Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries.

Seth A Berkowitz, Connor Drake, Elena Byhoff
Author Information
  1. Seth A Berkowitz: Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. ORCID
  2. Connor Drake: Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, NC, USA.
  3. Elena Byhoff: Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, USA.

Abstract

We sought to determine whether a country's social policy configuration-its welfare state regime-is associated with food insecurity risk. We conducted a cross-sectional study of 2017 U.N. Food and Agriculture Organization individual-level food insecurity survey data from 19 countries (the most recent data available prior to COVID-19). Countries were categorized into three welfare state regimes: liberal (e.g., the United States), corporatist (e.g., Germany), or social democratic (e.g., Norway). Food insecurity probability, calibrated to an international reference standard, was calculated using a Rasch model. We used linear regression to compare food insecurity probability across regime types, adjusting for per-capita gross domestic product, age, gender, education, and household composition. There were 19,008 participants. The mean food insecurity probability was 0.067 (SD: 0.217). In adjusted analyses and compared with liberal regimes, food insecurity probability was lower in corporatist (risk difference: -0.039, 95% CI -0.066 to -0.011, p  =  .006) and social democratic regimes (risk difference: -0.037, 95% CI -0.062 to -0.012, p  =  .004). Social policy configuration is strongly associated with food insecurity risk. Social policy changes may help lower food insecurity risk in countries with high risk.

Keywords

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Grants

  1. K23 MD015267/NIMHD NIH HHS

MeSH Term

Humans
United States
Cross-Sectional Studies
Public Policy
Norway
Surveys and Questionnaires
Food Insecurity

Word Cloud

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