Predictors and Outcomes Associated with Household Hunger in Lusaka, Zambia: Secondary Analysis of a Citywide Survey

  • Dr. Ben Chi University of North Carolina,Chapel Hill, NC, USA
  • N M Fuseini University of North Carolina,Chapel Hill, NC, USA
  • H Halwiindi University of Zambia, Lusaka, Zambia
  • J Winston University of North Carolina,Chapel Hill, NC, USA
  • C D M Stoner University of North Carolina, Chapel Hill, NC, USA
  • S L Martin University of North Carolina, Chapel Hill, NC, USA
  • T Kusanthan University of Zambia, Lusaka, Zambia
  • R Banda Ministry of National Development Planning, Lusaka, Zambia
  • S Rathod 6London School of Hygiene and Tropical Medicine, London, UK
  • J S A Stringer University of North Carolina,Chapel Hill, NC, USA
Keywords: Household hunger scale, HHS, health outcomes, Zambia, sub-Saharan Africa, food insecurity

Abstract

Background: Food insecurity has important social and health consequences for affected individuals and households. We sought to measure one aspect of food insecurity—household hunger—and evaluated its possible association with household morbidity and mortality.

Methods: We analyzed data from the final two rounds of a repeat cross-sectional, population-based survey conducted in Lusaka Zambia (May and August 2011). Using the Household Hunger Scale, we categorized participating households into three groups using established convention in the public health literature: little to no hunger, moderate hunger, and severe hunger. We used multilevel logistic regression to investigate associations between household hunger and the following morbidities, adjusting for individual, household, and cluster characteristics: malaria, persistent cough, tuberculosis, diarrhea, hospitalization, and death.

Results: Overall, 90.0%, (95%CI: 88.1–91.7%) participating households were considered to have little to no household hunger; 9.8% (95%CI: 8.2–11.6%) reported moderate household hunger; and 0.2% (95%CI: 0.1–0.4%) reported severe household hunger. Marital status, functional status, education, employment, household member requiring nursing care, and household wealth index were associated with all levels of hunger. Adjusted for individual and household characteristics and sampling cluster, hunger was associated with malaria (OR:1.29, 95%CI:1.03–1.63 [mild] and OR:3.68, 95% CI:1.76 –13.74 [severe]), persistent cough   (OR:1.64,   95%CI:1.13–2.38 [mild]),

tuberculosis (OR:2.24, 95%CI:1.45–3.46 [mild], OR:6.06;   95%CI:1.56–23.57   [severe]), and

hospitalization (OR:1.95; 95%CI:1.38–2.76 [mild]; OR:5.52; 95%CI:1.78-17.16 [severe]).Household hunger was not associated with death (p>0.05).

Conclusions: Household hunger was associated with a number of adverse health outcomes. Although further studies are needed, our findings suggest that programs to alleviate household hunger—an important aspect of food insecurity—could lead to measurable public health impacts.

LIST OF ABBREVIATIONS

DHS Demographic and Health Survey

HFIAS Household Food Insecurity Access Scale HHS Household Hunger Scale

HOH Head of household

Downloads

Download data is not yet available.

Author Biographies

Dr. Ben Chi, University of North Carolina,Chapel Hill, NC, USA

School of Medicine, Gillings School of Global Public Health

N M Fuseini, University of North Carolina,Chapel Hill, NC, USA

School of Medicine

H Halwiindi, University of Zambia, Lusaka, Zambia

School of Public Health

J Winston, University of North Carolina,Chapel Hill, NC, USA

School of Medicine

C D M Stoner, University of North Carolina, Chapel Hill, NC, USA

Gillings School of Global Public Health

S L Martin, University of North Carolina, Chapel Hill, NC, USA

Gillings School of Global Public Health

T Kusanthan, University of Zambia, Lusaka, Zambia

School of Humanities and Social Sciences

J S A Stringer, University of North Carolina,Chapel Hill, NC, USA

School of Medicine, Gillings School of Global Public Health

Published
2018-11-21
Section
Articles