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Introduction

Section 141 of the Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296) authorized the development of a research program on the causes and consequences of childhood hunger and food insecurity, and the characteristics of households with childhood hunger and food insecurity, with a particular focus on efforts to improve the knowledge base regarding contributing factors, geographic distribution, programmatic effectiveness, public health and medical costs, and consequences for child development, well-being, and educational attainment. The Economic Research Service (ERS) and Food and Nutrition Service (FNS) of the U.S. Department of Agriculture (USDA) conducted two outreach efforts to obtain input from the research community and other stakeholders to help focus on areas and methods with the greatest research potential. First, FNS sought written comments to selected questions through publication of a Federal Register notice.1 While the opportunity to comment was available to any member of the public, FNS also reached out to leading experts to ensure their awareness of the opportunity to influence the course of future research. The second effort was to convene a workshop under the auspices of the Committee on National Statistics (CNSTAT) of the National Research Council (NRC).

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1See https://www.federalregister.gov/articles/2012/09/11/2012-22290/request-for-information-research-on-the-causes-characteristics-and-consequences-of-childhood-hunger [August 13, 2013].



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1 Introduction S ection 141 of the Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296) authorized the development of a research program on the causes and consequences of childhood hunger and food insecurity, and the char- acteristics of households with childhood hunger and food insecurity, with a particular focus on efforts to improve the knowledge base regarding contributing factors, geographic distribution, programmatic effectiveness, public health and medical costs, and consequences for child development, well-being, and educational attainment. The Economic Research Service (ERS) and Food and Nutrition Service (FNS) of the U.S. Department of Agriculture (USDA) conducted two outreach efforts to obtain input from the research community and other stakeholders to help focus on areas and methods with the greatest research potential. First, FNS sought written comments to selected questions through publication of a Federal Register notice.1 While the opportunity to comment was available to any member of the public, FNS also reached out to leading experts to ensure their awareness of the opportunity to influence the course of future research. The second effort was to convene a workshop under the auspices of the Committee on National Statistics (CNSTAT) of the National Research Council (NRC). 1See https://www.federalregister.gov/articles/2012/09/11/2012-22290/request-for- information-research-on-the-causes-characteristics-and-consequences-of-childhood-hunger [August 13, 2013]. 1

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2 CAUSES AND CONSEQUENCES OF CHILD FOOD INSECURITY AND HUNGER In the fall of 2012, ERS and FNS requested that CNSTAT and the Food and Nutrition Board of the Institute of Medicine (IOM) convene a joint workshop, to be led by CNSTAT. The statement of task was as follows: An ad hoc steering committee will organize a public workshop on research gaps and opportunities to advance understanding of the causes and consequences of child hunger in the United States. The workshop is requested by the Economic Research Service of the U.S. Department of Agriculture, which is assisting the Food and Nutrition Service fulfill a mandate from Section 141 of the Healthy, Hunger-Free Kids Act of 2010 to pursue a research program on this important topic for the nation. The workshop agenda will review the adequacy of current knowledge, identify substantial research gaps, and consider data availability in such areas as: • economic, health, social, cultural, demographic, and other factors that contribute to childhood hunger or food insecurity; • the geographic distribution of childhood hunger and food insecurity; • existing federal assistance programs, and assessing the extent to which they reduce childhood hunger and food insecurity; • measures of food insecurity, specifically the degree to which they accurately estimate childhood hunger and food insecurity given survey constraints (e.g., the impact of exclusion of certain subgroups, such as the homeless); and • the effects of childhood hunger on child development, well-being, and educational attainment. The steering committee will develop the agenda for the workshop, identify topics for and authors of possible commissioned papers, ­ elect s and invite speakers and discussants, and moderate the discussion. Follow­ng the workshop, a designated rapporteur will prepare an indi- i vidually authored summary of the presentations and discussion. Com- missioned papers may be published with the summary or posted on the Internet. The steering committee, working by teleconference and e-mail, planned the workshop to fulfill the statement of task. The day-and-a-half workshop focused on four key topic areas: (1) determinants of child food insecurity and hunger; (2) individual, community, and policy responses to hunger; (3) impacts of child food insecurity and hunger; and (4) mea- surement and surveillance issues. Each session was initially planned to have one main speaker who would also prepare a commissioned paper, and two discussants, ending with open-audience discussion. The steering committee identified potential speakers for a topic based on their knowl- edge of individuals who conduct state-of-the-art research or have unique expertise in that topic, and selecting the group of speakers with a range

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INTRODUCTION 3 of disciplines and viewpoints. The steering committee also agreed on the following cross-cutting themes for the topics: 1. Does the way food security is measured, the unit (household ­ ersus v child hunger), and the severity/threshold matter for understanding of the topic? 2. Is existing evidence sufficient to make causal claims or merely associational? 3. Are there important data gaps? What types of additional data would be most beneficial: longitudinal, experimental, demonstrations, administrative, linked administrative-survey data, qualitative? 4. How might the USDA prioritize research efforts? What are the criti- cal questions in each topic area, and what kind of research could begin to answer them? 5. How can research questions be action oriented, i.e., to link research with potential programmatic or policy solutions? The four topic areas and the cross-cutting themes were intended to cover the questions of interest in the statement of task. The Workshop on Research Gaps—Causes and Consequences of Child Food Insecurity and Hunger took place at the main building of the National Academy of Sciences in Washington, DC, April 8–9, 2013. There were eight main sessions and a final wrap-up by the chair of the steering committee. (The workshop agenda can be found in Appendix A, and a list of workshop registrants can be found in Appendix B.) Chapter 2 provides a brief introduction to the food security measure that has been used in the United States since 2001. The description is based largely on comments by a number of presenters and is provided as background, because speakers referred to the concept and the measurement of food insecurity through- out the workshop. Each of the following eight chapters (3 through 7 and 9) is dedicated to one of the workshop sessions, with Chapter 8 covering two sessions and Chapter 10 providing a wrap-up by the chair of the steering committee. This report was prepared by a team of rapporteurs as a factual sum- mary of what occurred at the workshop. The steering committee’s role was limited to planning and convening the workshop. The views con- tained in the report are those of individual workshop participants and do not necessarily represent the views of nonparticipants, other workshop participants, the steering committee, the NRC, or the IOM.