A thesis submitted in partial fulfillment of the requirement for the degree of Master of Public Health from the Department of Global Health at the University of Washington in Seattle, Washington 2016.
Background: Food insecurity is associated with poor nutrition and growth, low educational attainment, and other negative outcomes that perpetuate poverty. Although significant progress to reduce food insecurity in Peru has been made in recent decades, 7.5% of the population still experiences food insecurity. While many food security interventions have been focused on rural areas, migration to Peru’s capital, Lima, has resulted in the dramatic growth of informal settlements. Little is known about food security in these areas and how food security relates to community characteristics.
Methods: This study was a food security assessment of 43 households in one informal settlement 30 km north of central Lima. We tested the hypothesis that residents with greater social capital, measured by trust, norms, and social networks, experience less severe food insecurity than those with lower social capital. We also examined the relationship between food insecurity and body size in mothers and their children 2-10 years old.
Results: Eighty-eight percent of households experienced some level of food insecurity and 35% were severely insecure. Structural social capital was significantly (p=0.03) associated with food insecurity, however, the directionality was the opposite as hypothesized; greater social capital was associated with greater food insecurity. We also found that 64% of mothers and 36% of children were overweight or obese. Food insecurity was not significantly associated with overweight or obesity in children (p=0.12) but there was a trend toward increased odds of overweight or obesity in children in households with greater food insecurity. Food insecurity was not a strong predictor of overweight and obesity in mothers, however, there was a significant association (p=0.05) between the length of time living in the community and the odds of overweight or obesity.
Discussion: Food insecurity is a significant issue in this community. The association between food insecurity and social capital may be a product of the survey tool; perhaps needier households have greater involvement in groups and seek help from individuals to address their needs. An alternative explanation is that households with greater social capital stretch their resources more thinly due to obligations to their social networks. While the association between food insecurity and overweight and obesity in this sample was weak, the association between overweight and obesity and length of time in the community may suggest that urban informal settlements are “obesogenic,” and lead to an increased risk of chronic disease. Food security and nutrition policy and programs that are community-driven and mobilize local assets, like income-generating projects and urban agriculture, are needed to address these complex issues.