{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:15:21Z","timestamp":1788286521846,"version":"build-2803163510"},"reference-count":69,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>The world produces enough food for all, yet it falls short of providing a nutritionally balanced diet, and what it produces is extremely unevenly distributed, with high levels of undernourishment and obesity co-existing, often within the same countries. Policy responses have achieved only limited success because they often fail to address the underlying causes of these outcomes. Drawing on Amartya Sen\u2019s entitlement framework and adapting it by making the conditions governing conversion analytically explicit, we explain food access in terms of people\u2019s endowments and the exchange, production, and transfer entitlements through which food is acquired. We examine two analytically distinct but mutually reinforcing forces: corporate power and wealth inequality. Corporate concentration can reshape production, supply chains, food environments and public policy, while wealth inequality limits access to productive assets, purchasing power and social protection. We argue that durable progress requires policies that rebuild household endowments, constrain excessive corporate and political power, strengthen conversion factors, and widen exchange, production and transfer entitlements. Priority measures include progressive taxation of income and particularly taxation of extreme wealth, social protection, competition and governance reform, secure land tenure and support for smallholders, regulation of food marketing, and investment in enabling infrastructure.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007192","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:37:44Z","timestamp":1788284264000},"page":"e0007192","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Power and entitlement: Addressing the structural drivers of food insecurity and malnutrition"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-3859","authenticated-orcid":true,"given":"Helen","family":"Walls","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"McKee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"pgph.0007192.ref001","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1525\/elementa.310","article-title":"Current global food production is sufficient to meet human nutritional needs in 2050 provided there is radical societal adaptation","volume":"6","author":"M Berners-Lee","year":"2018","journal-title":"Elem Sci Anth"},{"issue":"10","key":"pgph.0007192.ref002","article-title":"When too much isn\u2019t enough: Does current food production meet global nutritional needs?","volume":"13","author":"KKC Bahardur","year":"2018","journal-title":"PLoS One"},{"key":"pgph.0007192.ref003","author":"United Nations"},{"key":"pgph.0007192.ref004","article-title":"Beyond hunger: A healthy diet for a healthy life.","volume-title":"Atlas of Sustainable Development Goals 2023","author":"W Divyanshi","year":"2023"},{"key":"pgph.0007192.ref005","author":"World Health Organization","year":"2024"},{"key":"pgph.0007192.ref006","unstructured":"Oxfam I. 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inequalities","volume":"365","author":"M Marmot","year":"2005","journal-title":"Lancet"},{"key":"pgph.0007192.ref017","author":"Oxfam International","year":"2023"},{"key":"pgph.0007192.ref018","article-title":"Wealth of the world\u2019s billionaires grew by $2tn in 2024, report finds","author":"J Kollewe","year":"2025","journal-title":"The Guardian"},{"key":"pgph.0007192.ref019","author":"Oxfam International","year":"2026"},{"key":"pgph.0007192.ref020","article-title":"\u2018Health emergency\u2019: 15% of UK households went hungry last month, data shows","author":"P Butler","year":"2024","journal-title":"The Guardian"},{"key":"pgph.0007192.ref021","article-title":"UK middle classes \u2018struggling despite incomes of up to \u00a360,000 a year\u2019","author":"L Elliot","year":"2024","journal-title":"The Guardian"},{"issue":"6","key":"pgph.0007192.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001223","article-title":"Food sovereignty: power, gender, and the right to food","volume":"9","author":"RC Patel","year":"2012","journal-title":"PLoS Med"},{"issue":"12","key":"pgph.0007192.ref023","first-page":"809","article-title":"Addressing malnutrition: the importance of political economy analysis of power","volume":"10","author":"H Walls","year":"2021","journal-title":"Int J Health Policy Manag"},{"issue":"1","key":"pgph.0007192.ref024","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1146\/annurev-soc-031021-112747","article-title":"Food and inequality","volume":"49","author":"S Shostak","year":"2023","journal-title":"Annual Review of Sociology"},{"key":"pgph.0007192.ref025","article-title":"The people \u2013 food predicament in Africa: The quest for food security","volume":"1","author":"O Akpomuvie","year":"2011","journal-title":"International Journal of Humanities and Social Science"},{"key":"pgph.0007192.ref026","volume-title":"Poverty and famines: an essay on entitlement and deprivation","author":"A Sen","year":"1981","edition":"1"},{"key":"pgph.0007192.ref027","volume-title":"Commodities and capabilities","author":"A Sen","year":"1999"},{"key":"pgph.0007192.ref028","doi-asserted-by":"crossref","first-page":"106837","DOI":"10.1016\/j.landusepol.2023.106837","article-title":"Land tenure and food security in South India","volume":"132","author":"H Dagdeviren","year":"2023","journal-title":"Land Use Policy"},{"key":"pgph.0007192.ref029","doi-asserted-by":"crossref","DOI":"10.3389\/fsufs.2023.1290576","article-title":"SDG 2 \u2013 ending hunger: the effect of Nigeria\u2019s land titling on production output and food security of farming households","volume":"7","author":"TA Adeyemo","year":"2024","journal-title":"Front Sustain Food Syst"},{"key":"pgph.0007192.ref030","article-title":"Relationships between land tenure insecurity, agrobiodiversity, and dietary diversity of women of reproductive age: Evidence from Acholi and Teso subregions of Uganda","author":"B Ekesa","year":"2020","journal-title":"Matern Child Nutr"},{"key":"pgph.0007192.ref031","doi-asserted-by":"crossref","first-page":"100494","DOI":"10.1016\/j.jafr.2023.100494","article-title":"An empirical investigation of the dynamic linkages of land access and food security: Evidence from Ethiopia using system GMM approach","volume":"11","author":"A Mulusew","year":"2023","journal-title":"Journal of Agriculture and Food Research"},{"key":"pgph.0007192.ref032","doi-asserted-by":"crossref","first-page":"1407005","DOI":"10.3389\/fpubh.2024.1407005","article-title":"Latinos\u2019 diminished returns of educational attainment on reducing food insecurity: the role of ethnic disparities in family structure and employment","volume":"12","author":"S Assari","year":"2024","journal-title":"Front Public Health"},{"issue":"2","key":"pgph.0007192.ref033","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/02255189.2017.1382335","article-title":"Food security and democracy: do inclusive institutions matter?","volume":"39","author":"D Rossignoli","year":"2018","journal-title":"Canadian Journal of Development Studies \/ Revue canadienne d\u2019\u00e9tudes du d\u00e9veloppement"},{"issue":"3","key":"pgph.0007192.ref034","doi-asserted-by":"crossref","first-page":"924","DOI":"10.12944\/CRNFSJ.8.3.21","article-title":"The Impact of Political Risk and Institutions on Food Security","volume":"8","author":"A Abdullah","year":"2020","journal-title":"Curr Res Nutr Food Sci"},{"key":"pgph.0007192.ref035","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.gfs.2018.08.003","article-title":"Concepts and critical perspectives for food environment research: A global framework with implications for action in low- and middle-income countries","volume":"18","author":"C Turner","year":"2018","journal-title":"Global Food Security"},{"key":"pgph.0007192.ref036","author":"IPES-Food","year":"2017"},{"issue":"3","key":"pgph.0007192.ref037","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1007\/s13412-015-0292-2","article-title":"Resilience in a concentrated and consolidated food system","volume":"5","author":"MK Hendrickson","year":"2015","journal-title":"J Environ Stud Sci"},{"issue":"2","key":"pgph.0007192.ref038","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1162\/glep_a_00454","article-title":"Mega-Mergers on the Menu: Corporate Concentration and the Politics of Sustainability in the Global Food System","volume":"18","author":"J Clapp","year":"2018","journal-title":"Global Environmental Politics"},{"key":"pgph.0007192.ref039","author":"K Deconinck","year":"2021"},{"key":"pgph.0007192.ref040","first-page":"15","article-title":"Smallholders and rural people: Making food system value chains inclusive.","volume-title":"IFPRI Global Food Policy Report 2020","author":"R Vos","year":"2020"},{"issue":"6","key":"pgph.0007192.ref041","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.2135\/cropsci2014.09.0669","article-title":"Intellectual Property and Consolidation in the Seed Industry","volume":"55","author":"PH Howard","year":"2015","journal-title":"Crop Science"},{"issue":"17","key":"pgph.0007192.ref042","doi-asserted-by":"crossref","first-page":"5963","DOI":"10.1017\/S1368980021002780","article-title":"Marketing of commercial foods for infant and young children in Uruguay: sugary products, health cues on packages and fun social products on Facebook","volume":"24","author":"G Karageuzi\u00e1n","year":"2021","journal-title":"Public Health Nutr"},{"key":"pgph.0007192.ref043","article-title":"Health first, convenience second: Caregiver perspectives of commercially produced complementary foods in five Southeast Asian capital cities","author":"H Walls","year":"2023","journal-title":"Matern Child Nutr"},{"issue":"8","key":"pgph.0007192.ref044","first-page":"29","article-title":"Neuro-marketing and consumer behavior: Exploring the use of neuroscience techniques to understand how consumers make decisions and respond to marketing stimuli","volume":"10","author":"A Dutta","year":"2023","journal-title":"EPRA Int J Economics, Busin Management Stud"},{"issue":"11","key":"pgph.0007192.ref045","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1136\/jech-2017-209710","article-title":"\u201cNothing can be done until everything is done\u201d: the use of complexity arguments by food, beverage, alcohol and gambling industries","volume":"71","author":"M Petticrew","year":"2017","journal-title":"J Epidemiol Community Health"},{"key":"pgph.0007192.ref046","doi-asserted-by":"crossref","first-page":"101009","DOI":"10.1016\/j.ssmph.2021.101009","article-title":"Manufacturing doubt: Assessing the effects of independent vs industry-sponsored messaging about the harms of fossil fuels, smoking, alcohol, and sugar sweetened beverages","volume":"17","author":"N Maani","year":"2021","journal-title":"SSM Popul Health"},{"issue":"10383","key":"pgph.0007192.ref047","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/S0140-6736(23)00013-2","article-title":"Defining and conceptualising the commercial determinants of health","volume":"401","author":"AB Gilmore","year":"2023","journal-title":"Lancet"},{"key":"pgph.0007192.ref048","first-page":"38","author":"K Polanyi","year":"2002"},{"key":"pgph.0007192.ref049","doi-asserted-by":"crossref","first-page":"103184","DOI":"10.1016\/j.apgeog.2023.103184","article-title":"Social and spatial inequalities of contemporary food deserts: A compound of store and online access to food in the United Kingdom","volume":"163","author":"F Janatabadi","year":"2024","journal-title":"Applied Geography"},{"issue":"5","key":"pgph.0007192.ref050","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s11524-015-9984-x","article-title":"Constrained, convenient, and symbolic consumption: neighborhood food environments and economic coping strategies among the urban poor","volume":"92","author":"L Tach","year":"2015","journal-title":"J Urban Health"},{"issue":"9","key":"pgph.0007192.ref051","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(24)00187-7","article-title":"Financialisation: a 21st century commercial determinant of health equity","volume":"9","author":"S Friel","year":"2024","journal-title":"Lancet Public Health"},{"key":"pgph.0007192.ref052","doi-asserted-by":"crossref","DOI":"10.4159\/9780674369542","volume-title":"Capital in the twenty-first century","author":"T Piketty","year":"2014"},{"key":"pgph.0007192.ref053","article-title":"Britain\u2019s middle classes feel the pinch in cost of living crisis","journal-title":"Financial Times"},{"key":"pgph.0007192.ref054","article-title":"The British middle class is in freefall, its young people pushed into precarity","author":"O Jones","year":"2020","journal-title":"The Guardian"},{"key":"pgph.0007192.ref055","article-title":"America\u2019s middle-class meltdown: Core shrinks to half of US homes","author":"S Fleming","year":"2015","journal-title":"Financial Times"},{"key":"pgph.0007192.ref056","unstructured":"Eurofound. Eurofound talks: Is Europe\u2019s middle class disappearing?. 2024."},{"key":"pgph.0007192.ref057","unstructured":"Molloy S. Australia should prepare for the death of the middle class, experts warn. newscomau. 2024."},{"issue":"1","key":"pgph.0007192.ref058","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1080\/00213624.2021.1874796","article-title":"Explaining Stagnant Living Standards in a Generalized Asset Growth Context","volume":"55","author":"RS Goldberg","year":"2021","journal-title":"Journal of Economic Issues"},{"key":"pgph.0007192.ref059","volume-title":"Global inequality: A new approach for the age of globalization","author":"B Milanovic","year":"2016"},{"issue":"2","key":"pgph.0007192.ref060","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2471\/BLT.24.291950","article-title":"Artificial intelligence, recessionary pressures and population health","volume":"103","author":"J-A Occhipinti","year":"2025","journal-title":"Bull World Health Organ"},{"key":"pgph.0007192.ref061","first-page":"419","article-title":"Separations of wealth: Inequality and the erosion of checks and balances","volume":"18","author":"K Andrias","year":"2015","journal-title":"Journal of Constitutional Law"},{"key":"pgph.0007192.ref062","volume-title":"The new power elite: inequality, politics and greed","author":"A Shipman","year":"2018"},{"key":"pgph.0007192.ref063","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.socscimed.2017.03.029","article-title":"Health inequities in the age of austerity: The need for social protection policies","volume":"187","author":"A Ruckert","year":"2017","journal-title":"Soc Sci Med"},{"key":"pgph.0007192.ref064","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.gfs.2016.07.009","article-title":"Impact of Cash Transfer programs on Food Security and Nutrition in sub-Saharan Africa: a cross-country analysis","volume":"11","author":"S Tiwari","year":"2016","journal-title":"Glob Food Sec"},{"issue":"12","key":"pgph.0007192.ref065","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-003621","article-title":"Cash transfers and child nutritional outcomes: a systematic review and meta-analysis","volume":"5","author":"J Manley","year":"2020","journal-title":"BMJ Glob Health"},{"key":"pgph.0007192.ref066","author":"wemustdrawtheline.org","year":"2025"},{"key":"pgph.0007192.ref067","volume-title":"The three worlds of welfare capitalism","author":"G Esping-Andersen","year":"1990"},{"key":"pgph.0007192.ref068","unstructured":"Walls H, Pastorino S, Moyo B, Bundy D. Climate change, food system resilience and the need for social protection strategies that protect the next generation. PLOS Blogs: Speaking of Medicine and Health. 2024."},{"key":"pgph.0007192.ref069","volume-title":"School meals and food systems: Rethinking the consequences for climate, environment, biodiversity, and food sovereignty","author":"S Pastorino","year":"2023"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:37:53Z","timestamp":1788284273000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007192"}},"subtitle":[],"editor":[{"given":"Bram","family":"Wispelwey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":69,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0007192","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}