Food Insecurity in Portugal Among Middle- and Older-Aged Adults at a Time of Economic Crisis Recovery: Prevalence and Determinants

Food Insecurity in the Community: A Cross-Sectional Study in the Portuguese and Immigrant Population of Amadora

Introduction

Food insecurity, defined as limited or uncertain access to adequate food, is recognized as a public health problem linked to poor eating habits, chronic diseases, and social inequalities. This study aims to characterize and compare food insecurity status among immigrant and Portuguese populations receiving primary healthcare in Amadora.

Methods

A cross-sectional study was conducted based on interviews with individuals aged 18 and above, living in Amadora for at least 1 year. Sociodemographic and health status variables were collected, and food insecurity was assessed using a Portuguese-adapted version of the US Department of Agriculture Household Food Security Survey Module. Data analysis included binary logistic regression to explore the predictive capacity of variables, with food insecurity as the outcome.

Results

The estimated prevalence of household food insecurity was 29.7%, with 10.5% classified as severely food insecure. Single individuals (OR: 3.090; CI: 1.353-7.059), those with basic education (OR: 3.296; CI: 1.175-9.247); immigrants (OR: 4.358; CI: 2.206-8.611), households with three or more members (OR: 2.686; CI: 1.019-7.079), and incomes below EUR 1,100 (OR: 7.359; CI: 2.613-20.726) were more likely to belong to food insecure households. When Portuguese households were analyzed, low income (OR: 8.730; CI: 2.607-29.232) and smoking habits (OR: 3.375; CI: 1.345-8.469) were found to be potential determinants of food insecurity. As for immigrant households, being single (OR: 6.002; CI: 1.404-25.659), having a household with three or more members (OR: 13.953; CI: 2.119-91.887), and low income (OR: 7.110; CI: 1.257-40.226) increased the risk of food insecurity.

Conclusion

The results of this study show that food insecurity is significantly associated with sociodemographic and health factors, with differences between Portuguese and immigrant populations. Awareness of this problem and the need for monitoring should therefore be raised to prioritize community interventions.

Food insecurity is associated with an unhealthy lifestyle score in middle- and older-aged adults: findings from the EPIPorto cohort

The association of food insecurity with the combined effect of lifestyles is still limited. This study evaluated the association between food insecurity and a lifestyle score in middle- and older-aged adults. A cross-sectional study (2013-2016) was performed among 595 individuals (≥ 50 years) from the EPIPorto cohort (Porto, Portugal). Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Information on fruit and vegetable consumption (F&V), physical activity (PA) practice, tobacco smoking, and alcohol consumption were included in a lifestyle score. Those with F&V < five portions/day, < 150 min/week of moderate-intensity PA or < 75 min/week of vigorous-intensity PA, current smokers, consumers of > one drink of alcoholic beverages in women, and > two in men were assigned with one point; all the others had nil points. The score could range from 0 to 4, and was further categorised into three categories. Food insecurity was positively associated with an unhealthy lifestyle profile (OR = 2.272; 95%CI:1.079-4.782), independently of the adjustment variables. Analysing each lifestyle component, food insecurity was associated with low PA practice (OR = 2.365; 95%CI:1.020-5.485). Individuals from food insecure households were more likely to have an unhealthy lifestyle profile. Public health strategies should be developed among food insecure individuals to promote healthy lifestyles.

Influence of Social Adversity on Perceived Health Status and Depressive Symptoms among Portuguese Older People

This study aims to investigate how exposure to poverty, food insecurity, and abuse at older ages relates to health outcomes. A questionnaire collecting data on sociodemographic and economic characteristics, health status, depressive symptoms, food insecurity, and abuse was administered to a sample of 677 older adults. Logistic regression was used to quantify the association of poverty, food insecurity, and abuse with perceived health status and depressive symptoms. If the older person only reported experiences of abuse, it was more likely to report the presence of depressive symptoms, even after adjustment for covariates. If it was only reported the experience of food insecurity, it was more likely to report a worse health status. Older people exposed to at least two factors of vulnerability were significantly more likely to report (very) poor perceived health status (OR: 7.11, 95% CI: 2.77–18.25) and the presence of relevant depressive symptoms (OR: 4.34; 95% CI: 2.04–9.22). Thus, the combined effect of vulnerabilities was significantly associated with worse health among older people. Public health policies to mitigate these adverse exposures should be developed to promote health and well-being in this population.

Perceived poverty, perceived income adequacy and loneliness in Israeli young adults: Are social capital and neighbourhood capital resilience factors?

Loneliness is a severe risk factor that has been linked to diminished health outcomes and low quality of life across ages. Young adults have been identified as a high-risk group for experiencing loneliness, but only a few studies have explored the economic and social determinants of loneliness in this age group. Taking a social inequality approach to health, with loneliness as a focus, this study examined: (a) the associations between the following factors - subjective social status (SSS) indicators (perceived poverty and perceived income adequacy), offline and online social capital, and neighbourhood capital - and loneliness; and (2) whether social and neighbourhood capital were moderators in the association between SSS and loneliness. Cross-sectional data for individuals aged 20-29 were taken from the 2017 Israeli Social Survey (N = 1,508). Employing multinomial logit models, we found that perceived poverty was a strong predictor of loneliness. Greater social and neighbourhood capital decreased loneliness, whereas a higher use of online social networks increased loneliness. Neighbourhood capital and perceived trust were moderators, whereas trust was a resilience factor, neighbourhood capital strengthened the negative effect of perceived poverty on loneliness. To reduce the prevalence of loneliness in young adults, policymakers should examine various means of enhancing social and neighbourhood capital along with moderating the use of online social networks. However, they should be aware that interventions of this kind can do little to buffer the strong effect of perceived poverty on loneliness, as in most cases the effect of perceived poverty on the probability of loneliness is not ameliorated by improved social or neighbourhood resources.

The Early Impacts of COVID-19 on Food Security and Livelihood in Vietnam

In April 2020, Vietnam initiated a country-wide lockdown to curb the spread of COVID-19. This secondary data analysis evaluates whether NGO-supported households (n = 3,431) reporting to be severely impacted by the lockdowns differ from those reporting a lesser impact, regarding food availability within households and at markets and affordability. 19.2% of respondents indicated that the pandemic had severely impacted their livelihoods. In the severely impacted group, there was a higher percentage of urban residents (25.3 vs. 8.6%; p &lt; 0.001), households reporting decreased income (85.4 vs. 39.9%), and females (56.4 vs. 45.6%; p &lt; 0.001) than in the less impacted group. Both groups reported similar availabilities of staple food groups at the household-level, but the availability of green vegetables was lower in the severely affected group (Adjusted OR [aOR] = 0.62, 95% CI: 0.38, 1.00) than in the less affected group. However, local market availability of hygiene items (aOR = 1.64, 95% CI: 1.13, 2.39) and essential medicines (aOR = 1.80, 95% CI: 1.29, 2.50) were higher for the more impacted group relative to the less impacted group. While the self-reported livelihood impact of COVID-19 was associated with a loss of income, the association of indicators of food availability within households and at markets, and essential item affordability, did not frequently differ. Self-determination of a severe economic impact may represent a relative change in the household's socioeconomic status from before the pandemic.

Psychological Impact of the COVID-19 Pandemic and Social Determinants on the Portuguese Population: Protocol for a Web-Based Cross-sectional Study

BACKGROUND

The COVID-19 outbreak and consequent physical distance measures implemented worldwide have caused significant stress, anxiety, and mental health implications among the general population. Unemployment, working from home, and day-to-day changes may lead to a greater risk of poor mental health outcomes.

OBJECTIVE

This paper describes the protocol for a web-based cross-sectional study that aims to address the impact of the COVID-19 pandemic on mental health.

METHODS

Individuals from the general population aged 18 years or more and living in Portugal were included in this study. Data collection took place between November 10, 2020, and February 10, 2021. An exponential, nondiscriminative, snowball sampling method was applied to recruit participants. A web-based survey was developed and shared on social media platforms (eg, Facebook, Instagram, Twitter, LinkedIn, and WhatsApp groups) and through e-mail lists for recruitment of the seeds.

RESULTS

Data analysis will be performed in accordance with the different variables and outcomes of interest by using quantitative methods, qualitative methods, or mixed methods, as applicable. A total of 929 individuals had completed the web-based survey during the 3-month period; thus, our final sample comprised 929 participants. Results of the survey will be disseminated in national and international scientific journals in 2021-2022.

CONCLUSIONS

We believe that the findings of this study will have broad implications for understanding the psychological impact of the COVID-19 pandemic on Portuguese residents, as well as aspects related to the informal economy. We also hope that the findings of this study are able to provide insights and guidelines for the Portuguese government to implement action. Finally, we expect this protocol to provide a roadmap for other countries and researchers that would like to implement a similar questionnaire considering the related conclusions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28071.

Financial Strain and Loneliness among Young Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources

The COVID-19 (2019 novel coronavirus) pandemic, which has been accompanied by an economic crisis and multiple restrictions on our lives, has sparked renewed interest in the topic of loneliness as well as its determinants. We examined (1) the association between financial strain, occurring upon the outbreak of the virus, and loneliness among Israeli young people (aged 20–35); (2) the associations between cognitive social capital, psychological resources, and loneliness; and (3) whether these social and psychological resources were moderators in the financial strain–loneliness link. A real-time survey based on snowball sampling was conducted during April 2020 (N = 426). Hierarchical linear models were employed to explore associations between financial strain, cognitive social capital, psychological resources, and loneliness. Financial strain emerging during the pandemic was associated with greater loneliness. Cognitive social capital and optimism decreased loneliness. Sense of mastery moderated the financial strain–loneliness link. Policymakers must develop and extend mental health initiatives aimed at alleviating the psychological consequences of the pandemic and must also combat financial strain via unemployment compensation and social assistance programs. In line with the United Nations sustainable development goals, these tasks should be viewed as an integral part of promoting public health.

Unemployment and Psychological Distress among Young People during the COVID-19 Pandemic: Psychological Resources and Risk Factors

In the wake of COVID-19, unemployment and its potential deleterious consequences have attracted renewed interest. We examined (1) the association between unemployment, occurring upon the coronavirus outbreak, and psychological distress among Israeli young people (20–35-years-old); (2) the associations between various psychological resources/risk factors and psychological distress; and (3) whether these resources and risk factors were moderators in the unemployment-psychological distress link. A real-time survey based on snowball sampling was conducted during the month of April 2020 (N = 390). We employed hierarchical linear models to explore associations between unemployment, psychological resources, risk factors, and psychological distress. Unemployment was independently associated with greater psychological distress. Perceived trust, optimism, and sense of mastery decreased psychological distress, whereas financial strain and loneliness during the crisis increased this distress. The effect of unemployment on psychological distress did not depend on participants’ resource and risk factor levels. Policymakers must develop and extend health initiatives aimed at alleviating the mental health consequences of COVID-19-related unemployment and promote labor market interventions to help young job seekers integrate into employment. These measures, which are in line with the UN sustainable development goals, should be seen as an important route to promote public health.