title: Predictors of chronic food insecurity among adolescents in Southwest Ethiopia: a longitudinal study.
abstract: BACKGROUND
  Evidence on the differential impacts of the global food crisis as it translates into chronic food insecurity locally is essential to design food security interventions targeting the most vulnerable population groups. There are no studies on the extent of chronic food insecurity or its predictors among adolescents in developing countries. In the context of increased food prices in Ethiopia, we hypothesized that adolescents in low income urban households are more likely to suffer from chronic food insecurity than those in the rural areas who may have direct access to agricultural products.
  
  
  METHODS
  This report is based on data from the first two rounds of the Jimma Longitudinal Family Survey of Youth (JLFSY). Both adolescents and households were selected using a stratified random sampling method. A total of 1911 adolescents aged 13-17 years were interviewed on their personal experiences of food insecurity both at baseline and at year two. Multivariable logistic regression analyses were used to compare chronic adolescent food insecurity by household income, household food insecurity, and socio-demographic variables after one year of follow-up.
  
  
  RESULTS
  Overall, 20.5% of adolescents were food insecure in the first round survey, while the proportion of adolescents with food insecurity increased to 48.4% one year later. During the one year follow up period, more than half (54.8%) of the youth encountered transient food insecurity - that is, either during the first or the second round survey. During the follow up period, 14.0% of adolescents had chronic food insecurity (i.e. were food insecure at both rounds). Multivariable logistic regression analysis showed that adolescents in the urban households with low (OR = 1.69, P = 0.008) and middle (OR = 1.80, P = 0.003) income tertiles were nearly twice as likely to suffer from chronic food insecurity compared with those in high income tertile, while this was not the case in rural and semi-urban households. Female sex of adolescents (P < 0.01), high dependency ratio (P < 0.05) and household food insecurity (P < 0.001) were independent predictors of chronic adolescent food insecurity in urban, semi-urban, and rural areas, while educational status of the adolescents was negatively associated with chronic food insecurity (OR = 0.047, P = 0.002) in urban areas.
  
  
  CONCLUSIONS
  In the context of increased food prices, household income is an independent predictor of chronic food insecurity only among adolescents in the low income, urban households. Female gender, educational status of primary or less and being a member of households with high dependency ratio were independent predictors of chronic food insecurity in urban, semi-urban, and rural areas. The fact that the prevalence of chronic food insecurity increased among adolescents who are members of chronically food insecure urban households as income tertiles decreased suggests that the resilience of buffering is eroded when purchasing power diminishes and food resources are dwindling. Food security interventions should target urban low income households to reduce the level of chronic food insecurity and its consequences.
authors.affiliation: Department of Population and Family Health, College of Public Health and Medical Sciences, Jimma University, PO.Box:1104, Jimma, Ethiopia. tefera_belachew@yahoo.com
authors.forename: Tefera
authors.initials: T
authors.lastname: Belachew
authors.forename: David
authors.initials: D
authors.lastname: Lindstrom
authors.forename: Abebe
authors.initials: A
authors.lastname: Gebremariam
authors.forename: Challi
authors.initials: C
authors.lastname: Jira
authors.forename: Megan Klein
authors.initials: MK
authors.lastname: Hattori
authors.forename: Carl
authors.initials: C
authors.lastname: Lachat
authors.forename: Lieven
authors.initials: L
authors.lastname: Huybregts
authors.forename: Patrick
authors.initials: P
authors.lastname: Kolsteren
mesh_terms: D000293:Adolescent; D005002:Ethiopia; D005260:Female; D005500:Follow-Up Studies; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011203:Poverty; D036301:Qualitative Research; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*