Fed up: a qualitative investigation on the influencing factors of food insecurity in the Azores

Abstract Background In 2019, over 1 billion people experienced food insecurity. In the Azores, a 9-island archipelago in the Atlantic Ocean, 13.4% of its population perceived food insecurity, the highest regional rate in Portugal (10.1%). These geographical limitations paired with high unemployment and low education rates, may challenge their access to nutritious food. It is still unclear how these (and other) contextual factors may affect access and availability to food in this remote area, and how they interact with individual determinants. Methods Data collection was conducted in early 2022 with 13, in-depth, 1:1 semi-structured interviews regarding topics of food consumption and supply in the Azores. Non-probability sampling was used, with use of purposive and snowball sampling. We included key-stakeholders currently living in the islands or working in a role related to the islands (i.e., in healthcare, supply chain, agriculture, etc.). We performed a thematic analysis with an inductive-deductive iterative analysis. Results Participants identified several challenges related to access and availability of food. Vegetables, fruit and fish can be scarce and are subject to seasonal variation. There are clear regional disparities in access to food, with more isolated islands having less variety, quality and quantity of healthy foods available. Its topography and weather limit agricultural practices and transportation, but education, culture, and policies subsidizing the production of meat and dairy were also identified as important barriers to local production of fruits and vegetables. Conclusions Food insecurity is a public health concern in this outermost EU region. If topography and geography limit the production and access of nutritious foods, economic and agricultural policies are a leading theme of concern to highlight. The solution for food insecurity thus demands an interdisciplinary dialogue to better adjust future policies in the Azores and in similar regions. Key messages Food insecurity is a public health issue in the Azores, a European outermost region. Access to nutritious foods is unstable due to contextual variables such as geography, weather and policy. A possible solution to address food insecurity in the Azores islands demands interdisciplinary dialogue to better adjust future policies in this region and within similar contexts.


Background:
Health inequalities partially remain due to differences in diet between socioeconomic groups.Examining the association between socio-ecological factors and the diet of socioeconomically disadvantaged (SED) individuals can enhance the development of interventions to decrease health inequalities.

Methods:
In total, 278 SED adults residing in two Flemish municipalities completed a survey addressing sociodemographics, diet, health and their perceptions of the food environment.The objective food environment was examined by assessing food retailer information in street network-based buffers of 500m and 1000m around participants' addresses.Linear regression was used to test assumptions.

Conclusions:
Our findings suggest that factors associated with the diet of SED adults differ according to food and drink items.Interventions focused on this population should take these differences into account.

Key messages:
Individual and food environmental factors are both associated with the diet of socioeconomically disadvantaged adults but differ according to food and drink items.Individual factors and perceptions of the food environment more likely associated with a healthy diet.Objective factors of the food environment were more likely associated with an unhealthy diet.

Background:
In 2019, over 1 billion people experienced food insecurity.In the Azores, a 9-island archipelago in the Atlantic Ocean, 13.4% of its population perceived food insecurity, the highest regional rate in Portugal (10.1%).These geographical limitations paired with high unemployment and low education rates, may challenge their access to nutritious food.It is still unclear how these (and other) contextual factors may affect access and availability to food in this remote area, and how they interact with individual determinants.

Methods:
Data collection was conducted in early 2022 with 13, in-depth, 1:1 semi-structured interviews regarding topics of food consumption and supply in the Azores.Non-probability sampling was used, with use of purposive and snowball sampling.We included key-stakeholders currently living in the

Background:
The relationships between social factors and dietary risk behaviour in older adults have not yet been thoroughly investigated.In this analysis, we aimed to develop a brief index of dietary risk behaviour and examine its associations with sociodemographic, socioeconomic, psychosocial, and behavioural factors.

Methods:
A community-based postal survey was conducted to collect cross-sectional data from German adults aged 65 and older (n = 1687; 33% response proportion; 52% female Conclusions:A better understanding of the relationships between social factors and dietary risk behaviour among older adults can assist in group-specific targeting of dietary-related interventions.Demand-oriented dietary interventions should address underlying social factors to reduce inequities in dietary risk behaviour among older adults.The results may be transferable to municipalities in high-income European countries. Results:Physical activity, female gender, education level, and social support were negatively associated with dietary risk behaviour, while alcohol consumption and smoking were positively associated (Adj.R2 = 0.16, p < 0.001).The brief DRB based on vegetables/fruit, whole grains, and dairy products has proven to be appropriate in analysing dietary behaviour among older adults.