Data collection on food security and nutrition has often received low priority, especially during a crisis. This is counterintuitive as poor diet and obesity are major risk factors for COVID-19 and key contributors to negative public health outcomes. We need more and better-connected data on food systems and health to combat this pandemic and strengthen the world.
The COVID-19 pandemic has been a shock to health systems, but it also affected many other systems: food, education, economics. Thinking about how these systems interact and how we measure their impacts through data is critical to ending the current pandemic, helping the vulnerable, and preparing for future crises. Dr. Jessica Fanzo, a Bloomberg Distinguished Professor at the Paul H. Nitze School of Advanced International Studies, the Berman Institute of Bioethics, and the Bloomberg School of Public Health, believes that our ability to collect, connect, and analyze data streams on food insecurity and nutrition are essential to establishing better global health, particularly during crises.
Not great. There is not much data on the impacts of the pandemic on food systems, food security, and nutrition, and it has to do with the way that data is collected. In times of crisis there's prioritization, and we have only prioritized collecting data on cases, hospitalizations, and deaths. In the food world we need data on real-time food insecurity, what kinds of foods are available in local areas and their affordability and how people’s diets are changing. Food security data is compiled every year with country-level data so there’s immense lag that lacks detail at a more localized level.
Just this past July, one year into the pandemic, the numbers of those who are food insecure were reported. Food insecurity has gone up significantly from 690 million to 811 million people. It is thought that the increase is due mainly to people's loss of income and employment than changes to the flow and trade of food and the overall food supply. The food supply has been surprisingly stable throughout the pandemic in that food has been moving and is available in most parts of the world, but food prices are increasing. This of course makes it very difficult for households that have lost jobs or wages during the pandemic to meet their dietary needs. The data on food security during the pandemic is very scant or of poor quality despite the severity of the situation. Much of the data to understand the severity of food insecurity that is being published is through phone survey methods, which is not necessarily a bad thing in times of a pandemic, but it has its limitations.
The Food and Agriculture Organization (FAO) is a United Nations organization that collects and reports on food insecurity data every year through what they call the food balance sheets. The food balance sheets look at the food supply — what's grown, imported, exported, and lost in a country — to calculate calories available per capita, and that's how the FAO determines the number of people who are hungry or undernourished.
The agency also utilizes the food insecurity experience scale, which is an experience-based measure made up of eight questions, like, “During the last 12 months, was there a time when, because of a lack of money or other resources, you were worried you would not have enough to eat, or did you skip a meal?” FAO produces those figures every year with data provided directly by countries. This year, 30% of the world is experiencing moderate or severe food insecurity.
There is a new indicator that FAO is collecting called “the cost of a healthy diet:” how many people can afford just enough calories versus a diet that meets their nutrient needs versus a diet that's health protective. It focuses more on issues of equity. They show that about 3.8 billion people cannot afford a healthy diet, whereas most of the world can afford just basic calories.
Suboptimal diets are one of the top risk factors of morbidity and mortality, more than air pollution and tobacco smoke. When you think about COVID-19, one of the most significant underlying determinants of COVID-19 hospitalizations is obesity. One of the top contributors to obesity is a poor diet, so we really need to understand how the food system is functioning to provide healthier diets. These dietary risk factors alone should be a call for the health community and health systems to think about diets and food as central to understanding disease and risk.
The other big issue is that we know that most of these pandemics are zoonotic diseases. Of emerging infectious diseases, about 70% are zoonotic. A lot of that has to do with food and agriculture: we are expanding into new landscapes that are often biodiverse, and are destroying or shrinking natural habitats to grow more food. This puts wildlife that live in these ecosystems into closer proximity to domestic animals and humans, increasing the risk of zoonotic spillover events. There's a real push to do better surveillance and tracking of those future pandemic risks around zoonotic diseases, and predictive modeling data on the food system is central to that conversation.
One of the complexities when you have a lot of data is connecting it. We’re not looking at the linkages between the data points. The other big issue is we don't have much disaggregated data to investigate potential equity issues. We may have urban vs rural, or income classification disaggregation, but we don't have data disaggregated by tribe, caste, disability, etc. We don't have detailed data to see who's really marginalized or vulnerable. The UN and their research partners should be the ones pushing for disaggregation, putting it out in the world, and ensuring that they have the highest quality data.
Data collection and surveillance becomes a very low priority when a country is experiencing conflict, a natural disaster, or a pandemic. Collecting data on agriculture yields is not a high priority although locating and identifying marginalized and vulnerable people becomes an even higher priority in these crises, especially with food assistance. For example, Afghanistan is not in a place at the moment to build strong food surveillance systems with their current crisis. This Is where UN agencies, like the World Food Programme and other NGOs and humanitarian organizations can collect real-time data to assist in ensuring that vulnerable populations are given the food assistance that they may need.
That said, Afghanistan has made strong commitments toward food security and improving nutrition through the Scaling Up Nutrition movement so there is momentum that will hopefully be sustained. Countries that are dealing with conflict struggle with data collection and surveillance for obvious reasons, but in these countries, food security data is often where it is most needed.