>>WELCOME TO THE SECOND WEBINAR
IN THE LESSONS LEARNED FROM
GLOBAL FOOD AND NUTRITION
INSECURITY WEBINAR.
I'M WITH THE NIH INTERNATIONAL
CENTER.
THIS SERIES BUILDS ON THE
INVESTMENTS THE U.S. GOVERNMENT
IS MAKING ON FOOD AND NUTRITION
INSECURITY BOTH AT HOME AS WE
SAW IN THE WHITE HOUSE
CONFERENCE ON FOOD, NUTRITION
AND HUNGER, AND ABROAD WITH THE
RECENT PASSAGE OF THE GLOBAL
MALNUTRITION PREVENTION AND
TREATMENT ACT.
THE SERIES HIGHLIGHTS THE
INNOVATIVE RESEARCH PROJECTS ON
NUTRITION AND FOOD SECURITY AND
HEALTH OUTCOMES IN GLOBAL
SETTINGS, AND IDENTIFIES LESSONS
LEARNED AND OPPORTUNITIES FOR
ADAPTATION IN THE U.S. AND OTHER
CONTEXTS.
IN OUR FIRST WEBINAR WE HAD AN
OVERVIEW OF THE IMPACTS ACROSS
THE WORLD IN VARIOUS AGE GROUPS
AND SETTINGS INCLUDING THE
CONNECTIONS TO CHRONIC AND
INFECTIOUS DISEASES, AS WELL AS
SPECIFIC EXAMPLES OF INNOVATIVE
RESEARCH THAT PRESENT
OPPORTUNITIES FOR TRANSLATION
AND ADAPTATION.
THE SECOND LOOKS AT THE ROLE
THAT HOME, NEIGHBORHOOD AND
COMMUNITY FOOD ENVIRONMENTS PLAY
IN FOOD INSECURITY AND PROVIDE
EXAMPLES OF EFFECTIVE FOOD
ENVIRONMENT AND FOOD SYSTEM
INTERVENTIONS ACROSS MULTIPLE
REGIONS THAT ADDRESS EQUITY,
ACCESS, DISPARITIES AND
SUSTAINABILITY.
WE'LL HEAR EXCITING RESEARCH
EXAMPLES FROM LATIN AMERICA, THE
CARIBBEAN, THE AMERICAS, EUROPE
AND AFRICA.
I'M THRILLED TO PARTNER WITH
NIH'S OFFICE OF DISEASE
PREVENTION, OFFICE OF NUTRITION
RESEARCH, NATIONAL CANCER
INSTITUTE, NATIONAL HEART, LUNG,
BLOOD AND SLEEP INSTITUTE AND
THE NATIONAL INSTITUTE FOR CHILD
HEALTH AND HUMAN DEVELOPMENT AS
WELL AS U.S. AID, CDC AND USDA
TO DEVELOP THIS THREE-PART
SERIES.
WE WELCOME QUESTIONS FROM THE
AUDIENCE FOR OUR PANEL
DISCUSSION.
PLEASE CLICK ON THE SEND LIVE
FEEDBACK BUTTON DIRECTLY BELOW
THE VIDEO.
I WANT TO INTRODUCE OUR FIRST
SPEAKER AND THE LEAD FOR THIS
WEBINAR, PROFESSOR OF PUBLIC
HEALTH NUTRITION AT THE
UNIVERSITY OF GHANA.
>>THANK YOU VERY MUCH, SUSAN,
FOR YOUR KIND INTRODUCTION.
I WOULD LIKE TO FROM THE ONSET
EXPRESS MY SINCERE THANKS TO THE
NIH AND OTHER PARTNERS FOR THE
OPPORTUNITY TO CONTRIBUTE TO
THIS VERY IMPORTANT CONVERSATION
AS TO HOW YOU CAN LEVERAGE FOOD
ENVIRONMENTS TO ASSURE FOOD
SECURITY.
AS AN INTRODUCTORY PRESENTATION,
MY FRAMING PRESENTATION WHICH
INTRODUCED FOOD ENVIRONMENT AS A
CONCEPT -- DEFINITION OF
PERSPECTIVES, TYPOLOGIES, BUT
ALSO SUCH CONSTRUCTS COULD BE
EXPLOITED AS A POLICY TOOL TO
ASSURE FOOD SECURITY.
THE CONCEPTS OF FOOD ENVIRONMENT
ACTUALLY FIRST EMERGED IN
ECOLOGY WHERE PRACTITIONERS AND
RESEARCHERS WERE INTERESTED IN
EXPLORING THE CONTEXT AND
ATTRIBUTES OF FOOD CHAINS OF
VARIOUS SPECIES AND ABUNDANCE OF
FOOD SUPPLY OF DIFFERENT
ECOSYSTEMS.
SINCE THEN, THE CONCEPT HAS BEEN
EXPANDED AND APPLIED IN PUBLIC
HEALTH, WHERE INITIALLY IT WAS
NARROWLY FOCUSED ON WHAT WE
REFER TO TODAY AS --
ENVIRONMENTS AND NUTRITION
ENVIRONMENT.
IN 2010, THE CONCEPT WAS
EXPANDED TO THE DEFINITION AS
THE COLLECTIVE PHYSICAL ECONOMIC
POLICY, OPPORTUNITIES AND
CONDITIONS THAT INFLUENCE WHAT
YOU AND I EAT AND, THEREFORE,
OUR NUTRITIONAL HEALTH.
CURRENTLY THERE ARE MULTIPLE
DEFINITIONS AND PERSPECTIVES OF
THE CONCEPT OF FOOD ENVIRONMENT.
IN 2015, THEY FOCUSED ON THE
AVAILABILITY, CONVENIENCE AND
DESIRABILITY DIMENSIONS OF FOOD
ENVIRONMENT.
IN 2016, THE FAO RESEARCH OF THE
AVAILABILITY AND ACCESSIBILITY
DIMENSION BUT ALSO MORE
IMPORTANTLY EMPHASIZE THE FACT
THAT FOOD ENVIRONMENT DIFFER
DEPENDING ON CONTEXT.
IN 2017, DIMENSIONS OF FOOD
ENVIRONMENT MAINTAINING THE
AVAILABILITY, ACCESSIBILITY AND
AFFORDABILITY DIMENSIONS
PREVIOUSLY ARTICULATED.
THEN THE SAME YEAR, IN 2017, THE
HIGH LEVEL ASPECT ON FOOD
SECURITY AND NUTRITION, ALSO
TALKED ABOUT THE FACT THAT FOOD
QUALITY AND FOOD -- OUGHT TO BE
PART AND PARCEL OF A FOOD
ENVIRONMENT IN TERMS OF AS A
CONCEPT AND THEN DEFINITION.
IN 2020, THEY ARGUED THAT FOOD
ENVIRONMENT AS A CONCEPT TO BE
OF PRACTICAL IMPORTANCE, WE
OUGHT TO MOVE BEYOND JUST THE
BUILT ENVIRONMENT FOCUSED ON --
TO INTRODUCE A NATURAL FOOD
ENVIRONMENT AND -- OUGHT TO BE
CONSIDERED, ESPECIALLY -- IN THE
LOW AND MIDDLE INCOME COUNTRIES.
SO WE TALK ABOUT FOOD DESERTS
AND NUTRITIOUS FOOD, FOOD --
THAT DESCRIBE NEIGHBORHOOD WHERE
AND HOW THE FOODS -- AND FOOD --
HOW NUTRITIOUS FOOD EXISTS AND
IS AFFORDABLE.
FROM THOSE NEGATIVE CONNOTATIONS
OR DEPICTIONS OF FOOD
ENVIRONMENT, THEY ARE CURRENTLY
ALSO -- FOOD OASIS WHERE AN
ENVIRONMENT IS CHARACTERIZED
WITH ABUNDANCE OF HEALTHY AND
NUTRITIOUS FOODS THAT ARE
AFFORDABLE BUT ALSO CURRENTLY
ARE FOOD HAVENS THAT DESCRIBE
HEALTHY AND SUSTAINABLE FOOD
ENVIRONMENT.
GIVEN THAT WE LIVE IN A WORLD
WHERE FISCAL HUMAN BEINGS LIKE
YOU AND I ALSO HAVE -- IS JUST
IMPORTANT THAT FOOD ENVIRONMENT
ALSO EXPLOIT THAT, SO CURRENTLY
WE TALK ABOUT -- FOOD
ENVIRONMENT AS WELL IN DIGITAL
SETTINGS.
SO THE QUESTION IS WHAT HAVE ALL
THESE GOT TO DO WITH FOOD AND
NUTRITION SECURITY?
ONE WAY WOULD BE TO REVIEW THE
CONCEPT, DIMENSIONS AND
APPLICATIONS OF FOOD SECURITY,
BUT I'M NOT GOING TO DO THAT
BECAUSE LAST WEEK OUR COLLEAGUES
EXPLICITLY ADDRESSED THIS IN
SESSION ONE OF THIS WEBINAR
SERIES, AND SO TO CREATE THE
DEFINITION WHEN WE TALK ABOUT
FOOD SECURITY, WHAT WE MEAN IS
THAT ALL PEOPLE AT ALL TIMES
HAVE PHYSICAL, ECONOMIC, AND
SOCIAL ACCESS TO SUFFICIENT,
SAFE AND NUTRITIOUS FOOD THAT
MEET THEIR DIETARY FOOD
PREFERENCES AS WELL AS HEALTH
NEEDS.
AND THIS IS THE DEFINITION FROM
THE WORLD FOOD SUMMIT IN 1996.
SO THERE ARE MAJOR STAKEHOLDERS,
MULTIPLE APPROACHES, MULTIPLE
ENTRY POINT TO ADDRESSING THE
PROBLEM OF FOOD INSECURITY
CURRENTLY.
SO TODAY WHAT WE AIM TO DO IS
TO -- I HOPE TO CONVINCE YOU
THAT FOOD ENVIRONMENT AS A
CONCEPT COULD BE EXPLOITED AS AN
ENTRY POINT OR A TOOL TO ASSURE
FOOD AND NUTRITION SECURITY.
THERE'S A LOT OF EVIDENCE THAT
SHOWS THAT FOOD ENVIRONMENT
CONSTRAIN AND SIGNAL CONSUMERS
WHAT TO PURCHASE.
WE ALSO KNOW FOOD ENVIRONMENT
AFFECT CONSUMPTION OF HEALTHY
FOOD, AVAILABILITY,
AFFORDABILITY, CONVENIENCE,
DESIRABILITY, PHYSICAL AND
TEMPORAL ACCESS AS WELL AS
FINANCIAL ACCESS OF HEALTHY OR
UNHEALTHY FOOD, THEREFORE, IF
YOU'RE ABLE TO EXPLOIT THE FOOD
ENVIRONMENT TO EXPRESS THESE
MULTIPLE DIMENSIONS THEN WE'RE
CONTRIBUTING TO ENSURE FOOD AND
IMPROVED NUTRITION.
THERE ARE APPROACHES AND THEN
THERE ARE INTERVENTIONS
CURRENTLY BEING IMPLEMENTED IN A
NUMBER OF SETTINGS.
HALLADAY AND COLLEAGUES IN
2019 -- GLOBALLY, SO
INNOVATIONS, FOOD ENVIRONMENT --
TO SHIFT THE FOOD ENVIRONMENT
WITH RESPECT TO FISCAL ACCESS,
INNOVATIONS -- FOR EXAMPLE,
MUNICIPALITIES, JURISDICTIONS,
NATIONS -- ORDINANCES AND
PLANNING INSTRUMENTS THAT WORK
IN THESE DIRECTION.
THEY CAN HAVE PHYSICAL MEASURES,
FOR EXAMPLE, TAX EXEMPTION ON
LAND USED FOR AGRICULTURAL
PURPOSES.
YOU CAN ALSO HAVE INNOVATIONS OR
INTERVENTIONS THAT SEEK TO
ENCOURAGE HOW THEY DESCRIBE
CONSUMPTION OF UNHEALTHY FOOD OR
ZONING LAWS, ZONING PERMITS AND
LICENSES CAN BE USED.
THERE ARE ALSO PHYSI FISCAL MEAS
BEING DEPLOYED TO ENSURE THAT
UNHEALTHY FOOD ARE MADE
UNATTRACTIVE.
SO ALL THESE ARE MULTIPLE
INTERVENTIONS THAT WE CAN USE TO
SHAPE OUR FOOD ENVIRONMENT TO
ENSURE THAT THERE'S PHYSICAL
ACCESS TO HEALTHY FOOD.
USING HEALTHY FOOD PROCUREMENT
MODALITIES, REINFORCING SUPPLY
CHAINS, FACILITATING MOBILITY
AND PUBLIC TRANSPORTATION, ALL
OF THOSE ARE INTERVENTIONS OR
OPPORTUNITIES USING FOOD
ENVIRONMENT.
INDEED IN ALL THESE, GOVERNMENT
DO HAVE A ROLE AND THEY ALSO
HAVE AN OPPORTUNITY.
GOVERNMENTS EVERYWHERE -- TO
PROMOTE, TO PROTECT AND THEN
ASSURE HEALTH OF THEIR CITIZENS,
AND WE HAVE ARGUED THAT IF
GOVERNMENT -- A MIX OF -- AGENCY
AS WELL AS HIGH AGENCY FOOD
ENVIRONMENT POLICY MEASURES, FOR
EXAMPLE, SEEK TO INFORM ON
POWER, THOSE THAT GUIDE AND
INFLUENCE THEIR POLICY MEASURES
THAT INCENTIVIZE OR DESCRIBE
CONSUMPTION OF UNHEALTHY FOOD,
FOR EXAMPLE, SETTING TARGET FOR
OPPOSITION OF PROCESSED FOOD
RESTRICTING THE AVAILABILITY OF
FOOD VIRMT TO PROMOTE FOODS THAT
ARE KNOWN TO BE UNHEALTHY, HOW
PUBLIC SECTOR SETTINGS IMPLEMENT
CLEAR AND CONSISTENT POLICIES ON
HEALTHY FOOD PROCUREMENT AND
PROVISIONING, ALL POLICY
INTERVENTIONS INCENTIVIZE
CONSUMPTION OF UNHEALTHY FOOD
BUT AT THE SAME TIME, HAVE THOSE
THAT INSEPTEMBER ADVISE
CONSUMPTION OF HEALTHY ONES.
THEN FOOD ENVIRONMENT ACCESS THE
ITEM IMMEDIATE DECISIONS THAT
NEGATE THE IMPORTATION, THE
PRODUCTION, THE PROCESSING, THE
RETAIL MARKETING AND PURCHASE
AND CONSUMPTION OF UNHEALTHY
FOOD, AND, THEREFORE, LEADING TO
MAKING UNHEALTHY FOOD
UNAVAILABLE, UNATTRACTIVE AND
UNAFFORDABLE.
SO THERE IS VALUE IN EXPLOITING
FOOD ENVIRONMENT TOWARDS
ASSURING FOOD SECURITY.
I'LL END HERE AND HAND IT OVER
TO THE DISTINGUISHED PANEL OF
EXPERTS WHO ARE GOING TO BE ON
THE PRESENTATION FOR THE
PRACTICE OF FOOD ENVIRONMENT, WE
HE ARE GOING TO GIVE AS CONCRETE
PRACTICAL EXAMPLE OF THE
PRACTICE.
SO LET ME INTRODUCE THE SPEAKERS
WHO ARE GOING TO GIVE THOSE
PRACTICAL EXAMPLES FROM THE
DIFFERENT -- FIRST AN INSTRUCTOR
IN THE SECTION OF GENERAL
INTERNAL MEDICINE AT YALE SCHOOL
OF MEDICINE.
PROFESSOR FROM THE GEORGE
WASHINGTON UNIVERSITY.
AND CHARLOTTE GALLAGHER SQUIRES,
A RESEARCHER AT THE CENTER FOR
FOOD POLICY, UNIVERSITY OF
LONDON.
SO I'LL HAND OVER NOW TO THESE
DISTINGUISHED SPEAKERS TO GIVE
US PRACTICAL EXAMPLES FROM
DIFFERENT CORNERS OF THE WORLD.
OVER TO YOU.
>>THANK YOU.
I'M GOING TO SHARE MY SCREEN.
GOOD MORNING.
AS MENTIONED, I'LL BE TALKING TO
YOU TODAY ABOUT PERCEPTIONS OF
THE LOCAL FOOD ENVIRONMENT AND
HOUSEHOLD FOOD INSECURITY.
IN THE EASTERN CARIBBEAN
OUTCOMES RESEARCH COHORT STUDY.
TODAY I'M GOING TO DESCRIBE THE
STUDY DESIGN, DISCUSS THE LOCAL
FOOD ENVIRONMENT AND HOUSEHOLD
FOOD INSECURITY, PROPOSE FUTURE
DIRECTIONS, AND DISCUSS RESOURCE
RECOMMENDATIONS.
WE KNOW FROM THE LITERATURE THAT
HOUSEHOLD FOOD INSECURITY IS
ASSOCIATED WITH ALL FORMS OF
MALNUTRITION, AS WELL AS
INFECTIOUS AND NON-COMMUNICABLE
DISEASES.
THIS IS ALSO THE CASE IN THE
COHORT, TODAY I'M GOING TO FOCUS
ON RISK FACTORS FOR HOUSEHOLD
FOOD INSECURITY.
THE KEY MESSAGES TODAY ARE THAT
PERCEIVED FOOD AVAILABILITY AND
PERCEIVED FOOD QUALITY ARE
ASSOCIATED WITH HOUSEHOLD FOOD
INSECURITY, THAT WATER SECURITY
SHOULD BE CONSIDERED PART OF THE
LOCAL FOOD ENVIRONMENT, AND THAT
THESE FINDINGS HAVE IMPLICATIONS
FOR FOOD SECURITY AND HEALTH
POLICY IN THE EASTERN CARIBBEAN
REGION.
THIS IS A COHORT STUDY DESIGNED
TO FOLLOW OLDER ADULTS IN THE
EASTERN CARIBBEAN.
ITS PRIMARY PURPOSE IS TO
MEASURE THE PREVALENCE AND
INCIDENCE OF DIABETES, CANCER
AND HEART DISEASE, AS WELL AS
KNOWN AND POTENTIAL RISK FACTORS
INCLUDING FOOD INSECURITY.
ISLAND SITES INCLUDE THE TWO
CARIBBEAN U.S. TERRITORIES OF
PUERTO RICO AND THE U.S. VIRGIN
ISLANDS, AS WELL AS BARBADOS AND
TRINIDAD.
ELIGIBILITY CRITERIA ARE LISTED
ON THE LEFT-HAND SIDE OF THE
SLIDE.
IN TRINIDAD, PUERTO RICO AND
BARBADOS, STRATIFIED
MULTI-PROBABILITY SAMPLING FOR
THE BASELINE COHORT.
IN THE U.S. VIRGIN ISLANDS,
SIMPLE RANDOM SAMPLING WAS USED
ACROSS ST. THOMAS, ST. CROIX AND
ST. JOHN.
AFTER INFORMED CONSENT WAS
OBTAINED, PARTICIPANTS WERE
ASKED TO COMPLETE A HEALTH
SURVEY, A CLINICAL ASSESSMENT
AND PROVIDE A BLOOD SAMPLE FOR
IMMEDIATE TESTING TO IDENTIFY
MARKERS OF DISEASE.
WE USE THE LATIN AMERICAN AND
CARIBBEAN FOOD SECURITY SCALE
AND SPECIFICALLY THE NINE-ITEM
ADULT SUBSCALE TO MEASURE
HOUSEHOLD FOOD INSECURITY IN THE
COHORT.
THE SCALE IS WIDELY KNOWN BY ITS
SPANISH ACRONYM ELSA.
THIS IS A HOUSEHOLD LEVEL
EXPERIENTIAL FOOD SECURITY
SCALE.
THE ELCSA IS UNIQUELY ABLE TO
DETECT ASPECTS OF FOOD
INSECURITY INVOLVING DECREASED
ACCESS TO A SUFFICIENT QUANTITY
OR QUALITY OF FOOD.
IT ALSO MEASURES THE ANXIETY AND
UNCERTAINTY AROUND FOOD ACCESS.
THE INDIVIDUAL ITEMS ARE LISTED
HERE AND THE TIME FRAME BEING
EXAMINES IS THE PAST 90 DAYS.
OUR RASH MODELING INDICATED THE
PSYCHOMETRIC PROBABILITIES OF
THIS SCALE ARE EXCELLENT AND
THAT ALL NINE ITEMS SHOULD BE
USED.
WE MEASURED PERCEPTIONS OF THE
LOCAL FOOD ENVIRONMENT WITH FIVE
QUESTIONS.
THE TWO WE USED IN THIS ANALYSIS
ARE HIGHLIGHTED HERE.
ONE EACH FOR NEIGHBORHOOD FOOD
AVAILABILITY AND FOOD QUALITY.
SO THINKING ABOUT FOOD RESOURCES
IN YOUR NEIGHBORHOOD, HOW OFTEN
ARE LARGE SELECTION OF FRESH
FRUITS AND VEGETABLES AVAILABLE
IN YOUR NEIGHBORHOOD?
AND HOW OFTEN ARE THE FRESH
FRUITS AND VEGETABLES IN YOUR
NEIGHBORHOOD OF HIGH QUALITY?
THIS GRAPH IS SHOWING THE
PREVALENCE OF HOUSEHOLD FOOD
INSECURITY BY ISLAND AND LEVEL
OF SEVERITY AT WAVE 1.
THOSE WHO ARE MILDLY FOOD
INSECURE ARE SHOWN IN PURPLE.
MODERATE IN BLUE AND SEVERE IN
GREEN.
SO IF WE ADD UP THE PURPLE, BLUE
AND GREEN BARS FOR EACH SITE AND
OVERALL, WE CAN SEE THE PREF
PREVALENCE OF ANY LEVEL OF FOOD
INSECURITY AKLOSS ALL FOUR
ISLAND SITES WAS 27.6%.
THE PREVALENCE OF ANY HOUSEHOLD
FOOD INSECURITY WAS HIGHEST IN
TRINIDAD, AT 37.2%.
FOLLOWED BY THE U.S. VIRGIN
ISLANDS AT 33.5%.
PUERTO RICO AT 22.9%, AND
BARBADOS AT 21.4%.
AS YOU CAN SEE HERE, THERE WAS
ALSO IMPORTANT VARIABILITY
ACROSS SITES REGARDING THE
SEVERITY OF FOOD INSECURITY.
AS MY COLLEAGUE HAS SHOWN,
PERCEPTIONS OF THE LOCAL FOOD
ENVIRONMENT ARE ASSOCIATED WITH
FRUIT AND VEGETABLE INTAKE IN
THE COHORT STUDY, AND THIS
RELATIONSHIP IS MODIFIED BY FOOD
INSECURITY.
SO I EXPANDED UPON THIS ANALYSIS
TO EXAMINE PERCEPTIONS OF THE
LOCAL FOOD ENVIRONMENT AS A RISK
FACTOR FOR FOOD INSECURITY IN
THE COHORT.
SO THE PRIMARY AIMS OF THIS
ANALYSIS WERE TO UNDERSTAND HOW
PERCEPTIONS OF THE LOCAL FOOD
ENVIRONMENT ARE ASSOCIATED WITH
FOOD INSECURITY AND TO EXAMINE
WHETHER ACCESS TO SAFE WATER
SHOULD BE CONSIDERED PART OF THE
LOCAL FOOD ENVIRONMENT.
WE USED MULTIVARIABLE ORDINAL
LOGISTIC REGRESSION WITH DATA
FROM THE FIRST WAVE TO MODEL THE
PROBABILITY OF INCREASING OR
WORSENING FOOD INSECURITY FROM
MILD TO MODERATE TO SEVERE.
PERCEPTIONS OF THE LOCAL FOOD
ENVIRONMENT WERE MEASURED USING
THE TWO VARIABLES WE DISCUSSED
EARLIER.
RESPONSES WERE DICHOTOMIZED SUCH
THAT NEVER, RARELY OR SOMETIMES
WAS COLLAPSED INTO ONE CATEGORY
AND USUALLY OR ALWAYS WAS THE
REFERENCE CATEGORY.
WE FOUND FOOD AVAILABILITY
INDEPENDENTLY PREDICTED
HOUSEHOLD FOOD INSECURITY IN THE
COHORT.
THOSE WHO REPORTED POOR FRUIT
AND VEGETABLE AVAILABILITY HAD
43% INCREASED ODDS OF WORSENING
FOOD INSECURITY COMPARED TO
THOSE WHO REPORTED THAT FRESH
FRUITS AND VEGETABLES ARE
USUALLY OR ALWAYS AVAILABLE.
WE CONTROLLED FOR ALL OF THE
VARIABLES YOU SEE LISTED AT THE
BOTTOM OF THIS TABLE.
WHEN WE STRATIFIED THIS ANALYSIS
BY SEX, WE FOUND THAT
PERCEPTIONS OF LOCAL FRUIT AND
VEGETABLE AVAILABILITY WAS
ASSOCIATED WITH HOUSEHOLD FOOD
INSECURITY AMONG WOMEN BUT NOT
AMONG MEN.
AMONG WOMEN, THOSE WHO REPORTED
POOR FOOD AVAILABILITY HAD 65%
INCREASED ODDS OF WORSENING
HOUSEHOLD FOOD INSECURITY
COMPARED TO THOSE WHO REPORTED
THAT FRESH FRUITS AND VEGETABLES
ARE USUALLY OR ALWAYS AVAILABLE.
THE EFFECT ESTIMATE FOR MEN WAS
NOT STATISTICALLY SIGNIFICANT.
THOSE WHO REPORTED POOR FRUIT
AND VEGETABLE QUALITY HAD 54%
INCREASED ODDS OF WORSENING FOOD
INSECURITY COMPARED TO THOSE WHO
REPORTED THAT THE FRUIT AND
VEGETABLE QUALITY WAS USUALLY OR
ALWAYS HIGH.
WHEN WE STRATIFIED THIS ANALYSIS
BY SEX, WE FOUND THAT
PERCEPTIONS OF LOCAL FRUIT AND
VEGETABLE QUALITY WERE
ASSOCIATED WITH HOUSEHOLD FOOD
INSECURITY AMONG MEN NOW BUT NOT
AMONG WOMEN.
AMONG MEN, THOSE WHO REPORTED
POOR FRUIT AND VEGETABLE QUALITY
HAD TWO TIMES THE ODDS OF
WORSENING HOUSEHOLD FOOD
INSECURITY, COMPARED TO THOSE
WHO REPORTED THAT FRESH FRUITS
AND VEGETABLES ARE USUALLY OR
ALWAYS OF HIGH QUALITY.
THE EFFECT ESTIMATE FOR WOMEN
WAS NOT STATISTICALLY
SIGNIFICANT.
SO BOTH FOOD AVAILABILITY AND
FOOD QUALITY THEN INDEPENDENTLY
AND SIGNIFICANTLY PREDICTED
INCREASING LEVELS OF FOOD
INSECURITY IN THIS SAMPLE, AND
THIS ASSOCIATION WAS MODIFIED BY
SEX.
OUR SECOND AIM WAS TO EXAMINE
WHETHER ACCESS TO SAFE WATER
SHOULD BE CONSIDERED PART OF THE
LOCAL FOOD ENVIRONMENT.
WE FOUND THAT SOURCE OF POTABLE
WATER IN THE HOUSEHOLD WHICH WAS
USED AS A PROXY FOR WATER
SECURITY WAS ALSO INDEPENDENTLY
AND SIGNIFICANTLY ASSOCIATED
WITH HOUSEHOLD FOOD INSECURITY.
THOSE WHO DID NOT HAVE WATER
PIPED DIRECTLY INTO THEIR HOME
HAD 61% INCREASED ODDS OF
WORSENING HOUSEHOLD FOOD
INSECURITY COMPARED TO THOSE
WITH WATER PIPED DIRECTLY INTO
THEIR HOME.
SO WHERE DO WE GO FROM HERE?
IN COLLABORATION WITH LOCAL
PARTNER, WE'RE CONTINUING TO USE
DATA FROM THE ECHORN STUDY TO
STRENGTHENING THE LOCAL FOOD
ENVIRONMENT IN A REGION.
FOR EXAMPLE, THE MINISTRY OF
HEALTH IN BARBADOS IS INTERESTED
IN USING ECHORN DATA TO INFORM
THEIR NATIONAL NUTRITION POLICY.
AS THE ANALYSIS PRESENTED TODAY
HAS CONFIRMED, A SECOND AVENUE
OF RESEARCH IS TO EXAMINE THE
RELATIONSHIP BETWEEN WATER
INSECURITY AND HOUSEHOLD FOOD
INSECURITY.
WATER SECURITY LIKE FOOD
SECURITY HAS BEEN LINKED TO
IMPORTANT NUTRITIONAL, PHYSICAL,
MENTAL AND ECONOMIC WELL-BEING
OUTCOMES.
IT'S ASSOCIATED WITH AND HAS
BEEN SHOWN TO BE A PRE-CURSOR TO
FOOD INSECURITY.
ALSO HOUSEHOLDS THAT EXPERIENCE
BOTH WATER AND FOOD INSECURITY
HAVE A HIGHER RISK OF THE DUAL
BURDEN OF MALNUTRITION.
WE PLAN ON ADDING THE H WISE
SECURITY SCALE TO THE ECHORN
COHORT STUDY IN WAVE 3, BOTH
WATER AND FOOD SECURITY IN A
LONGITUDINAL MANNER CAN PROVIDE
IMPORTANT INFORMATION TO
RESEARCHERS AND POLICY MAKERS TO
INFORM LOCAL FOOD AND NUTRITION
SECURITY POLICY.
SO IN SUMMARY, THE LONGITUDINAL
MEASUREMENT OF FOOD AND WATER
INSECURITY IS IMPORTANT TO
ESTABLISH PREVALENCE AND
INCIDENCE AS BOTH ARE AFFECTED
BY LOCAL FOOD ENVIRONMENTS,
LOCAL ECONOMIES, AND LOCAL
CLIMATIC EVENTS LIKE CLIMATE
CHANGE FUELED NATURAL DISASTERS.
I'M THINKING OF HURRICANES IRMA,
MARIA AND FIONA, TO NAME A FEW.
THESE DATA CAN BE USED TO INFORM
FOOD AND NUTRITION SECURITY
POLICY AS WELL AS DISASTER
PREPAREDNESS POLICIES.
OUR SECOND RECOMMENDATION IS TO
EVALUATE PROGRAMS ADDRESSING
FOOD AND WATER SECURITY AT THE
LOCAL LEVEL USING EXPERIENCED
BASED HOUSEHOLD FOOD INSECURITY
SCALES AND DIETARY INTAKE
MEASURES.
IMPLEMENTATION AND IMPACT
EVALUATIONS OF THESE PROGRAMS
ARE ALSO NEEDED.
THIRD, IT'S IMPERATIVE THAT WE
BETTER UNDERSTAND THE IMPACT OF
EXISTING COLONIAL AND
NEOCOLONIAL RELATIONSHIPS ON THE
LOCAL FOOD ENVIRONMENT.
HOUSEHOLD FOOD INSECURITY AND
HOW RESEARCH CAN BE USED TO
ADDRESS OR CHANGE THE POWER AND
BALANCES AND INEQUALITIES
INHERENT IN THESE RELATIONSHIPS.
FOR EXAMPLE, FREE TRADE
AGREEMENTS AFFECT LOCAL FOOD
SYSTEMS AND ALL ECHORN SITES ARE
NET IMPORTERS OF FOOD, AS ARE
MANY OF THE OTHER CARACOM
COUNTRIES SO IT WILL REQUIRE A
DEEP TRANSFORMATION OF THESE
FREE TRADE AGREEMENTS AND OF
LOCAL AGRICULTURAL SYSTEMS.
FINALLY, OUR FOURTH
RECOMMENDATION IS TO CONTINUE TO
TEST THE USEFULNESS OF
EXPERIENCE BASED FOOD INSECURITY
MEASURES TO UNDERSTAND FOOD
ENVIRONMENT INTERVENTIONS.
SO THANK YOU TO THE ECHORN TEAM
PICTURED HERE, TO THE NIH FOR
THIS OPPORTUNITY, AND THANKS TO
EACH OF YOU FOR LISTENING TODAY.
>>THANK YOU SO MUCH.
I THINK I WILL GO AHEAD AND TAKE
THE LEAD FROM THERE.
I'LL SHARE MY SCREEN.
I'M AN ASSOCIATE PROFESSOR AT
GEORGE WASHINGTON UNIVERSITY.
TODAY I'M GOING TO BE TALKING
ABOUT TWO STUDIES WHERE WE
THOUGHT ABOUT LEVERAGING FOOD
ENVIRONMENTS FOR FOOD AND
NUTRITION SECURITY.
ONE OF THEM IS IN LATIN AMERICA
AND THE OTHER IS IN THE UNITED
STAISSMENTS FIRST AND FOREMOST,
I WANT TO SAY THAT THIS IS A
TEAM EFFORT, ESPECIALLY FOR THE
FIRST STUDY WITH REPRESENTATION
FROM PUERTO RICO, MYSELF, COSTA
RICA, BRAZIL, COLOMBIA, AND
CHILE.
AND FOR THE SECOND STUDY, IT'S
HIGHLY DEPENDENT ON A COMMUNITY
ADVISORY BOARD AND COMMUNITY
ACADEMIC PARTNERSHIP WITH
INVESTIGATORS AT GEORGE
WASHINGTON UNIVERSITY AND AT
HOPKINS.
SO TODAY SPECIFICALLY, I'M GOING
TO BE TALKING ABOUT THESE TWO
STUDIES.
THE FIRST ONE, WE USE MORE
TRADITIONAL METHODS TO EXAMINE
HOW SCHOOL FEEDING PROGRAMS IN
DIFFERENT COUNTRIES IN LATIN
AMERICA AND THE CARIBBEAN
RESPONDED TO THE GLOBAL PANDEMIC
OF COVID-19 TO MITIGATE FOOD AND
NUTRITION INSECURITY.
AND THE SECOND STUDY I WILL BE
TAKING A SYSTEMS LENS TO JUST
UNDERSTAND THE MORE COMPLEX
SYSTEM, WHAT ARE THE FACTORS,
HOW THEY INTERACT OVER TIME, AND
WHAT PATTERNS ARE CREATED TO
PUSH DIFFERENT COMMUNITIES
TOWARDS DIFFERENT FOOD CHOICES.
IN THIS PARTICULAR STUDY, I'M
GOING TO BE EXAMINING SUGARY
DRINKS AND TALKING ABOUT OUR
FINDINGS REGARDING HOW PROVIDING
A LOW COST WATER FILTER FOR USE
AT HOME DECREASED SUGARY DRINK
INTAKE IN THIS PARTICULAR
COMMUNITY THAT WAS PREDOMINANTLY
CENTRAL AMERICAN IMMIGRANT
COMMUNITY IN THE UNITED STATES.
SO AT THE BEGINNING OF THE
PANDEMIC, STARTING WITH THE
FIRST STUDY, THE WORLD FOOD
PROGRAM, THE FOOD AGRICULTURE
ORGANIZATION AND UNICEF ISSUED
RECOMMENDATIONS ABOUT HOW TO
MITIGATE THE EFFECTS OF THE
PANDEMIC OVER FOOD AND NUTRITION
OF SCHOOL CHILDREN.
THEY RECOMMENDED THE USE OF KITS
OR FOOD BASKETS NOW THAT THE
SCHOOLS WERE CLOSED, OR FOOD
VOUCHERS AND CASH IN ORDER TO
CONTINUE TO SERVE THE FOOD AND
NUTRITIONAL NEEDS OF VULNERABLE
SCHOOL CHILDREN.
THE RECOMMENDATION ALSO
EMPHASIZED THAT THE CONTENT OF
THE SCHOOL FEEDING SHOULD BE
SIMILAR OR BETTER IN TERMS OF
NUTRITIONAL CONTENT, THAT THAT
PROVIDED REGULARLY AT SCHOOL,
AND THAT IT SHOULD INCLUDE
FRUITS AND VEGETABLES, WHEN
POSSIBLE AND EMPHASIZING THE
LOCAL PRODUCTS AND AVOIDING
FOODS THAT WERE UNHEALTHY, FOR
EXAMPLE, PREPACKAGED JUICES OR
FOODS THAT CONTAINED ADDED
SUGARS, SODIUM AND SATURATED
FATS.
SO WE WANTED TO DOCUMENT AND
UNDERSTAND HOW THROUGHOUT LA TIP
AMERICA AND THE CARIBBEAN THE
COUNTRIES WERE FARING WITH THE
CLOSING OF THE SCHOOLS AND
CONTINUATION OF SCHOOL FEEDING
PROGRAMS.
WE CONDUCTED A RAPID COMPARATIVE
POLICY ASSESSMENT THAT HAS BEEN
PUBLISHED IN THE FOOD AND
NUTRITION BULLETIN, SO I
ENCOURAGE YOU TO SEARCH THAT
REFERENCE BUT IN BRIEF, WE DID
TWO PHASES OF DATA COLLECTION
FOR 11 DIFFERENT COUNTRIES,
ACTUALLY 10 COUNTRIES AND ONE
CITY, BAY N IN ARGENTINA.
WE DID A PUBLIC DOCUMENT SEARCH
OF SITES OF THE GOVERNMENT AS
WELL AS NEWSPAPERS AND SOCIAL
MEDIA FOR ALL COUNTRIES, TRYING
TO UNDERSTAND HOW THE PROGRAMS
HAD BEEN MODIFIED AND WERE BEING
IMPLEMENTED.
IN ORDER TO CONFIRM AND
TRIANGULATE THAT INFORMATION, WE
ALSO CONDUCTED STAKEHOLDER
SURVEYS WITH BOTH CLOSED AND
OPEN-ENDED QUESTIONS USING
SNOWBALL SAMPLING SURVEYS THAT
WERE BROUGHT BACK TO US.
THE IDEA WAS TO CONFIRM DATA
FROM THE PUBLIC DOCUMENTS FROM
PHASE ONE, TO OBTAIN INFORMATION
REGARDING THE NUTRITIONAL
CONTENT OF WHAT WAS ACTUALLY
DELIVERED AND TO IDENTIFY
BARRIERS AND FACILITATORS
ACCORDING TO THE KEY
STAKEHOLDERS PERSPECTIVE
REGARDING THE IMPLEMENTATION OF
THE MODIFICATIONS.
WE SOUGHT TO OBTAIN
REPRESENTATION FROM MOST OF THE
COUNTRIES IN IN LA LATIN AMERICD
CHOSE TO FINALLY DO WHERE IT WAS
FEASIBLE, ARGENTINA,
SPECIFICALLY BUENOS AIRES, EACH
REGION OPERATES VERY
DIFFERENTLY, BRAZIL, CHILE,
COLOMBIA, COSTA RICA, MEXICO,
ECUADOR, GUATEMALA, PERU, PUERTO
RICO AND URUGUAY.
THE COMMON THEMES WE FOUND IN
MITIGATING NUTRITIONAL
INSECURITY DURING THE PANDEMIC
IS THAT ALL SCHOOL FEEDING
PROGRAMS EVENTUALLY CONTINUED IN
VARIOUS FORMS, AND THAT INCLUDED
FOOD KITS, FOOD BASKETS, AS WELL
AS IN SOME CASES FOOD VOUCHERS
THAT WERE TO BE USED IN
SUPERMARKETS.
EITHER THE PARENTS WOULD COME
AND PICK THEM UP, IN SOME CASES
THE SCHOOL FEEDING PROGRAMS WERE
OPENED TO OTHER POPULATIONS THAT
WERE NOT JUST THE SCHOOL
CHILDREN OR THE SCHOOL CHILDREN
AND THEIR FAMILIES, AND THERE
WAS CONTROVERSY ABOUT WHETHER
THE SCHOOL FEEDING PROGRAMS IN
SOME COUNTRIES WERE BEING USED
TO FEED OTHER FAMILY MEMBERS AND
WHETHER THAT SHOULD BE OR SHOULD
NOT BE ACCEPTED.
THE AGILITY TO ROLL OUT THOSE
MODIFICATIONS HIGHLY DEPENDED
AND VARIED ON A FEW THINGS THAT
I'M GOING TO BE TALKING ABOUT.
BUT JUST TO GIVE YOU A RANGE,
CHILE WAS THE FIRST ONE TO GET
STARTED WITH THE MODIFICATIONS,
I GUESS IMPLEMENTING THE
MODIFICATIONS, RATHER, AND IT
TOOK MORE THAN ONE MONTH TO DO
SO IN PUERTO RICO.
ONE OF THE THINGS THAT EVERYBODY
ALL ACROSS THE COUNTRY HAS
MENTIONED WAS THAT THE UNIVERSAL
LAWS THAT PROTECTED THE SCHOOL
FEEDING PROGRAMS WERE A
FACILITATING FACTOR IN BEING
ABLE TO GO AHEAD WITH THE
MODIFICATIONS AND IN SOME CASES,
FOR EXAMPLE, IN COSTA RICA, THEY
TALKED ABOUT HOW THAT UNIVERSAL
LAW ALLOWED FOR INTERSECTIONAL
COLLABORATION THAT INCREASED
THEIR AJIBILITY OF RESPONDING TO
THE NEEDS OF THE DIFFERENT
POPULATIONS.
BUT IN KEY, THERE WERE THREE
DETERMINING FACTORS THAT WE
FOUND THAT AFFECTED EAR AFFECT R
FACILITATED OR BECAME BARRIERS.
THE FIRST WAS THE AUTONOMY AND
FINANCIAL RESOURCES IN ORDER TO
REMAIN NIMBLE.
SO FOR EXAMPLE, IN SOME OF THE
COUNTRIES, A, AND TO BE SPECIFI,
IN PERU, THE SCHOOL FEEDING
PROGRAM WAS ADMINISTERED UNDER A
MINISTRY THAT WAS DIFFERENT AND
SEPARATE FROM THE MINISTRY OF
EDUCATION, WHICH SEEMED TO HAVE
BECOME A CHALLENGE FOR THEM TO
RESPOND QUICKLY OR AS QUICKLY AS
THEY WOULD HAVE WANTED TO THE
NEEDS OF THEIR SCHOOL CHILDREN.
THE IMPLEMENTATION, THE SECOND
THING THAT WAS A STRONG FACTOR
WAS COMMUNITY AND FAMILY
ENGAGEMENT, INCLUDING TEACHERS,
BEFORE AND DURING THE
EMERGENCIES.
SO ONE OF THE FACTORS THAT WAS
MENTIONED HERE IS THAT URUGUAY
AND GUATEMALA, FOR EXAMPLE,
IDENTIFIED TEACHER AND PARENT
ENGAGEMENT AS A STRENGTH, EVEN
BEFORE THE PANDEMIC.
PARENTS IN GUATEMALA ARE PART OF
A LEGALLY RECOGNIZED
ORGANIZATION THAT RECEIVES
FINANCIAL RESOURCES TO PURCHASE
AND DELIVER FOODS EVEN BEFORE
THE PANDEMIC.
AND, THEREFORE, DURING THE
PANDEMIC THESE ORGANIZATIONS
CONTINUED TO OPERATE AND
PARTICIPATE AND WERE KEY TO THE
SUCCESS OF THE IMPLEMENTATION.
IN PUERTO RICO, LOW PARENT
PARTICIPATION AND ABSENTEES FROM
SCHOOL PERSONNEL WERE MENTIONED
AS CHALLENGES TO THE
IMPLEMENTATION OF THE
MODIFICATION.
AND FINALLY, CLEAR NUTRITIONAL
GUIDELINES ABOUT WHAT FOODS AND
BEVERAGES ARE ALLOWED IN THE
SCHOOL FEEDING PROGRAMS WERE A
KEY BARRIER IN SOME PLACES.
DEFINITELY A KEY FACILITATOR IN
OTHER COUNTRIES EXCEPT THAT
THERE WAS ALSO THE CONCERN THAT
THEY WERE NOT BEING MONITORED,
EVEN THOUGH THERE WERE CLEAR
GUIDELINES THAT WERE NOT
NECESSARILY BEING MONITORED AS
NEEDED DURING THE PANDEMIC.
SO WHAT WE FOUND IN LOOKING AT
THE NUTRITIONAL CONTENT IS THAT
IN SOME COUNTRIES, DESSERTS,
SWEETS, SUGARY BEVERAGES, SUGAR
AND SALT IN PACKETS WERE
PROVIDED TO STUDENTS' FAMILIES
SUGGESTING THAT THE ESTABLISHED
GUIDELINES WERE NOT BEING
FOLLOWED.
IN OTHER COUNTRY, CLEAR
GUIDELINES ABOUT RESTRICTING
SUGAR CONTENT WERE ACTUALLY NOT
ESTABLISHED.
NOW, CLEAR GUIDELINES ON WHAT
FOODS TO PROVIDE ARE CRITICAL,
BECAUSE IN PREVIOUS EMERGENCIES,
WHEN THESE GUIDELINES DID NOT
EXIST, THE FOOD ASSISTANCE WAS
SATURATED WITH CALORIE-RICH,
NUTRIENT-POOR FOODS, AND EVEN
THOUGH PEOPLE HAVE FOOD TO EAT,
THEIR NUTRITION ACTUALLY
SUFFERS.
POTENTIALLY EXACERBATING RISK
FACTORS FOR DIET-RELATED CHRONIC
DISEASES.
FOOD PREPARATIONS MAY ALSO HAVE
LEVERAGED THE VULNERABILITY OF
GOVERNMENTS DURING THE EMERGENCY
TO BOOST SALES OF ULTRA
PROCESSED PRODUCTS DURING THE
PANDEMIC, AS OTHERS HAVE
DOCUMENTED.
AND THESE FOODS TEND TO BE
SHELF-STABLE AND CAN BE
PRE-PACKAGED FOR INDIVIDUAL
CONSUMPTION DURING EMERGENCY
RESPONSES WITHOUT AN ASSESSMENT
ON HOW THEY MEET THE ESTABLISHED
NUTRITIONAL GUIDELINES.
AND SO IT IS IMPORTANT THAT
DURING THE PANDEMIC SOME SCHOOL
FEEDING PROGRAMS WERE BEING
LEVERAGED TO COMPLEMENT EXISTING
WHOLE COMMUNITY FEEDING EFFORTS.
FOR EXAMPLE, IN MEXICO, AND IN
PERU, ALSO USED AS RESOURCES
REDIRECTED TO FEED OTHERS BEYOND
SCHOOL CHILDREN IN PUERTO RICO
AS WELL.
SO WHILE WE USE THESE
TRADITIONAL METHODS AND WE WERE
ABLE TO IDENTIFY THE FACTORS
THAT ARE AVAILABLE, I ALSO WANT
TO PUSH US TO THINK ABOUT
SYSTEMS THINKING AND USING
SYSTEMS APPROACHES TO UNDERSTAND
NOT JUST WHAT ARE THE FACTORS,
BUT WHAT ARE THE
INTERCONNECTIONS ACROSS TIME OF
THESE FACTORS AND WHAT ARE THE
PATTERNS THAT ARE EMERGING IN
ORDER TO AFFECT FOOD AND
NUTRITION SECURITY.
I TRIED TO DO SOMETHING LIKE
THIS WITH THE FINDINGS THAT WE
HAD FROM THE TRADITIONAL
RESEARCH METHODS.
SO FROM THE SCHOOL FEEDING
PROGRAM, AUTONOMY AND FINANCIAL
SUPPORT DEFINITELY SEEMED TO
IMPACT THE AGILITY TO ACQUIRE
AND DISTRIBUTE FOODS GENERALLY,
BUT ESPECIALLY EMPHASIZED DURING
THE PANDEMIC.
COMMUNITY AND FAMILY ENGAGEMENT
SUPPORTED THAT AGILITY
PREPANDEMIC, AND AFTER THE
PANDEMIC.
DURING THE PANDEMIC, THESE
SYSTEMS WERE OVERBURDENED.
THE NUTRITIONAL GUIDELINES, HIGH
QUALITY NUTRITIONAL FOOD IS WHAT
AFFECTS NUTRITIONAL QUALITY OF
FOODS.
WE ALSO HAD OTHER FACTORS
AFFECTING HERE THAT I WOULD HAVE
LIKED TO UNDERSTAND A LITTLE
MORE, LIKE FOR EXAMPLE, THE
PROCUREMENT OF FOODS AND THE
FACT THAT DURING THE PANDEMIC,
IT WAS IMPOSSIBLE TO PROCURE
FOODS THAT WERE FRESH OR HIGHLY
CHALLENGED, AND THAT SEEMED TO
ALSO AFFECT AND OVERBURDEN THE
SYSTEM AND AFFECT THE
NUTRITIONAL QUALITY OF FOODS.
SO I'M GOING TO MOVE ON TO THE
SECOND STUDY, WHERE WE USE A
SYSTEMS APPROACH AND SHOW YOU
HOW THINKING ABOUT SYSTEMS
DYNAMICS CAN HELP US UNCOVER
OTHER NON-TRADITIONAL POTENTIAL
POLICY LEADERS A AS WELL.
THIS IS A COMMUNITY ACADEMIC
PARTNERSHIP WHERE THE COMMUNITY
WANTED TO ADDRESS SUGARY DRINK
INTAKE.
IT IS PREDOMINANTLY IN THE
GREATER WASHINGTON, D.C.
METROPOLITAN AREA IN THE UNITED
STATES, WE STARTED DOING FOCUS
DWREUGROUPS AND IN DEPTH INTERV,
SO FORMATIVE WORK TO UNDERSTAND
HOW WE COULD ADDRESS THE ISSUE
OF SUGARY DRINKS.
THIS ASPECT OF WATER EMERGED
QUITE DISTINCTLY ACROSS ALL OF
OUR FORMATIVE WORK.
AND YOU CAN READ THE QUOTES HERE
ABOUT HOW THESE MOTHERS IN THIS
PARTICULAR CASE MOTHERS WERE
TALKING ABOUT WATER SECURITY.
THEY OPENED THE TAP AND THE
WATER CAME OUT YELLOW AND THEY
SAID SHOULD I DRINK IT OR NOT?
AND THEY ALSO RECEIVED VISITS,
THIS HAPPENED NOT JUST IN D.C.
BUT IT HAS BEEN DOCUMENTED
ELSEWHERE IN THE UNITED STATES
FROM WATER FILTER COMPANIES THAT
SEEM TO BE PREDATORS ON THESE
COMMUNITIES, AND IMMIGRANT
COMMUNITIES IN GENERAL, TELLING
THEM THAT THE TAP WATER IS NOT
GOOD.
ABANDOAND THAT THEY SHOULD USE A
FILTER SO THAT THEIR CHIRP DO
NOT GET SICK.
IN AN EFFORT TO DECREASE SUGARY
DRINK INTAKE AND NOT TO SELL
WATER FILTERS, WE DECIDED TO
PROVIDE WATER FILTER PITCHERS,
LOW COST WATER FILTER PITCHER,
ALONG WITH AN EDUCATIONAL
HANDS-ON CURRICULUM DURING AN
INTD VENGS THINTERVENTION WE TEA
RANDOMIZED CONTROL TRIAL.
THESE STUDYS HAVE BEEN PUBLISHED
ELSEWHERE BY OUR STUDENTS, AND
YOU CAN SEE THE REFERENCES DOWN
BELOW, BUT WHAT WE FOUND IS THAT
THE GROUPS THAT RECEIVED THE
WATER FILTER PITCHER INCREASED
THEIR WATER INTAKE AND
SIMULTANEOUSLY REDUCED THE
SUGARY DRINK INTAKE.
WHETHER THAT WAS CONSCIOUSLY OR
UNCONSCIOUSLY.
IS SO THAT HELPED US -- I GUESS
IT MADE US WONDER WHAT ELSE WE
WERE MISSING IN THE LARGER
PICTURE, AND HOW COULD WE
SUPPORT THESE FAMILIES GOING
FORWARD AND WE DECIDED TO DO A
COMMUNITY PARTICIPATORY SYSTEMS
DYNAMIC MODELING, WHERE IF I
WANTED TO DRAW THIS, IF WE
WANTED TO DO THE ACTUAL
INTERVENTION, WE WOULD BYPASS
TRUSTED INFRASTRUCTURE AND FOCUS
ON TAP WATER CONSUMPTION, WHICH
INFLUENCES SUGARY DRINK
CONSUMPTION.
THIS IS A METHOD THAT IS USED
WITH DIFFERENT STAKEHOLDERS OF
VARIOUS EXECUTORS THAT THE
COMMUNITY LIVES IN.
AND YOU CAN SEE THAT THERE ARE
VARIOUS REINFORCING FACTORS.
I AM JUST GOING TO HIGHLIGHT
THAT IT HELPS US THINK BEYOND
THE TRADITIONAL INTERVENTION
POINT TO IDENTIFY WITH THEM IN A
PARTICIPATORY MANNER, AND BY
THEM, I MEAN THE ACTUAL FAMILIES
THAT ARE AFFECTED BY THESE, BUT
ALSO THE PROVIDERS OF SERVICES,
ABOUT WHAT COULD BE INNOVATIVE
APPROACHES IN THE SYSTEMS
THEMSELVES, ARE THEY EASY OR
HARD TO DO, AND DO THEY HAVE ANY
IMPACT ON EQUITY.
SO YOU CAN SEE THREE IDEAS THAT
EMERGED FROM THESE DISCUSSIONS,
A FEW OF THEM THAT ARE ALREADY
HAPPENING SO THEY ARE EASY TO
DO, AND PIPING REPLACING WHICH
IS DIFFICULT D TO DO BUT
WASHINGTON, D.C. IS ALREADY
DOING THIS, SO WE'RE WONDERING
WHETHER THAT CAN BE LEVERAGED TO
AFFECT SUGARY DRINK CONSUMPTION
THAT ALSO AFFECTS DIETARY
QUALITY.
SO IN SUMMARY, THERE'S STILL A
LOT TO BE UNPACKED ON WHAT ARE
THESE FACTORS IN THE
ENVIRONMENT, WHAT ARE THE
INTERACTIONS AND PATTERNS, BUT
WE HAVE A GREAT OPPORTUNITY WITH
RESEARCH METHODS THAT WE ALREADY
HAVE TO LEVERAGE THOSE AND
LEVERAGE THE MOMENTUM TO
ESTABLISH A COMMON GROUND FOR
DISCUSSION AND PROBLEM SOLVING
ACROSS SECTORS THAT TYPICALLY
ARE NOT TALKING ABOUT NUTRITION
SECURITY, SO WE CAN SEE HOW
NUTRITION SECURITY ESTABLISHES A
SYSTEMS THINKING CAPACITY ACROSS
STAKEHOLDERS TO PUSH NUTRITION
SECURITY FORWARD ACROSS
MUNICIPAL WATER PROVIDERS, FOR
EXAMPLE.
AND WE CAN RELY ON THE INGENUITY
AND CONTEXT EXPERTISE OF THESE
STAKEHOLDERS THAT ARE NOT
TRADITIONALLY REPRESENTED IN
RESEARCH, IN PUBLIC HEALTH
NUTRITION OR IN FOOD
INTERVENTIONS, TO IDENTIFY
OUTSIDE OF THE BOX INTERVENTION
OR LEVER POINTS, AND THAT ALSO
INCREASES THE OWNERSHIP OF THAT
PROBLEM SOLVING FOR THEM TO
FOLLOW THROUGH.
THANK YOU VERY MUCH.
HERE IS MY EMAIL, AND MY TWITTER
HANDLE.
THANK YOU.
>>HI, EVERYONE.
THANKS, URI.
I THINK I'M SHARING NOW.
SO THANK YOU SO MUCH FOR HAVING
ME TODAY TO SPEAK.
I'M DELIGHTED TO BE HERE.
I'M GOING TO BE PRESENTING
FINDINGS FROM A STUDY I
CONDUCTED WITH COLLEAGUES FROM
THE CENTER FOR FOOD POLICY AS
PART OF OUR WORK IN THE U.K.'S
OBESITY POLICY RESEARCH UNIT,
WHERE WE PROVIDE EVIDENCE TO THE
DEPARTMENT OF HEALTH TO INFORM
THEIR PUBLIC HEALTH AGENDA.
AND TODAY I'M HOPING TO
INTRODUCE THE VALUE OF THE LIVED
EXPERIENCE RESEARCH AND ALSO
RESULTS OUR STUDY FOUND USING
THIS APPROACH ABOUT THE NEXUS
BETWEEN FINANCIAL INSECURITY AND
FOOD ENVIRONMENT.
SO WHAT IS LIVED EXPERIENCE
RESEARCH?
THIS APPROACH USES IN DEPTH
METHODS TO INVESTIGATE PEOPLE'S
DAILY REALITIES.
AS AN ENTRY POINT FOR
UNDERSTANDING HOW FOOD AND FOOD
SYSTEMS ARE EXPERIENCED IN DAILY
LIFE.
ALSO TO UNDERSTANDING HOW WIDE A
SYSTEM'S SHAPE HOW WE ENGAGE
WITH FOOD ENVIRONMENTS,
INCLUDING ECONOMIC SYSTEMS,
CULTURAL, URBAN, FOOD EDUCATION
AND HEALTH.
THIS CAN HELP US ANSWER
QUESTIONS LIKE HOW DO PEOPLE
FEEL ABOUT THIS ASPECT OF THE
FOOD ENVIRONMENT?
WHAT ARE THE SOCIAL DIMENSIONS
WHICH SHAPE THIS POPULATION'S
EXPERIENCE OF FOOD AND FOOD
ENVIRONMENT?
AND HOW IS THIS INTERVENTION OR
POLICY EXPERIENCED IN THE
CONTEXT OF THIS POPULATION'S
DAILY LIFE?
AND WE DO THIS RESEARCH IN THE
CONTEXT OF ENGLAND, WHERE THERE
ARE SIGNIFICANT INEQUALITIES IN
ILL HEALTH, SUCH AS OBESITY, SO
THIS RECENT DATA FOUND THAT NOW,
SINCE COVID, 1 IN 3 CHILDREN
LIVING IN THE MOST DEPRIVED
NEIGHBORHOODS IN ENGLAND ARE
LIVING WITH OBESITY.
AND THIS IS MORE THAN TWO TIMES
THE PREVALENCE AMONGST CHILDREN
IN LEAST DEPRIVED AREAS.
AND FOOD I INSECURITY ALSO FOLLS
THE SAME SOCIAL GRADIENT WITH
THOSE ON LOW INCOMES MUCH MORE
LIKELY TO BE FOOD INSECURE, AND
IT'S THE EXPERIENCES OF THOSE ON
LOW INCOMES I'M GOING TO BE
FOCUSING ON TODAY.
SO IN THIS CONTEXT IN ENGLAND
AND TO COVID, AND WE REALLY
WANTED TO UNDERSTAND HOW COVID
AND ITS IMPACTS ON DAILY LIFE
WERE SHAPING FAMILY'S FEELINGS
ABOUT EXPERIENCE OF AND
ENGAGEMENT WITH FOOD AND FOOD
ENVIRONMENTS.
IN PARTICULAR, WE WANTED TO
UNDERSTAND HOW THIS DIFFERED
ACROSS SOCIOECONOMIC AND
DEMOGRAPHIC GROUPS.
AND FINALLY, WE WANTED TO DRAW
OUT LEARNINGS FOR MORE EFFECTIVE
AND EQUITABLE OBESITY PREVENTION
POLICY GOING FORWARD BEYOND
COVID.
AROUND WE CONDAND WE CONDUCTED L
STUDY, THREE TIMES OVER A YEAR,
IN WINTER 2020, WHEN ENGLAND WAS
STILL IN LOCAL LOCKDOWN, IN
SPRING 2021 AS WE WERE
RE-OPENING AND AT THE END OF
2021, AS WE WERE BEGINNING TO
SEE VARIOUS INCREASES IN THE
COST OF LIVING.
PARTICIPANTS TOOK PART IN REMOTE
INTERVIEWS OVER THE PHONE OR ON
ZOOM, AND ALSO TO PHOTOS,
RECORDED DIARIES AND FOOD MAPS
OF RELATED EXPERIENCES.
WE RECRUITED FROM THREE CASE
STUDY AREAS REPRESENTING
METROPOLITAN, RURAL, COASTAL,
AND URBAN GEOGRAPHIES.
SO I'M GOING TO TALK ABOUT HOW
FINANCIAL INSECURITY DIRECTLY
SHAPED HOW PEOPLE ENGAGED WITH
FOOD ENVIRONMENTS IN OUR STUDY
TO UNDERMINE NUTRITION.
I'M ALSO GOING TO TALK ABOUT TWO
WIDER CONTEXTS WHICH OFTEN OCCUR
ALONGSIDE FINANCIAL INSECURITY,
WHICH WERE HIGHLIGHTED AND
ACCELERATED DURING COVID.
SO ONE OF THESE IS TIME POVERTY
AND SCARCITY OF SOCIAL,
WELL-BEING AND LEISURE
OPPORTUNITIES.
FOOD SHOPPING WAS RELENTLESS AND
TIME INTENSIVE, INVOLVING
MEMORIZING PRICES AND SHOPPING
ACROSS MULTIPLE STORES TO GET
THE BEST DEALS.
IT INVOLVES PRIORITIZING
QUANTITY OVER QUALITY OF FOOD,
AS PARENTS VERY SENSIBLY HAD
CONCERNS AROUND HAVING ENOUGH
FOOD, AND THESE CAME BEFORE
HEALTH.
THEY ALSO INVOLVED UTILIZING
PROMPTS, DISCOUNTS AND
PROMOTIONS IN THE SUPERMARKET IN
AN ATTEMPT TO BUY MORE FOOD FOR
LESS.
SO THINGS LIKE BUY ONE GET ONE
FREE, MULTI-OFFERS IN THE U.K.,
MAJORITY OF WHICH ARE FOODS HIGH
IN SALTS, FATS AND SUGARS AND
PACKAGED CONFECTIONARY FOODS.
THIS IS A QUOTE FROM CLAIRE, A
SINGLE MOM WHOSE LOW INCOME HAD
FAILED TO KEEP UP WITH
INCREASING COST OF HER RENT AND
BILLS SINCE COVID.
SHE'S TRYING TO CUT HER FOOD
BUDGET TO AFFORD THESE COSTS,
AND SHE TALKS ABOUT HOW THE FOOD
ENVIRONMENT TRICKED HER TO BUY
MORE THAN SHE WOULD OTHERWISE,
THINGS LIKE READY MADE MEALS,
PREMADE PIZZAS AND CONFECTIONARY
FOODS.
BUT I BROADER CONTEXT ASSOCIATED
WITH FINANCIAL DEPRIVATION WHICH
WERE HIGHLIGHTED IN COVID.
FAMILIES ACROSS THE INCOME
SPECTRUM SPOKE ABOUT THE
CHALLENGE OF NOT BEING ABLE TO
ACCESS SOCIAL WELL-BEING AND
LEISURE ACTIVITY IN LOCKDOWN.
PARENTS FELT ANXIOUS AND GUILTY
THAT CHILDREN WERE MISSING OUT
ON THE FUN AND -- THAT THESE
OPPORTUNITIES USUALLY PROVIDED.
IN THIS CONTEXT, FOOD BECAME AN
ACCESSIBLE MEANS OF TREAT AND
REWARD.
SAYING YES TO CHILDREN'S
REQUESTS FOR JUNK FOOD PROVIDED
PARENTS WITH A SOLUTION AND WAY
TO FULFILL HOUSEHOLD WELL-BEING
NEEDS WHEN OTHER MEANS WERE
INACCESSIBLE.
NICOLE'S QUOTE HERE ILLUSTRATE
THIS WHEN SHE SPEAKS ABOUT, IN
LOCK DOWN, YOU'RE SO RESTRICTED
IN MANY DIFFERENT AREAS OF LIFE,
AND FOOD IS SOMETHING WHERE YOU
CAN TREAT YOURSELF WITH.
BEYOND LOCKDOWNS, FOR SOME
FAMILIES WE SPOKE TO, THIS
CONTEXT OF RESTRICTION EXISTED
BEYOND THIS CONTEXT BECAUSE OF
NOT BEING ABLE TO AFFORD OR
ACCESS SOCIAL WELL-BEING AND
LEISURE OPPORTUNITIES IN LOCAL
AREAS.
SO LEILA WAS A SINGLE MOTHER OF
TWO WHO LOST SIGNIFICANT INCOME
POST COVID FROM HER SMALL
BUSINESS.
AND HERE SHE WAS SPEAKING TO ME
ABOUT HOW SHE COULDN'T AFFORD
CINEMA TRIPS AND BOWLING FOR THE
KIDS ANYMORE.
SHE FEELS THAT HER KIDS ARE
MISSING OUT, BUT TAKEAWAYS NEAR
HER PROVIDED A SOLUTION TO THIS.
WHEN YOU'RE IN THE MOMENT, YOU
FEEL EMOTI EMOTIONALLY LIKE, YEU
SHOULD DO THIS BECAUSE THEY
DESERVE IT.
AND THE SECOND CONTEXT THAT WAS
BOTH HIGHLIGHTED AND ACCELERATED
BY COVID IN THIS TIME IS TIME
POVERTY.
THIS WASN'T JUST ABOUT THE
MINUTES IN A DAY PEOPLE HAD
FOOD.
THERE WAS ALSO THE AUTONOMY
PEOPLE HAD OVER THOSE MINUTES
AND THIS WAS GROWING POST COVID
AS SOME PEOPLE MOSTLY ON HIGH
INCOMES MOVED TO WORKING FROM
HOME AND HAD MORE FLEXIBILITY TO
FIT FOOD WORK AROUND WORK, WHILE
OTHER PEOPLE WE SPOKE TO WERE
WORKING IN KEY WORKER ROLES,
WORKING OUT THE HOME, AND LESS
AUTONOMY OVER THEIR WORKING
HOURS AND THOSE TENDED TO BE
THOSE ON LOW INCOMES.
AND IT WAS ALSO ABOUT THIS
OBJECTIVE EXPERIENCE OF THOSE
MINUTES.
SO THOSE WHO WORKED OUT THE HOME
ON THEIR FEET ALL DAY CAME HOME
FEELING EXHAUSTED WHILE THOSE
WORKING FROM HOME HAD MORE
ENERGY IN THE EVENINGS FOR ALL
THE WORK THAT GOES INTO
PREPARING MEALS.
COLLECT BLI THESE TIME POVERTY
CAPACITY FOR PREPARING AND
REALLY IMPORTANTLY FEEDING
FAMILY HEALTHY FOODS, SO ALL THE
WORK THAT GOES INTO MAKING SURE
KIDS SIT DOWN AND ACTUALLY EAT
THOSE FOODS.
AND THIS CONTEXT, FAST FOOD AND
PALATABLE FOOD THAT CHILDREN
WILL RELIABLY EAT AND ENJOY
PROVIDED A SOLUTION, AND AZARI
HERE TALKS ABOUT THE SOLUTION,
WHEN IT'S A TAKEOUT FOR A FACT
YOU KNOW THEY'LL SIT DOWN AND
EAT IT, HEALTHY COSTS MORE AND
IS SO MUCH EASIER AND CHEAPER TO
ORDER A COUPLE OF BURGERS AND
GET IT OVER AND DONE WITH.
SO TOGETHER THESE FINDINGS SHOW
THAT LOW INCOME ONLY RESTRICTED
ACCESS TO HEALTHY FOOD BUT ALSO
CREATED A SITUATION IN WHICH
UNHEALTHY FOOD WAS OFTEN THE
MOST SENSIBLE AND LOGICAL
SOLUTION FOR PARENTS.
WHEN MANAGING FOOD SHOPPING ON A
TIGHT BUDGET, ASPECTS OF THE
FOOD ENVIRONMENT LIKE DISCOUNTS
AND OFFERS WERE USED TO MAKE
MONEY GO FURTHER.
WHEN EXPERIENCING TIME POVERTY,
FAST FOOD AND PREPARED MEALS
PROVIDED A QUICK MEAL THAT THEIR
CHILDREN WOULD EAT WITHOUT FUSS.
WHEN SOCIAL AND LEISURE
ACTIVITIES WERE INACCESSIBLE,
JUNK, SNACK AND COMFORT FOODS
PROVIDED A CHEAP WAY TO MEET
HOUSEHOLD, EMOTIONAL AND SOCIAL
NEEDS.
AND THE PARENTS WE SPOKE TO
DIDN'T SIMPLY RESPOND TO THE
AVAILABILITY OF FOOD AND ITS
PRICE, ALTHOUGH THIS WAS VERY
IMPORTANT, BUT THEY ALSO
CREATIVELY DEVELOPED FOOD
PRACTICES TO MANAGE NON-FOOD
CHALLENGES, IN PARTICULAR, TIME
POVERTY AND LACK OF ACCESS TO
SOCIAL AND LEISURE ACTIVITIES IN
THEIR LOCAL COMMUNITIES.
SO BUYING SNACK FOODS, FAST
FOODS, FREEZER FOODS AND
ENERGY-DENSE FOODS HELPED
RESOLVE THESE CHALLENGES.
EVEN THOUGH PARENTS WERE VERY
AWARE THAT MANY OF THESE FOODS
WERE NOT IDEAL NUTRITIONALLY.
WHAT DOES THIS MEAN FOR
LEVERAGING FOOD ENVIRONMENT AND
FOOD SECURITY?
IT TELLS US WE NEED TO TAKE A
WHOSE SYSTEMS APPROACH IN
DEVELOPING OUR SOLUTIONS,
ALTERING WHAT IS AVAILABLE AND
ACCESSIBLE IN THE FOOD
ENVIRONMENT IS A FIRST AND VERY
CRUCIAL STEP, BUT WE COULD ALSO
THINK ABOUT LOOKING AT WHETHER
ENGAGING WITH THESE PARTS OF THE
FOOD ENVIRONMENT REALLY MAKE
SENSE IN THE CONTEXT OF PEOPLE'S
EVERYDAY LIVES.
AND LIVED EXPERIENCE RESEARCH
AND APPROACHES TO RESEARCH ARE A
GREAT TOOL TO BE ABLE TO DO THIS
KIND OF WORK, AND I'LL SHARE IN
THE CHAT A BRIEFING WE'VE
PRODUCED.
THANK YOU SO MUCH FOR LISTENING
AND FOR NIH FOR HAVING ME.
I'LL HAND OVER TO THE NEXT
SPEAKER.
>>THANK YOU VERY MUCH.
MUCH, CHARLOTTE.
NOW TO GIVE YOU AN AFRICAN
EXAMPLE, I'LL PRESENT TO YOU HOW
IMPLEMENTATION OF FOOD
ENVIRONMENTS RESEARCH IN
GHANA -- INFORMED ADVOCACY, BUT
ALSO DEMAND FOR FOOD-BASED
POLICY.
FOR THOSE OF YOU WHO ALREADY
KNOW ABOUT GHANA, IT IS A
RELATIVELY YOUNG COUNTRY
BATTLING MULTIPLE -- MONITORING
CURRENTLY AND LOCATED IN THE
WEST COAST OF AFRICA.
AND SO CURRENTLY, FOOD
INSECURITY IS A MAJOR PROBLEM IN
GHANA.
MALNUTRITION IS A PROBLEM BUT
ALSO CURRENTLY -- DEPICTED THE
TRAJECTORY OF OVERWEIGHT AND
OBESITY AMONG GHANA WOMEN,
SKYROCKETED TO 40% WHEN LAST WE
HAVE THE STUDY CONDUCTED IN
GHANA.
SO THIS IS A PROBLEM.
AS WE'RE ALSO CONCERNED AS
PUBLIC HEALTH PRACTITIONERS,
RESEARCHERS AND ADVOCATES.
SO WE WANTED TO CONTRIBUTE TO
ADDRESSING THIS PROBLEM THROUGH
DEVELOPMENT OF EFFECTIVE PUBLIC
POLICY MEASURES.
WE WERE SOON REMINDED OF THE
FACT THAT THERE WERE SEVERAL
LONG-STANDING CHALLENGES THAT
NEEDED TO BE ADDRESSED.
SO SUCH LONG-STANDING CHALLENGES
RELATED TO DATA -- POLICY FOCUS,
INERTIA, POLICY COHERENCE NEEDED
TO BE ADDRESSED.
SO AS IS OFTEN SAID IN GHANA, IF
YOU ATTEMPT TO DO -- SOMETHING
WRONG WHEN THE TIME IS WRONG.
WE HAD TO TAKE A STEP BACK AND
SPEND SOME TIME GENERATING
EVIDENCE, CURATED EVIDENCE AND
AVAILED TO RESEARCHERS, POLICY
MAKERS AND CIVIL SOCIETY
ORGANIZATIONS
THE EVIDENCE WE GENERATED, WE
SUBMITTED WIDELY THE EVIDENCE
WITHIN GHANA, BUT ALSO
INTERNATIONALLY AS WELL.
SOME OF THE IMPORTANT -- THAT
CAME FROM THIS WAS A SCORECARD
THAT WE GENERATED.
AS MOST SCORE CARDS DO, WE USED
THIS TO NAME AND SHAME, BUT ALSO
IN THIS CASE, WE USED THIS TO --
AND PRAISE.
SO WHERE GHANA WAS DOING WELL,
WE LET GOVERNMENT AND OTHER --
KNOW AND WHERE IT WASN'T DOING
WELL, WE LET THEM KNOW THERE WAS
A NEED TO INTRODUCE INTERVENTION
OR SKILL TOWARDS ADDRESSING
THESE MAJOR PROBLEMS.
ANOTHER INITIATIVE, WE AIMED TO
PROVIDE MEASUREMENTS,
EVALUATION, ACCOUNTABILITY AND
LEADERSHIP SUPPORT FOR THOSE IN
GHANA WHO WERE INTERESTED IN
ADDRESSING THESE PROBLEMS.
SO A SECOND OPPORTUNITY WERE
PROVIDED AS RESOURCES TO
GENERATE POLICY IMPACTING OR
POLICY INFLUENCING EVIDENCE.
EVIDENCE RELATED TO THAT WHICH
IS BEING ADVERTISED OR MARKETED
ON GHANAIAN TELEVISION, FOOD
ADVERTISING IN GHANA, AND THE
NUTRITION QUALITY OF THOSE
FOODS.
WE ALSO ASSESSED -- AND
THEREFORE CONSUMED IN GHANA AT
RETAIL OU OUTLEATHELET, POLICIED
PROGRAMS THAT SEEK TO -- IN
SCHOOLS.
WE PRODUCED OR BOUGHT SOME
TECHNICAL ACADEMIC AND COMPILED
THEM INTO WHAT YOU SEE HERE.
INSTEAD OF FOOD ENVIRONMENT IN
THE GREATER ACCRA REGION OF
GHANA.
ASSESSMENT AND RECOMMENDATIONS
TO VARIOUS STAKEHOLDERS.
BEYOND PRODUCING TECHNICAL
REPORT ACADEMIC -- AND
SUBMITTING THEM, WE ALSO USED
THOSE EVIDENCE TO ENGAGE
MULTIPLE STAKEHOLDERS.
AS YOU CAN SEE HERE, WE ENGAGE
DOCUMENT MINISTRIES -- WE ENGAGE
ACADEMICS FROM WITHIN GHANA,
AFRICA AND INTERNATIONALLY.
WE ALSO ENGAGED SOCIETY
ORGANIZATION AND UN AGENCIES AS
WELL.
THROUGH THIS ENGAGEMENT, THE
ENGAGEMENT FACILITATED COMMUNITY
UNDERSTANDING OF THE NEED FOR
POLICIES LIKE WHAT WE'RE TALKING
ABOUT TO BE IMPLEMENTED.
INDEED IT FACILITATES THAT WE
DEVELOP A SERIES OF POLICY
BRIEFS, AND THESE POLICY BRIEFS
ARE COMMUNICATED TO THE MINISTRY
OF HEALTH, AND WHERE I'M HAPPY
TO HAVE A VERY POSITIVE RESPONSE
FROM THE MINISTRY.
SO SOMETIME IN SEPTEMBER 2021,
THE MINISTRY CONVENED A
CONSULTIVE MEETING WITH KEY
STAKEHOLDERS IN GHANA TO AGREE
ON THE MODALITIES TO --
IMPLEMENT POLICIES THAT CAN
CONTRIBUTE TO IMPROVE THE
GHANAIAN FOOD ENVIRONMENT.
AND SO IN MARCH 2022, WITH
FUNDING FROM THE FOUNDATION, WE
GOT THE HD4HL PROJECT LAUNCHED
WHICH AIMS TO ENSURE THAT
GHANAIANS HAVE A HEALTHIER DIET.
AS WE KNOW, HAVING A HEALTHY
DIET WOULD LEAD TO HEALTHIER
LIVES.
THE HD4HL PROJECT TO DEVELOP A
FIT FOR -- SYSTEM AND THEN USE
THIS SYSTEM TO APPLY IN A NUMBER
OF FOOD BASED POLICYS THAT WE
HAVE REFERRED TO AS DOUBLE DD IN
THAT THOSE POLICIES HAVE THE
POTENTIAL TO ADDRESS -- FOR
YEARS BUT ALSO THE CURRENT RISE
IN OBESITY AND DISEASE.
SO BOTH -- AGAINST A POLICY
MESSAGE IN THE PACKAGE.
PUBLIC FOOD PROW KEURMT POLICIES
IS BEING CONSIDERED, FISCAL
POLICIES ARE INCLUDED, BUT ALSO
RESTRICTIONS.
IF THESE POLICIES -- THEY WOULD
CONTRIBUTE TO IMPROVING GHANAIAN
FOOD ENVIRONMENT, AND THUS HOW
FOOD -- INCREASED CONSUMPTION
WHICH DO HAVE SIGNIFICANT IMPACT
ON HEALTH AND NUTRITION
OUTCOMES.
BEYOND JUST TRANSLATING THE
RESEARCH THAT WE HAVE DONE AND
THEN HAVING THEM IMPLEMENTED
POLICIES TO BE IMPLEMENTED, WE
ARE INTERESTED IN SCALING AND
UNSCALING -- SO TO DO THESE, WE
CREATED A PLATFORM REFERRED TO
AS THE AFRICA FOOD ENVIRONMENT
RESEARCH NETWORK.
THE PLATFORM PROVIDES
OPPORTUNITY FOR FOOD ENVIRONMENT
PRACTITIONERS FROM WITHIN THE
REGION, AFRICAN REGION BUT ALSO
FROM WITHIN GLOBAL --
RESEARCH -- RELATED DIRECTLY OR
INDIRECTLY TO AFRICA KRNTING TOA
CONTRIBUTING TO THIS ENGAGEMENT.
CONVENED THE FIRST FOOD
ENVIRONMENT RESEARCH NETWORK
MEETING IN 2020.
THAT MEETING DELIBERATIONS LED
TO THE IDENTIFICATION OF
RESEARCH PRIORITIES THAT AFRICA
HAS COULD IMPLEMENT, AND ONCE
IMPLEMENTED, COULD CONTRIBUTE TO
IMPROVING FOOD ENVIRONMENT IN
THE REGION.
WE HAVE THE SECOND AFRICA FOOD
ENVIRONMENT RESEARCH MEETING IN
2021, AND SOMETIME IN 2023, WE
ARE PLANNING TO HAVE THE THIRD
MEETING.
SO THESE ARE SOME OF THE
APPROACHES AND INTERVENTIONS
THAT WE HAVE BEEN ABLE TO APPLY,
FOOD ENVIRONMENT RELATED
RESEARCH IN THEM.
THOSE WHO HAVE SUPPORTED THIS
FINANCIALLY TOWARD US
IMPLEMENTING THESE -- POLICY,
THE ROCKEFELLER FOUNDATION AS I
NOTED EARLIER, IDRC CANADA, THE
BILL AND MELINDA GATES ARE
PROVIDING INITIAL FUNDING FOR
STUDIES THAT HAVE BEEN PRESENTED
TODAY BUT ALSO IMPACTED THAT
WHICH WE ARE DOING TODAY.
AND CURRENTLY WE HAVE MINISTER
OF HEALTH MEETING THE --
PROJECT, GHANA IS KRBTDING TO
THIS, AND OTHER GOVERNMENTS AS
WELL AS CIVIL SOCIETY COALITION.
SO I WILL END HERE, AND HAND THE
FLOOR TO PROCEED.
THANK YOU.
>>WOW, THANK YOU SO VERY MUCH,
AMOS, SEFA, URI AND CHARLOTTE
FOR AN INCREDIBLY IMPACTFUL AND
COMPLEMENTARY SET OF SESSIONS
ILLUSTRATING CASE STUDIES FROM
DIFFERENT PART OF THE WORLD,
INCLUDING SUB-SAHARAN AFRICA,
LATIN AMERICAN AND CARIBBEAN
REGION AS WELL AS IN EUROPE
REPRESENTED BY THE U.K. IN THIS
INSTANCE.
I WANT TO THANK EACH AND ALL OF
YOU FOR STAYING ON TIME SO THAT
WE CAN NOW GET GOING WITH WHAT I
HOPE WILL BE A VERY EXCITING
PANEL DISCUSSION OR INTERACTION.
AND BEFORE I DO THAT, I WOULD
LIKE TO INTRODUCE TO
DISTINGUISHED PANELISTS THAT
WILL ALSO BE ASKED TO RESPOND TO
THESE PRESENTATIONS FROM THE
U.S. PERSPECTIVE, AND THESE ARE
DIANE HARRIS WHO IS A SENIOR
HEALTH SCIENTIST AND TEAM LEAD
WITH HEALTHY FOOD ENVIRONMENT
INITIATIVE AT THE CDC, AND ALSO
TANYA, PROGRAM DIRECTOR FROM THE
HEALTH BEHAVIOR RESEARCH BRANCH
AT THE NATIONAL CANCER
INSTITUTE.
AND WITHOUT ANY FURTHER ADO, YOU
ARE NOT GOING TO BE SURPRISED
THAT THE FIRST QUESTION IS IF
YOU CAN SHARE WITH THE AUDIENCE
BASED ON YOUR OWN PRESENTATIONS,
YOUR OWN EXPERIENCES, WHAT HAVE
YOU LEARNED FROM TODAY'S WEBINAR
IN TERMS OF LESSONS THAT CAN BE
SHARED ACROSS COUNTRIES, ACROSS
BORDERS, ACROSS WORLD REGIONS
WITH REGARDS TO WAYS TO IMPROVE
FOOD SYSTEMS IN -- ACROSS THE
DIFFERENT SETTINGS THAT YOU HAVE
ALL VERY NICELY ADDRESSED?
SO WHO WANTS TO GO FIRST?
>>I AM HAPPY TO START US OFF.
I THINK ONE COMMON THEME THAT WE
SEE ACROSS IS THIS QUALITATIVE
FORMATIVE ASPECT, AND THAT IS
GIVING THE VOICES TO THE
PARTICIPANTS THEMSELVES ABOUT
THEIR LIVED EXPERIENCES IN ORDER
TO IDENTIFY WHAT COULD BE LEVERS
OR INTERVENTIONS OR POLICIES AT
THE SYSTEMS LEVEL.
AND THE OTHER COMMON THEME THAT
I SEE IS ALMOST LIKE A PARADIGM
SHIFT ABOUT TAKING NUTRITION
OUTSIDE OF THE WORLD OF
NUTRITION AND RELATING TO WHAT
IS HAPPENING ELSEWHERE BEYOND
US, AND IT'S GOING TO TAKE THE
WORLD OF NUTRITIONISTS AND
PEOPLE WORKING WITH FOOD TO BE
ABLE TO CREATE THOSE BRIDGES AND
RELATE THEIR WORK TO OTHERS THAT
MAY NOT SEE THE LINKS SO
CLEARLY.
>>THANK YOU VERY MUCH FOR A
VERY THOUGHTFUL RESPONSE, URI.
AND IN THIS CONTEXT, I ANY TIME
WAKED TO ASK YOU, TANYA, IN
TERMS OF YOUR INSTITUTE IN THE
U.S., WHAT STRATEGIES ARE YOU
USING EVEN THAT YOU GIVE GRANTS,
YOU AWARD GRANTS TO COMMUNITY
BAITCOMMUNITY-BASED APPROACHES R
FOOD SECURITY AND SYSTEMS, WHAT
YOU HEAR TODAY RESONATES WITH
WHAT YOU WOULD CONSIDER
INNOVATIVE USEFUL APPROACHES FOR
THE U.S. TO ENHANCE THE FOOD
SYSTEMS?
>>SO THANKS SO MUCH TO SUSAN
FOR INVITING ME TO PARTICIPATE
IN THIS WEBINAR, AND I JUST WANT
TO SAY THAT ALL OF THE
PRESENTATIONS WERE OUTSTANDING.
SO I'D LIKE TO JUST GIVE A
PERSPECTIVE FROM NIH, SO JUST TO
MENTION THAT NIH IS VERY MUCH
INTERESTED AND THIS AREA OF
RESEARCH AND 2021, WE HELD A
WORKSHOP TITLED FOOD INSECURITY,
NEIGHBORHOOD FOOD ENVIRONMENT
AND NUTRITION HEALTH
DISPARITIES, THE STATE OF THE
SCIENCE, AND IT BROUGHT TOGETHER
A DIVERSE GROUP OF RESEARCHERS,
PRACTITIONERS AND POLICY MAKERS,
PEOPLE WHO HAVE EXPERTISE IN THE
SOCIAL AND BEHAVIORAL SCIENCES
AND WE ALSO HAVE FEDERAL
PARTNERS SUCH AS USDA AND CDC
THAT WERE INVOLVED IN THIS
WORKSHOP.
THE PURPOSE OF THE WORKSHOP WAS
TO EXAMINE THE STATE OF THE
SCIENCE AND KNOWLEDGE GAPS AS
RELATES TO THE FOOD ENVIRONMENT
>>Dr. Anderson: FOOD
INTO ADDRESS THE GAPS THAT ARE N
THE FIELD, AS WELL AS TO PROVIDE
EVIDENCE-BASED OR TO REVIEW
EVIDENCE-BASED LINKS AS IT
RELATES TO INTERVENTION AND
IMPLEMENTATION STRATEGIES.
TO IMPROVE THE FOOD ENVIRONMENT
AND TO UNDERSTAND AND ADDRESS
FOOD INSECURITY.
SO AS A RESULT OF THAT, THE
WORKSHOP AND THE RESEARCH GAPS
THAT WERE IDENTIFIED, WE AT NIH
DEVELOP A NOSI, A NOTICE OF
SPECIAL INTEREST, AND IT'S
TITLED STIMULATING RESEARCH TO
UNDERSTAND AND ADDRESS HUNGER,
FOOD AND NUTRITION INSECURITY SO
WE ARE ENCOURAGING RESEARCHERS
TO SUBMIT THEIR RESEARCH IF
THEY'RE INTERESTED IN FUNDING,
IF THEY FOCUS ON DEVELOPMENT AND
TESTING OF INNOVATIVE
INTERVENTIONS, NATURAL
EXPERIMENTS TO ADDRESS FOOD
INSECURITY AND NEIGHBORHOOD
LEVEL ACCESS AND AFFORDABILITY
OF HEALTHY FOODS TO UNDERSTAND
MECHANISMS AND PATHWAYS TWOOD
FOOD INSECURITIES AND
NEIGHBORHOOD FOOD ENVIRONMENTS,
CARDIOVASCULAR DISEASE, DIABETES
AND SOME TYPE OF CANCERS, AND TO
DEVELOP AND VALIDATE TOOLS TO
MEASURE NUTRITION AND FOOD
INSECURITY.
SO IF YOU'RE INTERESTED, I'M
SURE SUSAN CAN GET THAT
INFORMATION OUT TO EVERYONE, BUT
I JUST WANT TO HIGHLIGHT THIS
NOSI IS NOT-OD-22-135.
SO NIH IS VERY MUCH INTERESTED
IN THIS AREA OF RESEARCH AND WE
ENCOURAGE THOSE WHO ARE WORKING
IN THIS AREA TO APPLY FOR
FUNDING AND YOU WOULD SEE WHEN
YOU LOOK AT THIS NOSI THAT THERE
ARE MANY INSTITUTES AND ICs
AND OFFICES THAT ARE
PARTICIPATING, AND YOU CAN CALL
AND CONTACT THEM TO DISCUSS WITH
THEM YOUR RESEARCH AREAS.
AND WHAT YOU'RE INTERESTED IN
STUDYING.
>>THANK YOU SO VERY MUCH,
TANYA.
THIS IS A GREAT ANNOUNCEMENT,
THE ONE THAT WAS JUST MADE.
SO ONE FOLLOW-UP QUESTION, IS
THIS OPEN FOR FOREIGN COUNTRIES
AS WELL OR ONLY U.S. BASED?
>>IT OPEN TO FOREIGN COUNTRIES,
AND SUSAN'S OFFICE, FOGARTY, IS
ALSO A SPONSOR.
>>GREAT.
SO WHAT WOULD YOU APPLY FOR,
WHAT WOULD YOU PROPOSE BASED ON
THAT WONDERFUL RESEARCH THAT YOU
HAVE DONE TO FIGURE OUT
STRUCTURAL BARRIERS FACILITATORS
TO IMPROVE OR REALLY ALLOW FOR
PEOPLE TO ENJOY A HEALTHIER AND
EASIER TO ACCESS FOOD
ENVIRONMENTS?
WHAT WOULD YOU THINK CHARLOTTE
THAT WOULD ALLOY FOR AN
ATTRACTIVE SUBMISSION, WHAT TYPE
OF INTERVENTIONS WOULD YOU LIKE
TO PROPOSE OR SHARE WITH US?
>>WELL THE RESEARCH WE'RE
ACTUALLY PLANNING ON DOING NEXT
IS USING CO-CREATE METHODS, SO
THIS IS KIND OF AN ELEMENT OF
LIVED EXPERIENCE RESEARCH.
IT KIND OF WHAT YOU ALREADY
SPOKE ABOUT, WORKING WITH
COMMUNITIES THEMSELVES IN THE
DEVELOPMENT OF RESEARCH AND ALSO
IN THE DEVELOPMENT OF
INTERVENTIONS, AND YEAH, SO
THERE'S ONE LOCAL AREA YOU'RE
GOING TO BE FOCUSING ON IN
LONDON, AND THEY'RE ENGAGING
COMMUNITY MEMBERS IN A SERIES OF
CO-CREATE WORKSHOPS, LOOKING AT
THE ASSETS THAT LOCAL COMMUNITY
HAS AND HEALTHY EATING AND
HEALTH ASSET, AND LOCAL COUNCIL
WORKING WITH COMMUNITY MEMBERS
TO BUILD ON THESE ASSETS.
IN A VERY PARTICIPATORY
COLLABORATIVE WAY.
SO I'M REALLY INTERESTED IN
THOSE METHODS MOVING FORWARD.
AND THEN THE FOCUS OF THE
RESEARCH REALLY COMES FROM THE
COMMUNITIES THEMSELF, WHAT
INTERVENTIONS THEY SEE AS
IMPORTANT AND RELEVANT TO THEIR
EXPERIENCES.
>>WHICH REMINDS ME OF THE
WONDERFUL METHODOLOGY THAT URI
APPLIED IN WASHINGTON, D.C. TO
CO-CREATE THE WATER FILTER
INTERVENTION, WHICH I THINK IS
BRILLIANT.
SO CAN YOU TELL US A LITTLE BIT
MORE ABOUT THAT METHODOLOGY,
URI, HOW DOES IT WORK?
SEEMS LIKE A COMPLEX OF --
SYSTEMS KIND OF THINKING.
>>YES, THE LAST PAPER -- SORRY,
THE LAST STUDY IS USING
COMMUNITY PARTICIPATORY SYSTEMS
DYNAMIC MODELING BUT IT VERY --
IF YOU'RE FAMILIARIZED WITH
ALMOST FOCUS GROUP DISCUSSIONS,
IN DEPTH INTERVIEWS, IT WILL
SEEM VERY INTUITIVE TO YOU
BECAUSE IT IS BASICALLY
IDENTIFYING FROM DIFFERENT
SECTORS, IN OUR CASE WE WANTED
TO UNDERSTAND HOW TO BETTER
SUPPORT THE HOMES IN MAKING
EASIER DECISIONS.
KNOWING THAT POTENTIALLY TAP
WATER AND MISTRUST IN TAP WATER
WHICH GOES BEYOND THIS COMMUNITY
COULD HAVE BEEN A PROBLEM, HOW
DO WE BETTER ENTICE THEM OR
MOTIVATE THEM SINCE EVERYBODY
SEEMS TO HAVE THE EDUCATION
ASPECT OF UNDERSTANDING, EXCEPT
FOR THE JUICES, 100% JUICE WAS
CONFUSING WITH FRUIT FLAVORED
JUICE, ET CETERA.
BUT THAT'S ANOTHER TOPIC.
SO HERE WE USE THE FOCUS GROUP
DISCUSSIONS TO IDENTIFY WHAT
WERE THE SECTORS THAT THESE
FAMILIES TOUCH ON,
TRANSPORTATION, MUNICIPAL WATER
THAT THEY TALK ABOUT AND THAT
THEY INTERACT WITH.
AND THAT SUPPORT THESE HOMES IN
THESE COMMUNITIES WA AND WE INVD
FIVE DIFFERENT SECTORS INTO
THESE WORKSHOPS CALLED GROUP
MODEL BUILDING.
WE HAD TWO DIFFERENT WORKSHOPS,
SORRY, TWO-DAY WORKSHOP, RATHER.
IT A SERIES OF FACILITATED AND
GUIDED DISCUSSIONS WHERE
BASICALLY IT GIVES THE EXCUSE
FOR SECTORS TO BE ABLE TO SPEAK
TO EACH OTHER WHEN THEY
OTHERWISE MAYBE WOULD NOT HAVE
HAD THE EXCUSE TO COLLABORATE IN
THIS WAY FOR ACTIVE PROBLEM
SOLVING, ESPECIALLY IN THINKING
ABOUT NUTRITION OR SUGARY DRINK
INTAKE IN THIS PARTICULAR CASE,
AND SO YOU CAN IMAGINE WE HAD A
BIT OF RESISTANCE FROM SOME
INVITEES SAYING I DON'T WORK
WITH SUGARY DRINKS, I DON'T KNOW
WHY I'M BEING INVITED.
OR PEOPLE SAYING I DON'T WORK
WITH WA TE I DON'T KNOW WHY I'M
BEING INVITED.
SO THAT CONVERGENCE OF SECTORS
IS REALLY WHAT GROUP MODEL
BUILDING -- WHY IT'S SO RICH AND
WHY WE'RE ABLE TO COMBINE THEY
THEMSELVES WORK IN SMALL GROUPS
TO COME UP WITH THESE MODELS
THAT IDENTIFY FACTORS, THERE'S A
REFERENCE PROBLEM AND THEN THEY
SEE HOW THOSE FACTORS AFFECT
EACH OTHER OVER TIME.
WE CAN STILL UNPACK A WHOLE LOT
MORE, BUT THE FIRST WORKSHOPS
ARE FROM THEIR PERSPECTIVE.
I WANT TO EMPHASIZE THAT THIS IS
QUALITATIVE.
SO IT IS FROM THEIR PERSPECTIVE,
WHAT THEY CONSIDER IS IMPORTANT.
IF THAT CAN BE QUANTIFIED LATER
ON AND COULD BE USED AS MODEL
THAT CAN BE TIED, CALIBRATED
WITH QUANTITATIVE DATA AS WELL.
>>I THINK THAT BOTTOM LINE IS
THAT THIS METHODOLOGY LED TO A
HE DID SIGN OF A QUITE EFFECTIVE
INTERVENTION, WHICH I AT THE END
OF THE DAY, I THINK THAT
TRANSLATES VERY NICELY ACROSS
COUNTRIES, THAT BRINGS ALL GROUP
BASED MODELING, CBPR AND SO ON.
SO LET ME MOVE ON TO SEFA,
BEFORE WE CONCLUDE WITH A ROUND
ON THE BIG PICTURE TOPIC RELATED
TO WHAT DO ALL OF THESE MEANS
FOR COUNTRY LEVEL COMPREHENSIVE
POLICIES TO IMPROVE FOOD
SECURITY AND THAT PART OF THE
DISCUSSION, OF COURSE I WILL
START WITH AMOS AND DIANE, AS I
THINK THEY BOTH HAVE A LOT TO
SHARE WITH US.
SO S E SEFA, ESSENTIALLY THE
AUDIENCE WANTS TO KNOW THE DATA
HAS BEEN COLLECTED WITH ECHORN
VERY CLEAR FINDINGS YOU HAVE,
EVERYBODY UNDERSTANDS, SO WHAT'S
NEXT?
HOW HAS THAT DATA BEEN USED OR
WILL BE USED TO ACTUALLY
INFLUENCE FOOD POLICY, FOOD
SYSTEMS POLICIES IN THE
CARIBBEAN, AT LEAST IN THE
COUNTRIES WHERE ECHORN IS
WORKING RIGHT NOW?
>>THANK YOU, RAFAEL, FOR THE
QUESTION.
SO AS I MENTIONED EARLIER, ONE
OF THE THINGS THAT ECHORN IS NOW
DOING IS WORKING WITH THE
MINISTRY OF HEALTH IN BARBADOS,
THEY'RE INTERESTED IN LOOKING AT
OUR NUTRITION RELATED DATA TO
HELP INFORM THEIR NATIONAL
NUTRITION POLICY.
SO THIS IS A REALLY EXCITING
OPPORTUNITY TO PROVIDE
COUNTRY-LEVEL DATA TO THE
MINISTRY OF HEALTH IN BARBADOS
TO HELP INFORM THE POLICIES THAT
THEY WILL THEN PRODUCE.
I ALSO WANT TO HIGHLIGHT THE
WORK OF MANY LOCAL OR REGIONAL
ORGANIZATIONS IN THE CARIBBEAN
AS WELL.
THESE GROUPS ARE KIND OF ON THE
VANGUARD, ON THE LEADING EDGE OF
SOME OF THESE FOOD POLICIES, FOR
EXAMPLE, THE HEALTHY CARIBBEAN
COALITION, COMMUNITY AND COMMON
MARKET.
THE HEALTHY CARIBBEAN COALITION
IS WORKING ON A NUMBER OF LOCAL
FOOD ENVIRONMENT INITIATIVES
DESIGNED TO ADDRESS THINGS LIKE
CHILDHOOD OBESITY, FRONT OF
PACKAGE LABELING AND BACKYARD
GARDENING TO NAME JUST A FEW.
AND CARE COM IS WORKING ON
PROMOTING REGIONAL FOOD SECURITY
THROUGH LOCAL AGRICULTURE AND
SUSTAINABLE DEVELOPMENT
INITIATIVES AMONG MANY OTHERS.
SO I THINK OUR RESEARCH FINDINGS
CAN BE USED TO HELP INFORM THIS
WORK.
>>THANK YOU SO VERY MUCH, SEFA.
THIS IS A PERFECT SEGUE FOR THE
QUESTION THAT I HAVE FOR AMOS
AND DIANE.
SO AT THE END OF THE DAY, WE ALL
UNDERSTAND BASED ON THE
CONSENSUS DEFINITION OF FOOD
SECURITY AND NUTRITION SECURITY
AND SO ON THAT ADDRESSING IT
REQUIRES MULTICOMPONENT,
MULTILEVEL, MULTI-SECTORAL
INTERVENTIONS WITH STRONG
ENGAGEMENT FROM -- SOCIETY AND
INTERNATIONAL AGENCIES AND ON
AND ON, IT IS VERY IMPRESSIVE TO
THINK, ONE, WHAT AMOS PRESENTED
TO US AS TO HOW SYSTEMATIC, HOW
COMPREHENSIVE THE HEALTHY
FOOMEDZ POLICY FROM GHANA IS,
AND DIANE WHO KNOWS A LOT ABOUT
THE NEW WHITE HOUSE NATIONAL
STRATEGY ON NUTRITION, HUNGER
AND HEALTH AND THE DIFFERENT
PILLARS THAT IT HAS.
SO I WANTED TO ASK YOU, MAYBE
YOU CAN GO FIRST, AMOS AND DIANE
CAN FOLLOW ON YOUR RESPONSE AS
TO WHAT WERE THE KEY INGREDIENTS
TO ACTUALLY -- TO BEGIN WITH THE
STAKEHOLDERS TO AGREE TO TALK
WITH EACH OARL AND THEN FOR
ACTUALLY ENDING UP WITH A VERY,
VERY COMMON SENSE, AND WHAT IT
SEEMS TO BE COULD BE A VERY
IMPACTFUL APPROACH TO IMPROVING
FOOD AND NUTRITION SECURITY AND
FOOD SYSTEMS IN GHANA, FOR
EXAMPLE, ARE THERE ANY GAPS?
TODAY WE SAW THAT VERY --
BETWEEN WATERHOUSE HOLD SECURITY
AND HOUSEHOLD -- SECURITY IS
WATER PART OF EITHER THE
NATIONAL STRATEGIES INVOLVED IN
GHANA AND THE U.S.
AND IF NOT, WHAT CAN BE DONE TO
PUT IT INTO THE AGENDA, YOU
THINK IT DESERVES A PLACE.
SO THE FLOOR IS YOURS, AMOS, AND
THEN DIANE, PLEASE.
>>THANK YOU VERY MUCH, RAF.
AS TO WHAT IS IT WE HAVE
LEARNED, WHAT IS IT WE ALREADY
KNOW AND WHAT IS IT WE NEED TO
KNOW, AND, THEREFORE, DO, WE
HAVE OVER THE YEARS LEARNED A
LOT.
AND THAT WHICH WE HAVE LEARNED
BEEN WORK THAT RESEARCHERS HAVE
DONE BUT ALSO WORK THAT
PRACTITIONERS -- ARE DOING OR
ARE UNABLE TO DO.
THAT RESEARCHERS HAVE
IDENTIFIED.
SO TO BEGIN TO ANSWER THAT
QUESTION AS TO WHAT ARE THE GAPS
AND WHAT ARE THE PRIORITIES IN
SET AREAS IN COUNTRIES LIKE
U.S., GHANA, OTHERS NEED TO
ADDRESS, I THINK IT WOULD BE
IMPORTANT FOR US NOT TO JUST
FOCUS ON WHAT WE DO NOT KNOW, IT
IS IMPORTANT FOR US TO ALSO
SHARE WHAT WE ALREADY KNOW AND
AN IMPORTANT EXERCISE GIVEN
STAKEHOLDERS FROM ALL OVER THE
WORLD, AFRICA, LATIN AMERICA,
CARIBBEAN, U.S., EUROPE, TO
SHARE WHAT WE ALREADY KNOW AND
FROM SHARING, WE SHOULD BE ABLE
TO LEARN AND DO CROSS
FERTILIZATION.
BUT BEYOND WHAT WE KNOW, WHAT WE
NEED TO DO, THIS LEADS TO THE
QUESTION OF HOW DID WE GET TO
WHERE WE ARE NOW, FOR EXAMPLE,
IN GHANA.
THIS IS A VERY COMPLEX AND
SOMETIMES VERY EMOTIVE DEBATE.
FOOD SYSTEMS, FOOD ENVIRONMENT.
BECAUSE THEY ARE MUCH DIFFERENT
INTERESTS.
TO MAKE A HEADWAY, WHICH
REQUIRE -- MULTI-STAKEHOLDER
ENGAGEMENT, ENGAGEMENT DONE IN A
WAY THAT THE NEEDS OF THE TSH
ARE RECOGNIZED, SO IN OUR CASE,
IT WASN'T CONDUCTING RESEARCH
AND -- THE SAME RESEARCHERS WERE
ENGAGED IN POLICY MAKING,
ENGAGED IN PROGRAMS AND
PREVENTION, CIVIL SOCIETY
ORGANIZATION.
AS ARE NOTED, WE EVEN HAD U.N.
AGAINST US.
SO HAVING THAT COLLECTIVE OF
STAKEHOLDER WHO HAVE INTEREST IN
IMPROVING FOOD ENVIRONMENT AND,
THEREFORE, THEIR OWN HEALTH, IT
MADE THINGS A LITTLE EASIER.
THAT DOESN'T MEAN THERE HAVEN'T
BEEN CHALLENGES AND THOSE
CHALLENGES THAT HAVE BEEN
EXPERIENCED ELSEWHERE AS NOTED
FROM LATIN AMERICA, FROM EUROPE
AND AFRICA, WERE ALSO BUT I
THINK ONE -- IS IMPORTANT
ENGAGEMENT WITH MULTIPLE
STAKEHOLDERS, WHOSE VOICES OUGHT
TO BE HEARD, IRRESPECTIVE OF HOW
WEAK THEY ARE.
>>THANK YOU SO VERY MUCH, AMOS.
DIANE, THE FLOORT IS YOURS.
>>THANK YOU, DR. RAFAEL
ESCAMILLA.
THE PRESENTATIONS WERE WONDERFUL
AND MANY OF THE THEMES I'VE
HEARD WERE MUCH IN ALIGNMENT
WITH THE KIND OF WORK WE DO AT
CDC, AND WORK WITH STATES AND
COMMUNITIES IN THE U.S. IN ORDER
TO APPLY POLICY SYSTEMS AND
ENVIRONMENTAL CHANGE STRATEGIES
TO MAKE CHANGES IN FOOD
ENVIRONMENTS, AND REALLY
HONORING THE COMMUNITY'S INPUT
IN MOVING TOWARDS THESE CHANGES.
SPECIFICALLY, WE WANTED TO
HIGHLIGHT WHAT YOU MAY HAVE BEEN
HEARING ABOUT IN THE NEWS, THE
WHITE HOUSE CONFERENCE ON HUNGER
AND NUTRITION, AND THEN THE
SUBSEQUENT BIDEN HARRIS
ADMINISTRATION STRATEGY ON
HUNGER, NUTRITION AND HEALTH.
AS YOU MAY HAVE KNOWN EARLIER IN
2022, PRESIDENT BIDEN ANNOUNCED
HE WOULD POST THE FIRST WHITE
HOUSE CONFERENCE ON HUNGER,
NUTRITION AND HEALTH.
THE FIRST ONE THAT WAS HELD IN
OVER 50 YEARS.
THE FIRST ONE HAD LED TO MAJOR
POLICY CHANGE.
SOME OF THE NUTRITIONAL
ASSISTANCE PROGRAMS THAT WE KNOW
ARE EFFECTIVE AND WORK TO HELP
END -- OR TO REDUCE AND DECREASE
FOOD AND NUTRITION SECURITY IN
THE U.S.
SO IT WAS TIME TO HOLD ANOTHER
CONVENING AND THANKFULLY
PRESIDENT BIDEN STEPPED UP TO
PUT THIS TOGETHER.
THE PROCESS INCLUDED MANY
GOVERNMENT AGENCIES AND THERE'S
BEEN FEDERAL INTERAGENCY WORK
GROUPS THAT HAVE WORKED SINCE
THE SPRING AND THEY'VE HELD
LISTENING SESSIONS WITH FOLKS
FROM ALL DIFFERENT SECTORS,
INCLUDING PEOPLE THAT ARE IN THE
COMMUNITIES AND WHO HAVE THE
LIVED EXPERIENCES WITH HUNGER
AND LACK OF ACCESS TO FOODS.
SO THOSE WERE REALLY IMPORTANT
PROCESSES THAT HELPED IT FORM
THE ACTION PLAN THAT WAS THEN
DEVELOPED.
THERE WAS ALSO A PORTAL ON THE
WEBSITE WHERE ANYBODY FROM
ANYWHERE COULD SUBMIT THEIR
IDEAS AND RECOMMENDATIONS.
AND ALL OF THESE WERE INTEGRATED
THEN INTO THE ACTION PLAN WHICH
WAS RELEASED JUST BEFORE THE
CONFERENCE WHICH WAS HELD IN
SEPTEMBER.
CONCURRENTLY WITH THAT, THE CDC
FOUNDATION HAS BEEN WORKING WITH
THE WHITE HOUSE IN ORDER TO
ENCOURAGE COMMITMENTS FROM
DIFFERENT SECTORS, COMMITMENTS
THAT ARE WITHIN THEIR LANE IN
ORDER TO TACKLE HUNGER AND
REDUCE RELATED DISEASES AND
DISPARITIES.
AT THE LAST RELEASE, THOSE
COMMITMENTS ARE WORTH NOW
$8 BILLION OF INDUSTRY AND OTHER
COMMITMENTS IN ORDER TO TACKLE
HUNGER.
SO ULTIMATELY WITH ALL OF THIS
INPUT, THE NATIONAL STRATEGY ON
HUNGER, NUTRITION AND HEALTH WAS
RELEASED.
IT HAS FIVE PILLARS, IT'S
AVAILABLE ON THE WHITE HOUSE
SITE.
THE GOAL IS TO END HUNGER AND
INCREASE HEALTHY EATING AND
PHYSICAL ACTIVITY BY 2030.
SO FEWER AMERICANS EXPERIENCE
DIET-RELATED DISEASE WHILE
REDUCING RELATED HEALTH
DISPARITIES.
THE FIVE PILLARS ARE -- MANY OF
THE TYPES OF APPROACHES THAT
YOU'VE HEARD THROUGHOUT THIS
PRESENTATION TODAY.
SO THINGS LIKE IMPROVING FOOD
ACCESS AND AFFORDABILITY,
INTEGRATING NUTRITION AND
HEALTH, EMPOWERING ALL CONSUMERS
TO MAKE AND HAVE ACCESS TO
HEALTHY CHOICES, SUPPORTING
PHYSICAL ACTIVITY FOR ALL, AND
ENHANCING NUTRITION AND FOOD
SECURITY RESEARCH.
THE NATIONAL STRATEGY THEN IS
REALLY PROVIDING A ROAD MAP NOT
ONLY FOR AGENCIES ACROSS THE
FEDERAL GOVERNMENT TO WORK
TOGETHER AND TO CREATE NEW
OPPORTUNITIES IN ORDER -- AND
NEW PROGRAMS, NEW POLICIES IN
ORDER TO ADDRESS HUNGER, BUT
THERE'S ALSO A CALL TO ACTION,
AND LIKE I MENTIONED FOR THE
COMMITMENTS, FOR THE PRIVATE
SECTOR, FOR LOCAL, STATE,
TRIBAL, TERRITORY GOVERNMENTS,
PHILANTHROPY, CIVIL SOCIETY AND
OTHER PARTNERS TO ENGAGE IN THIS
WORK.
SO HOPEFULLY BY ALL OF US
WORKING TOGETHER, WE'LL CREATE
MORE OPPORTUNITIES TO ADDRESS
THE PERSISTENT HUNGER AND LACK
OF ACCESS TO FOOD WHICH IS STILL
INDEMIC IN THE UNITED STATES AS
IT IS IN OTHER COUNTRIES.
>>THANK YOU.
THIS IS FANTASTIC.
AS YOU CAN ALL IMAGINE WHAT
DIANA SHALL DESCRIBE THE
NATIONAL STRATEGY AND THE TEAM
IS DOING ACTUALLY FUNDING SOUND
RESEARCH AND EVALUATIONS THAT
ARE POLICY RELEVANT TO ACTUALLY
MOVE THIS TYPE OF POLITICAL WILL
INTO ACTUAL EFFECTIVE PROGRAMS
AND INTERVENTIONS IS IN MANY
WAYS A VERY POWERFUL WAY TO MOVE
FORWARD.
SO THANK YOU TO EACH AND ALL OF
YOU.
THANK YOU TO THE DISTINGUISHED
AUDIENCE.
I HOPE WE MET YOUR EXPECTATIONS.
WE COVERED FROM WORLD POLICIES
TO PROGRAMS ALL THE WAY TO
COMMUNITY ENGAGEMENT WORK.
SO THAT THE COMMUNITIES
THEMSELVES FROM NOW ON ARE A
VERY CENTRAL PART OF SHAPING UP
ANY ATTEMPTS TO IMPROVE THEIR
FOOD SYSTEMS THROUGH POLICIES
AND PROGRAMS WITHOUT LEAVING
ANYONE BEHIND.
THANK YOU SO MUCH.
IT BEEN A PLEASURE, AND I WANT
TO TURN THE WEBINAR BACK TO
SUSAN.
>>LET ME JUST ECHO RAFA'S
THANKS FOR THE SPEAKERS JOINING
US.
THIS WAS AN AMAZING DISCUSSION.
I THINK IT HIGHLIGHTS THE WORK
THAT'S TAKING PLACE AROUND THE
WORLD AND EMPHASIZES THE KIND OF
COMMON AREAS OF INTEREST AND
FOCUS, BUT WHILE ALSO
CONSIDERING THE SORT OF
INDIVIDUAL CONTEXT.
I THINK IF THIS SPARKS ANY
IDEAS, I URGE YOU TO LOOK AT THE
NOSI.
THIS REALLY HIGHLIGHTS THE
RELEVANT FUNDING OPPORTUNITIES
IN THIS AREA FROM 11 NIH ICOs.
SO JUST TO MENTION RECORDING OF
TODAY'S SESSION AND ALL THE
WEBINARS WILL BE POSTED AFTER
THE SERIES.
I HOPE YOU CAN JOIN US FOR OUR
THIRD AND FINAL WEBINAR.
THIS WILL TAKE PLACE ON MONDAY,
NOVEMBER 21ST, AT 3:00 P.M.
IT'S ON USING IMPLEMENTATION
SCIENCE TO ADDRESS FOOD AND
NUTRITION INSECURITY, LED BY DRE
UNIVERSITY OF SOUTH CAROLINA AND
THE SOCIETY FOR FOOD SCIENCE AND
IMPLEMENTATION.
IT WILL PROVIDE EXAMPLES OF
GLOBAL FOOD INSECURITY
INNOVATION THAT'S BEEN ADAPTED
ACROSS SETTINGS, AND I REALLY
HOPE THAT YOU'RE ABLE TO JOIN
US.
THANK YOU, EVERYONE.
>>THANK YOU, SUSAN.