The present study is part of a global call to address the growing challenges of food insecurity, known to impact both hunger and obesity [1]. Climate change has exacerbated food security challenges, and island nations, including the small island developing states (SIDS) are at high risk for continued impacts. island nations struggle As sea levels rise and the number and severity of natural disasters increases, to ensure the viability of local production and to minimize reliance on imports, which are largely processed foods [1, 3, 4].
Our findings indicate that the FIES is a reliable tool for use in the Bahamas and found that 21% of the population of Nassau was food insecure in 2017. More specifically, 11% was moderately food insecure and 10% was severely food insecure. For Saint Lucia, another Caribbean country, approximately the same percentage of the population (22.2%) experienced moderate or severe food insecurity in 2017, although fewer people (4.5%) experienced severe food insecurity. Information on the prevalence of food insecurity in other Caribbean countries is limited. However, people in The Bahamas experienced similar rates of moderate or severe food insecurity as the rest of the Americas (22.9%) in 2017, again with fewer people (6.2%) experiencing severe food insecurity [17]. Bahamian rates of severe food insecurity are generally lower in comparison with severe food insecurity rates in sub-Saharan Africa, as found in a recent study. However, Senegal, Mauritius, Mauritania all have similar rates of severe food insecurity (around 10%) [18]. In September 2019, Hurricane Dorian, one of the most intense tropical cyclones on record, made landfall on the Bahamas. While the data presented here pre-dates the storm, it is valuable as a pre-storm baseline upon which we can compare future rates.
There is substantial precedent for natural disasters to profoundly impact food security. In one study, the FAO found that across 140 disasters affecting at least 250,000 people, food supply losses after each disaster were equivalent to, on average, a 7 percent decrease of national per capita dietary energy supply [19]. Disasters cause unemployment, resulting in reductions of a households’ purchasing capacity while at the same time, food commodity availability becomes scarce leading to food inflation, and fewer resources, collectively increasing food insecurity, risk for malnutrition and hunger [19]. The World Food Program (WFP) stresses that four out of five people suffering from hunger live in areas that are particularly susceptible to disasters [20]. In developing countries, the agriculture sector on average absorbs a disproportionate 22 percent of total damage and loss from natural disasters [19].
Our analysis also included examining FIES item difficulty, which in this context is conceptualized as how difficult it is for a respondent to answer “yes” to each food insecurity question included in the standard tool. By learning which questions are more difficult, and by how much, these analyses also inform the manner in which a community or nation experiences food security, and enables comparisons across nations, and the globe. The Bahamian findings were unique in that early questions characterizing mild food security had a different order of difficulty than have been reported globally [21] (see Fig. 1). Globally, individuals more often report being WORRIED first, then eating FEWFOODS and then lack of HEALTHY foods. In contrast, individuals in the Bahamas do not report being WORRIED until after first reporting FEWFOODS and also reporting a lack of HEALTHY foods. It is not entirely clear the reason for this distinction in the Bahamas. However, it is possible that the strong religiosity of the nation and history of enduring difficult times, including experiences with storms, have led citizens to characterize worry differently, or later in the process, long after food becomes scarce. The presence of delayed worry suggests more qualitative research is needed to better understand the progressive experience of hunger across the globe, and the cultural meanings embedded in these experiences. Further, examination of how experiential responses differ before and after a disaster, may also inform our understanding of coping mechanisms.
The examination of the relationship between individual and household-level variables on food security revealed a protective effect for age (over 55 years) and for having completed some post-high school education or better. While it is not particularly surprising that having more education is associated with less food insecurity, the finding that older persons are less likely to experience food insecurity may run counter to that of other nations. For example, in Latin America and in the US, older individuals are often at higher risk [16, 22]. However, based on the knowledge of our Bahamian co-author, Bahamians have long held traditions to first feed the elders in the home, which may explain the effect. Data analysis also showed that households with higher rates of diet-related disease including diabetes, high blood pressure and heart disease are more likely to experience food insecurity. This finding is consistent with prior research from developed nations which has recognized the association between food insecurity diabetes and its risk factors as well as the compounded challenge in managing a chronic disease while experiencing food insecurity [23]. At the same time, interestingly, our analysis did not reveal an effect for obesity nor for cancer. It is possible that the effect which would have been captured by the obesity variable was overshadowed by that of the other diet related diseases, given their likelihood to co-exist.
Our research, from the data collection, to analysis and writing were completed as a collaborative led not by the nation’s government, but rather a partnership between a non-governmental institution, a for-profit market research firm and two academic institutions, one in the Bahamas, and one in the United States. Our collaborative approach represents a novel, interdisciplinary, and relatively low-cost mechanism to achieve answers in an environment where government staff and officials are often under-resourced and may also contribute to achievement of SDG 17 [24]. In areas that recognize the need for data about the problem of food insecurity, but where governmental resources are strained, such approaches may work to close important gaps in capacity, or related resources.
While offering novel insight into food insecurity in the Bahamas, this research is not without limitations. First, the Bahamas is an archipelago that lacks an easy mechanism to conduct data collection on all inhabited islands. Each island in the nation has unique characteristics and, likely, its own challenges including likely differences in food security, and perhaps the ways that food security is experienced. Without contacting residents from each island, we miss critical data. Our data were only collected in New Providence, home to 70% of the populous of the Bahamas, though in itself a unique island and is not necessarily characteristic of other islands. As such, our findings should not be attributed to other islands without great caution. Further, our results examining the relationship between household characteristics and food security outcomes, was limited by missing data, in particular high rates of missingness on questions about employment, housing, household income, household size, and household composition influence food insecurity. While it is unclear why so many individuals declined these questions, and not other, also relatively personal questions, it suggests that future research should review question wording and seek feedback prior to a second administration.
