Women’s Risk of Food Insecurity

Women are at high risk of becoming food insecure. While emergency food relief assistance is available, an underlying clientele culture and stigma combined with entrenched societal power inequality and gender role identification create barriers for women to access safe and nutritious food. This commentary aims to discuss this issue and provide suggestions on what needs to be done to ensure that those at highest vulnerability are food secure. within the household or those they are caring for, placing themselves as risk of poor physical and mental health [3,5,7]. Food security is defined as ‘when all people at all times have physical and economic access to sufficient safe and nutritious food that meets individual dietary needs and food preferences for an active and healthy life’ [1]. Underpinned by four dimensions: food availability; food access; food utilization; and, the stability or vulnerability of the previous 3 pillars, food insecurity is a global problem and impacts vulnerable people, in particular women [1]. Power inequalities, such male control [5] and domestic or intimate partner violence [3] further exacerbate the risk of women becoming food insecure. These situations create an environment of economic and/or physical abuse, and instill gender role identification. For those that leave, homelessness, poverty and a reliance on relief assistance ensues [3,5]. Being food insecure not only means experiencing hunger or undernourishment, but exists on many levels from being mildly food insecure whereby there are difficulties in obtaining adequate nutrition food for oneself or family members to experiencing severe food insecurity [10]. Where Do Vulnerable Women Access Food? Initially women sacrifice their needs for others [3,5,7]; any food that is purchased has to be cheap and last until the next pay or income support is received. In many cases healthy food, although preferred, is not a feasible choice due to cost and product life [5]. When there are few choices for food access, emergency relief may seem the only solution. Emergency relief assistance is defined as “the provision of financial and material aid to people in immediate need, or a referral to link people with specialist community services” [11]. Food is a major component of emergency relief assistance and in this context is recognized as a mechanism to foster engagement and communication and is seen by some as a symbol of security and safety [12]. The emergency relief sector comprises a variety of levels. At the coalface there are numerous religious, community, government and welfare organizations that provide clients with a safe refuge, food and individualized services such as health appointments, job interviews, budgeting and cooking skills [12]. In Australia, many of these organizations receive donated food from local food businesses and food rescue organizations such as Food bank. Collectively, it is these organizations that are increasingly Context Women due to a range of socio-economic conditions, such as domestic violence, poor employment and education may be more vulnerable to insecurity in their daily lives [1-4]. In the United States (US), it has been noted that female-led households have a high prevalence of household insecurity, 30.2% compared to 11% in the general population [4], with often poor economic and social implications, for example, women are more likely to live in a food insecure household than men, with women who are alone or are single parents at a higher risk of food insecurity than married women [2,5]. Such women may be vulnerable to food insecurity, due to low income, lack of support and the drive to put their children and others before themselves [5-8]. Due to the fluidity of individual food security and the lack of academic reporting regarding women and food insecurity in Australia, it is difficult to ascertain the exact numbers of women experiencing food insecurity in Australia. However, other measures such as poverty, a strong predictor for food insecurity, can be used to indicate the extent of the problem. In 201112, approximately 14.7% of Australian women experienced poverty [9] and thus were at risk of or experienced food insecurity. In Australia 46% of the workforce is female, however their average weekly full-time wage is18.2% lower than for men and they are more likely to be employed in part-time positions [8], thus reducing their earning capacity and placing them at risk of poverty, a primary determinant of food insecurity [6]. Lower income means a reprioritization of funds, food is replaced by accommodation costs, utility bills and other urgent costs, such as medical expenses [5]. As primary caregivers and mothers, women reallocate what food and resources they have to ensure household members remain healthy and free of illness. By internalizing the care giving role, women sacrifice their own hunger and prioritize other members either

within the household or those they are caring for, placing themselves as risk of poor physical and mental health [3,5,7].
Food security is defined as 'when all people at all times have physical and economic access to sufficient safe and nutritious food that meets individual dietary needs and food preferences for an active and healthy life' [1]. Underpinned by four dimensions: food availability; food access; food utilization; and, the stability or vulnerability of the previous 3 pillars, food insecurity is a global problem and impacts vulnerable people, in particular women [1]. Power inequalities, such male control [5] and domestic or intimate partner violence [3] further exacerbate the risk of women becoming food insecure. These situations create an environment of economic and/or physical abuse, and instill gender role identification. For those that leave, homelessness, poverty and a reliance on relief assistance ensues [3,5]. Being food insecure not only means experiencing hunger or undernourishment, but exists on many levels from being mildly food insecure whereby there are difficulties in obtaining adequate nutrition food for oneself or family members to experiencing severe food insecurity [10].

Where Do Vulnerable Women Access Food?
Initially women sacrifice their needs for others [3,5,7]; any food that is purchased has to be cheap and last until the next pay or income support is received. In many cases healthy food, although preferred, is not a feasible choice due to cost and product life [5]. When there are few choices for food access, emergency relief may seem the only solution.
Emergency relief assistance is defined as "the provision of financial and material aid to people in immediate need, or a referral to link people with specialist community services" [11]. Food is a major component of emergency relief assistance and in this context is recognized as a mechanism to foster engagement and communication and is seen by some as a symbol of security and safety [12]. The emergency relief sector comprises a variety of levels. At the coalface there are numerous religious, community, government and welfare organizations that provide clients with a safe refuge, food and individualized services such as health appointments, job interviews, budgeting and cooking skills [12]. In Australia, many of these organizations receive donated food from local food businesses and food rescue organizations such as Food bank. Collectively, it is these organizations that are increasingly

Context
Women due to a range of socio-economic conditions, such as domestic violence, poor employment and education may be more vulnerable to insecurity in their daily lives [1][2][3][4]. In the United States (US), it has been noted that female-led households have a high prevalence of household insecurity, 30.2% compared to 11% in the general population [4], with often poor economic and social implications, for example, women are more likely to live in a food insecure household than men, with women who are alone or are single parents at a higher risk of food insecurity than married women [2,5]. Such women may be vulnerable to food insecurity, due to low income, lack of support and the drive to put their children and others before themselves [5][6][7][8]. Due to the fluidity of individual food security and the lack of academic reporting regarding women and food insecurity in Australia, it is difficult to ascertain the exact numbers of women experiencing food insecurity in Australia. However, other measures such as poverty, a strong predictor for food insecurity, can be used to indicate the extent of the problem. In 2011-12, approximately 14.7% of Australian women experienced poverty [9] and thus were at risk of or experienced food insecurity.
In Australia 46% of the workforce is female, however their average weekly full-time wage is18.2% lower than for men and they are more likely to be employed in part-time positions [8], thus reducing their earning capacity and placing them at risk of poverty, a primary determinant of food insecurity [6]. Lower income means a reprioritization of funds, food is replaced by accommodation costs, utility bills and other urgent costs, such as medical expenses [5]. As primary caregivers and mothers, women reallocate what food and resources they have to ensure household members remain healthy and free of illness. By internalizing the care giving role, women sacrifice their own hunger and prioritize other members either being relied upon to help address the problem of food insecurity at government, population and individual levels.
Despite this service provision, women appear to be reluctant attendees. Research reporting the use of emergency food relief assistance and centres by women specifically however is limited and suggests that there are real and perceived barriers to approaching such services, even with levels of food insecurity that is damaging to their health. In part this may relate to issues of shame, fear and sense of failure [5,7]. However, this reluctance may also be reflective of a protective mechanism to deal with the existing power and gender equalities and gender role identification that have existed for centuries. Preliminary findings from two studies conducted by the authors highlight the paradox between women's duty and their stance in society. Observational and interview data collected mid-2015 from food charities in an Australian capital city revealed that women comprised 20% of attendees. Most were single with only 1 woman, during the study being accompanied by children. In comparison, women comprised 65% of charity employees and volunteers, being involved in the process of meal creation and delivery to the predominately male clients. In a separate study, involving interviews with clients who access food charities for food and other services, only 1 of the 15 participants was female. The low numbers of women seeking help from these organizations do not reflect the reality of female food insecurity, rather we postulate that women are more reluctant to attend such venues, are fearful given their own circumstances and as a result their food insecurity is covert.

The Conundrum
Access to an adequate standard of living to maintain health and wellbeing and nutritionally adequate food is a basic human right [13]. Emergency food relief centres provide the opportunity for people who are unable through their own means to receive food and, in some cases, services to help improve an individual's current standard of living. While these services are available there is stigma attached -a stigma of standing in a line waiting for food or showing a card that signifies you can no longer provide food for yourself or family [5,7]. Attending an emergency food relief centre also brings the realization that the entitlement to food is lost and that freedom of choice no longer exists -not only in terms of the ability to choose preferred foods, but also the ability to ensure sufficient food and nutritious food [5]. Together these bring about a loss of dignity and a sense of shame -a sense of where you now belong in society [7]. So while the basic human right of having access to adequate and nutritious food is met, the right in terms of equal dignity for all is lost [13].
Social and economic circumstances make women vulnerable to food insecurity. We would argue that this is related to gender inequality, which at the most basic level of seeking food access is compounded by a vulnerability of simply by being female. There is a view expressed in Australia of being the "lucky country" yet we would argue that many women and their families are less lucky; they are hidden from mainstream society and are being further marginalized. Food, is a basic human right, yet societal circumstances continue to infringe on the ability of some women to exercise their right to food, resulting in this group being a covert group. Indeed, whilst unwitting it may be that the very agencies that set out to support may in effect compound the food insecurity, by not being seen as safe places.
The nature and complexity of food insecurity and the many issues that intersect, (not least poverty) with it do mean that the policy context is complex and far reaching. Access to food depends upon political and social systems that enable "entitlement" [14] to assist people who cannot meet their own needs. There are such systems in place but we would argue that food insecurity is of itself an issue that is interwoven across multiple issues. There is a need to undertake research around the discourse of food charity, which is usually framed by notions of food or financial crisis, however in line with other authors this commentary notes that the complexity of the wider experience and the gender imbalance in seeking help is not reflective of the current societal and policy need. We can learn from elsewhere, Community Food and Health Scotland [15] has long provided support for community initiatives and raised the profile of food insecurity [16], supporting the governmental policy response.
What needs to be done to ensure the food security of women: • National and State policy needs to incorporate and include recognition of the role of food security so that it has a greater reach across areas and sectors.
• Scaffolding structural issues such as benefit payments to increase food access.
• Engagement with women at risk to seek their views and ideas to better improve systems.
• Cultural change in current emergency food relief needs to be facilitated so that a 'women and child' friendly environment is achieved, if not possible, then create women specific emergency relief centres.
• Policy imperatives can be raised through advocacy of women's groups, especially those living in poverty, at risk of being homeless and those in refuges and by Non-government organizations, with the issues being highlighted through traditional and social mediums.
• Continued recognition of women at political policy and societal levels to remove the gender imbalance and eliminate the patriarchal dominance that continues to exist.
Non-government organizations seek and/or be provided with funding to creatively address the problem.