Cox Chesa, Hammoudeh Weeam, Lin Tracy Kuo
Institute of Global Health Sciences, University of California, San Francisco, 550 16th Street, Mission Hall, Box 1224, San Francisco, CA, 94158, USA.
Institute of Community and Public Health, Birzeit University, PO Box 14, Birzeit, West Bank, Palestine.
BMC Public Health. 2025 Aug 8;25(1):2707. doi: 10.1186/s12889-025-23962-z.
The prevalence of undernourishment is significantly higher in conflict-affected low- and middle-income countries (LMIC), compared to LMICs not experiencing conflict. Evidence suggests that in these settings households may adopt coping strategies such as consuming less nutritious food and thereby reducing food diversity to mitigate the impact of food insecurity. The long-term trend of food diversity in a protracted conflict setting has not been explored in detail due to challenges in collecting systematic and representative data in conflict-affected and fragile settings.
This study examined food diversity - measured using food consumption scores (FCS) - among Palestinians in the Gaza Strip and the West Bank, utilizing a serial cross-sectional design to analyze a systematically random sampled dataset that was collected by the Palestinian Central Bureau of Statistics - from 2014, 2016, 2018, and 2020. We analyzed the distribution of household location by survey year and used multivariate linear regression to evaluate factors associated with changes in food consumption score.
Mean household FCS climbed from 71·9 in 2014 to 93·6 in 2016 but slipped to 73·4 in 2018 and 71·2 in 2020, signifying an overall decline in dietary diversity. For the West Bank, household location to the barrier, head of household gender (female), living in a refugee camp, and households with middle- or lower-income levels were associated with a reduction in FCS. For the Gaza Strip, households that reported minor mobility restrictions and middle- or lower-income levels were associated with a reduction in FCS.
The findings elucidate the long-term impact of conflict on household food diversity, highlight a significant and worsening issue of food insecurity amongst Palestinians residing in the occupied Palestinian territory, and underline urgent need to address this critical issue and further protect vulnerable populations in conflict-affected regions.
与未经历冲突的低收入和中等收入国家（LMIC）相比，受冲突影响的低收入和中等收入国家的营养不良患病率显著更高。有证据表明，在这些情况下，家庭可能会采取应对策略，如食用营养较少的食物，从而减少食物多样性，以减轻粮食不安全的影响。由于在受冲突影响和脆弱的环境中收集系统和有代表性的数据存在挑战，长期冲突环境下食物多样性的长期趋势尚未得到详细探讨。
本研究利用食物消费得分（FCS）衡量巴勒斯坦加沙地带和西岸的食物多样性，采用系列横断面设计，分析巴勒斯坦中央统计局在2014年、2016年、2018年和2020年收集的系统随机抽样数据集。我们按调查年份分析了家庭位置分布，并使用多元线性回归来评估与食物消费得分变化相关的因素。
家庭平均FCS从2014年的71.9攀升至2016年的93.6，但在2018年降至73.4，2020年降至71.2，这表明饮食多样性总体下降。对于西岸，靠近隔离墙的家庭位置、户主性别（女性）、居住在难民营以及中低收入水平的家庭与FCS降低有关。对于加沙地带，报告有轻微行动限制和中低收入水平的家庭与FCS降低有关。
研究结果阐明了冲突对家庭食物多样性的长期影响，凸显了居住在巴勒斯坦被占领土的巴勒斯坦人粮食不安全这一重大且日益严重的问题，并强调迫切需要解决这一关键问题，进一步保护受冲突影响地区的弱势群体。
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