklahoma 30.0 Jernigan Navajo Nation, food-insecure households 76.7 Pardilla, 61-62 Navajo Nation, households with child hunger 30.0 Pardilla, 61-62

Table 2. Type 2 Diabetes: Health Disparities by Race Proportion Source Youth SEARCH Study10 Non-Hispanic White youth (10-19) diagnosed with Type 2 diabetes 0.19 per 1000 Native American youth (10-19) diagnosed with Type 2 diabetes

1.74 per 1000 Adults Percentage with Diabetes CDC11 Whites 8 Asian Americans 9 Hispanics 13 Blacks 13 Native Americans 16

4 Hunger and Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Food Research & Action Center 2017. Page 1. http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well. 5 Pardilla M et al. High Levels of Household Food Insecurity on the Navajo Nation. Public Health Nutrition 2013; 17(1): 58-65. DOI: https://doi.org/10.1017/S1368980012005630. 6 Map the Meal Gap 2018: A Report on County and Congressional District Food Insecurity and County Food Cost in the United States in 2016. Page 22. Feeding America 2018. http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-full.pdf. 7 Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015; Nov 25. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d. 8 Map the Meal Gap 2015: Highlights of Findings for Overall and Child Food Insecurity. Page 19. Feeding America 2015. http://www.feedingamerica.org/research/map-the-meal-gap/2013/map-the-meal-gap-2013-exec-summ.pdf. 9 Jernigan VBB et al. Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study. American Journal of Public Health 2017; 107(3): 441. DOI: https://doi.org/10.2105/AJPH.2016.303605. 10 SEARCH for Diabetes in Youth Study Group et al. The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006; 118(4): 1510-1518. http://pediatrics.aappublications.org/content/118/4/1510.long. 11 Native Americans with Diabetes. Centers for Disease Control and Prevention 2017. https://www.cdc.gov/vitalsigns/aian-diabetes.

http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well

https://doi.org/10.1017/S1368980012005630

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-full.pdf

https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d

http://www.feedingamerica.org/research/map-the-meal-gap/2013/map-the-meal-gap-2013-exec-summ.pdf

https://doi.org/10.2105/AJPH.2016.303605

http://pediatrics.aappublications.org/content/118/4/1510.long

https://www.cdc.gov/vitalsigns/aian-diabetes




Food Sovereignty: The Navajo (Diné) Community

Food sovereignty is an important concept in any discussion about food security. Food sovereignty is defined as “the right of peoples, communities, and countries to define their own agricultural, labor, fishing, food and land policies which are ecologically, socially, economically and culturally appropriate to their unique circumstances. It includes the true right to food and to produce food, which means that all people have the right to safe, nutritious, and culturally appropriate food and to food-producing resources and the ability to sustain themselves and societies.”12

The Navajo (Diné) nation represents a community whose food sovereignty has been threatened and affected in recent years. Navajo nation is a region of 25,000 square miles across Arizona, New Mexico, and Utah, and is home to nearly 174,000 people.13 Food insecurity and child hunger in these communities are particularly high; a 2014 survey on food sovereignty for the Diné noted that the closest off-reservation food store requires a 155-mile round-trip journey.14 The survey also outlined a number of important strategies that should be implemented to restore food sovereignty as a component of food security.15 These included: a return to culturally appropriate practices and philosophies, such as holistic relationships that bring together food systems and mental, spiritual, and community well-being; rebuilding Diné capacity to participate in food production; utilizing indigenous methods that consider environmental sustainability and ecological conservation; working within sacred food boundaries (see the illustration above); and drawing on community-based knowledge.

12 Food Sovereignty: A Right for All: Political Statement of the NGO/CSO Forum for Food Sovereignty. Nyeleni 2002. https://nyeleni.org/spip.php?article125. 13 Navajo Population Profile: 2010 U.S. Census. Navajo Division of Health, Navajo Epidemiology Center 2013. http://www.nec.navajo-nsn.gov/Portals/0/Reports/NN2010PopulationProfile.pdf. 14 Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People. Diné Policy Institute, First Nations Development Institute 2014. Page 17. https://firstnations.org/knowledge_center/download/din%C3%A9_food_sovereignty_report_navajo_nation_food_system_and_case_rebuild. 15 Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People. Diné Policy Institute, First Nations Development Institute 2014. https://firstnations.org/knowledge_center/download/din%C3%A9_food_sovereignty_report_navajo_nation_food_system_and_case_rebuild.

Four sacred foods in the Navajo (Diné) Native American tradition: corn, beans, squash, and tobacco. Source: Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People. Diné Policy Institute, First Nations Development Institute 2014. Page 40.

https://nyeleni.org/spip.php?article125

http://www.nec.navajo-nsn.gov/Portals/0/Reports/NN2010PopulationProfile.pdf

http://www.nec.navajo-nsn.gov/Portals/0/Reports/NN2010PopulationProfile.pdf

https://firstnations.org/knowledge_center/download/din%C3%A9_food_sovereignty_report_navajo_nation_food_system_and_case_rebuild





Food Security Risks in Food-Rich Nations: Ukraine

Why is Ukraine Food Insecure?

The eastern European country of Ukraine gained its independence from the Union of Soviet Socialist Republics (USSR) in 1991, and today borders on central Asia, Poland, Lithuania, Austria, and Russia. During the 19th century, Ukraine was known as Russia’s “breadbasket,” due to its fertile soil and abundant agricultural output. Before World War I, for instance, Ukraine provided Russia with 98 percent of its wheat, 82 percent of its sugar, and 75 percent of its rye.16 Despite this history, a catastrophic forced famine (known as the Holodomor) in 1932 and 1933, under Josef Stalin,17 imposed political policies that forced Ukrainian peasants off their land, removed all available food, prevented the population from moving to other areas within the USSR, and suppressed media awareness and aid for the millions who starved to death.

Since the USSR dissolved in 1991, Ukraine has shifted to a market economy, but the country continues to experience economic and political challenges. These challenges are reflected in the 2016 Global Burden of Disease (GBD) data (see Figure 1). The death rate (number of deaths per year per 100,000 population) for the country overall increased steeply following the dissolution of the USSR, with subsequent improvements—noted by reduced rates—over the past decade.

16 The quote and statistics in this paragraph are taken from: Magocsi PR. A History of Ukraine. University of Toronto Press 1996. Page 6. 17 For more about the 1932-1933 famine, see the Annotated Bibliography and the recommended readings.

Figure 1. Death Rate, Ukraine, 1990-2016 (Both Sexes. All Ages. All Causes. Source: Global Health Data Exchange, Institute for Health Metrics and Evaluation 2018. http://ghdx.healthdata.org/gbd-results-tool.

http://ghdx.healthdata.org/gbd-results-tool






Understanding the Connection between Conflict and Food Insecurity

Figure 1 reflects nation-wide data from all of Ukraine. It does not show the effect of severe political and armed conflict for an estimated 3.4 million people who live in the country’s eastern-most provinces. Following Russia’s military annexation of Ukraine’s Crimea peninsula in 2014, this region has faced prolonged political unrest that has disrupted employment, agriculture, and food security for millions. This is illustrated in Figures 2 and 3, which are also included in the activity assigned for Lesson 3.

In 2016, the World Food Programme interviewed 1,600 households in eastern Ukraine affected by the conflict. The area is illustrated in the map (Figure 2). The survey identified households in four affected areas: government-controlled (GC), non-government-controlled (NGC), exclusion zone near government-controlled (GCB), or exclusion zone near the non-government-controlled (NGCB) area. The study reported a 19 percent food insecurity overall, with rates of approximately 45 percent in several of the conflict-ridden areas.18

Food security in these conflict regions of Ukraine was affected by multiple social factors. Unpredictable violence, partisan gunfire, and the resulting chaos affected employment, agriculture, and housing, increasing household poverty. Landmines and unexploded weapons increased risk of injuries and mortality for agricultural workers. Unemployment affected the ability to afford both heating fuel and food during the cold winters. Recent estimates have found that the population living below subsistence level in the conflict areas has risen by roughly 20 percent in 2013 to approximately 70 percent in 2015. Food insecurity doubled from 2016 to 2017.19 The most vulnerable are women, children, and the elderly.

The survey results suggested that food-related factors that affect health are among the most substantial difficulties that residents in Eastern Ukraine face today. In a 2017 study by FAO to assess and analyze the

18 Ukraine Food Security Update. World Food Programme 2016. Page 3. https://www.wfp.org/content/ukraine-food-security-update-june-2016. 19 2018 Humanitarian Needs Overview: Ukraine. United Nations Office for the Coordination of Humanitarian Affairs 2018. https://reliefweb.int/report/ukraine/ukraine-humanitarian-needs-overview-2018-enuk.

Figure 2. Map of eastern Ukraine regions in conflict. Source: Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017; Nov. Page 4. https://www.humanitarianresponse.info/en/node/156653.

https://www.wfp.org/content/ukraine-food-security-update-june-2016

https://reliefweb.int/report/ukraine/ukraine-humanitarian-needs-overview-2018-enuk

https://www.humanitarianresponse.info/en/node/156653




socioeconomic impact and economic vulnerability,20 residents in the affected regions named the difficulties or shocks they had experienced during the conflict. The quantities of shocks (Figure 3) varied depending on where they lived. However, the top four difficulties identified by all groups—food prices, fuel/utility costs, health/sickness costs, and transportation costs—directly affect food security.

Figure 3. Difficulties/Shocks Experienced. Source: Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. Page 24, Figure 28. http://www.fao.org/3/a-i8171e.pdf.

A large percentage of Ukraine residents—63.1 percent in 2015, 46.7 percent in 2017—reported that they lacked cash for basic needs.21 The loss of livestock was equally substantial. Households that survive by agriculture reported livestock had been lost due to needed cash, inability to purchase feed, lack of water, lack of feed, lack of shelter, slaughter for food, lack of veterinary care, or death during the conflict.22

The case of Ukraine illustrates how food security in a region naturally rich in agricultural resources may be undermined by health determinants outside the health sector, including violence, poverty, and the destabilization of basic necessities of life, such as housing, employment, and access to clean water.

20 Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/3/a-i8171e.pdf. 21 Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. Page 24, Figure 29. http://www.fao.org/3/a-i8171e.pdf. 22 Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. Page 34, Figure 47. http://www.fao.org/3/a-i8171e.pdf.

http://www.fao.org/3/a-i8171e.pdf







Bringing It Together

The stories of these two populations differ in many ways. However, each group lives in a country known for abundant, albeit inequitably distributed, agricultural resources. Both groups have suffered multi-generational experiences of discrimination, conflict, trauma, and marginalization due to political factors.

Students in North America today who think about the topic of “food security” may associate food risks with stereotyped images of visible poverty, famine and starvation, or chronic humanitarian disasters. In comparing and contrasting food-related health risks in these two populations, the case examples in this teaching pack illustrate how the causative factors of food insecurity are more complex than simple food deficit. Both stories invite analysis of intersecting social factors and positive responses crossing multiple social sectors.

This lesson plan was originally developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Lesson Plan Food Security: An Introduction 2018

Overview This is the first of four lessons in a teaching pack designed to introduce students to the concept of food security as it relates to global health and health risks, particularly in the context of political conflict and ethnic discrimination. The first lesson introduces the foundations of food security. The second and third lessons focus on identifying and understanding food-related health risks in two geographic settings of political conflict and discrimination, with populations shaped by persistent historical trauma: Native American communities in the United States and Ukraine. The fourth lesson is an opportunity to compare and contrast the contexts and responses discussed in Lessons 2 and 3, and further discuss potential approaches to advance food security in such settings.

Purpose The purpose of this lesson is to teach undergraduate learners what food security is and to articulate its relevance to health conditions around the world and in different social sectors and populations. First, students gain a basic understanding of key concepts and terms, and examples of situations or conditions that may increase food security risks in certain populations or community settings. Next, through interactive dialogue in small groups, students use a graphic image to brainstorm how different sectors, health conditions, or population groups may be associated with increased food security risks and possible solutions to these risks. Finally, the class will gather together again to share ideas and take-aways. A short list of further questions may further aid the final discussion, if time allows, to ensure that students understand these basic concepts before applying them to the narrative and graphic interpretation exercises in Lessons 2, 3, and 4.

Selected material from the Annotated Bibliography may be helpful when planning the lesson. The teaching pack’s companion Glossary also provides definitions for key terms used in these lessons.

Learner Level

Undergraduate

Time

1 hour



Food Security: An Introduction: Lesson Plan

Required Materials

• White board • Pens, pencils, or markers • Printouts of the “Plate” exercises (see below)

Required Pre-Reading

The first two readings below provide basic overviews that introduce students to two different summaries of food security, one from an international perspective (from the Food and Agriculture Organization) and one from a national perspective (from the United States Department of Agriculture). The third reading provides a summary of specific health risks related to food insecurity in the United States. Additional readings are suggested in the “Basic Reads” section of the Annotated Bibliography for this teaching pack.

• An Introduction to the Basic Concepts of Food Security. Food and Agriculture Organization 2008. http://www.fao.org/docrep/013/al936e/al936e00.pdf. [alternatively, the accompanying policy brief offers the same information in a condensed format: Policy Brief: Food Security. Food and Agriculture Organization 2006.] http://www.fao.org/forestry/13128-0e6f36f27e0091055bec28ebe830f46b3.pdf.

• Food Security in the U.S. United States Department of Agriculture 2017. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us.

• Hunger and Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Page 4, Figure 1: Chronic Diseases, Health Conditions, and Health Behaviors Associated with Food Insecurity. Food Research & Action Center 2017. http://frac.org/wp-content/uploads/hunger-health-impact-poverty-food-insecurity-health-well-being.pdf.

Learning Objectives At the end of this lesson, students will be able to:

1. Define food security and name four essential conditions for food security in any global setting. 2. Name several typical risk factors that undermine food security. 3. Draw connections between food security risks and responses in one or more of the following three

categories: a. Social sectors b. Health conditions c. Specific vulnerable populations

4. Explain in simple terms why food insecurity is not just about one person or household but is a complex intersection of factors that, together, may affect entire communities or populations.

http://www.fao.org/docrep/013/al936e/al936e00.pdf

http://www.fao.org/forestry/13128-0e6f36f27e0091055bec28ebe830f46b3.pdf

https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us

http://frac.org/wp-content/uploads/hunger-health-impact-poverty-food-insecurity-health-well-being.pdf

http://frac.org/wp-content/uploads/hunger-health-impact-poverty-food-insecurity-health-well-being.pdf




Procedure Introductory Overview (15 minutes)

The teacher uses the first 15 minutes of the lesson to discuss the assigned readings. Below are key points that should be covered in the overall goals for this brief introductory summary.

What is Food Security/Insecurity?

Food security, according to the Food and Agriculture Organization of the United Nations (FAO), is “a situation that exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”1 According to the FAO, there are four essential dimensions necessary for food security:2

(1) Safe and nutritious food must be available; (2) People must have the economic and physical capacities to access it;

that is, it must be attainable; (3) The nutrients in the available food must be usable to the body (this is

known as “food utilization”); and (4) Food resources must remain stable over time.

When the conditions above are not present, the population affected by this lack faces the risk of food insecurity.

Food insecurity (again according to the FAO) may be temporary, seasonal, or chronic and ongoing. The effect of food insecurity on health depends on how long it lasts as well as on many other different factors, including: age and stage of growth; the type and amounts of essential nutrients that are missing; the type and amounts of foods substituted in their place; disease; and household or community social factors (such as neglect, disability, unemployment, stress, poverty, domestic or armed violence, and other crises) that may further shape the daily experience of food insecurity. Long-term, chronic food insecurity typically leads to malnutrition, which the FAO defines as a bodily condition “caused by inadequate, unbalanced, or excessive consumption of macronutrients and/or micronutrients.” Both underweight and obesity are common signs of malnutrition. Chronic malnutrition is a risk factor that increases a person’s vulnerability to disease and infection, therefore food insecurity (depending on the situation, who is affected, and how long it lasts) can directly increase a person’s risk of developing adverse health conditions.

What Characteristics Increase Someone’s Risk of Food Insecurity?

Certain populations, or peoples living in certain individual, social, or economic circumstances, may face a higher-than-average risk of suffering the consequences of food insecurity. Discrimination, political violence, and the natural or built environment represent three key drivers or risk factors for food insecurity. Let’s look briefly at each of these.

Marginalized groups—people who experience racial, ethnic, gender, age, or disability-related discrimination and human rights abuses—often lack one or more of the four necessary conditions for food security, listed above. (1) Safe and nutritious food may not be available. (2) If it is available in the community, these persons 1 The State of Food Security and Nutrition in the World 2017: Building Resilience for Peace and Food Security. Food and Agriculture Organization 2017. Page 107. http://www.fao.org/3/a-I7695e.pdf. See also the Glossary that accompanies this teaching pack. 2 An Introduction to the Basic Concepts of Food Security. Food and Agriculture Organization of the United Nations 2008. Page 1. http://www.fao.org/documents/card/en/c/2357d07c-b359-55d8-930a-13060cedd3e3.

Four Dimensions of Food Security

Food security requires that safe and nutritious

food access is:

(1) AVAILABLE (2) ATTAINABLE (3) USABLE (4) STABLE


http://www.fao.org/documents/card/en/c/2357d07c-b359-55d8-930a-13060cedd3e3




may not be able to afford it or may not have the mobility or transportation necessary to obtain it. (3) Chronic illness or other health conditions (often due to long-term poverty) may limit how a person’s body processes the food he or she eats. Finally, (4) safety, storage, and income may not be stable enough to rely on food being available as needed. Anyone whose daily life is affected by discrimination may suffer food insecurity, even if the individual or group is in a household, community, or geographic region where adequate food is otherwise available, and where others are well-fed and healthy.

Food insecurity is also a risk in settings marked by political tensions, conflict, or physical violence. This too is related to gaps in one or more of the four essential conditions: (1) Gunfire, landmines, gang violence, and risks of being attacked or raped may inhibit a person or group from reaching available safe and nutritious food. (2) Life in a war zone or high-crime neighborhood limits job opportunities and may cause wounds that disable a person’s capacity to access food. (3) Conflict environments are high-stress environments, and stress, disturbed sleep, and untreated injuries or pre-existing medical conditions may all change how the body uses nutrients in what food is available; they may even induce a “toxic stress” that can negatively affect the lifetime health and development of affected children. Finally, (4) conflict-zone risks, such as theft, fire, and unpredictable bursts of violence, together destabilize a person’s or group’s reliable access to food resources.

Third, the natural or built environment can also increase food security risks. Again, this can relate to the four essential conditions: (1) A household or community located in a sparsely populated rural area marked by poverty and poor soil—or alternatively in a dense urban neighborhood without public transport to affordable grocery stores—may have limited food availability. (2) Those who live in such regions may be poor or disabled without economic and physical capacities to access safe and nutritious food. (3) Physical survival in extreme environments marked by excess heat or cold—or in substandard housing marked by pollution, mold, rats and bugs, or crowding with persons who are ill—may affect metabolism, digestion, and absorption of essential nutrients. And (4) environmental crises such as flood, drought, earthquake, fire, and pollution by toxic waste can kill livestock, harm crops and water supplies, and displace those who live in such regions, making safe and nutritious food sources unpredictable and unreliable. All these factors affect health.

The three broad drivers discussed above are typical clusters of determinants that affect food security risks. These clusters can overlap and many of the determinants within them may also occur in other situations. For example, political conflicts often include human rights abuses based on religious or ethnic discrimination, and frequently also destroy the natural or built environment. Any discussion of food security should consider these clusters and how they relate to each other.

Activity (20 minutes)

Choose one of the three “Plate” exercises on the following pages, depending on your class level and class goals:

• Food Security and the Social Sectors • Food Security and Health Conditions • Food Security and Populations

Each of these illustrates a plate, surrounded by factors that can affect food security—for good or for ill. Each of the three “plates” is followed by a table with a brief description and sample answers that students might suggest in response to the two questions.

Procedure: Divide the class into groups. Assign each group one or several of the categories around the rim of the plate. The number you assign will depend on the size and level of the class, and the time available for




reflection and discussion. Each group should come up with suggestions about how the assigned category(s) are relevant to food security.

Wrap-up Discussion (25 minutes)

The groups now come together again into a single class. Ask the class or sections to share their answers to the two questions and record them on the board. The categories on the board will depend on which of the three “plates” was assigned (see the suggestions in the tables that follow each “plate” image below). Leave the answers on the board, take a photo of the board, or transcribe the students’ responses; you will have the opportunity to return to them in Lesson 3.

Go Further

Additional discussion questions you might ask for the wrap-up session:

• Do you think it is possible to decide whether a person is “food insecure” by simply looking at them, for example, judging whether they are thin or fat, what they have in their pantry or refrigerator, or by other visible evidence? Why or why not? Explain your answer. This question helps students think about the fact that food insecurity may not be something obvious. People who don’t have reliable access to food may overcompensate by overeating when food is available. Also, food insecure households may routinely “stock up” on food that is inexpensive but not nutritious. As a result, they may be obese. It is also important to understand that malnutrition does not mean “under-nutrition” or starvation. Inadequate vitamins, minerals, protein, and other essential nutrients can affect health but are not always evident by looking at an individual.

• Do you think a person who is “food insecure” is always necessarily hungry? Why or why not? There are a number of possible responses to this question. Possible answers include:

o Yes, because they are always thinking about where they will get more food. (This invites further discussion about how hunger is defined.)

o No, but they might eat more food than they need because they are uncertain about their next meal.

o No, but they will feel more stress than people who have food security, and stress might make them eat more.

o Adults who are food insecure might not be hungry but their children might be hungry. o No, because they might be able to afford unhealthy inexpensive food that fills their stomach,

but these choices can increase risk of malnutrition and other health problems.




Activity Handout: “Food Security and the Social Sectors”

How might each of the 12 sectors of society around the rim of the plate above make food security (a) BETTER? (b) WORSE?

Option 1: Choose one or several of the sectors above, circle the sectors you choose, and write 1-2 words in the margins outside the plate that summarize how you think that sector contributes to a problem or might

help shape a solution to a food security risk that relates to health. Option 2: On a separate page, list your chosen sector(s) and write a 2-3 sentence story or example that

illustrates your answer.

Recommended: Try to suggest answers relevant to a community or household familiar to you.




Below are possible responses that students might suggest for the assignment above:

SECTOR FOR THIS SECTOR, THINK: WORSENS HEALTH-RELATED FOOD SECURITY RISKS BY:

CAN IMPROVE HEALTH-RELATED FOOD SECURITY BY:

Civil Society/ Press

Community organizations, non-governmental actors, social media, journalism and news organizations

Promoting or perpetuating discrimination; exacerbating food-rights inequities that hurt women, children, or marginalized groups; failing to report on shortages where community action could help; spreading misinformation

Supporting equity for all; identifying local groups that need food & how to help; fostering community awareness to promote health and address malnutrition/ obesity

Science/ Technology

Innovation, digital solutions, internet

Aggravating social inequities (e.g. disparities in access to high-tech services or products); using exploitative or harmful labor or environmental practices when mining rare materials used in tech manufacturing; using processes that waste water or release toxic waste into landfills or water supplies

Developing agricultural innovations like water-conserving practices, pest-resistant crops, or high-yield seeds; connecting best practices & food resources using technology, the internet, or social media; discovering disease prevention solutions and health technologies

Humanitarian Aid

Charitable emergency response organizations, especially in conflict or natural disasters

Donating foods that drive down local food prices and hurt farmers

Empowering affected population to lead aid and solutions

Economics/ Finance

Investment firms, banks, budgeting social services, cost effectiveness

Aggravating indebtedness; privileging the financially secure; failing to enable universal health coverage for all

Providing cash transfer & microfinance programs; fostering small businesses that affirm healthy options

Education/ Labor

Schools, unions, jobs, child labor

Failing to reduce the availability of cheap sugary sodas and junk food in schools and workplaces; limiting available time for food prep and healthy exercise

Promoting healthy foods & signage in schools and workplaces; providing basic, sound, and innovative nutrition education; paying decent wages and benefits for food & agricultural workers

Cities/Urban Planning

People living close together, housing, traffic, urbanization

Lacking affordable or accessible grocery stores; having high cost of living

Hosting urban farmer’s markets, gardens; reducing eviction risks for low-income urban residents; promoting food security for urban homeless

Private Business

Labor practices, trade and “industry,” how companies/advertising contributes to food access, pricing, and choices, out-of-pocket health-care costs

Promoting unhealthy and expensive foods; using false advertising for costly supplements; prioritizing land development over farms

Using labor and advertising to support community health advocacy




Government/ Law

Legal and government activities (e.g., how politicians and lawyers practice and enforce their roles as public servants)

Slashing school meal programs; eliminating food programs for infants at nutritional risk; ignoring human rights standards on food/water

Prioritizing public service to invest in the next generation through health awareness in all government programs

Food/ Agriculture

Food, water, farming, food storage, harvests, cooking, food safety

Using pesticides which negatively affect soil and water quality; adopting processes that remove essential nutrients from foods; lobbying for farmer surplus policies that make certain foods and ingredients artificially cheap for consumers

Adopting equitable food pricing; improving safe food storage for urban poor; building food-share options into local public services to minimize waste; protecting human rights & providing safe housing for migrant farm workers; embracing corporate social responsibility (CSR) across agribusinesses globally

Climate/ Environment

Weather, natural resource management, climate change

Exacerbating natural disasters such as fire, flood, unseasonable rain or drought; contributes to altered pest patterns; contributing to air pollution from coal, cook fires, traffic; reducing the number of available species globally

“Greening” more cities and urban spaces; embracing adaptive agriculture; providing safe housing for coastal high-risk residents; providing affordable climate-friendly cooking & heating innovations

Culture/ Religion

A group’s social views on an issue; taboos, art, identity, ethics, lifestyle ritual practices, ethnicity

Perpetuating discriminatory cultural practices or beliefs that result in health inequities (e.g. prioritizing feeding boys over girls; devaluing women, which results in malnourished & anemic childbearing and increased maternal mortality risks; ingestive taboos that deprive children of essential nutrients; promoting inappropriate or harmful “medicinal” foods)

Building on strong cultural/religion community cohesion to foster healthy food messaging; using art to emphasize positive health; ensuring solutions are rooted in intra-community leadership support; providing more girls’ education to build health and economic security

Design/ Engineering

Architecture, creating built environment, infrastructure, how space shapes behaviors

Failing to remedy urban/rural “food deserts;” contributing to high costs of safe public utilities (e.g., water pipes; power generators); prioritizing designs that disincentivize physical activity and community connections (e.g. sedentary spaces, highways)

Incentivizing creative “green” design and repair options; develop0ing innovative food engineering; promoting more public transport and affordable fresh food available on transport routes across rural/suburban areas




Activity Handout: “Food Security and Health Conditions”





HEALTH CONDITION

FOR THIS CONDITION, THINK: AFFECTS FOOD SECURITY WHEN:

CAN IMPROVE HEALTH-RELATED FOOD SECURITY

WHEN:

Disease Burden Overall risks related to general health and disease risks

Individuals or health systems face high drug costs; individuals or families lose job or home due to related disabilities

Governments or nongovernmental civic organizations establish social security policies & provide supportive resources

Children’s Health (including newborns)

What affects babies and children from the time they are in the womb into their teenage years

Teens have unplanned pregnancies; pregnant women have limited maternal education or face domestic stress or violence; cultural food taboos result in nutrient restriction for children or pregnant/lactating women; girls face gender discrimination that results in unequal health and educational opportunities

Maternal education is available; schools provide breakfast and lunch programs; healthy-food peer messaging at all ages is emphasized

Chronic Diseases and Risks

Heart health, diabetes, cancer; smoking, physical inactivity

Individuals face high drug or medical costs related to chronic illness; chronic diseases result in disability and/or limited employment; patients with chronic conditions live in a war zone or must flee disaster and are separated from needed medicines or services

Universal health care is provided; preventive medicine is emphasized; physical activity and good nutrition are incentivized; providers can adequately monitor patients’ chronic conditions

Infectious Diseases

Upper respiratory diseases (colds, flu, sinus and ear infections), tuberculosis, malaria, HIV/AIDS, Ebola, parasites and worms, fungus

Sick individuals face discrimination; infectious diseases are often accompanied by impaired food digestion/absorption (diarrhea, fever); they contribute to high child and maternal mortality

Public health efforts and regulations/policies ensure preventive measures are available to individuals and communities, such as screens and bednets, vaccines, and clean water

Maternal and Sexual / Reproductive Health

Family planning, abortion, fertility, maternal mortality, prenatal and postnatal care, gynecologic health

A mother dies and is no longer available to care for children; a woman is anemic due to chronic blood loss; teen girls may stop attending school if it does not have facilities to use when menstruating

Social and religious community messaging can improve women’s health equity; protecting the human rights of women and gender minorities reduces discrimination and inequities




Mental Health and/or Addictions

Depression, anxiety, post-traumatic stress disorder, schizophrenia; substance abuse, eating disorders; related disability

Misperceptions about the body can affect food choices; mental health disorders and related disability may lead to unemployment and lack of self-care

Appropriate health care, social services, and medications help enable individuals with mental health problems to live independent, functional, and healthy lives

Nutrition and Health

Obesity, undernutrition, oral health, stunting

Obesity or undernutrition affects food choices and available energy to work or be physically active; the lack of available healthy foods may result in a cycle of poor nutrition

Providing age-appropriate education about nutrition, cooking, and food systems helps establish life-long healthy eating habits; equal education and food program opportunities for boys and girls reduces nutritional inequities; access to nutritional and affordable foods helps reduce dependency on unhealthy choices

Violence and/or Injuries

Domestic abuse; accidental falls, abrasions, and burns; road traffic injuries

Fear of family members may inhibit healthy choices or access to nutritious foods; disabilities resulting from injury can affect livelihood and income; chronic infections from injuries have long-term effects on health

Policies that reduce risks and promote safety in the community or workplace limit injuries; laws which hold offenders accountable can limit the incidence of domestic abuse




Activity Handout: “Food Security and Vulnerable Populations”

How might each of the populations around the rim of the plate experience risks to their food security?

Option 1: Choose one or several of the populations listed above, circle your choice(s), and write 1-2 words in the margins outside the plate that summarize how you think that population might experience risks to

food security and how such risks might affect their health. Option 2: Write your answers on a separate page, with a 2-3 sentence story or example that illustrates your

answer.

Recommended: Try to suggest answers relevant to a community or household familiar to you.





POPULATION FOR THIS POPULATION, THINK: WHAT MIGHT PUT THIS POPULATION AT RISK FOR FOOD

INSECURITY?

HOW MIGHT FOOD SECURITY RISKS AFFECT HEALTH OF THIS

POPULATION?

Adolescents Youth from about age 9 to early 20s; think of adolescents who may be in school throughout this period, or who may have left school to marry or enter labor force

Living in a food-insecure household; choices resulting from unhealthy body image or peer pressure; domestic abuse; college or living expenses; social risks due to unplanned pregnancy; gang or addiction behaviors and risks

Poor nutrition may lead to impaired growth and/or concentration for school or work; stress responses; substance abuse; poor food choices due to limited funds or lack of knowledge about food prep; risks will vary depending on choices or situations

Aging / Elderly

How growth and aging connects with food needs in adulthood

Unemployment; illness and disabilities; homelessness; increased childcare costs or burden (e.g., caring for grandchildren); medication or housing costs; elder abuse and fraud

Cumulative effects of nutrition-related chronic diseases (diabetes, obesity, cardiovascular disease); deteriorating bone health in postmenopausal women can increase risk of injury; impaired wound healing

Displaced Persons (including migrants and/or refugees)

Homeless persons, those displaced due to environmental or political crises or conflicts, stateless persons, migrant farm workers, undocumented migrants, recent immigrants (legal or undocumented) who may speak a language other than that of the new country of residence

Lack of access to money, housing, employment, or familiar foods or food prep methods; language barriers; limited food choices; unsafe water; no refrigeration; fear of authorities; lack of access to education; extra burden of dependent children

Poor food access and choices may lead to undernutrition or obesity; infectious diseases may result from unsafe foods and water; stress responses increase chronic disease risks; existing health conditions may worsen due to inability to meet known needs

Women and Sexual Minorities

Persons at increased risk of discrimination on the basis of gender (e.g., girls/women, LGBTQ+ individuals); disparities or gaps between men and women’s food access and related health outcomes

Low income due to employment or household discrimination; feeding girls less than boys; eating disorders; substance abuse; other human rights abuses

Increased mental health risks; malnutrition-related infections or obesity; immune system disorders; suicide or cutting

Rural Populations

People who live outside the city and suburban communities

Lack of vehicle and/or lengthy distance to healthy food sources; isolation, poverty; inadequate health care

Untreated infections, chronic diseases, or work-related injuries

Urban Populations

People who live in cities (including those in informal settlements/ “slums”)

High living costs; high-risk housing with inadequate or unsafe infrastructure or utilities; poverty; inadequate health care

Dangerous work conditions to earn income; obesity due to lack of physical activity; “food deserts” or lack of grocery stores with healthy foods

This teaching pack was developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Lesson Plan Grocery Gap: Food Security in Native American Communities 2018

Overview This is the second of four lessons in a teaching pack designed to introduce students to the concept of food security as it relates to global health and health risks, particularly in the context of political conflict and ethnic discrimination. The first lesson introduces the foundations of food security. The second and third lessons focus on identifying and understanding food-related health risks in two geographic settings of political conflict and discrimination, with populations shaped by persistent historical trauma: Native American communities in the United States and Ukraine. The fourth lesson is an opportunity to compare and contrast the contexts and responses discussed in Lessons 2 and 3, and further discuss potential approaches to advance food security in such settings.

Purpose The purpose of this lesson is to teach undergraduate learners about multi-sectoral and multi-disciplinary factors that contribute to food security-related risks in Native American tribal communities in the United States. First, students will brainstorm a list of factors that contribute to food security risks in this population. Then, working in small groups, students will practice interpreting graphical data from the U.S. Census Bureau and the Food Access Research Atlas to map food security risks in select Native American communities. Finally, the class will gather together again to connect their analysis with the narrative stories in the readings, and brainstorm possible solutions that may advance food security in such settings.


Learner Level

Undergraduate

Time

50 minutes



Grocery Gap: Food Security in Native American Communities: Lesson Plan


1. Interpret charts and map data on food security among Native American communities living in tribal regions in the United States.

2. Name and briefly explain at least three reasons that Native American tribal communities in the U.S. have faced food security risks throughout history.

3. Explain how social conditions (e.g., poverty and discrimination) contribute to health conditions, and how health conditions may in turn affect social factors and community risks in the U.S.

Required Materials

• White or black board • Pens, pencils, or markers • Computer with internet access to the two websites used in the group activities


Prior to class, students should complete the following readings:

• Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015; Nov 25. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d.

• Food Distribution Program on Indian Reservations. United States Department of Agriculture Food and Nutrition Service 2018. https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir.

• Aji. Starving in the Land of Plenty: Hunger in Native America; Feeding America Blogathon. Native American Netroots 2010; Sep 27. http://nativeamericannetroots.net/diary/693.

Procedure Group Brainstorming: 10 minutes

The class should spend the first 10 minutes brainstorming answers to the following question: Based on the assigned readings, what factors contribute to food security risks for Native American tribal communities in the United States? Use a whiteboard to record answers. Invite students to think about all the factors in the ThinkProgress article by Alex Zielinski and the blog post by Aji that suggest why and how this population may have difficulty obtaining and preparing adequate food on a regular basis. Encourage students to think about the history of Native Americans in the U.S. and why history matters for how people experience life today. Below are possible answers students may suggest.

Leave the answers on the board, take a photo of the board, or transcribe the students’ responses. The review of these responses, in comparison with responses generated in Lesson 3, will be a core activity in Lesson 4.



https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir


http://nativeamericannetroots.net/diary/693




Examples of factors which make it difficult for Native American communities to obtain and prepare nutritious food include, but are not limited to:

Historical trauma of forced resettlements:

• Colonialization, violence, and oppression still limit where Native American tribal communities can obtain agricultural land, live according to tribal cultural practices, grow their own food, and hunt

• Food “deserts”: Most reservations lack grocery stores and residents may not have regular access to a vehicle required to drive long distances

• Some tribal reservations (e.g., Navajo communities in Arizona and New Mexico) are located on land with limited water supplies or poor-quality soil for farming

Racial/ethnic discrimination:

• Educational, employment, and racial discrimination aggravate poverty and marginalization • Discrimination is often associated with unemployment and poverty, which compound difficulties

in obtaining food

Poverty:

• Government “aid” food packages force rations of unhealthy foods (processed, high-sugar, white flour), which perpetuate insecurity, dependence, and increased health risks

• Disempowered from practicing “food sovereignty” (control over cultural food preferences) • When cars are not affordable due to wide-spread poverty, transport options are limited for buying

food as well as accessing health care • Shame and regular fear of going hungry affect daily choices, and can contribute to alcohol and

drug abuse risks • Single-parent (usually women)-headed households with low income and many dependents

Disease risks:

• Increased mental health risks (e.g., adolescent suicide rate is 150% higher the general U.S. population)

• Epidemic alcoholism and addiction rates; chronic stress • Higher rates of diabetes, obesity, high blood pressure, and other health conditions increase living

and health care costs, may cause physical disabilities that further affect food access and unemployment




Activity: 25 Minutes

Divide the class into small groups of 2-3 students. Each small group should have use of a computer with internet access, and select a “scribe” or reporter who will take notes and summarize their findings to the entire group.

1. First, open the “My Tribal Area” page of the United States Census Bureau: https://www.census.gov/tribal

2. Select a tribal area using the dropdown options on the left of the page, above the map, and click until you arrive at the page of information about the tribal area you have chosen. Make a note of where this area is located on a map of the United States. Keep this window open so you can come back to it for the assignment below.

3. Now, on a separate screen (or new browser window) go online to the “Food Access Research Atlas” map: https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas. Zoom in until you view the same area on the map as the location of the tribal area you have selected above.

4. As a group, explore the different data options in the Food Access Research Atlas map to answer the following questions about food access indicators for this tribal area. The next page illustrates and explains data based on one example. Take notes on what you find so you can share it with the other group and the class.

a. What tribal area did you choose and what is its approximate population? b. How much of this region is considered “low income”? c. Would you say it is easy or difficult for this population to travel regularly to a supermarket

and purchase the foods needed for a healthy household? Why? d. What information does the U.S. Census Bureau data provide about housing, employment,

economy, and education (hint: click on those tabs on that page) that might further affect the food choices and health risks for this population? Explain your answers.

e. Think of what you know about the average weather in this part of the U.S. Is it a region with lots of snow? Extreme heat? Risks of tornadoes or earthquakes? Dangerous animals or insects? How might these weather-related factors influence farming or hunting practices, food preparation and storage, and physical activity for the people in this area? How might these factors relate to health?

Example:

The first image below (Figure 1) illustrates the results of a search for the Aroostook Band of Micmac Trust Land in northeast Maine, a small population of several hundred people. Below that (Figure 2) is the corresponding area as it appears on the Food Access Research Atlas:

https://www.census.gov/tribal

https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas





Figure 1. U.S. Census Map and Data Example. https://www.census.gov/tribal/?st=23&aianihh=0115

Figure 2. Food Access Research Atlas Data Example. https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas:

Clicking on the yellow “L1 and LA using vehicle access” reveals that the region exactly corresponding to this tribal area is also notable as a “Low-income census tract where more than 100 housing units do not have a vehicle and are more than ½ mile from the nearest supermarket, or a significant number or share of residents are more than 20 miles from the nearest supermarket.” The yellow area also overlaps (and partially covers) the purple “Low vehicle access” region, “in which more than 100 households have no access to a vehicle and are more than 1/2 mile from the nearest supermarket.” Clicking on the light blue “Low Income” button would turn most of this map blue, indicating that this is a census tract “with a poverty rate of 20% or higher, or tracts with a median family income less than 80% of median family income for the state or metropolitan area.”

https://www.census.gov/tribal/?st=23&aianihh=0115






Wrap-up Discussion: 15 minutes

The small groups should now come together into a single class once again and share their findings from the web-based activity.

1. The scribe from each small group should state in 2-3 sentences (or timed to 2 minutes) what region their group studied and their group’s answers to 4a-4e above.

2. After each small group has summarized its findings, discuss the following questions among the entire class:

a. Does the tribal area you selected fit the picture of conditions and risks described in the Zielinski and Aji readings? What is the same or different? The instructor may wish to refer the class back to the whiteboard list above.

b. Based on the readings, how do you think conflict or interpersonal violence might present an additional risk for this community’s efforts to access healthy food regularly? Students might note that historical political violence against the Native American population creates a model of violence that continues to shape self-identities in the present. Discrimination has resulted in longstanding distrust of the U.S. government, cynicism about its food donation packets, and depression and despair about effective community-based policy changes to make things better. In addition, alcoholism, depression, poverty, and substance use further aggravate risks of violence.

c. Based on your responses to the above questions, as a group, ask each small group to brainstorm one possible solution to the food security risks they identified. In one sentence: how might the suggested solution address the food access challenges they have learned about in this lesson?

3. Discuss together: How is food insecurity in Native American communities in the U.S. today related to the history of this population in the history of the United States? Use the whiteboard to list what ingredients or contributing factors students identify as common to all of the tribal areas they considered in this lesson.

This teaching pack was developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Lesson Plan Broken Breadbasket: Food Security in Ukraine 2018 Overview This is the third of four lessons in a teaching pack designed to introduce students to the concept of food security as it relates to global health and health risks, particularly in the context of political conflict and ethnic discrimination. The first lesson introduces the foundations of food security. The second and third lessons focus on identifying and understanding food-related health risks in two geographic settings of political conflict and discrimination, among populations shaped by persistent historical trauma: Native American communities in the United States and Ukraine. The fourth lesson is an opportunity to compare and contrast the contexts and responses discussed in Lessons 2 and 3, and further discuss potential approaches to advance food security in such settings.

Purpose The purpose of this lesson is to teach undergraduate learners about multi-sectoral and multi-disciplinary factors that contribute to food security-related risks in Ukraine, particularly the eastern regions marked by armed conflict over border disputes with Russia. First, students will brainstorm a list of factors that contribute to food security risks in Ukraine. Then, working in small groups, students will practice interpreting graphical data to identify the socioeconomic impact and resulting needs residents report as a result of living in a conflict setting. Finally, the class will gather together again to connect their analysis with visual observation from the narrative readings, and brainstorm possible solutions that may advance food security in such settings.


Learner Level

Undergraduate

Time

50 minutes



Broken Breadbasket: Food Security in Ukraine: Lesson Plan


1. Demonstrate basic graphic literacy by interpreting maps and bar-chart data on risk-related food security in Ukraine.

2. Name and briefly explain at least three reasons residents of Ukraine have faced food security risks over the past century.

3. Explain how conflict and politics affects both health and social conditions for health in Ukraine.

Required Materials

• White or black board • Pens, pencils, or markers • Access to map and handouts (see Appendix of this Lesson)


Prior to class, students should complete the following readings:

• Nelson SS. In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War. National Public Radio 2017; Aug 4. https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war.

• 2017 Nutrition Country Profile: Ukraine. Global Nutrition Report 2017. Development Initiatives Poverty Research Ltd. 2017. http://globalnutritionreport.org/wp-content/uploads/2017/12/gnr17-Ukraine.pdf.

• View before class (choose one): o Video: How a Ukrainian Famine From the 1930s Relates to Today. MSNBC 2017; Oct 26.

http://www.msnbc.com/morning-joe/watch/how-a-famine-from-the-1930s-relates-to-today-1081958979540.

o Holodomor 1932-33: Famine Genocide in Ukraine. http://holodomorct.org. Students can explore the site for information of interest, or be assigned to one of the audio or video survivor accounts or memoirs at http://holodomorct.org/holodomor-information-links/accounts-memoirs.

Procedure Group Quiz and Brainstorming: 10 minutes

Begin with a one-minute oral quiz. Ask the class to give a quick guess of the answers to the following statement1:

On the eve of World War I, ______ percent of Russia’s SUGAR came from Ukraine [answer: 82 percent] ______ percent of Russia’s WHEAT came from Ukraine [answer: 98 percent] ______ percent of Russia’s RYE came from Ukraine [answer: 75 percent] Note: This data is not in the readings so students should not be graded on their answers

1 The answers, given in bracketed italics, are from Magocsi PR. A History of Ukraine. University of Toronto Press 1996. Page 6.

https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war


http://globalnutritionreport.org/wp-content/uploads/2017/12/gnr17-Ukraine.pdf


http://www.msnbc.com/morning-joe/watch/how-a-famine-from-the-1930s-relates-to-today-1081958979540

http://www.msnbc.com/morning-joe/watch/how-a-famine-from-the-1930s-relates-to-today-1081958979540

http://holodomorct.org/

http://holodomorct.org/holodomor-information-links/accounts-memoirs

http://holodomorct.org/holodomor-information-links/accounts-memoirs




The instructor can use the quiz responses to lead into brainstorming. Begin by asking, “If Ukraine was so agriculturally fertile that it was known as the ‘breadbasket’ of Russia, why is food security a problem in the country today? What happened? Let’s take 10 minutes to brainstorm together as a class from your readings.”

Write on the board the following question: What are the problems that put food security at risk in eastern Ukraine? Allow space on the board to record answers. Invite students to think about all the factors in the National Public Radio story that contribute to difficulties these individuals may face in obtaining and preparing adequate food on a regular basis. Below are possible answers students may suggest.

Leave the answers on the board, take a photo, or transcribe the students’ responses. The review of these responses, in comparison with responses in Lesson 3, will be a core activity in Lesson 4.

What are the problems that put food security at risk in Ukraine today?

Land disputes: border conflicts due to political disagreement over which country (Ukraine or Russia) should rule the region

History of the 1933 famine and political discrimination against Ukraine destroyed farms

Fear of personal safety: Daily, unpredictable gunfire in civilian neighborhoods

Failure of social/public services and utilities (heat, electricity, gas, plumbing)

Unemployment due to conflict and failed economic infrastructure

Farming and livestock grazing dangerous due to conflict and lack of effective security systems, even though Ukraine is famous for rich harvesting potential

Chronic stress, aggravating depression; alcoholism, mental health risks

Gender and age disparities in how the conflict affects the population (men and boys with guns, single-parent households responsible for young children; elderly as child caretakers)

Limited transport options: bicycles, walking

Border controversies: affects transport of food from other (safer) areas

Trucks and gasoline limited / targeted in crossfire

Data Interpretation Activity: 25 minutes

Students have come to class thinking the people whose living conditions were illustrated in the NPR essay about life in conflict-ridden eastern Ukraine. Now they will examine and discuss graphic data that further document the challenges of survival and security in this region.

Introducing the Activity (5 minutes)

After the opening brainstorming session is complete, the instructor should divide the class into four small groups. Each group may wish to move to a separate part of the classroom or into small circles to be able to talk together during this activity.

The teacher then distributes the following handouts (see Appendix) to each small group:

1. Map 2. “Difficulties/Shocks Experienced” 3. “Coping Strategies”




4. “Quantitative Loss of Livestock” and “Reasons for Loss of Livestock in the last six months” Note that these are together in one image to help students understand how they connect to specific livestock and the overall conflict; this image might require more time for discussion than the other three.

5. “Access to Markets”

Each small group should receive Handout 1 (map of Ukraine with conflict area marked) and one of the other four handouts with colored bar-chart data. Each group is assigned to study the bar chart handout and interpret the data aloud within the group, using the questions below as a guide.

At the end of five minutes, a spokesperson from each group should be prepared to give a very short summary of what their group’s data says about food insecurity in eastern Ukraine. The map is a visual reminder of that part of the world they are discussing and the different types of borders mentioned in the bar graphs (see key on each graphic).

Group Discussion (10 minutes)

1. What food security risk does this graph focus on? 2. What do the high bars mean and what are they compared with in this graphic? 3. If you lived in eastern Ukraine and this survey data was telling your family’s story, what would you be

most worried about?

Share Group Conclusions with Class (10 minutes)

Once all groups have interpreted their data handout, the entire class should come together again. One by one, spokespersons from each subgroups then explain to the entire class the graphic they were assigned and what it means for food insecurity. Since there are four figures, use a timer to give each group speaker no more than two minutes.

Wrap-up Discussion: 15 minutes

Now, encourage the students to think back to the assigned NPR article, its stories, quotes, and photographs. Students may have printouts or the instructor may wish to project selected images from the stories onto the board or a large screen. Pose the following questions to the class for open discussion.

1. Where in the stories you read and their images do you see some of the food security risks identified in the bar chart you studied? For example: What hints of food or livestock do you see in the photographs? Students may notice that they see only a loaf of bread; several cups and bottles that may look like juice or water; they may also reflect that lack of electricity and heat might limit food storage and preparation options. They may also observe that the only beverages mentioned in the article are beer and vodka. Both alcohol and a high-carbohydrate diet may compound diabetes risks. The ground and yards look untended, with no sign of farm animals or vegetable gardening.

2. Thinking through a global health lens is not just about identifying problems but also about advancing possible solutions. What solutions do you think might help improve the situation in eastern Ukraine and help its population experience better food security? Students might respond:

• A peaceful resolution to the border disputes and violence • Political negotiations • More help from the international community with regular and reliable humanitarian aid




• Stronger community governance by those who live in the area to enforce peace, safe agriculture, better jobs

• Improved transport and fuel for obtaining food from other parts of the country • Job development and school options that give gun-toting youth appealing alternatives and hope

for the future

If students have difficulties thinking of potential positive responses, reassure them that solutions always take time to consider, and will be the focus of Lesson 4.




Appendix

Source: Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017. Page 4. https://www.humanitarianresponse.info/en/node/156653.

Handout 1. Map of Eastern Ukraine Regions in Conflict





Handout 2. Difficulties/Shocks Experienced

Source: Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. Page 24, Figure 28. http://www.fao.org/3/a-i8171e.pdf.

Key: NGCP: Non-government-controlled area (see Ukraine map) GCB: Exclusion zone near government-controlled area NGC: Non-government-controlled area GC: Government-controlled area All: All areas surveyed





Handout 3. Coping Strategies







Handout 4. Quantitative Loss of Livestock and Reasons for Loss of Livestock in the Last Six Months

Source: Socio-Economic Impact and Needs Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. Page 34, Figures 45, 47. http://www.fao.org/3/a-i8171e.pdf. Key: NGCP: Non-government-controlled area (see Ukraine map) GCB: Exclusion zone near government-controlled area NGC: Non-government-controlled area GC: Government-controlled area All: All areas surveyed

Handout 5. Access to Markets


This lesson plan was originally developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Lesson Plan Food Security: Connecting Commonalities 2018

Overview This is the fourth of four lessons in a teaching pack designed to introduce students to the concept of food security as it relates to global health and health risks, particularly in the context of political conflict and ethnic discrimination. The first lesson introduces the foundations of food security. The second and third lessons focus on identifying and understanding food-related health risks in two geographic settings of political conflict and discrimination, among populations shaped by persistent historical trauma: Native American communities in the United States and Ukraine. The fourth lesson is an opportunity to compare and contrast the contexts and responses discussed in Lessons 2 and 3, and further discuss potential approaches to advance food security in such settings.

Purpose The purpose of this lesson is to teach undergraduate learners to consider how the lessons learned from the specific populations discussed in earlier lessons might be applied to global health more broadly. First, students will review their lists of risk factors recorded in Lessons 2 and 3. Next, they will draw connections between the two lists to identify common factors across the two populations, assess the impact of food security on health, and further brainstorm possible solutions that address these intersecting issues. A short supplemental writing exercise invites students to explore how one lesson they learned could apply to one of the populations discussed Lesson 1’s introduction to food security.

By the conclusion of this final lesson in the teaching pack, students should understand that food security depends on a wide range of complex and intersecting factors. They should be able to apply what they learned from the Native American and Ukraine narratives and activities to their understanding of food-health risks in other marginalized communities in different areas of the world today, and recognize that such risks may be rooted in decisions that trace back many decades or centuries to political violence and discrimination in earlier generations.




Food Security: Connecting Commonalities: Lesson Plan

Learner Level

Undergraduate

Time

40 minutes


1. Identify factors that residents of Ukraine and Native American communities in the U.S. share in common as related to food security, conflict, and discrimination.

2. Explain how these common intersecting factors influence population health. 3. Propose at least two or three potential positive responses or solutions to address food security risks

in such communities.

Required Materials

• The two marked-up whiteboards (or a printout of transcribed answers) from Lessons 2 and 3 • One of the three “Plate” exercises in Lesson 1, displayed either on screen or as a single enlarged

printout visible to the entire class • A clean whiteboard or blank easel pad • Colored index cards • Pens or markers

Procedure Review Lessons 1-3 (10 minutes)

The instructor should begin by asking the class to quickly re-read the two marked-up whiteboards with answers they provided in Lessons 2 and 3, listing the factors that contribute to food security risks in Ukraine and Native American tribal communities in the United States. The teacher might also point the class back to the four basic dimensions required for food security (see box) that were described and discussed in Lesson 1.

Ask for two student volunteers to briefly summarize the food security risks they identified in the Ukraine and Native American tribal community exercises, respectively.

Ask the class:

• What questions do you have after completing Lessons 2 and 3? List the first 2-3 questions on a whiteboard and refer to them during the “Connecting” session, below.

• What do you still not understand or wish you knew more about based on these stories? This is an important opportunity for students to name those things they still wonder based on Lesson 2. Naming student questions—without taking time to give answers, yet—is an important validation of student thinking and prods classroom engagement during the following session.

Four Dimensions of Food Security

Food security requires that safe and nutritious

food access is:

(1) AVAILABLE (2) ATTAINABLE (3) USABLE (4) STABLE




Connecting: Commonalities in Food Security and Health Risks (20 minutes)

The instructor should now build on the comments above, saying something like: “Let’s keep those questions in mind now as we think together about both of the communities. We’re going to use this lesson to think about: What do the Ukraine and Native American communities have in common related to food security? And what are some possible responses or possible solutions?”

Use the clean whiteboard to brainstorm suggestions on the following points:

(1) Common factors between Ukraine and Native American conflict and discrimination as it affects food security;

(2) How food insecurity is related to health; and (3) Responses or possible solutions.

Below is one example with sample text that might be mentioned. During the brainstorming, use students’ answers to help address or come back to the unanswered questions they have just identified.

Ukraine & Native American food security: Common factors?

How is food insecurity related to health for both communities?

Responses or possible solutions?

Past affects the present

Conflict worsens poverty

Poverty increases food risks

Food insecurity is stressful

“Them vs. us” hurts everyone

Trauma and discrimination affect: education, employment, mental health, transportation, food production and access

Children have chronic fear and increased risk of hunger

Affects agriculture options

Gender inequities

Human rights violated

Victimization violates dignity and sense of agency to make things better

What else?

Malnutrition due to inconsistent safe and adequate foods; the only free or cheap food is unhealthy

Obesity from “empty calories” to satisfy hunger; child obesity sets life habits that increase disease risks like heart disease and diabetes

Household stress may result in domestic strife & abuse, substance use including alcoholism, anxiety, and depression

More likely to eat unsafe food & drink polluted water if resources are limited or expensive

More people smoke because it suppresses hunger, increasing risk of cancer & “secondary smoke” diseases (asthma)

Disabled and marginalized people aren’t allowed to eat as much as those who have access to nutritious food, and they get sick or weak and can’t study or work

What else?

Political and health policies to reduce armed conflict

Agriculture and policy reforms (land access and culturally appropriate foods)

Make physical activity safe and enjoyable (ideas?)

Promote local leadership that supports agency for women to improve regular affordable and available food (how?)

Look at food safety and meal preparation: Is there fuel to boil water? Is food storage safe from spoilage/insects? Is there electricity for refrigeration? Is there transportation to a food source? If not, what needs to change, and how?

Tobacco taxation so healthy food is cheaper than smoking

Human rights-based awareness is vital and must come from within the community

Subsidies for healthy food industries

Insurance programs for farmers

What else?

The discussion above may take the entire class time. Depending on learner levels, if time remains, below is a final optional exercise that builds on the third column above to further focus on solutions and responses.

Teachers may also choose to substitute the exercise below as an alternative to the 3-column table described above.




Go Further: 15 Minutes

Put all notes and whiteboards away (or photograph and then erase them), and pass out colored index cards, one to each student. Now display the “Food Security and Populations” plate image selected from Lesson 1. The instructor may choose any of the three plates, but the third plate, “Food Security and Populations,” is the simplest for this wrap-up discussion.

Ask students to:

1. Choose one of the six populations listed around the rim of the plate. Write that word or phrase on the card.

2. Name (in writing or ask students to volunteer verbally) one important fact they learned about food security as a result of this module (Lessons 1-3) that specifically relates to the population they chose. Their answer may relate to either Ukraine or Native American communities, or both. Below are a few possible responses: Adolescent: Food security fosters dignity, respect, and hope for future education or employment. Aging: Old people are often poorest in settings of discrimination and conflict but they also may have the best stories and be able to help youth understand the group’s history of trauma and cultural alternatives. They may also have historical knowledge of traditional and cultural techniques for farming, hunting, and/or food preparation. Women and sexual minorities: Women are disproportionately responsible for childcare and food preparation tasks when discrimination, violence, and related economic poverty threaten basic survival; they are also negatively impacted when sexual and reproductive health and rights are undermined. Persons who identify as belonging to sexual minorities (LGBTQ+) may also face food security risks associated with discriminatory social, health care, or employment practices, including domestic or gender-based violence. Displaced, migrants, and refugees: Both Ukrainians and Native Americans face massive social injustices and health inequities as a direct result of displacement and lack of security in their home and land. Rural populations: Food security is worse for rural poor because they may not have reliable or regular transportation to healthy and affordable food options. Urban populations: Most cases in these lessons describe rural communities; however, we should keep in mind that armed violence and discrimination also occur in cities and can affect food security and health. Urban core areas sometimes lack healthy and affordable food options, and city-dwellers may depend on unreliable or inconvenient public transportation to access grocery stores. Malnutrition and obesity are risks and can affect schooling and employment in both rural and urban areas.

This annotated bibliography was originally developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Annotated Bibliography Hunger and Food Security 2018

Overview This bibliography is a curated list of educational resources to introduce students to issues surrounding hunger and food security. The multidisciplinary materials may be suitable for students at the high school, undergraduate college, and public health graduate school levels. Learning objectives and supporting materials will vary depending on how the material is used in a course. Brief annotations provide a summary to indicate which materials may be particularly relevant. Within each section, dated publications are listed in chronological order.

This bibliography accompanies a teaching module focused on hunger and food security and provides both general background resources and specialized resources. The bulk of the resources are focused on two specific case examples (Native American tribal communities in the United States and residents of the Ukraine) for educators who want to explore the topics in more depth. The materials listed here represent a diversity of viewpoints and opinions.

This annotated bibliography includes:

• Basic Reads • Reports • Articles and Notes • Portals and Interactives • Fact Sheets, Infographics, and Country Profiles • Multimedia and News • Organizations



Hunger and Food Security: Annotated Bibliography

Selected Resources – At a Glance BASIC READS

FOOD SECURITY: GENERAL OVERVIEW

Fact Sheet. An Introduction to the Basic Concepts of Food Security. Food and Agriculture Organization of the United Nations 2008. http://www.fao.org/documents/card/en/c/2357d07c-b359-55d8-930a-13060cedd3e3.

Data Interactive. Food Access Research Atlas. United States Department of Agriculture Economic Research Service 2017. https://www.ers.usda.gov/data/fooddesert.

Topic Portal. Food Security in the U.S. United States Department of Agriculture 2017. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us.

* Article. Ayala A, Meier BM. A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity. Public Health Reviews 2017; 38(10). DOI: https://doi.org/10.1186/s40985-017-0056-5.

Fact Sheet. Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Food Research & Action Center 2017. http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well.

*

Report. The State of Food Security and Nutrition in the World 2017. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. http://www.fao.org/state-of-food-security-nutrition/en.

Topic Portal. Understanding Hunger and Food Insecurity. Feeding America 2018. http://www.feedingamerica.org/hunger-in-america/what-is-hunger-and-food-insecurity.html.

FOOD INSECURITY AND UKRAINE

Topic Portal. Holodomor 1932-1933: Famine Genocide in Ukraine. http://holodomorct.org.

News Article. Nelson SS. In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War. National Public Radio 2017; Aug 4. https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war.

News Article. Applebaum A. How Stalin Hid Ukraine’s Famine From the World. The Atlantic 2017; Oct 13. https://www.theatlantic.com/international/archive/2017/10/red-famine-anne-applebaum-ukraine-soviet-union/542610.

Report. Socioeconomic Impact and Needs Assessment: Donetsk and Lugansk Regions, Ukraine. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/documents/card/en/c/0f5e7c99-ff85-4e1a-b813-add010352014.

Report. Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156653.

Fact Sheet. Ukraine: Humanitarian Snapshot. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukraine-humanitarian-snapshot-27-december-2017-en.

Infographic. Global Food Security Index: Ukraine. The Economist Intelligence Unit Ltd 2018. http://foodsecurityindex.eiu.com/Country/Details#Ukraine.

FOOD INSECURITY AMONG NATIVE AMERICANS IN THE UNITED STATES

Blog. Aji. Starving in the Land of Plenty: Hunger in Native America; Feeding America Blogathon. Native American Netroots 2010; Sep 27. http://nativeamericannetroots.net/diary/693.

News Article. Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015; Nov 25. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d.



https://www.ers.usda.gov/data/fooddesert/


https://doi.org/10.1186/s40985-017-0056-5



http://www.fao.org/state-of-food-security-nutrition/en


http://www.feedingamerica.org/hunger-in-america/what-is-hunger-and-food-insecurity.html




https://www.theatlantic.com/international/archive/2017/10/red-famine-anne-applebaum-ukraine-soviet-union/542610


http://www.fao.org/documents/card/en/c/0f5e7c99-ff85-4e1a-b813-add010352014



https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukraine-humanitarian-snapshot-27-december-2017-en


http://foodsecurityindex.eiu.com/Country/Details#Ukraine







Topic Portal. Food Distribution Program on Indian Reservations. United States Department of Agriculture Food and Nutrition Service 2017. https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir.

Data Portal. Profile: American Indian/Alaska Native. United States Department of Health and Human Services Office of Minority Health 2018. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62.

REPORTS

Report. Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People. Diné Policy Institute, First Nations Development Institute 2014. https://firstnations.org/knowledge_center/download/din%C3%A9_food_sovereignty_report_navajo_nation_food_system_and_case_rebuild.

* Report. Climate Change, Global Food Security, and the U.S. Food System. United States Department of Agriculture Office of the Chief Economist 2015. https://www.usda.gov/oce/climate_change/FoodSecurity.htm.

Report. Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation. Harvard Law School Food Law and Policy Clinic, Community Outreach and Patient Empowerment, Navajo Nation 2015. https://www.chlpi.org/food_library/good-laws-good-food-putting-food-policy-work-navajo-nation.

* Report. The Impact of Natural Hazards and Disasters on Agriculture and Food and Nutrition Security: A Call for Action to Build Resilient Livelihoods. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/emergencies/resources/documents/resources-detail/en/c/280784.

* Report. Regional Overview of Food Insecurity: Latin America and the Caribbean. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/publications/card/en/c/ef84a9e6-176c-4b72-a374-158ade1abb47.

* Report. Africa Regional Overview of Food Security and Nutrition 2016: The Challenge of Building Resilience to Shocks and Stresses. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofsn-africa/en.

* Report. Asia and the Pacific Regional Overview of Food Insecurity 2016: Investing in a Zero Hunger Generation. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/card/en/c/ea009918-8124-4320-a5d9-0a296b07c141.

* Report. Europe and Central Asia Regional Overview of Food Insecurity 2016: The Food Insecurity Transition. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofi-euca/en.

* Report. Near East and North Africa Regional Overview of Food Insecurity 2016: Sustainable Agriculture Water Management is Key to Ending Hunger and to Climate Change Adaptation. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofi-nena/en.

Report. WFP Ukraine: Food Security Update, June 2016. World Food Programme 2016. https://www.wfp.org/content/ukraine-food-security-update-june-2016.

* Report. 2017 Global Food Policy Report. International Food Policy Research Institute 2017. http://www.ifpri.org/publication/2017-global-food-policy-report.

* Report. The Future of Food and Agriculture: Trends and Challenges. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/publications/fofa/en.

* Report. Global Nutrition Report 2017: Nourishing the SDGs. Development Initiatives Poverty Research Ltd. 2017. http://www.globalnutritionreport.org/the-report.

* Report. Global Report on Food Crises. Food Security Information Network 2017. https://www.wfp.org/content/global-report-food-crisis-2017.

Report. Socioeconomic and Needs Impact Assessment: Donetsk and Lugansk Regions - Ukraine. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/documents/card/en/c/0f5e7c99-ff85-4e1a-b813-add010352014.



https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62



https://www.usda.gov/oce/climate_change/FoodSecurity.htm

https://www.chlpi.org/food_library/good-laws-good-food-putting-food-policy-work-navajo-nation

http://www.fao.org/emergencies/resources/documents/resources-detail/en/c/280784

http://www.fao.org/publications/card/en/c/ef84a9e6-176c-4b72-a374-158ade1abb47


http://www.fao.org/publications/rofsn-africa/en

http://www.fao.org/publications/card/en/c/ea009918-8124-4320-a5d9-0a296b07c141

http://www.fao.org/publications/rofi-euca/en

http://www.fao.org/publications/rofi-nena/en


http://www.ifpri.org/publication/2017-global-food-policy-report

http://www.fao.org/publications/fofa/en

http://www.globalnutritionreport.org/the-report

https://www.wfp.org/content/global-report-food-crisis-2017






*

Report. The State of Food Security and Nutrition in the World 2017. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. http://www.fao.org/state-of-food-security-nutrition/en.

Report. Segal LM et al. The State of Obesity: Better Policies for a Healthier America 2017. Trust for American’s Health, Robert Wood Johnson Foundation 2017. http://healthyamericans.org/reports/stateofobesity2017.

Report. Ukraine: Events of 2016. World Report 2017. Human Rights Watch 2017. https://www.hrw.org/world-report/2017/country-chapters/ukraine.

* Report. Map the Meal Gap 2018: A Report on County and Congressional District Food Insecurity and County Food Cost in the United States in 2016. Feeding America 2018. http://www.feedingamerica.org/research/map-the-meal-gap/overall-executive-summary.html.

Report. Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156653.

Report. Ukraine 2018 Humanitarian Response Plan. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156663.

Report. Monitoring Food Security in Countries with Conflict Situations: A Joint FAO/WFP Update for the United Nations Security Council, Issue No. 3. Food and Agriculture Organization of the United Nations, World Food Programme 2018. http://www.fao.org/emergencies/resources/documents/resources-detail/en/c/1095626.

Report. Young H, Marshak A. Persistent Global Acute Malnutrition. Tufts Friedman School of Nutrition Science and Policy Feinstein International Center, United States Agency for International Development 2018. http://fic.tufts.edu/publication-item/persistent-global-acute-malnutrition-a-discussion-paper-on-the-scope-of-the-problem-its-drivers-and-recommendations-for-policy-practice-and-research.

ARTICLES AND NOTES

Article. Evans-Campbell T. Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities. Journal of Interpersonal Violence 2008; 23(3): 316-338. DOI: http://dx.doi.org/10.1177/0886260507312290.

Article. Pardilla M et al. High Levels of Household Food Insecurity on the Navajo Nation. Public Health Nutrition 2013. DOI: https://doi.org/10.1017/S1368980012005630.

* Note. Rosenberg J et al. Concept Note: Malnutrition. Harvard Business Publishing 2015. http://www.globalhealthdelivery.org/case-collection/concept-notes/malnutrition.

* Article. Swinburn B et al. Strengthening of Accountability Systems to Create Healthy Food Environments and Reduce Global Obesity. The Lancet 2015; 385(9986): 2534–2545. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61747-5/fulltext.

* Article. Hasell J, Roser M. Famines. Our World in Data 2017. https://ourworldindata.org/famines.

Article. Jernigan, VBB et al. Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study. American Journal of Public Health 2017; 107(3): 441-446. DOI: https://doi.org/10.2105/AJPH.2016.303605.

* Article. Ayala A, Meier BM. A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity. Public Health Reviews 2017; 38(10). DOI: https://doi.org/10.1186/s40985-017-0056-5.

Article. Why Low-Income and Food-Insecure People are Vulnerable to Poor Nutrition and Obesity. Food Research & Action Center 2018. http://frac.org/obesity-health/low-income-food-insecure-people-vulnerable-poor-nutrition-obesity.

PORTALS AND INTERACTIVES

* Data Portal. FAOSTAT: Food and Agriculture Organization of the United Nations Statistics Division. Food and Agriculture Organization of the United Nations. http://faostat3.fao.org/home/E.

Topic Portal. Holodomor 1932-1933: Famine Genocide in Ukraine. http://holodomorct.org.



http://healthyamericans.org/reports/stateofobesity2017

https://www.hrw.org/world-report/2017/country-chapters/ukraine

http://www.feedingamerica.org/research/map-the-meal-gap/overall-executive-summary.html





http://fic.tufts.edu/publication-item/persistent-global-acute-malnutrition-a-discussion-paper-on-the-scope-of-the-problem-its-drivers-and-recommendations-for-policy-practice-and-research


http://dx.doi.org/10.1177/0886260507312290

https://doi.org/10.1017/S1368980012005630

http://www.globalhealthdelivery.org/case-collection/concept-notes/malnutrition

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61747-5/fulltext

https://ourworldindata.org/famines


https://doi.org/10.1186/s40985-017-0056-5

http://frac.org/obesity-health/low-income-food-insecure-people-vulnerable-poor-nutrition-obesity


http://faostat3.fao.org/home/E





* Data Interactive. The FAO Hunger Map 2015. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/hunger/en.

Data Interactive. Food Access Research Atlas. United States Department of Agriculture Economic Research Service 2017. https://www.ers.usda.gov/data/fooddesert.

Topic Portal. Food Distribution Program on Indian Reservations. United States Department of Agriculture Food and Nutrition Service 2017. https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir.

Topic Portal. Caucasus, Central Asia and Ukraine. United Nations Office for the Coordination of Humanitarian Affairs 2018. http://www.unocha.org/rocca.

* Data Portal. CountrySTAT: Food and Agriculture Data Network. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/economic/ess/countrystat/en.

Web Portal. Famine Early Warning System. United States Agency for International Development 2018. http://www.fews.net.

* Data Portal. Food Safety: Databases. World Health Organization 2018. http://www.who.int/foodsafety/databases/en.

Topic Portal. Global Forum on Food Security and Nutrition. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/fsnforum/home.

Topic Portal. Health Response to the Humanitarian Crisis in Ukraine. World Health Organization: Regional Office for Europe 2018. http://www.euro.who.int/en/health-topics/emergencies/health-response-to-the-humanitarian-crisis-in-ukraine.

Topic Portal. Navajo Nation. Partners In Health 2018. https://www.pih.org/country/navajo-nation.

Data Portal. Nutrition Landscape Information System. World Health Organization 2018. http://www.who.int/nutrition/nlis/en.

Data Portal. Profile: American Indian/Alaska Native. United States Department of Health and Human Services Office of Minority Health 2018. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62.

* Topic Portal. Research Program on Climate Change, Agriculture and Food Security. CGIAR 2018. https://ccafs.cgiar.org.

Topic Portal. Understanding Hunger and Food Insecurity. Feeding America 2018. http://www.feedingamerica.org/hunger-in-america/what-is-hunger-and-food-insecurity.html.

FACT SHEETS, INFOGRAPHICS, AND COUNTRY PROFILES

* Infographic. FAO and Post-2015. Infographic. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/resources/infographics/infographics-details/en/c/266124.

* Infographic. A Framework for Assessing Effects of the Food System. The National Academies Press 2015. http://www.nap.edu/visualizations/assessing-decisions-about-food-and-agriculture.

Infographic. 2017 Nutrition Country Profile: Ukraine. Global Nutrition Report 2017. Development Initiatives Poverty Research Ltd. 2017. http://globalnutritionreport.org/wp-content/uploads/2017/12/gnr17-Ukraine.pdf.

Fact Sheet. Hunger and Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Food Research & Action Center 2017. http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well.

Fact Sheet. Ukraine: Humanitarian Snapshot. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukraine-humanitarian-snapshot-27-december-2017-en.

Infographic. Global Food Security Index: Ukraine. The Economist Intelligence Unit Ltd. 2018. http://foodsecurityindex.eiu.com/Country/Details#Ukraine.

Country Profile. Ukraine. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/countryprofiles/index/en/?iso3=ukr.

http://www.fao.org/hunger/en




http://www.unocha.org/rocca

http://www.fao.org/economic/ess/countrystat/en

http://www.fews.net/

http://www.who.int/foodsafety/databases/en

http://www.fao.org/fsnforum/home

http://www.euro.who.int/en/health-topics/emergencies/health-response-to-the-humanitarian-crisis-in-ukraine


https://www.pih.org/country/navajo-nation

http://www.who.int/nutrition/nlis/en


https://ccafs.cgiar.org/


http://www.fao.org/resources/infographics/infographics-details/en/c/266124

http://www.nap.edu/visualizations/assessing-decisions-about-food-and-agriculture








http://www.fao.org/countryprofiles/index/en/?iso3=ukr




MULTIMEDIA AND NEWS

Blog. Aji. Starving in the Land of Plenty: Hunger in Native America; Feeding America Blogathon. Native American Netroots 2010; Sep 27. http://nativeamericannetroots.net/diary/693.

News Article. Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015; Nov 25. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d.

* Podcast. Famine and Conflict: The Unfolding Food Security Crisis. Advanced Training Program on Humanitarian Action, Harvard Humanitarian Initiative 2017. http://atha.se/podcasts/famine-and-conflict-unfolding-food-security-crisis.

News Article. Applebaum A. How Stalin Hid Ukraine’s Famine from the World. The Atlantic 2017; Oct 13. https://www.theatlantic.com/international/archive/2017/10/red-famine-anne-applebaum-ukraine-soviet-union/542610.

News Article. Nelson SS. In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War. National Public Radio 2017; Jul 24. https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war.

News Article. Bonenberger A. The War No One Notices in Ukraine. The New York Times 2017; Jun 20. https://www.nytimes.com/2017/06/20/opinion/ukraine-russia.html.

Video. Holodomor Reconsidered: The Bolshevik Revolution and the Ukrainian Famine. Ukrainian Research Institute Harvard University 2017. https://www.youtube.com/watch?v=eqdoxz-pmEM.

News Article. Goldberg E. The U.S. Already Tested Trump’s Canned Goods Idea on Native Americans. It was Bad. The Huffington Post 2018; Feb 22. https://www.huffingtonpost.com/entry/trump-snap-canned-goods-native-americans_us_5a8c403de4b0e1acb11d833a.

ORGANIZATIONS

* Organization. Food and Agriculture Organization of the United Nations. http://www.fao.org/home/en.

* Organization. Food Security Information Network. Food and Agriculture Organization of the United Nations, World Food Programme, International Food Policy Research Institute. http://www.fsincop.net.

* Organization. International Food Policy Research Institute. http://www.ifpri.org.

* Organization. Oxfam International Inc. https://www.oxfam.org.

* Organization. World Food Programme. http://www.wfp.org.

*indicates resource listed in GHELI’s online Repository




http://atha.se/podcasts/famine-and-conflict-unfolding-food-security-crisis






https://www.nytimes.com/2017/06/20/opinion/ukraine-russia.html

https://www.youtube.com/watch?v=eqdoxz-pmEM

https://www.huffingtonpost.com/entry/trump-snap-canned-goods-native-americans_us_5a8c403de4b0e1acb11d833a


http://www.fao.org/home/en

http://www.fsincop.net/

http://www.ifpri.org/

https://www.oxfam.org/

http://www.wfp.org/




Annotated Bibliography

BASIC READS

FOOD SECURITY: GENERAL OVERVIEW

An Introduction to the Basic Concepts of Food Security Fact Sheet. An Introduction to the Basic Concepts of Food Security. Food and Agriculture Organization of the United Nations 2008. http://www.fao.org/documents/card/en/c/2357d07c-b359-55d8-930a-13060cedd3e3. This three-page summary from the Food and Agriculture Organization of the United Nations (FAO), is a practical guide to basic food security concepts. It outlines the four dimensions of food security (availability, access, utilization, and stability), defines the difference between chronic and transitory food insecurity with a note about seasonal food security, introduces the Integrated Food Security Phase Classification (IPC) used to measure the severity of food security, summarizes dimensions of vulnerability that shape food security policies, and briefly highlights the interrelationship between hunger, malnutrition, and poverty. Despite its dated bibliography, the fact sheet is a clear and organized brief of key themes for a timeless issue.

Food Access Research Atlas Data Interactive. Food Access Research Atlas. United States Department of Agriculture Economic Research Service 2017. https://www.ers.usda.gov/data/fooddesert. This interactive atlas, developed by the United States Department of Agriculture, is a useful tool to understand the geography of food accessibility in the United States. Users can create maps by census tracks, compare and download food-access data, and overlay relevant indicators such as distance from the nearest supermarket, rates of poverty, limited access to a vehicle, and proportion of individuals living in group quarters.

Food Security in the U.S. Topic Portal. Food Security in the U.S. United States Department of Agriculture 2017. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us. This topic portal from the United States Department of Agriculture (USDA) provides basic information about food security in the United States. Resources include: a brief overview, definitions, key statistics and graphs, measures, survey tools, interactive charts and highlights, history, media resources including videos, and links to related reports and USDA information on other food-related topics.

A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity Article. Ayala A, Meier BM. A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity. Public Health Reviews 2017; 38 (10). DOI: https://doi.org/10.1186/s40985-017-0056-5. GHELI repository link: http://repository.gheli.harvard.edu/repository/12277 This open-access article in Public Health Reviews summarizes human rights documents and scholarship on the rights to health and to food in an analytical interpretation of government obligations to ensure food security as a human right. The article discusses food and nutrition security as a health determinant, the ways in which food insecurity is related to malnutrition, the role of gender and maternal health in food insecurity risks globally, the role of factors such as climate change, urbanization, humanitarian emergencies and disasters, the food industry and globalization of unhealthy diets, and national laws in a human rights approach to food and nutritional health.

Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being Fact Sheet. Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Food Research & Action Center 2017. http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well. This fact sheet from the Food Research & Action Center summarizes key points on how poverty, food insecurity, and poor nutrition impact health and well-being. The fact sheet is designed to inform national food policy research, action, and anti-hunger advocacy efforts with evidence-based data. It includes definitions of key terms and infographics, a one-




https://doi.org/10.1186/s40985-017-0056-5

http://repository.gheli.harvard.edu/repository/12277






page list of chronic diseases, health conditions, and health behaviors associated with food insecurity, and research citations relevant to food insecurity in the United States today.

The State of Food Security and Nutrition in the World 2017 Report. The State of Food Security and Nutrition in the World 2017. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. http://www.fao.org/state-of-food-security-nutrition/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11687 This annual United Nations report indicates that global hunger is on the rise again, after steadily declining for over a decade. The report is jointly published by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP), and the World Health Organization (WHO). The report points out that conflict, compounded by climate-related shocks, has driven the resurgence of hunger and many forms of malnutrition that affect 815 million people worldwide.

Understanding Hunger and Food Insecurity Topic Portal. Understanding Hunger and Food Insecurity. Feeding America 2018. http://www.feedingamerica.org/hunger-in-america/what-is-hunger-and-food-insecurity.html. This web portal briefly defines food insecurity, links to recent reports, and highlights key aspects of hunger and food insecurity in the United States. Feeding America, a national network of more than 200 food banks, is the largest hunger relief and advocacy organization in the U.S. FOOD INSECURITY AND UKRAINE

Holodomor 1932-1933: Famine Genocide in Ukraine Topic Portal. Holodomor 1932-1933: Famine Genocide in Ukraine. http://holodomorct.org. This web portal, originally created in 2007 with periodic updates, provides information about the 1932-1933 Ukraine famine, called “Holodomor.” The site aims to serve as a reliable educational resource for teachers, and includes a historical timeline with analysis as well as eyewitness accounts, links to multiple educational sources, and a “news/events” blog of recent publications and events.

In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War Article. Nelson SS. In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War. National Public Radio 2017; Aug 4. https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war. This article and photo essay from National Public Radio describes and illustrates daily life for residents of Eastern Ukraine, trying to survive while caught in the middle of an armed conflict between government forces and Russian separatists. The article highlights the war’s effects on the region’s economic instability as well as on the health of its residents, who suffer from high stress levels, alcohol abuse, and living conditions without reliable heat, electricity, gas, or plumbing.

How Stalin Hid Ukraine’s Famine from the World Article. Applebaum A. How Stalin Hid Ukraine’s Famine from the World. The Atlantic 2017; Oct 13. https://www.theatlantic.com/international/archive/2017/10/red-famine-anne-applebaum-ukraine-soviet-union/542610. This article from The Atlantic provides a historical summary of the 1932-1933 famine in the Ukraine that took place under Josef Stalin and deprived the population of all available food leading to widespread starvation. The article is adapted from the author’s book, Red Famine: Stalin’s War on Ukraine, and describes events through the careers of two journalists, Walter Duranty and Gareth Jones. It offers a useful overview of how politics impacts food insecurity even in regions where food is plentiful, and the importance of journalism in global awareness and response.











Socioeconomic Impact and Needs Assessment: Donetsk and Lugansk Regions, Ukraine Report. Socioeconomic Impact and Needs Assessment: Donetsk and Lugansk Regions, Ukraine. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/documents/card/en/c/0f5e7c99-ff85-4e1a-b813-add010352014. This report presents an analysis of social and economic vulnerability in the conflict-affected Donetsk and Lugansk regions of Ukraine, with a particular focus on rural people living along the line affected by political and armed conflict. The study measures the economic and social vulnerability of 662,933 residents (229,696 households), investigating their level of exposure to shocks and prevalent coping strategies.

Ukraine 2018: Humanitarian Needs Overview Report. Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156653. This United Nations report provides an overview of the human toll of the armed conflict in eastern Ukraine and the needs for humanitarian assistance and protection in a region largely forgotten by the international community. It describes the historical context of armed conflict and consequent doubling of food insecurity since 2016, escalating cases of multi-drug resistant TB, HIV, and polio, and ongoing challenges such as Ukraine’s extremely harsh winters, restrictions on humanitarian access, and limited employment opportunities. The elderly make up almost 30 percent of people in need. The report is designed to help humanitarian aid workers but would also be useful in classroom discussion about public health and humanitarian response, food insecurity, and studies related to Russia and the former Soviet Union.

Ukraine: Humanitarian Snapshot Fact Sheet. Ukraine: Humanitarian Snapshot. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukraine-humanitarian-snapshot-27-december-2017-en. This fact sheet from the United Nations provides a one-page summary of conditions, risks, and needs due to ongoing armed conflict in east Ukraine, from a humanitarian perspective. The resource includes a map with checkpoints, a timeline of the conflict since June 2014, and statistics on aid funding and people in need by location. Designed for humanitarian aid workers and agencies, the fact sheet would also be useful in classroom discussion about humanitarian response, food insecurity, health-related risks due to armed conflict, and the study of Russia and the former Soviet Union. The document is periodically updated.

Global Food Security Index: Ukraine Infographic. Global Food Security Index: Ukraine. The Economist Intelligence Unit Ltd. 2018. http://foodsecurityindex.eiu.com/Country/Details#Ukraine. This interactive data tool from The Economist Intelligence Unit Ltd. provides infographics on food security in Ukraine, including relative food affordability, availability, and quality and safety. It is part of the Global Food Security Index, a dynamic quantitative and qualitative benchmarking model that measures drivers of food security—such as affordability, availability, and quality—across a set of 113 developing and developed countries. FOOD INSECURITY AMONG NATIVE AMERICANS IN THE UNITED STATES

Starving in the Land of Plenty: Hunger in Native America Blog. Aji. Starving in the Land of Plenty: Hunger in Native America; Feeding America Blogathon. Native American Netroots 2010; Sep 27. http://nativeamericannetroots.net/diary/693. This blog post is an opinion essay that summarizes the primary health, hunger, and food security risks faced by American Indian/Alaska Native people living in the U.S. today, based on the family experiences of the author, a journalist for the community. The essay is a readable and carefully researched summary of key data on food access, economics, and government assistance related to food and health for this population. It concludes with suggestions that invite the communities to specific personal, local, and national action.







http://foodsecurityindex.eiu.com/





The Native American Community Faces Dangerously High Rates of Food Insecurity Article. Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d. This article from ThinkProgress highlights the problem of food insecurity in Native American communities across the U.S. and explores current data in historical context of displacement of tribes that were once the most agriculturally prosperous groups of people in North America. Data suggest that 60 percent of counties with a Native American majority live with high food insecurity, gaps in health care access, chronic poverty, and more than double the incidence of diabetes compared to white Americans. The author highlights the potential for the best culturally responsive solutions coming from within the Native American communities.

Food Distribution Program on Indian Reservations Topic Portal. Food Distribution Program on Indian Reservations. United States Department of Agriculture Food and Nutrition Service 2017. https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir. This topic portal is the homepage of the U.S. government’s food assistance program for low-income American Indians and Alaska Natives who live on Indian reservations, in designated areas near reservations, and in the state of Oklahoma. The site includes information on participant eligibility and resources such as fact sheets and lists of foods available to recipients.

Profile: American Indian/Alaska Native Data Portal. Profile: American Indian/Alaska Native. United States Department of Health and Human Services Office of Minority Health 2018. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62. This website, hosted by the United States Department of Health and Human Services, provides demographic, language, educational, economic, and health information about American Indian and Alaska Native peoples in the United States. An interactive map allows users to access detailed information about government resources in each of 12 American Indian/Alaska Native regions, and the site provides links to full Census reports and selected data about the prevalence and risk factors among American Indian and Alaska Native peoples for specific diseases and other health conditions.

REPORTS

Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People Report. Diné Food Sovereignty: A Report on the Navajo Nation Food System and the Case to Rebuild a Self-Sufficient Food System for the Diné People. Diné Policy Institute, First Nations Development Institute, W.K. Kellogg Foundation 2014. https://firstnations.org/knowledge_center/download/din%C3%A9_food_sovereignty_report_navajo_nation_food_system_and_case_rebuild. This report from the Diné Policy Institute, published by the First Nations Development Institute in collaboration with the W.K. Kellogg Foundation, provides research data on food and food sovereignty among the Navajo Nation (also called the Diné). Food sovereignty is defined as the right of peoples to healthy and culturally appropriate food produced through ecologically sound and sustainable methods, and their right to define their own food and agriculture systems. The report is available upon free registration with the First Nations Development Institute, and includes sections on: results from community surveys and interviews of a food assessment, Diné knowledge and food, historical analysis of the Diné food system, the health, economy, and state of the Navajo Nation food system today, and implications and strategies and recommendations for improving Diné food sovereignty. The report includes maps and charts useful in classroom teaching.










Climate Change, Global Food Security, and the U.S. Food System Report. Climate Change, Global Food Security, and the U.S. Food System. United States Department of Agriculture Office of the Chief Economist 2015. https://www.usda.gov/oce/climate_change/FoodSecurity.htm. GHELI repository link: http://repository.gheli.harvard.edu/repository/12074 This report from the United States Department of Agriculture describes the effects of climate change on global, regional, and local food security. Climate change is expected to diminish global progress on food security—the availability, accessibility, utility, and stability of food— as higher emissions and concentrations of greenhouse gases contribute to disruptions in food production and decreases in food safety by influencing transportation, processing, storage, and infrastructure of agriculture and food systems. The report reviews a range of scenarios that estimate the impact on food insecurity of varying levels of greenhouse gas emissions control, population growth, and economic growth, and offers evidence to support decision-makers in adapting food systems in a changing global climate.

Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation Report. Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation. Harvard Law School Food Law and Policy Clinic, Community Outreach & Patient Empowerment, Navajo Nation 2015. https://www.chlpi.org/food_library/good-laws-good-food-putting-food-policy-work-navajo-nation. This report was created in collaboration with the Food Law and Policy Clinic at Harvard Law School, Partners In Health’s Community Outreach & Patient Empowerment (COPE), and the Navajo Nation, a Native American territory covering about 17.5 million acres across portions of northeastern Arizona, southeastern Utah, and northwestern New Mexico in the United States. The report provides an overview of the laws governing food and food access in the Navajo Nation, and challenges that food access pose in nutrition-related health problems such as obesity, diabetes, hypertension, and cardiovascular disease.

The Impact of Natural Hazards and Disasters on Agriculture and Food and Nutrition Security: A Call for Action to Build Resilient Livelihoods Report. The Impact of Natural Hazards and Disasters on Agriculture and Food and Nutrition Security: A Call for Action to Build Resilient Livelihoods. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/emergencies/resources/documents/resources-detail/en/c/280784. GHELI repository link: http://repository.gheli.harvard.edu/repository/10935 This report from the Food and Agriculture Organization of the United Nations (FAO) looks at the impact of natural hazards and disasters on agriculture and food and nutrition security. It presents the preliminary findings of an FAO study on the quantitative economic impact of disasters on agriculture and on the livelihoods and food security of populations affected, particularly in developing countries over the past decade. Key themes addressed include the food security of populations; adoption of agricultural technologies; types of hazards that have the greatest impact on crops, livestock, fisheries, or forestry; disaster risk reduction; and resilience in agriculture and livelihoods.

Regional Overview of Food Insecurity: Latin America and the Caribbean Report. Regional Overview of Food Insecurity: Latin America and the Caribbean. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/publications/card/en/c/ef84a9e6-176c-4b72-a374-158ade1abb47. GHELI repository link: http://repository.gheli.harvard.edu/repository/10934 This report from the Food and Agriculture Organization of the United Nations looks at how food and nutritional security have become integral to the political agenda of Latin America and the Caribbean, and how the full eradication of hunger and malnutrition is now a regional development objective. Latin America and the Caribbean pioneered the proposal of eradicating hunger by 2025, a goal adopted in 2005 with the Hunger Free Latin America and the Caribbean Initiative and then fully incorporated into the Community of Latin American and Caribbean States’ (CELAC) Plan for Food Security, Nutrition and Hunger Eradication.

https://www.usda.gov/oce/climate_change/FoodSecurity.htm


https://www.chlpi.org/food_library/good-laws-good-food-putting-food-policy-work-navajo-nation








Africa Regional Overview of Food Insecurity and Nutrition 2016: The Challenge of Building Resilience to Shocks and Stresses Report. Africa Regional Overview of Food Security and Nutrition 2016: The Challenge of Building Resilience to Shocks and Stresses. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofsn-africa/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11521 This report examines food insecurity in Africa. Produced by the United Nations Food and Agriculture Organization (FAO), this 2016 report is an updated companion to FAO’s global report, The State of Food Insecurity in the World 2015. Focusing on the enduring challenges to the region, including widespread poverty, malnutrition, undernourishment, and obesity, the report notes that several policies and strategies have yet to prove useful. With unstable markets, climate change concerns, and region-wide conflict, a multi-sectoral approach is needed for the region to reach its goals in the timeline set by the 2030 Sustainable Development Agenda.

Asia and the Pacific Regional Overview of Food Insecurity 2016: Investing in a Zero Hunger Generation Report. Asia and the Pacific Regional Overview of Food Insecurity 2016: Investing in a Zero Hunger Generation. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/card/en/c/ea009918-8124-4320-a5d9-0a296b07c141. GHELI repository link: http://repository.gheli.harvard.edu/repository/10933 This report examines food insecurity in Asia and the Pacific region. Produced by the Food and Agriculture Organization of the United Nations (FAO), this 2016 report is an updated companion to FAO’s global report, The State of Food Insecurity in the World 2015. The report outlines a new drive to eradicate hunger, undernourishment, and malnutrition in the region. It also introduces a special report section which will focus on a key topic or trend in food security and nutrition each year; this year’s publication features a discussion of the importance of milk and smallholder dairy in the region, concluding that the promotion of milk consumption and the rise of small-scale farms greatly benefit nutrition.

Europe and Central Asia Regional Overview of Food Insecurity 2016: The Food Insecurity Transition Report. Europe and Central Asia Regional Overview of Food Insecurity 2016: The Food Insecurity Transition. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofi-euca/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11522 This report examines food insecurity in Europe and Central Asia. Produced by the United Nations Food and Agriculture Organization (FAO), this 2016 report is an updated companion to FAO’s global report, The State of Food Insecurity in the World 2015. With a focus on the recent shift from fighting undernutrition to promoting healthier diets, the report explores a variety of topics, including the effects of poverty, trends in overweight and obesity, nutritional deficiencies among different populations, and fiscal considerations such as taxing sugary drinks. The report analyzes countries in groups, based on their major food insecurity concerns.

Near East and North Africa Regional Overview of Food Insecurity 2016: Sustainable Agriculture Water Management is Key to Ending Hunger and to Climate Change Adaptation Report. Near East and North Africa Regional Overview of Food Insecurity 2016: Sustainable Agriculture Water Management is Key to Ending Hunger and to Climate Change Adaptation. Food and Agriculture Organization of the United Nations 2016. http://www.fao.org/publications/rofi-nena/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11523 This report examines food insecurity in the Near East and North Africa regions. Produced by the United Nations Food and Agriculture Organization (FAO), this 2016 report is an updated companion to FAO’s global report, The State of Food Insecurity in the World 2015. The report focuses on the challenges that remain to achieving the Sustainable Development Goals (SDGs) related to ending hunger, achieving food security, improving nutrition, and promoting sustainable agriculture. The report acknowledges successes in areas such as sanitation and food production, but notes that high variability across the regions and ongoing conflicts will continue to hinder progress.




http://www.fao.org/hunger/en/






http://www.fao.org/publications/rofi-euca/en


http://www.fao.org/publications/sofa/2015/en/


http://www.fao.org/publications/rofi-nena/en







WFP Ukraine: Food Security Update, June 2016 Report. WFP Ukraine: Food Security Update, June 2016. World Food Programme 2016. https://www.wfp.org/content/ukraine-food-security-update-june-2016. This report from the World Food Programme (WFP) explores how armed conflict in two regions of eastern Ukraine is affecting food security. It provides graphics and brief summaries of food-related data that were derived from 1,600 household interviews conducted by the Kiev International Institute of Sociology for WFP, in April and May 2016. The report identifies 19 percent of households as food insecure, with the lowest food consumption among female-headed households and the elderly. Government-provided social benefits (pensions, unemployment benefits, and social payments to children, mothers, and internally displaced persons) were identified as the primary income source for more than 50 percent of households, and nearly half of the respondents reported that they coped with food insecurity resulting from the conflict by reducing expenditures on health expenses. Households’ financial accessibility to food was most affected by high food prices, food inflation, low wages, and social benefits that affected finances.

2017 Global Food Policy Report Report. 2017 Global Food Policy Report. International Food Policy Research Institute 2017. http://www.ifpri.org/publication/2017-global-food-policy-report. GHELI repository link: http://repository.gheli.harvard.edu/repository/11613 This report from the International Food Policy Research Institute examines the global state of food policy in 2016, outlining major developments made and progress achieved. With a strong focus on cities, the report explores the future of food and nutrition policy in a rapidly urbanizing world. The report highlights major challenges and areas of concern that will need to be addressed in 2017, covering issues including rural-urban relations, food security, diet and nutrition, and governance. It also includes summaries of regional developments, and sections explaining the indicators that are included along with the publication. This report is accompanied by a synopsis, a web version, an interactive map of global food policy indicators, a slide deck, and a series of downloadable indicators.

The Future of Food and Agriculture: Trends and Challenges Report. The Future of Food and Agriculture: Trends and Challenges. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/publications/fofa/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11500 This report from the Food and Agriculture Organization of the United Nations (FAO) calls for major transformations in agricultural systems and in how we manage our natural resources. The report outlines 15 trends and 10 challenges that agriculture and food systems are facing now, and provides insights into the actions that will be needed to eradicate hunger and malnutrition. Of particular relevance to global health are sections about population dynamics, urbanization, and aging; climate change; conflicts, crises, and natural disasters; poverty, inequality, and food insecurity; nutrition and health; governance for food and nutrition security; and development finance. Useful materials for educators include a downloadable 50-page executive summary, as well as a downloadable animation, infographic, audio, and presentation.

Global Nutrition Report 2017: Nourishing the SDGs Report. Global Nutrition Report 2017: Nourishing the SDGs. Development Initiatives Poverty Research Ltd. 2017. http://www.globalnutritionreport.org/the-report. GHELI repository link: http://repository.gheli.harvard.edu/repository/10926 This report from Development Initiatives Poverty Research Ltd. and produced and disseminated by the International Food Policy Research Institute (IFPRI) documents the status of the world’s nutrition and progress made to meet global nutrition targets established by the World Health Assembly. The 2017 edition places particular focus on the role of nutrition in the 2030 Sustainable Development Agenda, which was adopted by the international community in 2015 and established 17 Sustainable Development Goals (SDGs) to address global challenges through economic, social, and environmental progress. Information is provided on nutrition indicators in children, adolescents, and adults, social determinants, and intervention coverage; food supply; economics; and demography. The report suggests that there are five core areas of development that run through the SDGs which nutrition can contribute to and benefit from—sustainable food production, infrastructure, health systems, equity and inclusion, and peace and stability—and emphasizes that ending malnutrition in all its forms will catalyze improved outcomes across the SDGs. The Global Nutrition Report is published annually and represents a multi-partner collaborative effort to consider how countries can


http://www.ifpri.org/publication/2017-global-food-policy-report


http://www.ifpri.org/publication/2017-global-food-policy-report-synopsis

http://ebrary.ifpri.org/cdm/pageflip/collection/p15738coll2/id/131085/type/singleitem/pftype/pdf

http://www.tellmaps.com/ifpri/embed2.jsp

http://www.tellmaps.com/ifpri/embed2.jsp

https://www.slideshare.net/ifpri/global-food-policy-report-2017




https://youtu.be/jF07b7IDxus

http://www.fao.org/resources/infographics/infographics-details/en/c/471471/

http://www.fao.org/news/audio-video/detail-audio/en/?uid=12052

https://www.slideshare.net/FAOoftheUN/the-future-of-food-and-agriculture-trends-and-challenges






implement interventions that are specific, measurable, and achievable. IFPRI also provides previous editions of the Global Nutrition Report, and offers access to data, interactive maps, regional and country profiles, and infographics.

Global Report on Food Crises Report. Global Report on Food Crises. Food Security Information Network 2017. https://www.wfp.org/content/global-report-food-crisis-2017. GHELI repository link: http://repository.gheli.harvard.edu/repository/11502 This report from the Food Security Information Network (FSIN) provides a global overview of food insecurity as well as individual country estimates of those affected by food conditions deemed either “stressed” or “crisis, emergency, or famine” based on the international and standardized Integrated Food Security Phase Classification (IPC). It also examines the major food crises of 2016 in countries and/or population groups across the world—many of which were caused or exacerbated by conflict, natural disasters, and high food prices—and within each country profile provides a one-page infographic overview, a nutrition snapshot, information about the key drivers of that food crisis, and a specific outlook for the future.

Socioeconomic Impact and Needs Assessment: Donetsk and Lugansk Regions—Ukraine Report. Socioeconomic Impact and Needs Assessment: Donetsk and Lugansk Regions, Ukraine. Food and Agriculture Organization of the United Nations 2017. http://www.fao.org/documents/card/en/c/0f5e7c99-ff85-4e1a-b813-add010352014. This report presents an analysis of social and economic vulnerability in the conflict-affected Donetsk and Lugansk regions of Ukraine, with a particular focus on rural people living along the line affected by political and armed conflict. The study measures the economic and social vulnerability of 662,933 residents (229,696 households), investigating their level of exposure to shocks and prevalent coping strategies.

The State of Food Security and Nutrition in the World 2017 Report. The State of Food Security and Nutrition in the World 2017. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. http://www.fao.org/state-of-food-security-nutrition/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11687 This annual United Nations report indicates that global hunger is on the rise again, after steadily declining for over a decade. The report is jointly published by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP), and the World Health Organization (WHO). The report points out that conflict, compounded by climate-related shocks, has driven the resurgence of hunger and many forms of malnutrition that affect 815 million people worldwide.

The State of Obesity: Better Policies for a Healthier America 2017 Report. Segal LM et al. The State of Obesity: Better Policies for a Healthier America 2017. Trust for American’s Health, Robert Wood Johnson Foundation 2017. http://healthyamericans.org/reports/stateofobesity2017. This report explores the problem of obesity in the United States and describes and considers a wide range of responses related to health and food policies based in schools, communities, and the healthcare sector. The contributing role of food insecurity is defined and discussed within the section on nutrition assistance, on pages 71-73.

Ukraine: Events of 2016 Chapter. Ukraine: Events of 2017. World Report 2018. Human Rights Watch 2018. https://www.hrw.org/world-report/2018/country-chapters/ukraine. GHELI repository link: http://repository.gheli.harvard.edu/repository/11423 This country chapter from the Human Rights Watch’s World Report 2018 summarizes conflict and human rights-related challenges in Ukraine during 2017 due to political conflict between Ukraine and Russia, particularly as it affected residents of eastern Ukraine. Issues include arbitrary detention and cruelty, the need for accountability, freedom of expression and media, sexual orientation and gender identity, tensions in the Crimea, and the role of key international actors.








http://healthyamericans.org/reports/stateofobesity2017




https://www.hrw.org/world-report/2017




Map the Meal Gap 2018: A Report on County and Congressional District Food Insecurity and County Food Cost in the United States in 2016 Report. Map the Meal Gap 2018: A Report on County and Congressional District Food Insecurity and County Food Cost in the United States in 2016. Feeding America 2018. http://www.feedingamerica.org/research/map-the-meal-gap/overall-executive-summary.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/11614 This report from Feeding America, the nation’s largest nonprofit hunger relief organization, summarizes the latest data on overall and child-specific food insecurity in the United States at the state, county, and congressional district levels. As of 2016, 41 million people in the U.S. lived in food-insecure households and 13 million were children. The report is intended to influence government policy makers and is based on USDA Economic Research Service data. The full 2018 report and technical appendix is accompanied by report briefs (with references), which include an executive summary and standalone briefs on the topics of child food insecurity, food price variation, and health implications. Individual, downloadable state-wide profiles, an interactive online tool, “Map the Meal Gap,” which maps the locations where food insecurity exists in the U.S., and previous food insecurity reports dating back to 2011 are also available.

Ukraine 2018: Humanitarian Needs Overview Report. Ukraine 2018: Humanitarian Needs Overview. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156653. This United Nations report provides an overview of the human toll of the armed conflict in eastern Ukraine and the needs for humanitarian assistance and protection in a region largely forgotten by the international community. It describes the historical context of armed conflict and consequent doubling of food insecurity since 2016, escalating cases of multi-drug resistant TB, HIV, and polio, and ongoing challenges such as Ukraine’s extremely harsh winters, restrictions on humanitarian access, and limited employment opportunities. The elderly make up almost 30 percent of people in need. The report is designed to help humanitarian aid workers but would also be useful in classroom discussion about public health and humanitarian response, food insecurity, and studies related to Russia and the former Soviet Union.

Ukraine 2018 Humanitarian Response Plan Report. Ukraine 2018 Humanitarian Response Plan. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/node/156663. This report from the United Nations Office for the Coordination of Humanitarian Affairs provides updated data on humanitarian needs in Ukraine, designed for use by humanitarian agencies and individuals globally. The report summarizes the conditions and risks faced by those living in a region now in its fourth year of daily hostilities. The report focuses on the 4.4 million people in eastern Ukraine who experience an average of one shelling every 30 minutes, provides an overview of the crisis, outlines response strategies, and summarizes key needs, which include: protection, food security, water and sanitation, health and nutrition, shelter, education, and logistical and economic assistance. The report will be most helpful to humanitarian aid organizations but is also useful for college-level discussion about public health, international aid, and the social determinants of health in armed conflict settings.

Monitoring Food Security in Countries with Conflict Situations: A Joint FAO/WFP Update for the United Nations Security Council, Issue No. 3 Report. Monitoring Food Security in Countries with Conflict Situations: A Joint FAO/WFP Update for the United Nations Security Council, Issue No. 3. Food and Agriculture Organization of the United Nations, World Food Programme 2018. http://www.fao.org/emergencies/resources/documents/resources-detail/en/c/1095626. This report from the Food and Agriculture Organization (FAO) of the United Nations and the World Food Programme provides data on acute food insecurity in conflict-ridden countries that are routinely monitored by the United Nations Security Council. It includes a one-page graphic reference table defining the United Nations’ phases of food insecurity, priority response objectives, food consumption, nutritional status, and mortality rates. The bulk of the report is devoted to short summaries of each of the 16 countries and one region identified as facing severe food shortage in 2017: Afghanistan, Burundi, the Central African Republic, the Democratic Republic of the Congo, Guinea-Bissau, Haiti, Iraq, the Lake Chad Basin, Lebanon, Liberia, Mali, Somalia, South Sudan, the Sudan, the Syrian Arab Republic, Ukraine, and Yemen.




http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-full.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-full.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-all-modules.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-executive-summary.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-child-food-insecurity.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-food-price-variation.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://www.feedingamerica.org/research/map-the-meal-gap/2016/2016-map-the-meal-gap-health-implications.pdf?s_src=W186ORGSC&s_referrer=google&s_subsrc=http%3A%2F%2Fwww.feedingamerica.org%2Fresearch%2Fmap-the-meal-gap%2Foverall-executive-summary.html

http://map.feedingamerica.org/







Persistent Global Acute Malnutrition Report. Young H, Marshak A. Persistent Global Acute Malnutrition. Tufts Friedman School of Nutrition Science and Policy Feinstein International Center, United States Agency for International Development 2018. http://fic.tufts.edu/publication-item/persistent-global-acute-malnutrition-a-discussion-paper-on-the-scope-of-the-problem-its-drivers-and-recommendations-for-policy-practice-and-research. This report from the Feinstein International Center at Tufts University and the United States Agency for International Development (USAID) draws from a literature review and informant interviews to outline the scope, causes, and policy, practice, and research recommendations for persistent global acute malnutrition (GAM). GAM is a protracted problem for children between six and 59 months of age in 25 countries marked by humanitarian emergencies, resulting in growth stunting and increased under-five mortality. The problem calls for new approaches to nutrition-specific interventions in crisis settings.

ARTICLES AND NOTES

Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities Article. Evans-Campbell T. Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities. Journal of Interpersonal Violence 2008; 23(3): 316-338. DOI: http://dx.doi.org/10.1177/0886260507312290. This article from the Journal of Interpersonal Violence explores historical trauma on American Indian communities through a multilevel framework. It dissects current approaches to historical trauma and intergenerational transmission of historical trauma to better understand factors of influence. It also explores the interplay of historical and contemporary trauma to suggest new directions in trauma response for affected communities.

High Levels of Household Food Insecurity on the Navajo Nation Article. Pardilla M et al. High Levels of Household Food Insecurity on the Navajo Nation. Public Health Nutrition 2013. DOI: https://doi.org/10.1017/S1368980012005630. This article from Public Health Nutrition reports data from a cross-sectional study of 176 members of the Navajo Nation interviewed about food insecurity risk factors. Researchers found that 76.7 percent reported some level of food insecurity, the highest reported to date in the U.S., alongside very high rates of child hunger at 30 percent, and 82.5 percent overweight and obesity. Low socioeconomic status, significantly associated with food insecurity, needs to be considered in efforts to reduce chronic disease.

Concept Note: Malnutrition Note. Rosenberg J et al. Concept Note: Malnutrition. Harvard Business Publishing 2015. http://www.globalhealthdelivery.org/case-collection/concept-notes/malnutrition. GHELI repository link: http://repository.gheli.harvard.edu/repository/10737 This concept note from Harvard Business Publishing provides an overview of malnutrition, including its definition, causes (including food insecurity), and management related to prevention, diagnosis, and treatment. It also describes the state of global malnutrition, including national and international efforts to reduce malnutrition and the stakeholders involved. Subjects covered in this note include: maternal and child health, children, intergenerational disease, public-private partnership, nutrition, strategy, political leadership, scale-up, community health workers, health care delivery, malnutrition, and cross-sector collaboration. This concept note is part of the Global Health Delivery Online Case Collection, which is a growing set of Harvard Business School-style teaching case studies, each with an accompanying teaching note, designed to educate current and future managers on how programs, governments, and enterprises determine their strategies and design systems to meet the needs of patients and populations. This specific concept note may be used with the Global Health Delivery Online case, Reducing Child Malnutrition in Maharashtra, India.



http://dx.doi.org/10.1177/0886260507312290

https://doi.org/10.1017/S1368980012005630

http://www.globalhealthdelivery.org/case-collection/concept-notes/malnutrition


https://www.ghdonline.org/cases/

https://www.ghdonline.org/cases/

http://www.globalhealthdelivery.org/case-collection/case-studies/asia-and-middle-east/reducing-child-malnutrition-in-maharashtra-india




Strengthening of Accountability Systems to Create Healthy Food Environments and Reduce Global Obesity Article. Swinburn B et al. Strengthening of Accountability Systems to Create Healthy Food Environments and Reduce Global Obesity. The Lancet 2015; 385(9986): 2534–2545. DOI: http://dx.doi.org/10.1016/S0140-6736(14)61747-5. GHELI repository link: http://repository.gheli.harvard.edu/repository/11894 This article from The Lancet argues that significant efforts to improve the healthiness of food environments are required in order to meet the World Health Organization’s target to halt the rise in obesity and diabetes. Given the opposition of industry groups and the reluctance of governments to impose regulations toward this goal, quasi-regulatory approaches are offered as a potential solution to achieve progress, with an emphasis on strengthening accountability systems to improve performance on obesity reduction. The authors propose a four-step accountability framework (“take the account, share the account, hold to account, and respond to the account”) which identifies multiple strategies to effect change, including quasi-regulatory approaches, procurement mechanisms, improved transparency, monitoring, and management of conflicts of interest. They suggest that strengthened accountability systems could support government leadership and stewardship, limit the influence of private sector actors that hold conflicts of interest related to public policy development, and bolster civic engagement in creating demand for healthy food environments and in monitoring progress towards obesity prevention. This paper is part of The Lancet series, Obesity 2015, which explores how food environments can facilitate unhealthy eating, exploiting people’s biological, psychological, social, and economic vulnerabilities.

Famines Article. Hasell J, Roser M. Famines. Our World in Data 2017. https://ourworldindata.org/famines. GHELI repository link: http://repository.gheli.harvard.edu/repository/12080 This article from Our World in Data examines the history of famine and famine mortality over time, using a global data set of famines from the mid-19th century through 2016. The presence of major famines—defined as an “acute episode of extreme hunger that results in excess mortality due to starvation or hunger-induced diseases” and distinct from persistent malnutrition—has diminished dramatically in recent decades, and famines occur in far more limited geographical regions than in previous eras. The article includes numerous figures that would be useful in teaching about the history of famine, conflict, and public health; discusses the availability, quality, and limitations of famine data; and specifies the numerous historical datasets that were included in the analysis.

Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study Article. Jernigan, VBB et al. Food Insecurity and Chronic Diseases Among American Indians in Rural Oklahoma: The THRIVE Study. American Journal of Public Health 2017; 107(3): 441-446. DOI: https://doi.org/10.2105/AJPH.2016.303605. This article from the American Journal of Public Health presents data from 513 American Indian (AI) adults, with 56 percent reporting inadequate amounts of food and 62 percent inadequate food quality, alongside prevalence of diabetes (28.4 percent), obesity (60 percent) and hypertension (4.1 percent) significantly higher than those with adequate food quantity. The researchers, who include members of the community, call for more culturally tailored measures that relate tribal food programs, traditional food practices, and household food sharing, as well as addressing environmental barriers to healthy food access, in order to help eliminate chronic disease disparities.

A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity Article. Ayala A, Meier BM. A Human Rights Approach to the Health Implications of Food and Nutrition Insecurity. Public Health Reviews 2017; 38(10). DOI: https://doi.org/10.1186/s40985-017-0056-5. GHELI repository link: http://repository.gheli.harvard.edu/repository/12277 This open-access article in Public Health Reviews summarizes human rights documents and scholarship on the rights to health and to food in an analytical interpretation of government obligations to ensure food security as a human right. The article discusses food and nutrition security as a health determinant, the ways in which food insecurity is related to malnutrition, the role of gender and maternal health in food insecurity risks globally, the role of factors such as climate change, urbanization, humanitarian emergencies and disasters, the food industry and globalization of unhealthy diets, and national laws in a human rights approach to food and nutritional health.

http://dx.doi.org/10.1016/S0140-6736(14)61747-5


http://repository.gheli.harvard.edu/repository/11128/

http://repository.gheli.harvard.edu/repository/11128/

https://ourworldindata.org/famines



https://doi.org/10.1186/s40985-017-0056-5





Why Low-Income and Food-Insecure People are Vulnerable to Poor Nutrition and Obesity Article. Why Low-Income and Food-Insecure People are Vulnerable to Poor Nutrition and Obesity. Food Research & Action Center 2018. http://frac.org/obesity-health/low-income-food-insecure-people-vulnerable-poor-nutrition-obesity. This article from the Food Research & Action Center, a national food policy research, action, and anti-hunger advocacy organization based in Washington, D.C., highlights key factors that connect economics and food insecurity in the United States to the health risks of poor nutrition and obesity. The article is organized into evidence-based bullet points designed to help policy advocates lobby for action on food security risk factors, including: inadequate access to healthy foods, cycles of food deprivation and overeating, the role of physical activity, obesity-promotion food marketing, health care inequities, and links between food insecurity and stress, anxiety, and depression.

PORTALS AND INTERACTIVES

FAOSTAT Data Portal: Global Food and Agriculture Statistics Data Portal. FAOSTAT: Food and Agriculture Organization of the United Nations Statistics Division. Food and Agriculture Organization of the United Nations. http://faostat3.fao.org/home/E. GHELI repository link: http://repository.gheli.harvard.edu/repository/11270 This data portal is maintained by the United Nations Statistics Division of the Food and Agriculture Organization (FAOSTAT). Browse, download, compare, search, and analyze data across several data domains including production, trade, emissions, food security, agri-environmental indicators, food balances, prices, inputs, population, investment, forestry, R&D indicators, and emergency response.

Holodomor 1932-1933: Famine Genocide in Ukraine Topic Portal. Holodomor 1932-1933: Famine Genocide in Ukraine. http://holodomorct.org. This website aims to serve as an authoritative source for teachers on the 1932-1933 Ukraine famine (“Holodomor”) and its relevance to contemporary events related to politics and conflict. This site includes a historical timeline with analysis as well as eyewitness accounts, links to multiple educational sources, and a blog of recent news publications and events.

The FAO Hunger Map 2015 Data Interactive. The FAO Hunger Map 2015. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/hunger/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11257 These 2015 interactive maps, developed by the United Nations’ Food and Agriculture Organization (FAO), display progress made by nations towards reducing undernourishment worldwide, as measured by three primary measures: Hunger by Country, Millennium Development Goal hunger target, and World Food Summit Goal. The maps utilize three-year data averages for the 2014-2016 period, and users can also view historical maps with hunger data dating back to 1990-1992.

Food Access Research Atlas Data Interactive. Food Access Research Atlas. United States Department of Agriculture Economic Research Service 2017. https://www.ers.usda.gov/data/fooddesert. This interactive atlas, developed by the United States Department of Agriculture, is a useful tool to understand the geography of food accessibility in the United States. Users can create maps by census tracks, compare and download food-access data, and overlay relevant indicators such as distance from the nearest supermarket, rates of poverty, limited access to a vehicle, and proportion of individuals living in group quarters.

Food Distribution Program on Indian Reservations Topic Portal. Food Distribution Program on Indian Reservations. United States Department of Agriculture Food and Nutrition Service 2017. https://www.fns.usda.gov/fdpir/food-distribution-program-indian-reservations-fdpir. This topic portal is the homepage of the U.S. government’s food assistance program for low-income American Indians and Alaska Natives who live on Indian reservations, in designated areas near reservations, and in the state of Oklahoma.


http://faostat3.fao.org/home/E



http://www.fao.org/hunger/en







The site includes information on participant eligibility and resources such as fact sheets and lists of foods available to recipients.

Caucasus, Central Asia and Ukraine Topic Portal. Caucasus, Central Asia and Ukraine. United Nations Office for the Coordination of Humanitarian Affairs 2018. http://www.unocha.org/node/253159. This topic portal provides links to data, maps, infographics, news media, team activities, and reports related to the region of Caucasus, Central Asia, and Ukraine from the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), with a focus on issues related to emergencies, disasters, and conflict. The portal includes links to OCHA’s periodic Humanitarian Bulletin, with data on health-related economic risks, including insecure access to fuel, safe water, and food during severe winter weather in the region.

CountrySTAT: Food and Agriculture Data Network Data Portal. CountrySTAT: Food and Agriculture Data Network. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/economic/ess/countrystat/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11271 This data portal, offered by the Food and Agriculture Organization (FAO) of the United Nations, is a web-based information technology system for food and agriculture statistics at the national and subnational levels. The site centralizes and integrates data coming from various sources, allowing it to be harmonized according to international standards while ensuring data quality and reliability. This supports analysis, informed policy-making, and monitoring with the goal of eradicating extreme poverty and hunger. Through national and regional collaborations, FAO forms partnerships with statistical offices and the ministries of agriculture, fisheries, forestry, and others to introduce the CountrySTAT system and build national capacity to use it. In each country, the national government makes a substantial contribution to ensure its deployment and continued training and maintenance.

Famine Early Warning System Web Portal. Famine Early Warning System. United States Agency for International Development 2018. http://www.fews.net. The Famine Early Warning Systems Network (FEWS NET) provides information for early warning and analysis on food insecurity. Created in 1985 by the United States Agency for International Development (USAID), FEWS NET helps decision-making in humanitarian crises and provides evidence-based analysis on approximately 34 countries.

Food Safety: Databases Data Portal. Food Safety: Databases. World Health Organization 2018. http://www.who.int/foodsafety/databases/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11298 This data portal is a collection of food-safety related databases from national institutions across the world, as well as the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) scientific committees. Databases include those addressing the burden of food-borne diseases, chemical and pesticide contaminants, contaminant levels in food, dietary exposure assessments, and individual food consumption. The portal also offers links to the WHO Department of Food Safety and Zoonoses (FOS), which strengthens health security and promotes sustainable development of Member States. FOS, in close collaboration with the WHO Regional and Country Offices, assists Member States to develop food safety policies and successfully implement risk-based food-borne disease surveillance, prevention, and control programs. Links to food-safety resources in individual WHO regions are also available.

Global Forum on Food Security and Nutrition Topic Portal. Global Forum on Food Security and Nutrition. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/fsnforum/home. The Global Forum on Food Security and Nutrition (FSN Forum), offered by the Food and Agriculture Organization of the United Nations, is an online platform that encourages dialogue about food security among a wide range of stakeholders drawn from academia, civil society organizations, and international and governmental agencies. The forum facilitates discussion to create transparency in policy processes while combatting hunger, food insecurity, and malnutrition. Select topics include policies and strategies, agricultural techniques, rural development, sustainable

http://www.unocha.org/node/253159

https://reliefweb.int/report/ukraine/humanitarian-bulletin-ukraine-issue-23-1-november-31-december-2017

http://www.fao.org/economic/ess/countrystat/en


http://www.fews.net/

http://www.who.int/foodsafety/databases/en


http://www.who.int/foodsafety/about/en/

http://www.fao.org/fsnforum/home




development, and social protection. Overall, this forum strengthens capacities by spreading awareness and fostering collaboration in working towards a common goal of combatting food insecurity.

Health Response to the Humanitarian Crisis in Ukraine Topic Portal. Health Response to the Humanitarian Crisis in Ukraine. World Health Organization: Regional Office for Europe 2018. http://www.euro.who.int/en/health-topics/emergencies/health-response-to-the-humanitarian-crisis-in-ukraine. This topic portal from the World Health Organization provides links to facts and figures, news, stories, reports, and multimedia about the humanitarian crisis in Ukraine, and offers information about local and international health responses.

Navajo Nation Topic Portal. Navajo Nation. Partners In Health 2018. https://www.pih.org/country/navajo-nation. This topic portal briefly summarizes the work of Partners In Health (PIH) in health care accompaniment with the Navajo Nation, with a focus on addressing community health concerns such as diabetes and healthy food access. The portal features an infographic map illustrating food quality in and distance between available food stores within the Navajo Nation, and links to two reports: Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation, and the annual report of Community Outreach and Patient Empowerment (COPE), PIH’s sister organization within the Navajo Nation.

Nutrition Landscape Information System (NLiS) Data Portal. Nutrition Landscape Information System (NLiS). World Health Organization 2018. http://www.who.int/nutrition/nlis/en. This web-based tool from the World Health Organization (WHO) provides global food and nutrition-related data drawn from WHO and partner databases in the form of country profiles and downloadable datasets. Associated links include the NLiS Country Profile Indicators Interpretation Guide, a valuable teaching resource to help students in high school, college, and graduate health sciences understand how malnutrition is measured using child growth charts and related data. The NLiS Integrated WHO Nutrition Global Database provides a global nutrition monitoring framework that may be searched by indicators, countries, gender, age, and year.

Profile: American Indian/Alaska Native Data Portal. Profile: American Indian/Alaska Native. United States Department of Health and Human Services Office of Minority Health 2018. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62. This website, hosted by the United States Department of Health and Human Services, provides demographic, language, educational, economic, and health information about American Indian and Alaska Native peoples in the United States. An interactive map allows users to access detailed information about government resources in each of 12 American Indian/Alaska Native regions, and the site provides links to full Census reports and selected data about the prevalence and risk factors among American Indian and Alaska Native peoples for specific diseases and other health conditions.

Research Program on Climate Change, Agriculture and Food Security Topic Portal. Research Program on Climate Change, Agriculture and Food Security. CGIAR 2018. https://ccafs.cgiar.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11305 This topic portal addresses the increasing challenge of global warming and declining food security on agricultural practices, policies, and measures. The Research Program on Climate Change, Agriculture and Food Security (CCAFS) is the product of a strategic collaboration between CGIAR (formerly the Consultative Group for International Agricultural Research) and Future Earth. Led by the International Center for Tropical Agriculture, CCAFS is a collaboration among all 15 CGIAR research centers and brings together researchers in the agricultural, climate, environmental, and social sciences to identify and address the most important interactions, synergies, and trade-offs between climate change and agriculture. Research flagship areas include: climate-smart agricultural practices, climate risk management, low emissions agriculture, gender and social inclusion, and policies and institutions. Work spans the following regions: East Africa, West Africa, Latin America, Southeast Asia, and South Asia. Publications include working papers, case studies, and briefs. Tools offered include models, maps and data.



https://www.pih.org/country/navajo-nation

https://www.chlpi.org/wp-content/uploads/2013/12/Navajo-Food-Policy-Toolkit-May-2015.pdf

http://act.pih.org/page/-/annual-report/FINAL_COPE-2015-AnnualReport.pdf

http://act.pih.org/page/-/annual-report/FINAL_COPE-2015-AnnualReport.pdf

http://www.who.int/nutrition/nlis/en

http://www.who.int/nutrition/nlis_interpretationguide_isbn9789241599955/en/

http://apps.who.int/nutrition/landscape/search.aspx


https://ccafs.cgiar.org/


http://www.icsu.org/future-earth

https://ciat.cgiar.org/

http://www.cgiar.org/centers/index.html

https://ccafs.cgiar.org/publications

https://ccafs.cgiar.org/resources/tools-maps-models-and-data




Understanding Hunger and Food Insecurity Topic Portal. Understanding Hunger and Food Insecurity. Feeding America 2018. http://www.feedingamerica.org/hunger-in-america/what-is-hunger-and-food-insecurity.html. This web portal briefly defines food insecurity, links to recent reports, and highlights key aspects of hunger and food insecurity in the United States. Feeding America, a national network of more than 200 food banks, is the largest hunger relief and advocacy organization in the U.S.

FACT SHEETS, INFOGRAPHICS, AND COUNTRY PROFILES

FAO and Post-2015 Infographic. FAO and Post-2015. Infographic. Food and Agriculture Organization of the United Nations 2015. http://www.fao.org/resources/infographics/infographics-details/en/c/266124. GHELI repository link: http://repository.gheli.harvard.edu/repository/11398 This infographic highlights the powerful connections and linkages that exist between food security and the emerging priorities of a sustainable development agenda. Developed by the Food and Agricultural Organization (FAO) of the United Nations, the graphic underscores the pressing challenges associated with a growing global population that will approach 9 billion by 2050. This challenge is compounded by the additional threats of climate change, increasing water and land scarcity, soil and land degradation, and a deteriorating natural resource base, threats that will mainly hurt the world’s poor and vulnerable.

A Framework for Assessing Effects of the Food System Infographic. A Framework for Assessing Effects of the Food System. The National Academies Press 2015. http://www.nap.edu/visualizations/assessing-decisions-about-food-and-agriculture. GHELI repository link: http://repository.gheli.harvard.edu/repository/11390 This infographic, based on the report, A Framework for Assessing Effects of the Food System by the Institute of Medicine and the National Research Council, highlights how decision makers can weigh the larger benefits and risks of food policy decisions. The food supply chain is interconnected with human health, the health of the environment, and social and economic systems. The report is also accompanied by a summary brief.

2017 Nutrition Country Profile: Ukraine Infographic. 2017 Nutrition Country Profile: Ukraine. Global Nutrition Report 2017. Development Initiatives Poverty Research Ltd. 2017. http://globalnutritionreport.org/wp-content/uploads/2017/12/gnr17-Ukraine.pdf. This two-page infographic summarizes in visual graphs and tables data on Ukraine pertaining to nutrition and health. Summaries of data include: economics and demography, child anthropometry, adolescent and adult nutrition status, intervention coverage and child feeding practices, underlying determinants (food supply, gender, girls’ education, water and sanitation, government expenditures), financial resources, and policy, legislation, and institutional arrangements. The fact sheet is part of the 2017 Global Nutrition Report from the International Food Policy Research Institute, an international research center focused on global issues of agriculture, policy, and food.

Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being Fact Sheet. Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Food Research & Action Center 2017. http://frac.org/research/resource-library/hunger-health-impact-poverty-food-insecurity-poor-nutrition-health-well. This fact sheet from the Food Research & Action Center summarizes key points on how poverty, food insecurity, and poor nutrition impact health and well-being. The fact sheet is designed to inform national food policy research, action, and anti-hunger advocacy efforts with evidence-based data. It includes definitions of key terms and infographics, a one-page list of chronic diseases, health conditions, and health behaviors associated with food insecurity, and research citations relevant to food insecurity in the United States today.


http://www.fao.org/resources/infographics/infographics-details/en/c/266124


http://www.nap.edu/visualizations/assessing-decisions-about-food-and-agriculture


http://www.nap.edu/read/18846/chapter/1

http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/FoodSystemRBFINAL.pdf








Ukraine: Humanitarian Snapshot Fact Sheet. Ukraine: Humanitarian Snapshot. United Nations Office for the Coordination of Humanitarian Affairs 2017. https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukraine-humanitarian-snapshot-27-december-2017-en. This fact sheet from the United Nations provides a one-page summary of conditions, risks, and needs due to ongoing armed conflict in east Ukraine, from a humanitarian perspective. The resource includes a map with checkpoints, a timeline of the conflict since June 2014, and statistics on aid funding and people in need by location. Designed for humanitarian aid workers and agencies, the fact sheet would also be useful in classroom discussion about humanitarian response, food insecurity, health-related risks due to armed conflict, and the study of Russia and the former Soviet Union. The document is periodically updated.

Global Food Security Index: Ukraine Infographic. Global Food Security Index: Ukraine. The Economist Intelligence Unit Ltd. 2018. http://foodsecurityindex.eiu.com/Country/Details#Ukraine. This interactive data tool from The Economist Intelligence Unit Ltd. provides infographics on food security in Ukraine, including relative food affordability, availability, and quality and safety. It is part of the Global Food Security Index, a dynamic quantitative and qualitative benchmarking model that measures drivers of food security—such as affordability, availability, and quality—across a set of 113 developing and developed countries.

Ukraine Country Profile. Ukraine. Food and Agriculture Organization of the United Nations 2018. http://www.fao.org/countryprofiles/index/en/?iso3=ukr. This web-based country profile provides a basic summary of food-related agricultural data in Ukraine and links to country summaries, videos, maps, and reports published about the Ukraine by the Food and Agriculture Organization (FAO).

MULTIMEDIA AND NEWS

Starving in the Land of Plenty: Hunger in Native America Blog. Aji. Starving in the Land of Plenty: Hunger in Native America; Feeding America Blogathon. Native American Netroots 2010; Sep 27. http://nativeamericannetroots.net/diary/693. This blog post is an opinion essay that summarizes the primary health, hunger, and food security risks faced by American Indian/Alaska Native people living in the U.S. today, based on the family experiences of the author, a journalist for the community. The essay is a readable and carefully researched summary of key data on food access, economics, and government assistance related to food and health for this population. It concludes with suggestions that invite the communities to specific personal, local, and national action.

The Native American Community Faces Dangerously High Rates of Food Insecurity News Article. Zielinski A. The Native American Community Faces Dangerously High Rates of Food Insecurity. ThinkProgress 2015; Nov 25. https://thinkprogress.org/the-native-american-community-faces-dangerously-high-rates-of-food-insecurity-703a7737e87d. This article from ThinkProgress highlights the problem of food insecurity in Native American communities across the U.S. and explores current data in historical context of displacement of tribes that were once the most agriculturally prosperous groups of people in North America. Data suggest that 60 percent of counties with a Native American majority live with high food insecurity, gaps in health care access, chronic poverty, and more than double the incidence of diabetes compared to white Americans. The author highlights the potential for the best culturally responsive solutions coming from within the Native American communities.




http://foodsecurityindex.eiu.com/

http://www.fao.org/countryprofiles/index/en/?iso3=ukr







Famine and Conflict: The Food Security Crisis Podcast. Famine and Conflict: The Unfolding Food Security Crisis. Advanced Training Program on Humanitarian Action, Harvard Humanitarian Initiative 2017. http://atha.se/podcasts/famine-and-conflict-unfolding-food-security-crisis. GHELI repository link: http://repository.gheli.harvard.edu/repository/11949 This podcast from the Advanced Training Program on Humanitarian Action (ATHA) features six experts in global nutrition policies and humanitarian aid responses who consider the risk and reality of famine in four countries today: Yemen, South Sudan, Somalia, and Nigeria. Famine and food security crises in all four locations are linked to armed conflict. The 90-minute podcast discusses causes of and responses to these crises, which are directly related to a rise in global migration, as well as the responsibilities that the donor, political, and humanitarian communities bear to prevent and avert them. With provided links to recommended readings, the podcast could also serve as a classroom module for student discussion at the graduate level in public health or humanitarian aid.

How Stalin Hid Ukraine’s Famine from the World News Article. Applebaum A. How Stalin Hid Ukraine’s Famine from the World. The Atlantic 2017; Oct 13. https://www.theatlantic.com/international/archive/2017/10/red-famine-anne-applebaum-ukraine-soviet-union/542610. This article from The Atlantic provides a historical summary of the 1932-1933 famine in the Ukraine that took place under Josef Stalin and deprived the population of all available food leading to widespread starvation. The article is adapted from the author’s book, Red Famine: Stalin’s War on Ukraine, and describes events through the careers of two journalists, Walter Duranty and Gareth Jones. It offers a useful overview of how politics impacts food insecurity even in regions where food is plentiful, and the importance of journalism in global awareness and response.

In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War News Article. Nelson SS. In Eastern Ukraine, A Struggle for Survival in the Crossfire of a Little-Seen War. National Public Radio 2017; Aug 4. https://www.npr.org/sections/parallels/2017/07/24/539099158/in-eastern-ukraine-a-struggle-for-survival-in-the-crossfire-of-a-little-seen-war. This article and photo essay from National Public Radio describes and illustrates daily life for residents of eastern Ukraine, trying to survive while caught in the middle of an armed conflict between government forces and Russian separatists. The article highlights the war’s effects on the region’s economic instability as well as on the health of its residents, who suffer from high stress levels, alcohol abuse, and living conditions without reliable heat, electricity, gas, or plumbing.

The War No One Notices in Ukraine News Article. Bonenberger A. The War No One Notices in Ukraine. The New York Times 2017; Jun 20. https://www.nytimes.com/2017/06/20/opinion/ukraine-russia.html. This article from The New York Times descriptively depicts the political conflict in Ukraine and its devastating impact on individuals and families. This conflict between Russia and Ukraine began when former President Yanukovych left Ukraine for Russia during anti-government protests. Despite Ukrainian hopes for intervention from Western countries, long-term solutions have still not materialized. With much of the population displaced and relocated towards Kiev due to the fighting, affected civilians who remain in the war zone are primarily elderly or destitute individuals unable or unwilling to leave. The article illustrates the effects of war on the current political climate in Ukraine, and how this greatly impacts the lifestyles of those living in the eastern region of the country.

Holodomor Reconsidered: The Bolshevik Revolution and the Ukrainian Famine Video. Holodomor Reconsidered: The Bolshevik Revolution and the Ukrainian Famine. Ukrainian Research Institute Harvard University 2017. https://www.youtube.com/watch?v=eqdoxz-pmEM. This online 31-minute lecture by Pulitzer Prize-winning author and journalist, Anne Applebaum, is the first of a two-part video on Ukraine’s 1932-1933 “Holodomor” (forced death by starvation), based on her 2017 book, Red Famine: Stalin’s War on Ukraine. Part 2, a separate one-hour video also available, highlights audience interaction during the Q&A discussion session following the lecture.






https://www.nytimes.com/2017/06/20/opinion/ukraine-russia.html

https://www.youtube.com/watch?v=eqdoxz-pmEM

https://www.youtube.com/watch?v=L6sskgmAvKA




The U.S. Already Tested Trump’s Canned Goods Idea on Native Americans. It was Bad. News Article. Goldberg E. The U.S. Already Tested Trump’s Canned Goods Idea on Native Americans. It was Bad. The Huffington Post 2018; Feb 22. https://www.huffingtonpost.com/entry/trump-snap-canned-goods-native-americans_us_5a8c403de4b0e1acb11d833a. This blog essay from The Huffington Post is an editorial summarizing current U.S. government-funded food packages available to Native Americans who live on reservations and receive food assistance. It includes a brief overview of the United States Department of Agriculture (USDA)’s Food Distribution Program on Indian Reservations (FDPIR), a program first established in the 1970s now locally administered by tribal organizations and state agencies. The essay focuses on current debates over the food available in FDPIR packages, proposed reforms, and their health implications for a population with high levels of poverty, diabetes, and heart disease.

ORGANIZATIONS

Food and Agriculture Organization of the United Nations Organization. Food and Agriculture Organization of the United Nations. http://www.fao.org/home/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/11345 The Food and Agriculture Organization of the United Nations (FAO) is committed to achieving food security for all, ensuring people have regular access to enough high-quality food to lead active, healthy lives. Three main goals include the eradication of hunger, food insecurity and malnutrition; the elimination of poverty and the driving forward of economic and social progress for all; and, the sustainable management and utilization of natural resources, including land, water, air, climate, and genetic resources for the benefit of present and future generations. The Statistical Programme of Work provides a summary of all of the principal statistical activities at FAO. Media resources include: infographics, webcasting, podcasts, and audio and visuals.

Food Security Information Network Organization. Food Security Information Network. Food and Agriculture Organization of the United Nations, World Food Programme, International Food Policy Research Institute. http://www.fsincop.net. GHELI repository link: http://repository.gheli.harvard.edu/repository/11356 The Food Security Information Network (FSIN) is a global initiative to strengthen food and nutrition security information systems co-sponsored by the Food and Agriculture Organization of the United Nations, World Food Programme, and International Food Policy Research Institute for producing reliable and accurate data to guide analysis and decision-making. FSIN serves as a neutral technical platform for exchanging expertise, knowledge, and best practices; developing harmonized methods and tools; and facilitating capacity development on food and nutrition security measurement and analysis.

International Food Policy Research Institute Organization. International Food Policy Research Institute. http://www.ifpri.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11359 The International Food Policy Research Institute (IFPRI) provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries. Established in 1975, IFPRI currently has more than 500 employees working in over 50 countries. It is a research center of the CGIAR Consortium, a worldwide partnership engaged in agricultural research for development.

Oxfam International Organization. Oxfam International Inc. https://www.oxfam.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11336 Oxfam tackles the structural causes of the injustice of poverty working with partners locally and globally. They use a combination of rights-based sustainable development programs, public education, campaigns, advocacy, and humanitarian assistance in disasters and conflicts. Priority issues addressed by Oxfam include: active citizenship; gender justice; inequality and essential services; natural resources; saving lives; and sustainable food. Access media resources such as videos and photo galleries, and reports and papers on their programming, advocacy, and research.



http://www.fao.org/home/en


http://www.fao.org/about/what-we-do/so1/en/





http://www.fao.org/news/en/

http://www.fsincop.net/


http://www.ifpri.org/


https://www.oxfam.org/


https://www.oxfam.org/en/explore/issues/global-citizenship

https://www.oxfam.org/en/explore/issues/gender-justice

https://www.oxfam.org/en/explore/issues/gender-justice

https://www.oxfam.org/en/explore/issues/inequality-and-essential-services

https://www.oxfam.org/en/explore/issues/natural-resources

https://www.oxfam.org/en/explore/issues/saving-lives

https://www.oxfam.org/en/explore/issues/sustainable-food

https://www.oxfam.org/en/research




World Food Programme Organization. World Food Programme. http://www.wfp.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11318 The World Food Programme (WFP) is the world’s largest humanitarian agency fighting hunger globally. Consistent with its mandate, which reflects the principle of universality, WFP uses food aid to support economic and social development; meets refugee and other emergency food needs, and associated logistics support; and promotes world food security in accordance with the recommendations of the United Nations and FAO. WFP is part of the United Nations system and is voluntarily funded.

http://www.wfp.org/


http://www.wfp.org/food-security

http://www.wfp.org/logistics

http://www.wfp.org/food-security?icn=homepage-food-security&ici=ourwork-link

This glossary was originally developed by the Global Health Education and Learning Incubator at Harvard University in 2018. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.



Glossary of Terms Hunger and Food Security 2018

This glossary accompanies a teaching pack that focuses on food security and health risks related to famine and nutritional insufficiencies, developed by the Global Health Education and Learning Incubator (GHELI) at Harvard University. GHELI has also developed companion teaching materials on this subject, which include an annotated bibliography and a series of lesson plans that incorporate instructor’s notes, learning objectives, discussion questions, and classroom activities.

Note: Sources for terms below are noted in parentheses at the end of each entry, with additional information at the end of this document.

Anthropometry: Use of human body measurements to obtain information about nutritional status. (Food and Agriculture Organization of the United Nations 2017)

Body Mass Index (BMI): The ratio of weight for height, measured as the weight in kilograms divided by the square of height in meters. (Food and Agriculture Organization of the United Nations 2017)

Conflict: Struggles between interdependent groups that have either actual or perceived incompatibilities with respect to needs, values, goals, resources or intentions. This definition includes (but is broader than) armed conflict – that is organized collective violent confrontations between at least two groups, either state or non-state actors. [The report from which this definition is derived] focuses on conflicts that threaten or entail violence or destruction, including where fragility raises the risk of damaging conflicts and where protracted crises persist. (Food and Agriculture Organization of the United Nations 2017)

Conflict Sensitivity: Conflict sensitivity means to study the profile, causes, actors and dynamics of conflict and the interaction between these and the proposed intervention. In the context of sustaining peace, this means maximizing positive impacts toward peace while minimizing negative impacts, including potentially creating so-called future hazards. (Food and Agriculture Organization of the United Nations 2017)

Dietary Energy Intake: The energy content of food consumed. (Food and Agriculture Organization of the United Nations 2017)

Dietary Energy Supply (DES): Food available for human consumption, expressed in kilocalories per person per day (kcal/person/day). At country level, it is calculated as the food remaining for human use after deduction of all non-food utilizations (i.e. food = production + imports + stock withdrawals − exports − industrial use − animal feed – seed – wastage − additions to stock). Wastage includes loss of usable products occurring along distribution chains from farmgate (or port of import) up to retail level. (Food and Agriculture Organization of the United Nations 2017)



Hunger and Food Security: Glossary of Terms

Famine: A famine is a widespread scarcity of food that may apply to any faunal species. This phenomenon is usually accompanied by regional malnutrition, starvation, epidemic, and increased mortality. Starvation caused by famine is the most serious form of hunger. (Food and Agriculture Organization of the United Nations 2018)

Food Deserts: Areas where people have limited access to a variety of healthy and affordable food. (U.S. Department of Agriculture of the United Nations 2012)

Food Insecurity: A situation that exists when people lack secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life. It may be caused by unavailability of food, insufficient purchasing power, inappropriate distribution or inadequate use of food at the household level. Food insecurity, poor conditions of health and sanitation, and inappropriate care and feeding practices are the major causes of poor nutritional status. Food insecurity may be chronic, seasonal, or transitory. (Food and Agriculture Organization of the United Nations 2017)

Food Security: A situation that exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Based on this definition, four food security dimensions can be identified: food availability, economic and physical access to food, food utilization, and stability over time. (Food and Agriculture Organization of the United Nations 2017)

Food Sovereignty: Food sovereignty is the right of peoples, communities, and countries to define their own agricultural, labor, fishing, food, and land policies which are ecologically, socially, economically, and culturally appropriate to their unique circumstances. It includes the true right to food and to produce food, which means that all people have the right to safe, nutritious, and culturally appropriate food and to food-producing resources and the ability to sustain themselves and societies. (NGO/CSO Forum for Food Sovereignty 2002)

Fragility: Fragility is defined as the combination of exposure to risk and insufficient coping capacities of the state, system and/or communities to manage, absorb or mitigate those risks. The new OECD fragility framework is built on five dimensions of fragility – economic, environmental, political, societal, and security – and measures each through the accumulation and combination of risks and capacity. See OECD. 2016. States of Fragility 2016: Understanding Violence. Paris. Available at www.oecd.org/dac/states-of-fragility-2016-9789264267213-en.htm. (Food and Agriculture Organization of the United Nations 2017)

Global Acute Malnutrition (GAM): A measure of acute malnutrition in refugee children aged between 6 and 59 months. GAM provides information on the percentage of all children in this age range in a refugee population who are classified with low weight-for-height and/or edema. It is obtained by combining the number of children in this age range who have moderate acute malnutrition and severe acute malnutrition. (United Nations High Commission on Refugees Emergency Handbook 2018)

Hunger: As used here, the term hunger is synonymous with chronic undernourishment. (Food and Agriculture Organization of the United Nations 2017)

Kilocalorie (kcal): A unit of measurement of energy. One kilocalorie equals 1,000 calories. In the International System of Units (SI), the universal unit of energy is the joule (J). One kilocalorie =4.184 kilojoules (kJ). (Food and Agriculture Organization of the United Nations 2017)

Macronutrients: Here refers to the proteins, carbohydrates and fats available to be used for energy; measured in grams. (Food and Agriculture Organization of the United Nations 2017)

Malnutrition: An abnormal physiological condition caused by inadequate, unbalanced, or excessive consumption of macronutrients and/or micronutrients. Malnutrition includes undernutrition and overnutrition as well as micronutrient deficiencies. (Food and Agriculture Organization of the United Nations 2017)

Micronutrients: Vitamins, minerals, and other substances that are required by the body in small amounts; measured in milligrams or micrograms. (Food and Agriculture Organization of the United Nations 2017)




Nutrition Security: A situation that exists when secure access to an appropriately nutritious diet is coupled with a sanitary environment, adequate health services, and care, in order to ensure a healthy and active life for all household members. Nutrition security differs from food security in that it also considers the aspects of adequate caring practices, health, and hygiene in addition to dietary adequacy. (Food and Agriculture Organization of the United Nations 2017)

Nutrition-Sensitive Interventions: Interventions designed to address the underlying determinants of nutrition (which include household food security, care for mothers and children, and primary health-care services and sanitation) but not necessarily having nutrition as the predominant goal. (Food and Agriculture Organization of the United Nations 2017)

Nutritional Status: The physiological state of an individual that results from the relationship between nutrient intake and requirements and from the body’s ability to digest, absorb and use these nutrients. (Food and Agriculture Organization of the United Nations 2017)

Obesity: See Overweight and Obesity.

Overnutrition: A result of excessive food intake relative to dietary nutrient requirements. (Food and Agriculture Organization of the United Nations 2017)

Overweight and Obesity: Body weight that is above normal for height as a result of an excessive accumulation of fat. It is usually a manifestation of expending fewer calories than are consumed. In adults, overweight is defined as a BMI of more than 25 but less than 30, and obesity as a BMI of 30 or more. In children under five years of age, overweight is defined weight-for-height greater than 2 standard deviations above the WHO Child Growth Standards median, and obesity as weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median. (Food and Agriculture Organization of the United Nations 2017)

Stunting: Low height for age, reflecting a past episode or episodes of sustained undernutrition. In children under five years of age, stunting is defined height-for-age less than –2 standard deviations below the WHO Child Growth Standards median. (Food and Agriculture Organization of the United Nations 2017)

Undernourishment: A state, lasting for at least one year, of inability to acquire enough food, defined as a level of food intake insufficient to meet dietary energy requirements. For the purposes of this report, hunger was defined as being synonymous with chronic undernourishment. (Food and Agriculture Organization of the United Nations 2017)

Undernutrition: The outcome of poor nutritional intake in terms of quantity and/or quality and/or poor absorption and/or poor biological use of nutrients consumed as a result of repeated disease. It includes being underweight for one’s age, too short for one’s age (stunted), dangerously thin for one’s height (wasted) and deficient in vitamins and minerals (micronutrient malnutrition). (Food and Agriculture Organization of the United Nations 2017)

Underweight: In adults, underweight is defined as a BMI of less than 18.5, reflecting a current condition resulting from inadequate food intake, past episodes of undernutrition or poor health conditions. In children under five years of age, underweight is defined as weight-for-age less than –2 standard deviations below the WHO Child Growth Standards median, and is thus a manifestation of low height for age and/or low weight for height. (Food and Agriculture Organization of the United Nations 2017)

Wasting: Low weight for height, generally the result of weight loss associated with a recent period of inadequate caloric intake and/or disease. In children under five years of age, wasting is defined as weight-for-height less than –2 standard deviations below the WHO Child Growth Standards median. (Food and Agriculture Organization of the United Nations of the United Nations 2017)




SOURCES

Although the terms included in this glossary have been selected from sources believed to be reliable, no warranty expressed or implied is made regarding accuracy, completeness, legality, reliability, timeliness, or usefulness of any information.

Dutko P et al. Characteristics and Influential Factors of Food Deserts. United States Department of Agriculture 2012. Page iii. https://www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf. The State of Food Security and Nutrition in the World 2017: Building Resilience for Peace and Food Security. Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization 2017. Pages 107-108. http://www.fao.org/3/a-I7695e.pdf.

FAO Term Portal. Food and Agriculture Organization of the United Nations. http://www.fao.org/faoterm/en.

Food Sovereignty: A Right for All. NGO/CSO Forum for Food Sovereignty 2002. https://nyeleni.org/spip.php?article125.

Emergency Handbook. United Nations High Commissioner for Refugees 2018. https://emergency.unhcr.org/entry/86022/acute-malnutrition-threshold.

https://www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf


http://www.fao.org/faoterm/en

https://nyeleni.org/spip.php?article125

https://emergency.unhcr.org/entry/86022/acute-malnutrition-threshold

instructor’s note food security in marginalized communities… · food insecurity (again...

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