RESUMEN
Rising temperatures are expected to stall progress on food insecurity by reducing agricultural yields in the coming decades. But hot periods may also increase food insecurity within days when it gets too hot to work and earn an income, thus limiting households' capability to purchase food. Here I exploit variations in heat levels during a household survey spanning 150 countries in a quasi-natural experiment to show that particularly hot weeks are associated with higher chances of food insecurity among households (0.5767, 95% confidence interval 0.2958-0.8576, t = 4.024, d.f. = 427,816, P < 0.001). This association is mediated by reductions in income and health for households and the effects are stronger in countries with lower incomes and more agricultural or precarious forms of employment. The results highlight the importance of labour market disruptions for food insecurity and suggest integration of these concerns into heat action plans and food programmes.
Asunto(s)
Calor , Pobreza , Humanos , Composición Familiar , Abastecimiento de Alimentos , Inseguridad AlimentariaRESUMEN
There is low civil society mobilization for NCD policies in low- and middle-income countries (LMICs) despite a growing NCD burden. While existing research explains low mobilization largely through constraints such as inadequate funding and capacity at the organizational level, we explore the issue from the perspective of people living with NCDs and ask how lay understandings of hypertension may inform potential mobilization for multisectoral policy actions by people living with hypertension. To explore this question, we develop a theoretical framework that casts mobilization as a function of people's recognition of disease importance, attribution of NCD risk factors to government policies, beliefs about who bears responsibility for NCD prevention and management, and beliefs around efficacy of multisectoral policies. We present findings from 45 semi-structured interviews with people living with hypertension in a qualitative study in Chennai, India. Our thematic analysis reveals that respondents can dedicate limited time and resources to actions around hypertension. People living with hypertension also strongly internalize responsibility for developing and managing their condition and focus primarily on achieving lifestyle changes. Instead of demanding multisectoral policy action around hypertension, respondents recommend that government actions focus on measures that enable their lifestyle changes, such as increasing awareness and health care capacities, and express doubts about the efficacy of government policies. Our findings expand existing theories around mobilization by revealing how people's own understanding of their illness, its risk factors and their underlying drivers, as well as their perception of challenges in NCD policy making can present barriers to mobilization around multisectoral policies. Theory on health social movements would benefit from a deeper integration of individual perspectives and a closer consideration of the specific challenges of living with NCDs given the local context.