The goal of this study was to measure food insecurity among families with children in a low-income district of Lima, Peru and to identify the formal and informal food resources available to them that may affect their food security status. In June-July 2019, we collected data from 329 randomly selected households in Villa El Salvador (Lima, Peru). Following a mixed methods approach, we found that the percentage of households using food assistance programs (FAPs) increased with increasing levels of food insecurity, but two FAPs were heavily used by households regardless of food (in)security. The main reasons for using FAPs included financial need, already being signed up in the program, and believing that the food was of nutritional value; the main reasons for non-use were finding the program unnecessary, dislike or poor perceived quality of the food, and not being able to sign up for the program. Similarly, informal food resources, such as buying food on credit or receiving food from someone outside the household, were incrementally used with increased levels of food insecurity. Our study clarifies the relationship between level of household food insecurity and FAP use – FAPs more commonly used by food insecure households were used because of financial need, whereas the FAPs most commonly used by food secure households were those with automatic enrollment. At a programmatic level, our research highlights the need for making nutritious and preferred foods available in FAPs and standardizing the application of enrollment criteria.

Objectives To examine the association between food insecurity – the inability to acquire adequate nutritious foods due to economic constraints – and perceptions of food accessibility, quality, and variety in one's neighborhood in a low socioeconomic district of Lima, Peru. Methods A household survey was conducted among randomly selected households with at least one child <18 years of age in Villa El Salvador (Lima, Peru; N = 329). The language-validated questionnaire included questions from the Perceived Nutrition Environment Measures Survey (NEMS), which were adapted to the local setting and translated into Spanish. These NEMS questions assessed perceived accessibility, quality, and variety of foods in the neighborhood of residence on a Likert scale (e.g., 1 = completely agree to 5 = completely disagree) and were later dichotomized for analysis. The questionnaire also included the Household Food Insecurity Access Scale (HFAIS), to measure food insecurity. Multivariable logistic regression was used to assess the association between the perceived neighborhood food environment and food insecurity, adjusting for sociodemographic variables. Results About 77% of the households reported having food insecurity. Adjusting for age, gender, and education of the homemaker, food insecurity was associated with perceptions of decreased accessibility to fresh fruits and vegetables (OR = 5.05; 95% CI = 2.03–12.60) and low-fat products (OR = 2.07; 95% CI = 1.18, 3.65); low quality of fresh fruits and vegetables (OR = 3.28; 95% CI = 1.84, 5.86) and low-fat products (OR = 2.13; 95% CI = 1.22, 3.73); and a low variety of fresh fruits and vegetables (OR = 2.62; 95% CI = 1.43, 4.79) in the neighborhood. Conclusions Food insecure families living in a low-income district in Lima, Peru share negative perceptions of access, quality, and variety of food in their surrounding neighborhood. Efforts to improve the availability of affordable healthy foods in low-income neighborhoods in Lima may help ameliorate food insecurity. Funding Sources This work was supported by the National Institute on Minority Health and Health Disparities’ Minority Health and Health Disparities International Training Grant, the Fulbright U.S. Student Program, and the Carol Lavin Bernick Faculty Grant Program (Tulane University).