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Open research questions in Food Security and Health in Diverse Populations

121 unresolved questions extracted from the limitations and future-work sections of 2,370 Food Security and Health in Diverse Populations papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Abstract Introduction Health systems are partnering with social service organizations (SSOs) to establish health-related social needs (HRSN) programs, yet best practices have not been established.

    Health system-community partnerships in a Medicaid nutrition and housing program, 2020-2023: a mixed-methods evaluation · 2026 · DOI

  • Abstract Introduction There are still some gaps in the knowledge about food insecurity (FI) as a determinant of quality of life (QoL); for example, it is not known whether there is a dose‒response relationship, whether these associations occur longitudinally, and how they behave in a population where the target audience is not composed of people affected by health problems.

    Association between household food insecurity and quality of life: a longitudinal study in Northeast Brazil, 2014–2019 · 2026 · DOI

  • While the predictive abilities of our models were modest based on the inclusion of only a few non-modifiable sociodemographic features, it is plausible that we could potentially 14 medRxiv preprint doi: https://doi.org/10.64898/2026.06.23.26356305 ; this version posted June 26, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . further improve the performance of our models by including features from the broader environments where patients live and work (i.e., contextual SDOH). Our ongoing efforts aim to explore the inclusion of hundreds of these contextual SDOH using environmental, built, and social exposomic variables, employing techniques that would help us overcome some of the limitations of feature selection in the current and prior studies [46, 47]. These future approaches should provide a more comprehensive assessment than models based on a limited set of non-modifiable features. A critical next step will be external validation using data from an independent healthcare system, such as Heart of Ohio Family Health, which operates six Federally Qualified Health Centers based in Franklin County, Ohio. This would allow us to assess model transportability and recalibrate performance prior to broader deployment.

    Leveraging Machine Learning Approaches to Identify Health-Related Social Needs Screening from Electronic Health Records · 2026 · DOI

  • Similarly, if SNAP benefits reduce labor supply – but importantly, there are mixed findings on the labor supply effect of SNAP – this will reduce earnings and can potentially reduce the amount of EITC refunds received in the following calendar year (when they file taxes for the current tax year), depending on the family’s earn- ings level.

    Do Larger Earned Income Tax Credit and Supplemental Nutrition Assistance Program Benefits Create Complementary Effects on Child Development? · 2026 · DOI

  • In this study, we characterized the broader environmental context for family-based childcare (FCC) homes in Chicago, Illinois, to identify gaps in knowledge and directions for future work.

    Family-Based Childcare in Chicago: Opportunities to Advance Environmental and Social Justice for Children. · 2026 · DOI

  • Although this study provides important insights into the determinants of food insecurity in Somalia, several limitations should be acknowledged. First, the exclusion of conflict-affected populations may have introduced selection bias. Second, the cross- sectional design limited causal inference between key variables and food insecurity. Third, spatial displacement of survey cluster locations may have caused geographic misclassification, particularly in nomadic areas. Fourth, a key limitation of this study is that the analysis is based on 2018/2019 survey data, which do not capture the effects of more recent shocks, including the severe 2022–2023 drought and the 2024 floods that substantially affected food security conditions in Somalia. Consequently, the findings may not fully reflect the current magnitude and dynamics of food insecurity in the country. Finally, reliance on self-reported data may have introduced reporting bias and underestimated food deprivation. households are more vulnerable to food insecurity, suggesting the need to strengthen and scale up social protection programs that prioritize households with higher dependency ratios. The protective effect of education and school attendance highlights the importance of investing in human capital through expanded access to education, school feeding initiatives, and complementary household support programs to enhance long-term resilience. Livelihood-related assets also play a critical role in food security outcomes. Households without livestock and those experiencing livestock losses are significantly more vulnerable, underscoring the need for livestock protection strategies, including drought preparedness interventions, and timely restocking programs following shocks. Similarly, improving access to financial services and strengthening livelihood diversification opportunities can help reduce household vulnerability. At the community level, substantial wealth disparities, limited access to electricity, and marked regional differences, particularly the higher vulnerability observed in Central and Southern Somalia, highlight the importance of geographically targeted interventions. Policy efforts should prioritize investment in rural infrastructure, energy access, market integration, and financial inclusion. Strengthening these structural determinants, while tailoring interventions to the dominant pastoral and agro-pastoral livelihood systems, is essential for sustainably reducing food insecurity across Somalia.

    Multidimensional determinants of food insecurity among households in Somalia: evidence from the 2018/2019 Somalia health and demographic survey · 2026 · DOI

  • This project focused on the experiences of community and health system decision makers, and clinicians, and does not represent the views of individuals with lived experience with food insecurity or DRM. Future work will follow- up on selected research questions, using participatory approaches which actively engage individuals with lived experience in ways that are respectful and collaborative. Although we encour- aged participants to focus on the ‘disease- related’ aspect of malnutrition, participants may have been discussing malnu- trition more broadly. Although participants acknowledged the need to focus on Indigenous communities, collaborative and Indigenous- led efforts are needed to further explore this topic. Our participants had varied roles, and each brought diverse experiences; however, given the vast geographic and socioeconomic range of the population, our sample is rela- tively small for mapping this topic widely. CONCLUSIONS The nuanced relationship between food insecurity and DRM is deeply intertwined through shared structural inequities. To effectively address these dual challenges, health systems must move beyond traditional food charity toward integrated, ethical screening processes that link patients to sustainable supports. Systemic change, driven by cross- sectoral research, targeted education, and policy intervention, is essential to mitigate the health risks associated with both food insecurity and DRM.

    <i>“We treat the symptom, not the system”:</i> a qualitative study exploring connections between food insecurity and disease-related malnutrition in Canada · 2026 · DOI

  • The heterogeneity of research designs among literature included in this study presents a significant limitation. Studies were quasi-experimental, longitudinal, retrospective, or cross-sectional in nature, making direct comparison challenging. Furthermore, some studies analyzed state-level data while others utilized nationwide data, introducing pos- sible geographic variations in findings. This variation may introduce reporting bias, as some WIC impacts may be pronounced, reduced, or absent in certain regions due to demographic variability or differences in program implementation. Pertaining to bias, multiple factors led to an increased ROB in the studies incorporated into the review as illustrated in Appendix II. The predominant factors of increased ROB were confounding (Domain 1) and bias arising from measurement of outcomes (Domain 6). Confounding bias persisted despite adjustments for maternal characteristics, including age and parity, since several critical behavioral and social variables could not be entirely accounted for. Owing to this, the confounding domain was rated moderate in several stud- ies. Measurement-related bias also led to an elevated ROB due to the predominant use of administrative and birth certificate data, which solely indicate the occurrence of WIC enrollment without detailing the extent of benefit utilization, and other variables. Notwith- standing these limitations, the ROB analysis is also a strength of this review. The majority of studies were rated as having a low overall ROB, with no domains attaining serious or Awosan et al. Discover Public Health (2026) 23:768 Page 11 of 24 critical levels. This suggests that although some uncertainty persists, particularly in areas with residual confounding or limits in outcome assessment, the overall evidence base is relatively strong. The uniformity of results among low risk of bias studies enhances the assurance that the beneficial correlations identified between WIC participation and gesta- tional or child health outcomes are unlikely to be attributed to bias. 6 Gaps addressed by the current review This review enhances the existing literature by synthesizing recent outcome fields and conducting more in-depth analyses of domains that were either left out or insufficiently explored in previous systemic reviews. Previous reviews primarily focused on neonatal and child health outcomes, specifically acknowledging the dearth of evidence regarding maternal health outcomes, including gestational health complications. Conversely, this review offers a more comprehensive synthesis of maternal health outcomes, present- ing evidence on GWG, GDM, preeclampsia, gestational hypertension, labor difficulties, and emerging evidence in maternal mental health. It also extends existing findings on birth outcomes by incorporating evidence on lower gestational age, reductions in pre- term birth, and reduced stillbirths among Black women. Although maternal mortality remains unaddressed, the inclusion of these outcomes directly improves an area previ- ously recognized as a significant gap. For neonates, the review presents evidence on lower rates of low Apgar scores and limited evidence of reduced perinatal death. Additionally, it introduces quantitative and economic estimates demonstrating the financial value of WIC participation through improved birth outcomes. Beyond birth, this review strengthens the evidence on infant outcomes, including reduced infant mortality and NICU utilization, healthcare utiliza- tion, such as increased engagement with pediatric and emergency care services, and neurodevelopmental outcomes, particularly communicative and adaptive functioning. Finally, this review offers a detailed analysis of racial disparities, emphasizing the varied benefits of WIC participation across different communities and reinforcing its signifi- cance in mitigating systemic inequalities.

    Effect of WIC participation on gestational and childhood health · 2026 · DOI

  • Future Work Future work will focus on incorporating real-time satellite imagery, IoT sensor data, and social media sentiment analysis to further strengthen prediction accuracy. Future work will focus on: 1) Integrating deep learning and advanced time-series fore- casting models to enhance prediction accuracy and cap- ture seasonal variations in crop yield and climate patterns.

    Identifying Risk Factors and Predicting Food Security Status Using Supervised Machine Learning Algorithms · 2026 · DOI

  • Abstract This article aims to provide a comprehensive understanding of the main drivers of food insecurity in five understudied Arab countries in the Middle East and North Africa (MENA) region (Egypt, Tunisia, Jordan, Sudan, and Morocco) during the COVID‐19 pandemic.

    Key lessons learned from food insecurity during the COVID‐19 pandemic in Arab countries · 2025 · DOI

  • It challenges the narrative that caring about food safety is limited to affluent consumers, instead highlighting the structural constraints that prevent people in urban poverty from acting upon food safety concerns, including (1) power imbalances within food charities and (2) lack of overall food security.

    Eating at the Margins: Negotiating Food Safety and Food Security in Ho Chi Minh City’s Charities · 2024 · DOI

  • Although Australia has been measuring FI for 40 years, it has been characterised by measurement inconsistency, inadequacy and infrequency, resulting in insufficient data for policymaking.

    Nationally representative estimates of food insecurity during COVID‐19: An investigation of the Food Insecurity Experience Scale in Australia · 2024 · DOI

  • BackgroundSocial determinants of health (SDHs) are the primary drivers of preventable health inequities, and the associations between SDHs and health outcomes among individuals with type 2 diabetes remain unclear.

    Associations of social determinants of health with life expectancy and future health risks among individuals with type 2 diabetes: two nationwide cohort studies in the UK and USA · 2024 · DOI

  • Mobile food pantries (MFP) generally have been effective in addressing food insecurity, but few studies have investigated their use to alleviate food insecurity among college students.

    Using a Mobile Food Pantry to Address the Food Insecurity Needs of College Students · 2023 · DOI

  • Future research should focus more frequently on IPV perpetration as opposed to victimization, and further examine the moderating and mediating mechanisms that inform the link between IPV and food insecurity.

    The Link Between Intimate Partner Violence and Food Insecurity: A Review of Quantitative and Qualitative Studies · 2023 · DOI

  • Abstract The paper contributes to the scarce literature on the negative effect of coronavirus 2019-induced income and food price shocks on household economic access to food, focusing on Malawi during the first two pandemic waves and using a country representative sample.

    COVID-19 income and price shocks effect on household food access in Malawi · 2022 · DOI

  • CONCLUSION: Our findings contribute to the limited literature examining trends in food hardship among sexual minority groups and suggest potentially different patterns of food insecurity, food assistance, and SNAP participation among sexual orientation subgroups, which may call for group-specific, nuanced approaches for lessening food hardship.

    Sexual Orientation and Food Hardship: National Survey of Family Growth, 2011-2019 · 2022 · DOI

  • , Miles, McBeath, Brockett, & Sorenson, 2017; Morris, Smith, Davis, & Null, 2016); however, published research on student food insecurity and housing insecurity remains sparse.

    Prevalence and Correlates of Food Insecurity and Homelessness Among University Students · 2020 · DOI

  • Relationships between obesity prevalence and access to grocery and varied nontraditional (eg, dollar, drug, and convenience) SNAP settings are underexplored.

    Supplemental Nutrition Assistance Program (SNAP)-Authorized Grocery, Convenience, Dollar, and Restaurant or Delivery Service Settings Are Associated With Increased Obesity Prevalence in Virginia · 2020 · DOI

  • BACKGROUND: In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries.

    Food insecurity, mental distress and suicidal ideation in rural Africa: Evidence from Nigeria, Uganda and Ghana · 2018 · DOI

  • &#13;\nFuture studies should focus on per capita FAFH expenditure, the effect of the lifestage of the individual, rather than age, on FAFH expenditure, FAFH expenditure for different meals (breakfast, lunch and dinner) and facility types (quick- and full-service restaurants) and the effect of income and socio-demographic factors on FAFH expenditure on different food types (for example beef, chicken, lamb, potatoes and salads).

    An investigation into food-away-from-home consumption in South Africa · 2017 · DOI

  • This article addresses this gap in the literature by examining how the physical labor of food provisioning varies for women engaged in AFNs relative to those not engaged in AFNs, and how diverse AFNs as well as socioeconomic status (SES) influence the labor of food provisioning for women engaged in AFNs.

    Alternative Food Networks and the Labor of Food Provisioning: A Third Shift? · 2016 · DOI

  • 6% from the 2009 American Recovery Reinvestment Act (ARRA), the impact of these competing conditions on household food insecurity (HFI, household food insecure but child food secure) and child food insecurity (CFI, household and child food insecure) in households with infants and toddlers has not been investigated.

    Trends in Household and Child Food Insecurity Among Families with Young Children from 2007 to 2013 · 2015 · DOI

  • CHAOS is a measurement that has not been tested widely among food insecure populations, but has been shown to be an influencing factor on child development, and might help explain some of the stress experienced by low-income families.

    A Cross-Sectional Exploration of Food Security, Depression, and CHAOS in Low-Income Households with Children · 2015 · DOI

  • This article focuses on an understudied food subsidy program, the Child and Adult Care Food Program (CACFP), examining whether it reaches low-income children and whether children who receive CACFP differ from those who do not receive it.

    The Child and Adult Care Food Program: Who Is Served and Why? · 2011 · DOI

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121 open questions have been extracted from the limitations and future-work passages of 2,370 Food Security and Health in Diverse Populations papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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