Research Opportunities Concerning the
Causes and Consequences of

Child Food Insecurity and Hunger

WORKSHOP SUMMARY

Nancy Kirkendall, Carol House, and Constance F. Citro, Rapporteurs


Committee on National Statistics

Division of Behavioral and Social Sciences and Education

Food and Nutrition Board

Institute of Medicine

NATIONAL RESEARCH COUNCIL AND
                                 INSTITUTE OF MEDICINE                 
                     OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

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Nancy Kirkendall, Carol House, and Constance F. Citro, Rapporteurs Committee on National Statistics Division of Behavioral and Social Sciences and Education Food and Nutrition Board Institute of Medicine

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THE NATIONAL ACADEMIES PRESS   500 Fifth Street, NW   Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Gov- erning Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engi- neering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract/Grant No. AG-32SB-C-12-0001 between the National Academy of Sciences and the U.S. Department of Agriculture. S ­ upport of the work of the Committee on National Statistics is provided by a consortium of federal agencies through a grant from the National Science Founda- tion (No. SES-1024012). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number-13:  978-0-309-29284-9 International Standard Book Number-10:  0-309-29284-0 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2013 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Research Council and Institute of Medicine. (2013). Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity ­ and Hunger: A Workshop Summary. N. Kirkendall, C. House, and C.F. Citro, Rappor- teurs. Committee on National Statistics, Division of Behavioral and Social Sciences and Education. Food and Nutrition Board, Institute of Medicine. Washington, DC: The National Academies Press.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the ­ cademy has a mandate that requires it to advise the federal govern- A ment on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the char- ter of the National Academy of Sciences, as a parallel organization of outstand- ing engineers. It is autonomous in its administration and in the selection of its m ­ embers, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in pro- viding services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Steering Committee for the Workshop on Research Gaps— Causes and Consequences of Child Food Insecurity and Hunger James P. Ziliak (Chair), Center for Poverty Research and Department of Economics, University of Kentucky Judith S. Bartfeld, Department of Consumer Science, University of Wisconsin–Madison Deborah A. Frank, Department of Pediatrics, Boston University School of Medicine Sonya Jones, Center for Research in Nutrition and Health Disparities, University of South Carolina Susan L. Parish, The Heller School for Social Policy and Management, Brandeis University Rafael Pérez-Escamilla, Office of Community Health and Department of Chronic Disease Epidemiology, Yale School of Public Health Nancy Kirkendall, Study Director Carol House, Senior Program Officer Agnes E. Gaskin, Administrative Assistant v

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Committee on National Statistics 2013–2014 Lawrence D. Brown (Chair), Department of Statistics, The Wharton School, University of Pennsylvania John M. Abowd, School of Industrial and Labor Relations, Cornell University Mary Ellen Bock, Department of Statistics, Purdue University David Card, Department of Economics, University of California, Berkeley Alicia Carriquiry, Department of Statistics, Iowa State University Michael E. Chernew, Department of Health Care Policy, Harvard Medical School Constantine Gatsonis, Center for Statistical Sciences, Brown University James S. House, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor Michael Hout, Survey Research Center, University of California, Berkeley Sallie Keller, Virginia Bioinformatics Institute, Virginia Polytechnic Institute Lisa Lynch, The Heller School for Social Policy and Management, Brandeis University Colm O’Muircheartaigh, Harris School of Public Policy Studies, University of Chicago Ruth Peterson, Criminal Justice Research Center, Ohio State University Edward H. Shortliffe, Biomedical Informatics, Columbia University and Arizona State University Hal Stern, Donald Bren School of Information and Computer Sciences, University of California, Irvine Constance F. Citro, Director Jacqueline R. Sovde, Program Assocate vi

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Food and Nutrition Board Suzanne P. Murphy (Chair), Epidemiology Program, University of Hawaii Cancer Center Cheryl A.M. Anderson, Department of Family and Preventive Medicine, University of California, San Diego Patsy M. Brannon, Division of Nutritional Sciences, Cornell University Fergus M. Clydesdale, Food Science Policy Alliance, Department of Food Science, University of Massachusetts Richard J. Deckelbaum, Institute of Human Nutrition, Columbia University Medical Center Sharon M. Donovan, Nutrition and Health, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign Lee-Ann Jaykus, Department of Food, Bioprocessing and Nutritional Sciences, North Carolina State University Gordon L. Jensen, Department of Nutritional Sciences, Pennsylvania State University Joanne R. Lupton, Department of Nutrition and Food Science, Texas A&M University Susan T. Mayne, Chronic Disease Epidemiology, Yale Schools of Public Health and Medicine James M. Ntambi, Department of Nutritional Sciences, University of Wisconsin–Madison Rafael Pérez-Escamilla, Office of Community Health and Department of Chronic Disease Epidemiology, Yale School of Public Health Martin Philbert, Toxicology and Senior Associate Dean for Research, University of Michigan, School of Public Health Mary T. Story, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Patrick J. Stover, Division of Nutritional Sciences and Institute for Nutritional Genomics, Cornell University Connie M. Weaver, Department of Food and Nutrition, Purdue University Ann Yaktine, Interim Director vii

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Reviewers T his workshop summary has been reviewed in draft form by individ- uals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s (NRC’s) Report Review Committee. The purpose of this inde- pendent review is to provide candid and critical comments that will assist the institution in making its published summary as sound as possible and to ensure that the summary meets institutional standards for clarity, objectivity, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the pro- cess. We wish to thank the following individuals for their review of this workshop summary: Helen H. Jensen, Food and Nutrition Policy Divi- sion of the Center for Agricultural and Rural Development, Iowa State University; Sonya Jones, Center for Research in Nutrition and Health Disparities, University of South Carolina; Robert A. Moffitt, Department of Eco­ omics, Johns Hopkins University; and Parke E. Wilde, Friedman n School of Nutrition and Policy, Tufts University. Although the reviewers listed above have provided many construc- tive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this summary was overseen by Alicia Carriquiry, Department of Statistics, Iowa State Uni- versity. Appointed by the NRC, she was responsible for making certain that an independent examination of this summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this sum- mary rests entirely with the authors and the institution. ix

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Contents  1 Introduction 1   2 Defining and Measuring Food Security 4   3  Individual and Household Determinants of Child Food Insecurity and Hunger 11   4  Contextual Factors Linked to Child Food Insecurity and Hunger 27   5 Individual and Family Coping Responses to Hunger 43   6 Community Responses to Food Insecurity and Hunger 62   7 Public Policy Responses to Hunger 76   8  Health and Developmental Correlates of Child Food Insecurity from Pregnancy to Adolescence 94   9  Measurement and Surveillance of Child Food Insecurity and Hunger 121 10 Wrap-Up 139 Bibliography 145 Appendixes A Agenda 187 B Registered Participants 192 xi

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