Analysing diet composition and food insecurity by socio-economic status in secondary African cities

This chapter takes as its starting point theorizing around nutrition and food system transitions thought to be increasingly occurring in urban Africa, and how this may be linked to a growing non-communicable disease burden. We focus specifically on the secondary city context by analysing household survey data gathered from six cities across Ghana, Kenya and Uganda during 2013–2015. We asked how diet composition and diversity, food sources and food security varied by socio-economic status, using expenditure and demographic data to create a proxy for household well-being. In this way, we investigate one of the claimed keystones affecting urban food systems and dietary health in sub-Saharan Africa—that of obesogenic urban food environments. Our findings indicate that the socio-economic status of a household was the most important factor influencing household dietary diversity and food security status, i.e. better-off households were more likely to feel food secure and eat from a greater variety of food groups. In addition, the number of income sources was additionally associated with higher dietary diversity. We also found that a household’s involvement in agriculture had only a small positive effect on food security in one city and was associated with a reduction in dietary diversity scores. Our findings emphasize the importance of supporting aggregated national and international statistics on agricultural production and trade with detailed local analyses that focus on actual household food access and consumption. We also see reasons to be cautious about making causal claims regarding consumption change and obesogenic urban environments as the major contributor to a rising obesity and non-communicable disease burden in Africa