Liberal trade policy and food insecurity across the income distribution: an observational analysis in 132 countries, 2014–17

Background. Eradicating food insecurity is necessary for achieving global health goals. Liberal trade policies may increase food supplies but how these policies influence individual-level food insecurity remains uncertain. Methods. We combined Food and Agricultural Organization data from 460,102 persons in 132 countries, 2014-2017, with a country-level trade policy index from the Konjunkturforschungsstelle (KOF) Swiss Economic Institute. We examined the association between a country’s trade policy score and the probability of reporting ‘moderate/severe’ food insecurity using regression models and algorithmic weighting procedures. We control for multiple covariates, including GDP, democratization, and population size. We further examined heterogeneity by country- and household-income. Results. Liberal trade policy was not significantly associated with moderate/severe food insecurity after covariate adjustment. However, among households in high-income countries with incomes larger than $25,430 per person per year, a unit increase in the trade policy index (more liberal) corresponded to a 0·07 % (95% CI: -0·10% to -0·04%) reduction in the predicted probability of reporting moderate/severe food insecurity. Among households in the lowest income decile (<$450 per person per year) in low-income countries, a unit increase in the trade policy index was associated with a 0·35% (95% CI: 0·06% to 0·6%) increase in the predicted probability of moderate/severe food insecurity.Interpretation. The relationship between liberal trade policy and food insecurity varies across countries and households. Liberal trade policy is predominantly associated with lower food insecurity in high-income countries but corresponds to increased food insecurity among some very poor30 households in low-income countries.