Using an intersectionality framework to assess gender inequities in food security: A case study from Uganda

• Published in: World medical and health policy 2024-09, Vol.16 (3), p.316-342
• Main Authors: Barak, Farzaneh, Musiimenta, Peace, Melgar‐Quiñonez, Hugo
• Format: Article
• Language: English
• Subjects: Adults; Case studies; Corruption; Disadvantaged; Employment; Food security; Gender differences; Gender inequality; Health disparities; Higher education; Households; Intersectionality; Marital status; Minority groups; Satisfaction; Social support
• ISSN: 1948-4682; 2153-2028; 1948-4682
• DOI: 10.1002/wmh3.602

Prior research in health equity, including food security, indicates that disadvantaged groups, such as women with limited resources, face many obstacles in achieving food security. One of the first of its kind to draw on intersectionality and the social determinants of health frameworks, this study identified and tested gender differences in experiencing food security inequities using nationally representative data from the Gallup World Poll, Uganda 2019 ( N = 951). Binary logit models disaggregated by gender were estimated to identify gender differences in food security. Three points of intersection were categorized: individual characteristics (gender, age, region, marital status, household number of children and adults); available resources (education, income, employment, shelter, social support); and the socio‐political context (community infrastructures, corruption within the business). Testing the moderation effect of gender with each variable (difference‐in‐difference) showed that although most variables correlated with a difference in experiencing food security by gender, only two—marital status, and social support—presented a statistically significant difference. Accounting for this moderation effect, the final model showed that lacking shelter and residing in Eastern Uganda decreased food security. More adults in the household, higher education, higher income, available social support, and satisfaction with community infrastructures enhanced the odds of food security. Results suggest that (a) conventional food security quantitative approaches may not suffice to model inequities when gender is a control variable rather than a foundation to explain inequities; and (b) gendered‐centered analysis helps better identify disadvantaged groups and inform policies that target associated inequities. 关于健康公平（包括粮食安全）的以往研究表明，资源有限的妇女等弱势群体在实现粮食安全方面面临许多障碍。作为有关交叉性和健康框架的社会决定因素的第一批研究，我们的研究利用2019年乌干达盖洛普世界民意调查(N = 951)的全国代表性数据，确定并检验了“经历粮食安全不平等”一事中的性别差异。对按性别分类的二元Logit模型进行估计，以确定粮食安全方面的性别差异。对三个交叉点进行了分类:个体特征（性别、年龄、地区、婚姻状况、家庭儿童和成人人数）；可用资源（教育、收入、就业、住房、社会支持）；以及社会‐政治情境（社区基础设施、企业内部的腐败）。通过检验性别对每个变量的调节效应（双重差分法）后发现，尽管大多数变量与不同性别的粮食安全体验差异相关，但只有婚姻状况和社会支持这两个变量呈现了统计学上的显著差异。考虑到这种调节效应，最终模型表明，“缺乏住所”和“居住在乌干达东部”降低了粮食安全的可能性。提高了粮食安全可能性的因素包括:家庭中更多的成年人、高等教育、更高的收入、可用的社会支持、以及对社区基础设施的满意度。结果表明，(a)当性别是一个控制变量而不是解释不平等的基础时，传统的粮食安全定量方法可能不足以模拟不平等；(b)以性别为中心的分析有助于更好地识别弱势群体并为针对相关不平等问题的政策提供信息。 Investigaciones anteriores sobre equidad en salud, incluida la seguridad alimentaria, indican que los grupos desfavor