Post-migration food habits of sub-Saharan migrants in Victoria: a cross-sectional study

Objective: (i) To describe sub-Saharan African (SSA) post-migration food habits and eating patterns; and (ii) to examine how the food habits of SSA households in Victoria reflect post-migration acculturation.
Design: A cross-sectional survey using a snowball sampling technique. Data on food habits and eating patterns were obtained using semi-structured, face-to-face interviews from November 2001 to April 2002.
Subjects: A total of 139 households of demographically diverse recent migrants from across sub-Saharan Africa.
Setting: Melbourne metropolitan and Melbourne fringes.
Analysis: Data were summarised using descriptive statistics.
Results: SSA migrants and refugees indicated dietary acculturation characterised by three processes: substitution, supplementation and modification of recipes. They experienced difficulty locating their traditional foods, in particular, African vegetables (34.2%), unprocessed maize meal (29.1%), camel milk (23.1%) and maize grain (13.7%). The new foods adopted since arrival were pizza, breakfast cereals and fast foods, but also included new fruits and vegetables. Takeaway food such as Pizza Hut or McDonalds featured prominently in the SSA post-migration diet. Reasons for eating out were favourite food (48.3%), routine family outing (38.3%), special occasion (33.3%) and no time to cook (25%). A significant change in meal pattern was the inclusion of breakfast, although 21% reported skipping breakfast.
Conclusion: Many of the observed dietary changes were not consistent with good health and may predispose this population to rapid weight gain and chronic disease. Rapid modernisation and the Anglo-Australian culture interact in a complex way with traditional eating and socialisation practices of SSA migrants. Understanding these forces can allow effective health promotion and community development strategies to be developed for the future health of SSA migrants and their communities.

Obesity and undernutrition in sub-Saharan African immigrant and refugee children in Victoria, Australia

The study assessed the anthropometric status of 337 sub-Saharan African children aged between 3-12 years who migrated to Australia. These children were selected using a snowball sampling method stratified by age, gender and region of origin. The prevalence rates for overweight and obesity were 18.4% (95%CI: 14 - 23%) and 8.6% (95%CI: 6% -12%) respectively. The prevalence rates for the indicators of undernutrition were: wasting 4.3% (95%CI: 1.6%-9.1%), underweight 1.2% (95%CI: 0.3%-3.0%), and stunting 0.3 (95%CI: 0.0%-1.6%). Higher prevalence of overweight/obesity was associated with lower household income level, fewer siblings, lower birth weight, western African background, and single parent households (after controlling for demographic and socio-economic factors). Higher prevalence rates for underweight and wasting were associated with lower household income and shorter lengths of stay in Australia respectively. No effect was found for child's age, gender, parental education and occupation for both obesity and undernutrition indices. In conclusion, obesity and overweight are very prevalent in SSA migrant children and undernutrition, especially wasting, was also not uncommon in this target group.

Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa

There has been an increase in Australia's intake of refugees and migrants from sub-Saharan Africa over the last two decades. These refugees have been exposed to nutritional risks prior to migration, which, together with changes associated with acculturation, impact on their health and nutritional status post-migration. However, there is a paucity of data in Australia that has examined the health and nutritional status of this ethnic minority in Australia. Despite basic research assessing the nutritional status of children, none have specifically concentrated on the health and nutritional situation of sub-Saharan refugee children. In the absence of such studies, this paper explores issues relating to obesity in sub-Saharan African refugee children within a cultural and public health framework. We begin by outlining the history of obesity and its cultural meaning. We then move to a consideration of predisposing factors for obesity and how these factors translate into obesity risk contexts of sub-Saharan refugees post-migration. We argue there are a number of key challenges related to culture and the relationship between socio-economic factors post-migration that require addressing by health professionals, dieticians and health educators to ensure the delivery of successful health outcomes.

Does democracy facilitate economic growth or does economic growth facilitate democracy? an empirical study of Sub-Saharan Africa

This paper examines the relationship between democracy and economic growth in 30 Sub-Saharan African countries. As our proxy for democracy we first use the democracy index constructed by Freedom House and then check the sensitivity of our findings using, as an alternative proxy for democracy, the Legislative Index of Electoral Competitiveness (LIEC). We find support for the Lipset hypothesis - in the long run, real GDP Granger causes democracy and an increase in GDP results in an improvement in democracy ??? in Botswana and Niger with both datasets, for Chad with the Freedom House data only and for Cote d???Ivoire and Gabon with the LIEC data only. Support for the compatibility hypothesis - in the long run democracy Granger causes real income and an increase in democracy has a positive effect on real income - is found for Botswana with the Freedom House data and for Madagascar, Rwanda, South Africa and Swaziland with the LIEC data. Support for the conflict hypothesis - in the long run democracy Granger causes real income and an increase in democracy has a negative effect on real income - is found for Gabon with the Freedom House data and Sierra Leone with the LIEC data.

Does gender inequality reduce growth in sub-Saharan African and Arab countries?

This paper uses 1974 to 2001 panel data for 31 sub-Saharan African and 10 Arab countries and Arellano–Bond estimations to empirically assess the impact on growth of an important indicator associated with MDG 3; namely the ratio of 15–24-year-old literate females to males. Our findings indicate that gender inequalities in literacy have a statistically significant negative effect that is robust to changes in the specification. In addition, it seems that gender inequality has a stronger effect on growth in Arab countries. Interestingly, we find that the interaction between openness to trade and gender inequality has a positive impact. This result suggests that trade-induced growth may be accompanied by greater gender inequalities.

Response of inflation to shocks: new evidence from Sub-Saharan African countries

In this paper, we investigate whether or not the inflation rate of 17 Sub-Saharan African countries can be modelled as a stationary process. We achieve this goal through using univariate and panel stationarity tests for data over the period 1966 to 2002. We use the Kwiatkowski, Phillips, Schmidt and Shin (KPSS, 1992) univariate test and allow for multiple structural breaks. We find that except for Burkina Faso, Burundi and Gambia, the inflation rate is stationary for the rest of the 14 countries. We then apply the panel version of the KPSS test, developed by Carrion-i-Silvestre et al. (2005), which accounts for multiple structural breaks. We find strong evidence of panel stationarity of the inflation rate. However, for a panel consisting of Burkina Faso, Burundi and Gambia, we could not find evidence that the inflation rate is stationary. © 2013 Elsevier B.V.

Migration-related influences on obesity among sub-Saharan African migrant adolescents in Melbourne, Australia

Aim: The aim of the present study was to examine migration- and socioeconomic-related influences on obesity among African migrant adolescents in Melbourne, Australia. Methods: Anthropometric data were collected from 99 parents and 100 adolescent offspring who also completed questionnaires eliciting demographic, socioeconomic and migration data. Multiple linear regressions were used to assess the relationship between migration- and socioeconomic-related factors and adolescent body mass index (BMI). Results: Only gender and parental BMI were associated with adolescent BMI after adjusting for adolescent age, adolescent gender, religion, parental BMI, parental education level and annual income. Boys (β=-1.45; P < 0.05) had lower BMI than girls. Parental and adolescent BMI were positively associated (β = 0.11; P < 0.05). In examining migration-related factors and adolescent BMI, after adjusting for gender and parental BMI, parental acculturation patterns and pre-migration life environment were associated with adolescent BMI, explaining, respectively, 6.5 and 4.0% of the variance in BMI. An integrated parental acculturation pattern was negatively associated with adolescent BMI (β=-0.17; P < 0.05) while adolescents whose parents came from rural areas had a higher BMI (β = 1.48; P < 0.05) than those whose parents came from urban areas. Adolescent acculturation patterns and length of stay in Australia were non-significantly associated with their BMI. Conclusions: Gender, pre-migration life environment and parental acculturation patterns seem to influence the prevalence of overweight and obesity among African migrant adolescents. Culturally competent obesity prevention programmes targeted towards African adolescents should consider these aspects in their design and delivery; however, further research is required to determine their relative contributions to African adolescent obesity in Australia.

Sociocultural factors and perceptions associated with type 2 diabetes among sub-Saharan African migrants in Melbourne, Victoria

Aim: To explore how non-diabetic sub-Saharan African migrants residing in Melbourne, construct and interpret type 2 diabetes mellitus (T2DM) and its risk factors and to provide an evidence-based theoretical framework to inform community-based prevention programs. Methods: Seven focus group discussions (two with women only, two with men only and three of mixed gender) were carried out among Ghanaian, Zimbabwean, Sudanese and Burundian migrants living in Melbourne (n = 61; age range: 18 to 61 years). Results: Three distinct themes emerged: not paying much attention to the threat of T2DM and othering; T2DM being outside the individuals' control; and entrapment within rich industrialised culture and lifestyle. Participants perceived T2DM to be a disease of the wealthy caused by intake of too much sugar and sedentary behaviour, which were particularly compounded by lifestyle-related changes upon migration to an industrialised country. However, they also perceived T2DM to be associated with bad luck. Conclusions: Culturally competent prevention and education programs are needed to increase health literacy and dispel religious and cultural myths about T2DM among sub-Saharan African migrants.

Mortality, malnutrition and the humanitarian response to the food crises in Lesotho

Background: At the height of the food crisis in southern Africa, the Government of Lesotho declared a state of famine and emergency in April 2002 and launched a Famine Relief Appeal for over $137 million. World Vision, in partnership with the World Food Program, became involved in December 2002 providing food aid to affected communities.
Objective: to document mortality rates, causes of death, malnutrition prevalence, and the proportion of lost pregnancies after almost three years of humanitarian response to the food crisis in Lesotho and to propose a way forward.
Design: A two-stage, 30 cluster household survey was undertaken in three districts from the 16th to the 26th of May 2005, with a sample size of 3610 people.
Results: The crude mortality rate (CMR) of 0.8/10,000/day (95%CI: 0.7-0.9). The reported CMR was significantly lower than the CMR emergency threshold (<1/10,000/day). Using 2000 as a pre-drought baseline, 38528 excess deaths occurred between 2000 and 2005. The under-five mortality rate (U5MR) of 3.2 deaths/10,000/day (95%CI: 2.8-3.6/10,000/day) was 4 times the reported CMR and 1.4 times higher the U5MR emergency threshold for sub-Saharan Africa (2.3/10,000/day). CMR was lower among food aid beneficiaries (0.68; 95%CI: 0.57-0.79) than non-beneficiaries (1.42; 95%CI: 1.13-1.70). This was also true for U5MR (2.94; 95%CI: 2.39-3.50 versus 6.44; 95%CI: 5.21-7.68). The prevalence of wasting increased from 5.4% to 12% while that of stunting declined from 45.4% to 36.2% between 2000 and 2005, but the nutritional status did not vary by beneficiary status.
Conclusion: Despite the alarming U5MR, findings suggest that the food aid program ensured survival mainly among adults. The situation could have been catastrophic in the absence of humanitarian assistance.

Tonic sol-fa in South Africa : a case study of endogenous musical practice

Tonic Sol-fa was introduced to South Africa during the mid nineteenth century initially by Christian missionaries and later by professional educators to schools, teacher training institutions and local communities. Despite Tonic Sol-fa being the principal means of formal pedagogy and the most commonly-accepted notational medium through which South African communities have developed and sustained what is unquestionably a vibrant choral music tradition, there has been some fairly forthright condemnation of the overall effects of European music - particularly tonal-functional harmony - on indigenous culture. Agawu (2003) and Nzewi (1999), for example, have identified what they describe as the adverse effects of European music on African culture.

This paper counters these criticisms in one respect. It argues that, as one of the most prominent manifestations of European musical culture in sub-Saharan Africa, Tonic Sol-fa represents what Ntuli (2001) identifies as endogenous knowledge - knowledge acquired from non-indigenous sources that has been assimilated and integrated with indigenous knowledge to become the collective heritage of a people. This contention is supported by four short case studies of indigenous South African composers - two past and two contemporary musicians - who have utilised Tonic Sol-fa in their choral music writing and teaching, albeit in differing ways. The paper aims to counter the general criticism that European music has been injurious to indigenous African culture; rather it argues that in reality this manifestation of European music represents an exemplar of endogenous knowledge.

Migrants getting fat in Australia: acculturation and its effects on the nutrition and physical activity of African migrants to developed countries

Obesity is a significant health problem in Australia and other developed countries and acculturation is one fo the many risk factors. This new book summarizes acculturation and anthropometric outcomes among sub-Saharan African migrants in Australia. The book further examines the relationship between acculturation and food, energy and nutrient intake and physical activity. Some policy recommendations are proposed.

Mortality rates, prevalence of malnutrition, and prevalence of lost pregnancies among the drought-ravaged population of Tete province Mozambique

Background: Tete Province, Mozambique has experienced chronic food insecurity and a dramatic fall in livestock numbers due to the cyclic problems characterized by the floods in 2000 and severe droughts in 2002 and 2003. The Province has been a beneficiary of emergency relief programs, which have assisted >22% of the population. However, these programs were not based on sound epidemiological data, and they have not established baseline data against which to assess the impact of the programs. Objective: The objective of this study was to document mortality rates, causes of death, the prevalence of malnutrition, and the prevalence of lost pregnancies after 2.5 years of humanitarian response to the crisis. Methods: A two-stage, 30-cluster household survey was conducted in the Cahora Bassa and Changara districts from 22 October to 08 November 2004. A total of 838 households were surveyed, with a population size of 4,688 people. Results: Anthropometric data were collected among children 6-59 months of age. In addition, crude mortality rates (CMRs), under five mortality rates (U5MRs), causes of deaths, and prevalence of lost pregnancies were determined among the sample population. The prevalence of malnutrition was 8.0% (95% confidence interval (CI)=6.2-9.8%) for acute malnutrition, 26.9% (95% CI=24.0-29.9%) for being underweight, and 37.0% (95% CI=33.8-40.2%) for chronic malnutrition. Boys were more likely to be underweight than were girls (odds ratio (OR)=1.34; 95% CI=1.00, 1.82; p<0.05) after controlling for age, household size, and food aid beneficiary status. Similarly, children 30-59 months of age were significantly less likely to suffer from acute malnutrition (OR=0.45; 95% CI=0.26, 0.79; p<0.01) and less likely to be underweight (OR=0.37; 95% CI=0.27, 0.51; p<0.01) than children 6-29 months of age, after adjusting for the other, aforementioned factors. The proportion of lost pregnancies was estimated at 7.7% (95% CI=4.5-11.0%). A total of 215 deaths were reported during the year preceding the survey. Thirty-nine (18.1%) children <5 years of age died. The CMR was 1.23/10 000/day (95% CI=1.08-1.38), and an U5MR was 1.03/10 000/day (95% CI=0.71-1.35). Diarrheal diseases, malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) accounted for more than two-thirds of all deaths. Conclusions: The observed CMR in Tete Province, Mozambique is three times higher than the baseline rate for sub-Saharan Africa and 1.4 times higher than the CMR cut-off point used to define excess mortality in emergencies. The current humanitarian response in Tete Province would benefit from an improved alignment of food aid programming in conjunction with diarrheal disease control, HIV/AIDS, and malaria prevention and treatment programs. The impact of the food programs would be improved if mutually acceptable food aid programme objectives, verifiable indicators relevant to each objective, and beneficiary targets and selection criteria are developed. Periodic re-assessments and evaluations of the impact of the program and evidenced-based decision-making urgently are needed to avert a chronic dependency on food aid.