Malnutrition (Undernutrition) Among Poor and Vulnerable Populations

Food insecurity, or the inability to access sufficient, culturally appropriate food for adequate nutrition, is a major problem for the poorest segments of the world's population, the 1 billion or so people who live on less than two dollars per day (Food Security and Insecurity is more fully addressed in module 11). These poorest members of society often face chronic malnutrition, which some call undernutrition to distinguish it from nutrition diseases of overconsumption or poor food choices, which are considered malnutrition of a different type. Undernutrition is sometimes coupled with nutrition-related illnesses and long work hours in paid employment or smallholder agriculture on small and/or degraded land bases that often accompany poorer farms in rural areas. Undernutrition represents a failure of human societies and food systems to create access to a minimum standard of diet quality that can allow all human beings to live to their potential. In addition, the difficulty posed by undernutrition may fall disproportionately on the most vulnerable members of society: women, children, and the disabled and elderly. A particular burden is faced by caregivers of children (women, and increasingly grandparents) to both provide adequate care and feeding and take on the role of earning money to farm or buy food.

Organizations who work with these populations have worked to identify barriers to better care and feeding practices because it has been recognized that if the allocation of food within households is not equitable, simply increasing farm production or access to food can sometimes fail to increase consumption of healthy foods by vulnerable groups in households. Increasing the direct involvement and knowledge of parents and other caregivers in nutrition practices, and focusing attention on children under five years of age can help to improve nutrition outcomes and child growth in many poor households. These aspects of care, feeding, nutrition, and harmonization with local culture are important parts of food security referred to as the utilization component (this will be further addressed in module 11.2). As an example of the sort of trade-off that can occur between agricultural and nutrition goals in improving livelihoods, agricultural methods that are introduced to improve soil quality or increase agricultural income can be labor-intensive and must take care not to place undue additional time burdens on caregivers, who may then neglect the care and nutrition needs of children.

The challenges of chronic malnutrition are often linked in rural food producing households to small land bases and/or degraded soils, which is of concern to us because it is a highly problematic case that links human system factors in the form of poverty, and natural system factors in the form of the degradation of earth's ecosystems. As will be described further in module 10.2, the coupling of malnutrition and soil degradation can form a 'poverty trap' for rural households, where unproductive soils demand large amounts of labor for small yields, with limited alternative options for food production or employment because of inequality -- or lack of social sustainability -- in the local and global human system. In this way, degraded soils have particular bearing on malnutrition because of the additional work and expenditure of calories required to coax yields from degraded land, which both deepens issues of food deficit and malnutrition, and can translate to expansion of the land area under degrading practices, or contribute to continued production at the lowest level that soil will allow. These factors can trap households in poverty. Such a situation can also translate into the migration of a smallholder household in search of more lucrative activities, which often means a dramatic change in diet towards more urban and processed foods, even if it changes the overall income possibilities of a family and can be considered as an adaptive response to food shortage and vulnerability.