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Hunger and society

The causes of hunger
Child nutrition and dietary diversity within the family: A view from the Caribbean
Supplementary feeding and nutrition of the young child

The causes of hunger

Urban Jonsson
World Hunger Programme, The United Nations University, Tokyo, Japan

HUNGER AS A PRESSING GLOBAL PROBLEM OF HUMAN SURVIVAL

Hunger is one of the most serious and obvious manifestations of the crisis in the world. With the breakdown of the traditional local food security mechanisms, hunger has become almost inseparable from poverty. It is spread by the same "market mechanism" as commodities on the world market (1). Unfavourable weather, inflation, and changing investment priorities in the rich, food-surplus-producing countries affect the conditions of survival of the poor in the periphery.

The United Nations has had the alleviation of hunger on its agenda for the last twenty years. In the 1950s and 1960s most of the work was directed towards increasing food production, reducing the population growth rate, and promoting the theory of the trickle-down effect of economic growth (2). The technical aspects of the problem of hunger were well documented and thoroughly discussed in numerous books, reports, and publications (3,4). During the 1970s, however, the value of this approach was questioned by people who saw the problem of hunger mainly as a manifestation of the social structure of societies (5).

The UN World Food Conference was held in 1974, a year when hunger in the world had reached a level that was unacceptable to most governments in the third world. In the main document adopted by the Conference, "The Declaration of the Eradication of Hunger and Malnutrition," the views on the causes of hunger reflected a more politically conscious perspective:

The situation of the peoples afflicted by hunger and malnutrition arises from their historical circumstances, including social inequalities, including in many cases alien and colonial domination, foreign occupation, racial discrimination, apartheid and neocolonialism in all its forms, which continue to be among the greatest obstacles to the full emancipation and progress of the developing countries and all the peoples involved. [6]

The most important result of the Conference was its contribution to shifting the problem of hunger from the technical arena to a more social and political one. This shift was also reflected by FAO:

The causes of inadequate nutrition are many and closely interrelated, including ecological, sanitary and cultural constraints, but the principal cause is poverty. This, in turn, results from socio-economic development patterns which in most of the poorer countries have been characterized by a high degree of concentration of power, wealth and incomes in the hands of relatively small elites of national or foreign individuals or groups. [7]

In many of the documents of WHO, UNICEF, the International Bank for Reconstruction and Development, the International Fund for Agricultural Development, and other international organizations and bilateral agencies, similar statements have been made. The proposals for action, however, do not reflect these analytical statements very closely. This discrepancy between the level of analysis and the level of proposals for action is, today, a characteristic common to the work of most governments and aid organizations. It is a problem in itself and should be studied.

In recent years a large number of institutions and scholars have tried to analyse the world crisis and most of them have touched upon the problem of hunger in the world. A number of schools of thought have emerged. It is, however, beyond the scope of this paper to try to make a systematic classification and analysis of them. Only two of the more recent reports will be referred to: the report of the Brandt Commission and the so-called Scheveningen Report.

Hunger and food occupies a substantial part of the report of the Brandt Commission (8). The Commission "sees no more important task before the world community than the elimination of hunger and malnutrition in all countries." It is further stated:

We are well aware that this is not a limited task-it involves nearly all aspects of the world economy and the development process, to create and distribute both the required food and the employment and incomes which will enable the food to be bought by those who need it. But the world has the capacity to achieve such a goal; it is imperative that it does so. [9]

In July 1979 high-level government officials and development thinkers met in Scheveningen, Netherlands, to discuss the new international development strategy (10). In the perspective of a world in crisis and turmoil, an attempt was made to redefine development The symposium identified six key issues for such a new international development strategy. The first of these is outlined as follows:

[Development] should above all aim at two key elements of national self-reliance in the Third World and eradicate the obstacles facing them; sustainable production of domestic food supplies and endogenous capacities of developing, acquiring and adapting technology. [ 11 ]

Clearly, the problem of hunger is considered one of the most serious problems of mankind and a concrete manifestation of the world in crisis.

A THEORETICAL CONCEPTUALIZATION OF HUNGER AND SOCIETY

The Definition of "Hunger"

In all languages there is a distinction between the name and the named. "Hunger" is one name which English-speaking people give to a situation or process in reality. But, in English as probably in all languages, there are many names given to the same situation or process. Moreover, translated into other languages, "hunger" may mean many different things. It is important, therefore, to define the use of the word "hunger." In this paper it means the deterioration of health status and/or social and productive porformance of individuals arising from an intake of food either too tow in quantity, or of the wrong kind, or both. The individual may or may not recognize the hunger. Some people affected by hunger are hungry, some are not, because they adapt themselves to a lower food intake by reducing physical activity. In other cases, a lack of specific nutrients causes hunger that is not felt by the individual (malnutrition or hidden hunger).

Hunger as a Symptom of Poverty

Food is a basic human need and a basic human right. The need for food is self-evident so most well-nourished people probably never think about it. Most subsistence societies direct their efforts at satisfying this need before others.

Hunger is closely related to poverty. Indeed, poverty can often be measured by the prevalence of hunger. But hunger is not equivalent to poverty, for in some countries people are poor but not hungry (12). At the same time, poverty is more than hunger, for in some countries people are not only hungry but they are also deprived of most human rights (13). The study of hunger reveals some important aspects of poverty in society and, therefore, needs to be undertaken in the context of a theory of society.

Some Basic Concepts of a Dialectical Approach to a Theory of Society

The development of society can be such as is determined by both the technical and material conditions and the social conditions of production (14). The word "determined" does not mean that everything is predetermined. Ideology, politics, culture, religion, etc. may all influence development. The technical and material conditions of production reflect the relation between people, the means of production, and nature. The means of production are identical with the existing tools, technology, available natural resources, etc. But more subjective characteristics, such as technical know-how, professionalism, imagination, will-power, and ideas may also condition production. All of these are here called potential resources.

The social conditions of production reflect the relation between people and the means of production. These conditions determine what is produced out of everything that is potentially possible to produce. The existing property relations are most important for the social conditions of production, which can also be described in terms of the ownership of and access to the means of production, the division of labour, the power structure, etc. This is here called the economic structure of society.

There is a continuous interaction between the potential resources and the economic structure of a society that results in a certain mode of production. This is here called the economy.

But the basic interaction between the potential resources and the economic structure of a society also influences people's perceptions, their culture, religion, and ideology. When contradictions are overcome or solved by changes in the economic structure of the society, then the superstructure (ideology, culture, etc.) will slowly change. Such a change will in turn affect the basic interaction.

In summary, the economy and the political and ideological superstructure interact in every society. This interaction is represented schematically in figure 1.

The interaction between the economy and the superstructure (politics and ideology) manifests itself in many different observable ways. The extent to which the objective interactions are measurable is one of the most controversial areas of social science.

One of the more important implications of looking at a society in this way is that, in the last analysis, production, distribution, and consumption are basically all determined by the economic structure of the society. Changes in any one of them will always be constrained by the existing structure. But this analysis also implies that efforts to change the pattern of production, distribution, and consumption can themselves change the economic structure of the society.

Sometimes we find a conflict between those who are advocating structural change in society to alleviate the causes of hunger and those who are suggesting immediate actions to improve the situation (15). There is not always a real contradiction between long-term and short-term actions. Short-term actions "to alleviate immediate hunger' may serve the purpose of a first important step towards changing the structure of the society.

Another important implication of the above theory is that technology by itself cannot be right or wrong. One cannot in principle oppose food aid, fertilizers, high-yielding cereal varieties, computers, or nuclear energy. It is only in a specific society and at a given point of time that one can analyse and predict the danger or the usefulness of such transformations of the potential resources. Food aid, capital-intensive technology, etc. are all used in such different countries as the USA, the USSR, Brazil, Cuba, China, and Tanzania. It is surprising how seldom this basic dialectical relationship between technology and society is considered when recommendations for using or not using a certain type of technology are made.

A theory of hunger and society should be developed from this dialectical model of a society. But before going into the details of such a model, we will summarize some contemporary "mono-disciplinary" approaches.

FIG. 1. A Dialectical Framework of a Theory of Society

Holism and Reductionism

Problems examined in a mono-disciplinary way tend to be attacked with mono-disciplinary actions. For example, a medical doctor dealing with the health aspects of hunger and malnutrition tends to recommend health interventions only. Or somebody concerned with population growth might believe that the solution to the hunger problem is simply to reduce the population, etc. Although such reductionistic approaches and interventions may be correct in some specific cases, they are generally incomplete and sometimes defer more significant interventions. Characteristics such as poverty, exploitation, hunger, and malnutrition at the level of a society are system characteristics (16). In order to understand such complex variables, a holistic approach is needed.

Some of the more common reductionistic approaches to the problem of hunger are listed in table 1. This table exaggerates the situation, as most people try to broaden their views beyond their disciplinary backgrounds and recognize the need for multifactorial approaches.

One of the methodologies used in a holistic approach is interdisciplinarity. Too often, however, this is replaced by mere multidisciplinarity. The two have very little in common. Multidisciplinary groups have two main characteristics: they are concerned with some problem which all the members agree is important to study and seek to solve, and the participants come from a variety of disciplines. The group is often pluralistic in values and interests (17).

An interdisciplinary group has a multidisciplinary composition and is problem-oriented; but its members either share views of what might be the basic causes of the problem, or they know or try to find out why their views differ. If the views of what causes hunger are not shared, it is difficult to achieve a consensus on what should be done to alleviate hunger (18). The method of inter-paradigmatic dialogue used by the Human and Social Development Programme of the United Nations University is an interesting approach to the problem of transforming multidisciplinary groups into interdisciplinary ones (19).

It is important to realize that a holistic, multidisciplinary approach to a hunger problem may very well result in monodisciplinary recommendations for action, since reductionistic approaches sometimes yield good results.

TABLE 1. Reductionistic Approaches to the Problem of Hunger

A Conceptualization of Hunger and Society

In an analysis of the causes of hunger in a society, three dimensions should be considered: (i) the depth of the analysis, (ii) the various types of basic causes, (iii) the level of the society at which the causes exist. We will consider these three dimensions in more detail.

Analyses of hunger can be undertaken at varying levels of "depth" of the problem. This is the first dimension. A deeper analysis will increase the complexity but will also lead to a larger number of options for long-term actions. It is possible to distinguish four general levels of depth of analysis (20).

1. Symptoms or signs: The direct observable manifestations of hunger in a society. These are mainly deficiency symptoms. They are usually not specific and may be caused by a number of different nutrient deficiencies or diseases in combination. Therefore, it is difficult to base any action on the assessment of these symptoms, although the symptoms themselves do indicate that a problem exists.

2. Immediate causes: The immediate causes of hunger are inadequate intake of nutrients and disease (21). The interaction between these two factors is important and well known (22). If the patterns of disease and of nutrient intake are known, the picture of hunger becomes clearer. It is possible to select a number of health and dietary measures that can improve the situation.

3. Underlying causes: The underlying causes of disease and inadequate nutrient intake in a society are many and complex 123, 24, 25). But most of the factors are a result of unequal access to, for example, goods, services, and other resources among individuals or groups of individuals. Examples of these are food, housing, education, water, and health services. The production, distribution, and consumption of all these goods and services are determined by the socio-economic structure of the society, including its political and ideological superstructure.

4. Basic causes: The contradictions and the interrelations within the economy and between the economy and the political and ideological superstructure are the ultimate determinants of the development of a society. The basic causes explain how the potential resources of a given society are mobilized for production of goods and services and how these are distributed.

The different categories of causes are shown in figure 2.

In order to understand why hunger exists, one has to understand the links between the different levels. Until today most research has been concentrated on studies at the levels of symptoms, intermediate causes, and, to some extent, underlying causes. Today we know much more about the metabolism of nutrients and the processing characteristics of food than we do about the concrete role of politics and ideology in creating or alleviating hunger in society.

A large number of surveys have been conducted in order to gauge the prevalence of hunger. They are mostly limited to the first and second levels of depth of analysis. However, the conclusions drawn from some of these surveys include rather value-biased guesses about underlying and basic causes. Very few studies deal with the analysis of the basic causes of hunger.*

In most underdeveloped countries where hunger persists, actions at the level of underlying causes will not be enough to solve the hunger problem. In most cases there must be a change in the socio-economic structure. That is why studies at this-the basic-level are so important today.

The second dimension to be considered is the categorization of the basic causes of hunger into different types related to the head components of the dialectical model introduced earlier. Five different types of basic causes of hunger can be identified:

1. Historical causes: imperialism, colonialism, neocolonialism, slavery, exploitation, division of labour, laws of inheritance, religion, wars, technology, etc. Every society has a history. History may be understood from the interaction between the economy and politics, ideology, etc. These causes can be understood by analysing the society in components of types 2 - 5 below.

2. Ecological and technological causes: natural resources, climate, land fertility, technical know-how. These are related to the technical and material conditions of production (potential resources).

3. Economic causes: property relations, ownership of or access to means of production, division of labour, power structure, imperialism and neo-colonialism, exploitation, etc. These are related to the social conditions of production {economic structure of a society).

4. Ideological and cultural causes: ideology, religion, opinions, conceptions, mores, beliefs and habits, traditional laws, etc. These are related to the superstructure of a society.

5. Political causes: power structure, military and police, law and the courts, democratic rights, fiscal policy, employment policy, organizations, etc. These are mainly related to the structure and function of the State.

The third dimension to be considered is the level of society at which the causes of the problems exist. Let us take the "inadequate intake of food" by an individual as a problem caused by maldistribution of food (underlying cause). The maldistribution of food may exist at many different levels of a society. The following levels can be identified:

- international level: maldistribution of food among countries;
- national level: maldistribution of food among regions/ areas of a country;
- area level: maldistribution of food among villages (or localities of urban areas);
- village (local) level: maldistribution of food among households;
- household level: maldistribution of food among house hold members.

Hunger always manifests itself functionally at the individual level, but the underlying and basic causes may work at any level. The alleviation of hunger requires action at the level of the society where the main causes are.

FIG. 2. Different Levels of Causes of Hunger

TABLE 2. Types of Basic Causes of Hunger at Different Levels of Society

Sometimes we say that a village, an area, or even a country is affected by hunger. While hunger at the individual level is objectively identifiable, "hunger" at higher levels must include a value-judgement in its definition. Hunger needs to affect a certain percentage of the population and to be of a sufficiently serious character before we talk about hunger in a village, hunger in an area, etc.

SOME CONCLUSIONS

Hunger manifests itself at the individual or household level as nutrient deficiency, metabolic disorders, loss of weight, apathy, etc. This is a symptom of a complex social disorder, where the causes are to be traced via immediate and underlying causes to the basic causes. The symptoms and the different types of causes exist at many different levels of a society from household to international levels. The basic causes can only be understood in relation to the specific historical, ecological, economic, cultural, and political context. The basic causes can be categorized according to these dimensions of the context.

It is useful to design a model using the dimension of the type of basic cause and the dimension of the level of the society at which the causes exists.

In table 2 some of the most common basic causes of hunger at different levels of a society are suggested. The historical causes can of course be any combination of the causes mentioned in the columns for ecology, economy, politics, etc. This proposal is far from complete and in most cases some of the causes are dominant over others.

TABLE 3. Some Symptoms and Causes of Hunger at Different Levels of Society

TABLE 4. Some Methods of Identifying Hunger at Different Levels of Society

But the matrix allows for a systematic interpretation of all possible types of causes, where each type is related to certain aspects or components of the socio-economic structure of the society.

Another useful structuring is to combine the dimension of the depth of the analysis and the dimension of the level of the society.

The symptoms of the problem of hunger manifest themselves in different ways at different levels of a society. At the individual and household levels the clinical manifestations are most obvious, while at the village level anthropometric variations may be easier to observe. At the national level the age-specific mortality rate may be the most valid parameter reflecting hunger.

The same is true with the underlying causes. Inadequate intake of food at the household level may be a manifestation of low food availability at the household level, lack of extension/education services at the village level, or inadequate production of agricultural inputs at the national level.

In table 3 an example of the different manifestations of symptoms and the immediate, underlying, and basic causes of hunger at different levels of a society are shown. The table is far from complete. It should just serve as an example of this approach.

With the matrix shown in table 3, it should be possible to identify the most valid and appropriate methods by which the problem of hunger ran be identified at different depths of analysis and levels of a society. Anthropometric surveys, for example, serve mostly to identify symptoms and should be used only at the village and maybe the area level. A brief summary, showing an approach to classifying methods of data collection, is presented in table 4 (20),

The conceptual model proposed here makes it easier to approach the problem of hunger in society in a systematic way. It is a holistic model, encompassing all important aspects of hunger. But it is also operational, allowing an analysis of the existing combinations of causes of hunger in any specific situation (locality and point in time). It should facilitate identification of feasible and potentially effective interventions within any societal context.

REFERENCES

1. V. Harle, ea., Political Economy of Food: Proceedings of an International Seminar, Tampere Peace Research Institute Research Report No. 12 (Tampere, Finland, 1976).

2. Food and Agriculture Organization, Indicative World Plan for Agricultural Development (FAO, Rome, 1976).

3. UN Department of Economic and Social Affairs, Strategy Statement on Action to Avert the Protein Crisis in Developing Countries (United Nations, New York, 1971).

4. T.T. Poleman, "Food and Population in Historical Perspective," in T.T. Poleman and D.K. Freebairn, eds., Food, Population, and Employment (Praeger, New York, 1973).

5. A. Berg., N. Scrimshaw, and D.L. Call, eds., Nutrition, National Development, and Planning (MIT Press, Cambridge, Mass., USA, 1973).

6. Declaration on the Eradication of Hunger and Malnutrition, World Food Conference, 1974.

7. Food and Agriculture Organization, Annual Report, 1974 (Rome).

8. Independent Commission on International Development Issues (Brandt Commission), North-South: A Programme for Survive/ (MIT Press, Cambridge, Mass., USA, 1980).

9. Ibid., p. 103.

10. "Towards a New International Development Strategy: The Scheveningen Report," Development Dialogue, 1980, no. 1, pp. 55-67.

11. Ibid., p. 63.

12. R.O. Whyte, RUM/ Nutrition in China (Oxford University Press, London, 1972), p. 54.

13. G. Myrdal, Asian Drama: An Inquiry into the Poverty of Nations (Pantheon, New York,1968).

14. L Althusser, Lire le Capital (Paris, 1965).

15, M. B. Wallerstein, "Inter-disciplinary Dialogue on World Hunger: A Summary of the Workshop on Goals, Processes, and Indicators of Food and Nutrition Policy," Food and Nutrition Bulletin, 2 (3): 16-23 (1980).

16. L Joy, "Food and Nutrition Planning," J. Agr. Economics, 24 11): 165-197 (1973).

17. J. earmark and G. Wallén, Knowledge Production in Interdisciplinary Groups, Dept. of the Theory of Science, University of Goteborg, Report No.37 (Goteborg, Sweden, 1975).

18. U. Jonsson and Thierry Brun, "The Politics of Food and Nutrition Planning,"in L. Joy, ea., Nutrition Planning: The State of the Art (IPC Tech. Press, London, 1978).

19. J. Galtung, Goals, Processes, and Indicators of Development: A Project Description (UN University, Tokyo, 1978).

20. B. Ljungqvist, O. Mgaza, and U. Jonsson, "The Role of Nutrition Surveys in Solving Nutrition Problems," Nutrition in Europe: Proceedings of the Third European Nutrition Conference, Uppsala, Sweden, 19-21 June 1979 (1980).

21. D.L. Call and F.J. Levinson, "A Systematic Approach to Nutrition Intervention Programmes," in Berg, Scrimshaw, and Call, eds., Nutrition, National Development, and Planning'

22. J.E, Gordon, ``synergism of Malnutrition and Infectious Disease," in Nutrition in Preventive Medicine, WHO Series, no. 62 (WHO, Geneva, 1976).

23. J. Cravioto, "Complexity of Factors Involved in Protein-Calorie Malnutrition," in Malnutrition Is a Problem of Ecology, Bibliotheca Nutritio et Dieta, No. 14 (S. Karger, Basel, Switzerland, 1970).

24. S. George, How the Other Half Dies (Pelican, London, 1976).

25. V.M. Dandekar and N. Rath, "Poverty in India" (2 parts), Economic and Political Weekly, 2 Jan. 1971, pp. 2548, and 9 Jan. 1971, pp. 106-146.

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