Wicks Rosemary, Trevena Lyndal J, Quine Susan
School of Public Health, The University of Sydney, NSW Australia.
J Am Diet Assoc. 2006 Jun;106(6):921-4. doi: 10.1016/j.jada.2006.03.006.
Adequate nutrition is an essential determinant of health. Disadvantaged individuals within the cities of developed countries continue to have poor health, yet the role of food insecurity in such groups is poorly understood. This cross-sectional study describes such experiences among 22 randomly selected participants who participated in interviews at a charity-run soup kitchen in urban Sydney, Australia. Interviews explored four constructs of food insecurity (quantitative, qualitative, psychological, and social), identifying related barriers and coping strategies. Reliable access to food was limited. Low income; high rents; poor health; and addictions to cigarettes, alcohol, illicit drugs, and gambling were associated with dependence on charities. Poor dentition and lack of food storage and cooking facilities were important barriers to adequate nutrition. Meals were missed and quantities restricted as a coping strategy. Participants demonstrated adequate knowledge and a desire to eat healthful food. Opportunities for social interaction and trust in soup kitchen staff were important motivators of attendance. Strategies to reduce food insecurity among seriously disadvantaged city dwellers should focus less on education and more on practical solutions, such as accessing affordable healthful food for those without kitchen facilities, improving dentition, and reducing addictions. It is also important to facilitate social networks with trusted support organizations.
充足的营养是健康的重要决定因素。发达国家城市中的弱势群体健康状况仍然不佳，但粮食不安全在这类人群中的作用却鲜为人知。这项横断面研究描述了在澳大利亚悉尼市区一家慈善施粥所接受访谈的22名随机挑选参与者的此类经历。访谈探讨了粮食不安全的四个方面（数量、质量、心理和社会），确定了相关障碍和应对策略。可靠的食物获取途径有限。低收入、高租金、健康状况差以及对香烟、酒精、非法药物和赌博的成瘾与依赖慈善机构有关。牙齿不好以及缺乏食物储存和烹饪设施是获得充足营养的重要障碍。作为一种应对策略，有人会错过用餐，并且限制食量。参与者表现出对健康饮食有足够的认识和意愿。社交互动的机会以及对施粥所工作人员的信任是前来就餐的重要动力。减少严重弱势城市居民粮食不安全状况的策略应少侧重于教育，而多侧重于实际解决方案，例如为没有厨房设施的人提供价格合理的健康食品、改善牙齿状况以及减少成瘾行为。促进与可信赖支持组织建立社交网络也很重要。
