TRADITIONAL AND ALTERNATIVE FOOD SECURITY INTERVENTIONS: EFFECTS ON

HEALTH AND FOOD SECURITY

29 may 2014Dr Federico Roncarolo

FAO, IFAD and WFP:The State of Food Insecurity in the World 2013.The multiple dimensions of food security. Rome, 2013

Food insecurity in the world

Food insecurity in Canada

PROOF Research to identify policy options to reduce food insecurity

Food insecurity by province

PROOF Research to identify policy options to reduce food insecurity

ENQUÊTE SUR LES EFFETS DES INTERVENTIONS

COMMUNAUTAIRES EN SÉCURITÉ ALIMENTAIRE

CHAIRE CACIS - Chaire Approches Communautaires et Inégalités de Santé

Intervention strategy Characteristics Type of relation

Traditional (food banks, soup kitchens, food boxes)

Interventions based on food gathering and redistribution, they try to answer to an immediate and daily need of food

Food assistanceFood aid

Alternative (collective kitchens, community gardens, buying groups)

Interventions developing networks of mutual aid and social participation through skills developments

Mutual aid integration Social integration

Social transformation (Community-supported agriculture, food-related community economic development)

Interventions aimed at the participation in collective actions, with the objective of increasing citizens’ empowerment on individual and collective food security

Empowerment of people and collectivity

Intervention strategies in food insecurity

To assess the effects of interventions conducted by community organizations in the Montreal Metropolitan Region to address the food security and health of their

users, and to generate evidence-based data on the effects of two different strategies to fight food insecurity

Objective

• Longitudinal study of newly recruited participants in traditional and alternative food security interventions.

• Participants selected in a two stage cluster sampling frame.

Description of the study

• Sample units: community organizations working on food security in the Montreal Metropolitan Region

• Analysis units: participants in food security interventions individuals between 18 and 65 years of age registered for the first time, and for less than 6 months in selected MMR food security community organizations

Population

• Organizations: • 50 new participants for traditional

interventions• 30 new participants for alternative

interventions

• Participants: • between 18 and 65 years of age• registered for the first time, and for less than 6

months

Inclusion criteria

30-45 minutes questionnaires administered face to face in French or in English, according to the preference of

participants.

Follow-up nine months after the first interview

Methods

T1 T2 Traditional interventions

711 372 (52.3%)

Alternative interventions

113 78 (69%)

Total 824 450 (54.6%)

• 16 organizations implementing traditional interventions

• 6 organizations implementing alternative interventions

Particpants at T1 and T2

Traditional intervention

Alternative intervention

Total

The organization quit the study

25 (7.4%) -- 25 (6.7%)

Not found 228 (67.3%) 14 (40%) 242 (64.7%)Not available/rejected

86 (25.4%) 18 (51.4%) 104 (27.8%)

Not concordant data -- 3 (8.6%) 3 (0.8%)Total 339 (100%) 35 (100%) 374 (100%)

Missing at the follow-up

Descriptive characteristics of new participants in traditional and

alternative interventions     Traditional

interventions

n. (%)

Alternative intervention

s n. (%)

Total n. (%)

Gender* MaleFemale

332 (46.7)365 (51.3)

22 (19.5)87 (77.0)

354 (43.0)452 (54.9)

Age <30 years30-49 years50-65 years

117 (16.5)370 (52.0)222 (31.2)

24 (21.2)58 (51.3)29 (25.7)

141 (17.1)428 (51.9)251 (30.5)

Country of birth*

CanadaOthers

466 (65.5)241 (33.9)

47 (41.6)65 (57.5)

513 (62.3)306 (37.1)

Marital status*

Married/ common law spouseSingleOther (separated, divorced, widowed)

214 (30.1)340 (47.8)139 (19.5)

45 (39.8)34 (30.1)29(25.7)

259 (31.4)374 (45.4)168 (20.4)

Education* Less than a high school diplomaSecondary (high) school diploma or equivalentLess than a bachelor degreeBachelor’s degree or above

197 (27.7)186 (26.2) 196 (27.6)107 (15.1)

25 (22.1)25 (22.1) 26 (23.0)34 (30.1)

222 (26.9)211 (25.6) 222 (26.9)141 (45.2)

Number of other people in household beside the respondent, mean (sd)*

1.61 (1.50) 2.20 (1.55) 1.70 (1.52)*p<0.05

T1 T20%

10%20%30%40%50%60%70%80%90%

100%

10.5 10.3

32

14.1

27.4

21.8

7

33.3

5.1

24.4

3.2

16

3.820.5

11 23.1

NSP/NRPMore then 40000$30000-40000$20000-30000$15000-20000$10000-15000$5000-10000$Less than 5000$

Traditional AlternativeI n t e r v e n t i o n

46.2%

69.9%

Household income

Food security

V. Van Gogh, 1885: The potatoes eaters

Food security scaleDefinition of security 10-items

adults food security scale

8-items adults food security scale

Household food security

Security (no or 1 indication of difficulties with income-related food access)

0 or 1 positive answers

0 or 1 positive answers

Adult + child in insecurity

Moderate insecurity (indication of compromise in quality and/or quantity of food consumed )

2 to 5 positive answers

2 to 4 positive answers

Adult OR child in moderate food insecurity

Severe insecurity(indication of reduced food intake and disrupted eating patterns)

≥ 6 positive answers

≥5 positive answers

Adult OR child in severe food insecurity

Canadian Community Health Survey, Cycle 2.2, Nutrition (2004)— Income-Related Household Food Security in Canada

Food security: adults

T1 T2 T1 T20%

10%20%30%40%50%60%70%80%90%

100%

11.623.4 32.4 40

3938.3

39.437.3

49.438.3 28.2 22.6

Severe insecur-ityModerate insecur-itySecurity

Traditional Alternative

OR: 0.47 (i.c.95%: 0.19-1.15)OR: 0.35 (i.c.95%: 0.23-0.53)

p=0.902

I n t e r v e n t i o n s

Food security: children

T1 T2 T1 T20%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

24.340.3 45.7

61.8

58.151.4 42.8

35.3

17.6 8.3 11.4 5.9

Severe insecurityModerate insecuritySecurity

OR: 0.42 (i.c.95%: 0.08-2.15)OR: 0.36 (i.c.95%: 0.18-0.69)

p=0.698

Traditional AlternativeI n t e r v e n t i o n s

Food security: households

T1 T2 T1 T20%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

10.5 20.932.4 38.7

39.840.2

36.638.7

49.7 38.9 31 22.7

Severe insecurityModerate insecuritySecurity

Alternative

OR: 0.46 (i.c.95%: 0.20-2.02)OR: 0.38 (i.c.95%: 0.27-0.55)

p=0.738

TraditionalI n t e r v e n t i o n s

Health and wellness

Matisse, 1909: The dance

T1 T260626466687072

63.97

66.91

70.6270.59

Physical component

TraditionalAlternative

T1 T250

55

60

65

70

75

58.13

63.8666.06

71.1

Mental component

Beta coeff : Trad: 2.33 (i.c.95%: -0.25;4.91)Altern: -2.20 (i.c.95% : -7.87;3.47)Interaction time-group: p=0.222

Beta coeff : Trad: 6.01 (i.c.95%: 3.90-8.11)Altern: 4.09 (i.c.95% : -0.85;9.03)Interaction time-group: p=0.573

Health and wellness

Percentile scale

Conclusions

• Participants in traditional and alternative interventions present significant differences before starting the interventions

• Does food insecurity interventions increase inequalities among the most vulnerable who attend traditional interventions and participants in alternatives?

• If we just consider T1 and T2 results, it seems that the effects of traditional interventions are effective in reducing food insecurity and improving mental health

• Alternative interventions seem to have some positive effects concerning food insecurity and mental health although they never reach a statistical significant level

Giuseppe Arcimboldo, 1573: Summer

Thank you!