Food Insecurity and Management of Health, Education and Unemployment Risks

Key Note Address at the 4th IDS Amritsar International Seminar on Water, Energy and Food Security Nexus, sponsored by Ministry of Earth Science, Government of India, New Delhi,on 8 February 2013.

Food Insecurity and Management of Risks
By
Dr. Amitava Mukherjee ,
Executive Director, Development Tracks in Research Training and Consultancy, plc
New Delhi-110019
Email: amimuk@gmail.com, Website: <amitavamukherjee.me>

Food insecurity is a state where:

1. food is not systemically available at all times;
2. food that is available is not culturally acceptable1 , where culture is broadly defined to include religious beliefs, customs, usage and practices;
3. people do not have economic access to food;
4. people do not have physical access to food;
5. people do note have social access to food;
6. food that people do not consume has the requisite nutritional value2 for a healthy life; and
7. people do not have access to potable water, for absorption of food by the body.

Granted that, food insecurity exists when one or more of these conditions exist. Clearly, not only is it important to ensure availability of food (obviating condition (i) above)  but also to guarantee that people have adequate physical, social, cultural and economic access3  to food to meet their dietary needs and food preferences for an active and healthy life4 . Thus increased food production, to circumvent condition (i) above and elimination of poverty, to tackle condition (iii) above, are important, “but much else also needs to be done”, including amongst other things:

-enhancement of general economic growth,
-expansion of employment and decent rewards for work,
-diversification of production,
-enhancement of medical and health care,
-arrangement of special access to food on the part of vulnerable people (including
deprived mothers and small children),
– spread of basic education and literacy,
-strengthening of democracy and the news media,
-reduction of gender based inequalities.

These different requirements call for an adequately broad analysis alive of the diversity of causal antecedents that lie behind the many sided nature of food insecurity in the contemporary world” (Sen 1997).

B. The measurement of food insecurity

While defining food insecurity is relatively easy, measuring it is somewhat more difficult. Food insecurity in many ways is a severe form of poverty. Though poverty and food insecurity are closely related, they are not direct measures of each other. Shifts and trends in poverty may foretell similar changes in food insecurity, but not necessarily so. Because people must eat to survive, they will often sacrifice many other basic needs, such as clothing, shelter and transportation, before they decide to suffer food insecurity. Thus a person may be able to avert food insecurity but in the process may lapse into other forms of poverty.

Amongst the widely accepted measure of food insecurity is the percentage of the population, especially of children, who are undernourished, which reflects both the average amount of food available per person as well as the extent to which people can access food in a country. Stunting, wasting and under-weight children can also be taken as proxy measures of food insecurity. (See Table-1 below for definitions of some of these terms). According to the MDGs hunger can be measured with the two indicators suggested, namely, (i) prevalence of underweight children fewer than 5 years of age and (ii) proportion of population below minimum level of dietary energy consumption.

C. Shocks and Risks as Causes of Food insecurity

Amongst the causes that lead to food insecurity risks and shocks faced by poor people are the foremost. Risks, in the context of food insecurity, denote an uncertain outcome of events that can damage the well being of the people, by pushing them into food insecurity or deepening the same and shock means an adverse realization of a stochastic variable. Risk is thus an ex-ante concept and shock is an ex-post one.

Knowing that a crisis may descend anytime, not knowing whether one will be able to cope with it, are all parts of poor men’s landscape of life. Poor people are exposed to a wide array of risks and shocks. This has generated a forbidding amount of literature on the various aspects of risks and shocks in developing countries including their sources and kinds, their effects on poor households as also on individual, household and community responses to managing these.

There are various ways in which risks and shocks can be classified. For example risks and shocks can be classified as political, environmental, economic and social risks (Holmes and Jones, 2009). Risks and shocks can be classified as macro, meso and micro risks. Risks and shocks can also be broadly categorized into: idiosyncratic and covariate risks and shocks (Bhattamishra and Barrett, 2007). All classifications have their own advantages and disadvantages. There can also be various combinations and permutations of these risks and shocks. For example, economic risks and shocks can be either idiosyncratic or covariate. Similarly idiosyncratic and covariate risks and shocks can be at the macro, meso or micro level. Table 2 below presents the various combinations of risks and shocks. In this paper we discuss the issue of food insecurity and risks in terms of idiosyncratic and covariate risks as it helps both to keep the discussion uncomplicated and formulate policy options without much complexity.

Now what do we mean by Idiosyncratic and covariate risks and shocks?

Idiosyncratic risks and shocks are those risks and shocks where the experience of one household in this regards is typically unrelated to the experience of neighbouring households’ experiences. Covariate risks and shocks are those risks and shocks which

Table- 2

Main sources of Idiosyncratic and Covariant risk

many households in the same locality suffer. For ease of understanding we shall discuss the link between food insecurity and shocks only, given their ex post character.

               Idiosyncratic shocks commonly arises due to chronic illness or sudden illness (usually not the infectious diseases), crop yield shocks associated with microclimatic variations, localized wildlife damage, loss of draught power due to death or maiming of animals used in cultivation/transportation, pest infestation, and one-off events such as property loss due to fire, theft or vandalism, sudden death or loss of limbs of the breadwinner or even a temporary job loss where employment is largely in the informal sector and domestic violence. On the other hand covariate shocks occur due to natural disasters like the Indian Ocean Tsunami that led to 400,901 people big displaced in Indonesia alone (OCHA, 2005), clearly swelling the ranks of hungry; war (like the war in Afghanistan), civil strife like the one in Sri Lanka which has created 3,00,000 internally displaced persons who face food insecurity of different degrees; food price instability such as the one seen in 2008 that had added nearly 41 million people to those who were hungry (FAO 2008); financial crises such as the one that grips the world now that had thrown out of job 24.8 million workers jeopardizing their economic access to food5 etc., where everyone in a community is vulnerable.

Generally, there are insurance available against idiosyncratic risks such as life insurance, health insurance and draft animal insurance, but they are very expensive for those who are most likely to suffer them, namely, the poor. Insurance against covariate risks are not generally available as the risks are too large, barring a few publicly funded ones like crop insurance in India and where available they are prohibitively expensive.

It may be underscored that though the distinction between idiosyncratic and covariate shocks is critical for policy making, traces of idiosyncratic shocks can be found even in largely covariate shocks, because there are discernible differences between households in their exposure and capacity to respond to shocks. Additionally the extent to which a risk is covariant or idiosyncratic is a function of the underlying causes. For example, job loss can be an idiosyncratic risk for a casual mason due to heavy rain, or job loss can be covariate risk for a whole community of casual workers if it is the outcome of macroeconomic turbulence as seen in 2008. Similarly, the risk of becoming affected by HIV/AIDS can be an idiosyncratic risk germane to causing food insecurity or it can be a covariate risk if it becomes a pandemic, contributing to food insecurity in a community or even a nation like in some African countries. However, the bottom line is that a growing body of empirical evidence suggests that idiosyncratic risks dominate over covariate risks in Asia like in Africa (Deaton, 1997) and hence idiosyncratic shocks are the dominant causes of food insecurity in this region. The main sources of idiosyncratic and covariant risks are also shown in Table-2 above.

There are basically five main clusters of idiosyncratic risks: (i) sickness, injury and disablement; (ii) natural disasters (iii) aging; (iv) crime and domestic violence and (v) unemployment and other labor market risks. We shall briefly discuss them here

(i) Sickness, injury and disablement: Poor people often live and work in environments that expose them to greater risk of illness or injury, and they have less access to health care (Prasad, Belli and Das Gupta 1999). Their health risks are strongly connected to the availability of food, which is affected by almost all the risks the poor face (natural disasters, wars, harvest failures, and food price volatility). Communicable diseases like SARS, Bird Flu and H1N1 Virus that have afflicted Asia since 2003 are concentrated among the poor. Respiratory infections are considered by some experts as the leading cause of illness and even death (Gwatkin, Guillot, and Heuveline 2000). In India, for instance, it has been found that the poor are 4.5 times as likely to contract tuberculosis as the rich and twice as likely to lose a child before the age of two (World Bank 1998).

Illness and injury in the household have both direct costs (for promotive health; preventive health care and curative health care) and opportunity costs like lost income or schooling while ill. Direct costs eat into the economic power of the poor to access food while the opportunity costs affect both the short term loss of economic access to food for the poor and long term loss in economic access in term of higher capability poverty. The timing, duration, and frequency of illness also affect its impact on the food security of the people. Poor households can compensate for an illness during the slack agricultural season, but illness during the peak season leads to heavy loss of income, especially on small farms, leading to diminution of economic access to food, usually necessitating taking out loans at usury rates of interest making further inroads into the economic access to food, something that triggered the global phenomenon called the “Grameen Bank of Bangladesh.

In the Indian context Open Defecation is a major cause of food insecurity. It is not widely recognized that most of the child malnutrition (which is a major form of food Insecurity) is caused by open defecation. And India is the home to over 58 per cent of world’s open defecation. Open defecation leads to Faecal Infections and other deprivations that causes undernourishment in Children, leading to impaired cognition, physical deprivation and the like, which agitated the mind of even the Prime Minister of India who had reportedly said that “child malnutrition is a curse we must remove. Thus India has about one third of the entire world’s people who live on less than 1.25 $ a day.

Indeed there is a syndrome of open defecation, Faecal Infections, poverty and undernourishment. Among the Faecal Infections, diarrhea is dramatic, measureable and often visible. Hence it attracts a lot of attention and remedies have been found. But combinations of other infections which do not have such dramatic symptoms may, taken one with the others, be more devastating in the their impact on child health and nutrition. They include but is not restricted to, hookworm causing anemia (200 million cases in India); enteropathy (damage to the wall of the gut, reducing absorption of nutrition, and energy used in fighting infections which get into the blood stream); ascaris, tapeworms and other intestinal parasites that ‘steal’ food from children; livefluke, dysentery, hepatitis, typhoid and other infections (trachoma, polio etc). One medical authority considers that enteropathy alone is more harmful to child nutrition than diarrheas. These can all be cut off through sanitation and hygiene. See Diagram below

(ii) Natural disasters: Natural disasters cause food insecurity to millions of people. Just take two examples. The December 26, 2004 Asian tsunami tragedy demonstrates the destructive capacity of natural disasters, and their impact upon food security. According to early impact assessments, agricultural and fishery losses due to the tsunami were severe. For example, in Tamil Nadu state of India, 59 000 fishing vessels have been destroyed, affecting the livelihood of nearly 700 000 fisher-folk and their families. In Aceh province of Indonesia, income losses in agriculture and fisheries make up more than one-third of total losses due to the disaster, while in the worst-affected districts of Sri Lanka, 80 percent of fishing vessels have been destroyed or seriously damaged, throwing hundred and thousand of people into the throes of food insecurity.

More recently on 3 May 2008, a cyclone (Nargis) devastated Myanmar’s low-lying Irrawaddy delta region leaving more than 1 million people homeless. An estimated 80,000 people died in the delta’s Labutta district alone. Myanmar had been expected to export 600,000 tons of rice in 2008, including to Sri Lanka and Bangladesh but it could not live upto the expectation as the cyclone flooded 5,000 square kilometers (1,930 square miles) of farmland in the country’s main rice-growing area, worsening a food crisis even outside of Myanmar. Additionally since an 80 per cent loss in the December 2008 harvest was recorded (CARE, 2009) it means food distribution must continue in Myanmar itself to prevent food insecurity and starvation.

               (iii) Aging: Many risks are associated with aging: illness, social isolation, inability to continue working, inability to cook and uncertainty about transfers (usually from sons and daughters) being able to provide an adequate means of livelihood and so on. The incidence of poverty among the elderly varies significantly. In many countries in Central Asia, like Georgia and Armenia, the incidence of poverty is above average among the elderly, particularly among people 75 and older. There is also a gender dimension to the problem of poverty associated with old age. Women, because of their higher life expectancy at birth, constitute the majority of the elderly, and they tend to be more prone to food insecurity in old age than men (World Bank 2000). With better health care facilities and rising income in many of the Asian Countries, the number of elderly people in the developing countries in Asia and the Pacific, will increase significantly in the foreseeable future adding to the number of food insecure.

               (iii) Crime and domestic violence: Crime and domestic violence reduce earnings, take away income and destroy assets, which entrenches food insecurity. Unlike the rich, the poor have few, if at all, means to protect their life, property, assets and income, against crime, all of which help fight food insecurity. Crime also hurts children of poor people: children exposed to violence may perform worse in school thereby reducing their income earning capabilities which may, in the long run, be germane to lower purchasing power and hence, lower economic access to food. A study of urban communities in the Philippines, amongst other countries, showed that difficult economic conditions destroys social capital as involvement in community organizations declines, informal ties among residents weaken, and gang violence, vandalism, and crime increase (Moser 1998). Violence and crime may thus deprive poor people of two of their best means of reducing vulnerability to food insecurity, human and social capital, which act as “informal” insurance against transitory food insecurity. Rich and poor women alike are victims of domestic violence, but the incidence is often higher in poor households

               (iv) Unemployment and other labour market risks: Labour market risks include unemployment, falling wages, and taking up hazardous and low-quality jobs in the informal sector as a result of macroeconomic crises or policy reforms. The first workers to be laid off during cutbacks in public sector jobs are usually those with low skills, who then are exposed to food insecurity, amongst other things and are forced to migrate to urban areas adding to the already staggering numbers of urban poor, a pattern observed in many countries during the structural adjustment reforms of the 1980s and early 1990s. Economic crises such as the East Asian crisis in 1999 and the ones in 2007-200, also had significant effects on labour markets, with real wages and non-agricultural employment falling in all affected countries.

Fluctuations in demand for labour often disproportionately affect women and young workers who are therefore at greater risk of facing food insecurity. Most public sector retrenchment programs have affected women’s employment more than men’s (World Bank 2000), and women are more likely than men to work for small firms, which tend to be more elastic to demand fluctuations and pay lower wages, both of which have a strong bearing on women’s purchasing power and economic access to food. As incomes fall, poor households try to respond by cutting consumption of food, pulling out children from school and pruning health care, especially for women and girl children.

Liberalization of markets often boosts the price of staples which could benefit small farmers if they are net sellers of food but in many cases they are net buyers of food. Thus, the urban poor, rural landless, poor people, artisans, herdsmen, fisher folks and farmers are confronted with seasonality, selling food immediately after the harvest when food is plentiful and prices are low and buying food when it is scarce and prices are high. All these categories of poor are exposed to different degrees of food insecurity. Traders in food can step in and equalize prices over the year through arbitrage, but rural areas lack transport facilities and related infrastructure to facilitate the process, apart form the question of incentives.

For the rural poor, crop diversification and income diversification into nonfarm activities can help reduce food price and harvest risks, and eliminate food insecurity due to successive harvest failures, for various natural causes. For example, because of insufficient monsoons in India in 2009 indebtedness in 80 per cent of households in 160 districts declared drought affected will increase. According to the latest count, as many as 246 districts spread across 10 states, or 40% of the total number of districts, have been declared drought-hit. Even if the weather gods relent in the coming days, the rains may be too little, too late to undo the damage to the kharif (roughly June-October) harvest which is reckoned at 20 million tonnes for paddy alone. The situation is tailor-made to stoke inflationary fires, deepen rural distress and cause food insecurity especially when according to the latest Economic Survey, the per capita consumption expenditure of 71.9% of the rural population was less than Rs 20 per day in 2004-05. (Gangadharan, 2009).

D. Agenda for Public Action

(i)  Increase and diversification of production especially in agriculture.
Mr. Sharad Pawar was somewhat right, when he mentioned that we must raise agricultural output before enacting food law. “Solution is that unless and until we increase production, we will not be able to implement this (food security bill)”. (Times of India, 30 January 2012, p. 13). For this to happen, perhaps the most striking feature of agricultural innovations will have to be a shift away from the high external input-intensive model of the Green Revolution of the sixties to a New Green. The first Green Revolution of the last century achieved significant yield increases through promotion of high external inputs agriculture, of irrigated water, chemical fertilizer, pesticide and insecticides and fossil fuel. In contrast, the Second Green Revolution must increase yields, by moving agriculture from high external input-intensive agriculture to “High Tacit-and-Explicit Knowledge-Intensive Food Production” in both induced food production and autonomous food production systems (read food from common property resources). The Second Green Revolution must integrate traditional knowledge and technology with advances in modern-day science and agricultural engineering (including plant genetics, plant pathology and information technology) and encompass the ecologically integrated approaches, like intergraded pest and soil fertility management, minimum tillage and drip irrigation. Additionally the Knowledge-Intensive Food Production system must focus more on the entire systems of crop production rather than on individual crops. Such an approach can help to deliver resilience and sustainability to food production, and at once, score high on the equity front, ultimately distributing power and autonomy to individual farmers.

     Policies pertaining to access

               (ii) Enhancement of general economic growth that generates employment and guaranteeing decent rewards for work. And the economy needs to grow fast, so that employment is created, giving people economic access to food. As Joseph Stiglitz argued in Kolkata, on 12 January 2012, that “hunger is not caused by an absolute shortage of grain but by the lack of income of those in poverty to get access to it” (The Hindu, 13th January 2012, p. 13). Since much is said and written about it, we need not labour the details here except to say that an enabling environment for investment should be created (not like allowing FDI in multi brand retail trade and then keeping it in abeyance) and the choice of technology must be pro-employment. Additionally the legal architecture has to ensure a decent reward for work, that minimum wages are inviolable and that exploitative intermediation is ruled out. Growth also means that the governments have more resources to share the cake and make investments necessary for food security.
(iii) Protection of the poorer sections of society from both idiosyncratic and covariate shocks that impinge on food security. Most food insecure people are vulnerable to two kinds of shocks, idiosyncratic shocks (affecting individual households such as sudden loss in employment, loss of limbs and unexpected illness) and co-variate shocks (that affect large sections of society such as earthquakes, floods, droughts and epidemiological catastrophes). In case of co-variate shocks, the governments, aid agencies, non-state actors and you name it, all get on an overdrive to provide relief and rehabilitation. But in case of idiosyncratic shocks the affected households are largely left to fend for themselves, depending in many cases on informal systems of insurance. A lot needs to be done here on a range of measures. Promotion of micro-insurance, community- based insurance and self-insurance, income guarantees (like the National Rural Employment Guarantee Scheme) and right to access common property resources for non-timber forest produce should be on top of the agenda for tackling idiosyncratic shocks.
The various ways in which the State (read Government), individuals, households and communities can deal with the different kinds of shocks are tabulated in Table -3.

Table 3

Mechanisms for managing shocks

(i)              Diversify the delivery system. Despite every effort and the food security bill, there will be significant sections of society which will not be able to secure food for themselves for a variety of reasons, including physical incapacity and psychological barriers. The State need to provide food (not just grain) for these sections of people and in the delivery of food, the mode of delivery as also the institutional mechanisms for such delivery of food have to be as varied as possible: Ration Shops constitute one critical element in this scenario. The delivery of food can take other forms such as food stamps, direct cash transfers, free kitchen for cooked foods run by non-state actors and the like. And the focus should be on “reach” and “depth” as much as on the range. And the institutional mechanism for delivery of food can include ration shops, non-sate actors like NGOs and private companies, charities, Gram and traditional Panchayats.

(ii)               Eliminate gender based inequalities that lead to eight kinds of food insecurities faced by women.

Women face several inequalities, notable amongst which are natality based inequality (where sex-selective abortion does not succeed or is not possible for whatever reason, the girl child starts from the womb with familial and parental environments that are hostile to her existence), inequality in access to food (even mothers are all too eager the son gets to eat first and better food), to education, to health care, employment opportunities and role in certain jobs. These inequalities invade the capability of women to achieve food security.  Inequality in ownership and inheritance of assets hinder food security of women. Critical assets such as homes and land are very asymmetrically owned, impairing women’s capability to access food. There is no gainsaying the fact that such inequalities must be removed through institutional and structural changes if we dream of a food secure India. The war against food insecurity will be lost or won in the war against gender discrimination.

(iii)             Health and Education Securities for food security. A package of health security, especially access to reproductive health, sanitation and potable drinking water, and education security has to be made available to every citizen. Healthcare is available to only 10 per cent of the people at the top of the pyramid, which has to be reversed. Over 55000 women die in child birth every year and thirteen lakh children who die before they reach their first birthday (Times of India, 16 January 2012, p. 11), which are both a direct function of the failure of health infrastructure. This has to be stopped. With total fertility rate at 2.6 per cent per woman on a population base of over 1.1 billion people, trying to achieve food security will be as futile as trying reach a mirage.  Only when we have health security can we achieve rapid fertility decline, vital for food security.  Health security is even necessary for economic security (Ela Bhatt: “When Health is Security” Times of India, p. 18), which in turn has a direct bearing on economic access to food. For example, the recent study by Naadi Foundation (The HUNGAMA Survey Report, 2012), found the prevalence of malnutrition is significantly higher among children from low-income families, although rates of child malnutrition are significant among middle and high income families. Children from households identified as Muslim or belonging to Scheduled Castes or Schedule Tribes generally are worse off.

Similarly education security is critical for food security in several ways. For example, in the 100 Focus Districts studied by in the aforesaid Naadi Foundation Report, found that 66 per cent mothers did not attend school; rates of child underweight and stunting are significantly higher among mothers with low levels of education; the prevalence of child underweight among mothers who cannot read is 45 per cent while that among mothers with 10 or more years of education is 27 per cent. The corresponding figures for child stunting are 63 and 43 per cent respectively. It was also found that 92 per cent mothers had never heard the word “malnutrition”. Though Right to Education is a constitutional right, it is a matter of public history that the quality of education has still to be raised to desired level (“Brick in the Wall”, in Times of India, 18th January 2012, p. 20). We must also leap frog in renewable energy sources such as solar, wind, biomass and bi-gas and invest in transmission and distribution like in battery and other storage technologies and in micro-grids, as aids to delivery of proper social services, essential for food security.

I.  Concluding Remarks

Thus the one-line answer to solving our problems of malnutrition, food insecurity and starvation in India is: get back to basics. Focus on investments in technology for increasing agricultural productivity, on growth and employment, on primary health care and basic education, on gender equality, on provision for sanitation and potable water and strengthening the elements that make for a robust democracy. This is no rocket science. Just that the powers that be must have the political will to work for the voiceless majority. This is not only good economics but is also good politics: the voiceless majority constitutes the most energetic voters.

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