1Department of Health Policy and Management,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
2Center for a Livable Future,Johns Hopkins Bloomberg School of Public Health,615 N. Wolfe Street,W7010,Baltimore,MD 21205,USA.
Public Health Nutr. 2018 Jul;21(10):1961-1970. doi: 10.1017/S1368980018000198. Epub 2018 Feb 20.
OBJECTIVE: Food insecurity is associated with toxic stress and adverse long-term physical and mental health outcomes. It can be experienced chronically and also triggered or exacerbated by natural and human-made hazards that destabilize the food system. The Baltimore Food System Resilience Advisory Report was created to strengthen the resilience of the city's food system and improve short- and long-term food security. Recognizing food insecurity as a form of trauma, the report was developed using the principles of trauma-informed social policy. In the present paper, we examine how the report applied trauma-informed principles to policy development, discuss the challenges and benefits of using a trauma-informed approach, and provide recommendations for others seeking to create trauma-informed food policy. DESIGN: Report recommendations were developed based on: semi-structured interviews with food system stakeholders; input from community members at outreach events; a literature review; Geographic Information System mapping; and other analyses. The present paper explores findings from the stakeholder interviews. SETTING: Baltimore, Maryland, USA. SUBJECTS: Baltimore food system stakeholders stratified by two informant categories: organizations focused on promoting food access (n 13) and community leaders (n 12). RESULTS: Stakeholder interviews informed the recommendations included in the report and supported the idea that chronic and acute food insecurity are experienced as trauma in the Baltimore community. CONCLUSIONS: Applying a trauma-informed approach to the development of the Baltimore Food System Resilience Advisory Report contributed to policy recommendations that were community-informed and designed to lessen the traumatic impact of food insecurity.
目的:食物不安全与毒性应激以及负面的长期身心健康结果有关。它可以长期经历,也可以由破坏食物系统稳定的自然和人为灾害引发或加剧。巴尔的摩食物系统弹性咨询报告的创建是为了增强城市食物系统的弹性,并改善短期和长期的食物安全。该报告认识到食物不安全是一种创伤形式,因此是按照创伤知情型社会政策的原则制定的。在本文中,我们研究了报告如何将创伤知情原则应用于政策制定,讨论了采用创伤知情方法的挑战和益处,并为其他寻求制定创伤知情型食物政策的人提供了建议。
设计:根据以下内容制定了报告建议:与食物系统利益攸关方的半结构化访谈;外联活动中社区成员的意见;文献综述;地理信息系统制图;以及其他分析。本文探讨了利益攸关方访谈的结果。
地点:美国马里兰州巴尔的摩市。
对象:巴尔的摩食物系统利益攸关方,分为两类信息提供者:专注于促进食物获取的组织(13 个)和社区领袖(12 个)。
结果:利益攸关方访谈为报告中的建议提供了信息,并支持了巴尔的摩社区中慢性和急性食物不安全被视为创伤的观点。
结论:将创伤知情方法应用于巴尔的摩食物系统弹性咨询报告的制定有助于提出社区知情的政策建议,并旨在减轻食物不安全的创伤性影响。
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