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Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
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2

Defining and Measuring Food Security

This chapter introduces the food security measure that has been used in the United States since 1995 and provides a brief history of its development, as described by workshop participants.1 This information is provided as background in this chapter because most speakers used the concept and measurement of food insecurity throughout the workshop.

DEFINING FOOD SECURITY

“Food security” is a status assigned to households and some individuals in households based on responses to questions that have constituted the Household Food Security Survey Module (HFSSM) in the Current Population Survey (CPS) since 1995 (Economic Research Service, 2012). Various aspects of it were described during the workshop by Craig Gundersen (Chapter 3), John Cook (Chapter 8), and Edward Frongillo (Chapter 9). As shown in Box 2-1, the HFSSM consists of 10 questions for households without children and 18 questions for households with children. Each question is qualified by the stipulation that the outcomes are due to a lack of financial resources. This version of the questionnaire uses a one-year reference period, asking many questions about the time period “in the last 12 months.” The questions may also be asked using a

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1Detailed information about the history of food security measurement and the measurement itself is available on the website of the Economic Research Service (ERS), U.S. Department of Agriculture. See http://www.ers.usda.gov/data-products/food-security-in-the-united-states.aspx [August 14, 2013].

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
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BOX 2-1
Questions Used to Assess Food Security of Households in the Current Population Survey

To reduce burden on higher income respondents the full Food Security Supplement in the Current Population Survey is not administered to households that (1) report incomes above 185 percent of the federal poverty line and (2) give no indication of food access problems on both of two preliminary screening questions. The preliminary screening questions are listed below:

1.   People do different things when they are running out of money for food in order to make their food or their food money go further. In the last 12 months, since December of last year, did you ever run short of money and try to make your food or your food money go further?

2.   Which of these statements best describes the food eaten in your household—enough of the kinds of food we want to eat, enough but not always the kinds of food we want to eat, sometimes not enough to eat, or often not enough to eat?

These households are deemed to be food secure and are not asked the questions in the Household Food Security Survey Module.

Household Food Security Survey Module Survey— One-Year Reference Period

Now I’m going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was OFTEN true, SOMETIMES true, or NEVER true for your household in the last 12 months.

1.   “We worried whether our food would run out before we got money to buy more.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

2.   “The food that we bought just didn’t last, and we didn’t have money to get more.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

3.   “We couldn’t afford to eat balanced meals.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

4.   In the last 12 months, did you or other adults in the household ever cut the size of your meals or skip meals, because there wasn’t enough money for food? (Yes/No)

5.   (If yes to question 4) How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?

6.   In the last 12 months, did you ever eat less than you felt you should, because there wasn’t enough money for food? (Yes/No)

7.   In the last 12 months, were you ever hungry, but didn’t eat, because there wasn’t enough money for food? (Yes/No)

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
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8.   In the last 12 months, did you lose weight, because there wasn’t enough money for food? (Yes/No)

9.   In the last 12 months, did you or other adults in your household ever not eat for a whole day, because there wasn’t enough money for food? (Yes/No)

10. (If yes to question 9) How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?

(Questions 11–18 were asked only if the household included children age 0–17)

Now I’m going to read you several statements that people have made about the food situation of their children. For these statements, please tell me whether the statement was OFTEN true, SOMETIMES true, or NEVER true in the last 12 months for any child under 18 years old living in the household.

11. “We relied on only a few kinds of low-cost food to feed the children in our household, because we were running out of money to buy food.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

12. “We couldn’t feed the children in our household a balanced meal, because we couldn’t afford that.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

13. “The children in our household were not eating enough, because we just couldn’t afford enough food.” Was that OFTEN, SOMETIMES, or NEVER true for you in the last 12 months?

14. In the last 12 months, did you ever cut the size of any of the children’s meals, because there wasn’t enough money for food? (Yes/No)

15. In the last 12 months, were the children ever hungry but you just couldn’t afford more food? (Yes/No)

16. In the last 12 months, did any of the children ever skip a meal, because there wasn’t enough money for food? (Yes/No)

17. (If yes to question 16) How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?

18. In the last 12 months, did any of the children ever not eat for a whole day, because there wasn’t enough money for food? (Yes/No)

SOURCE: Coleman-Jensen et al. (2012:3–4). Reprinted with permission. Question text excerpted from December 2012 Current Population Survey Food Security Supplement. See http://www.ers.usda.gov/datafiles/Food_Security_in_the_United_States/Current_Population_Survey/2012/qn2012.pdf [October 10, 2013].

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×

30-day reference period. The CPS collects responses for both the previous 12 months and for the 30 days just prior to the survey.

Households are classified into food security status categories based on the number of food-insecure responses to the questions,2 consistent with statistical evidence that this number reflects the level of food hardship experienced by the family. The three categories of household food security are (1) food secure (fewer than 3 food-insecure responses); (2) low food security (more than 2 but fewer than 6 food-insecure responses for households without children, more than 2 but fewer than 8 food-insecure responses among households with children); and (3) very low food security (6 or more food-insecure responses among the 10 questions for households without children, 8 or more food-insecure responses among the 18 questions for households with children). Families are said to be food insecure if they fall in categories 2 or 3. Children in a food-insecure household are said to have low food security if 2 to 4 of the child-related questions have food-insecure responses. They are said to have very low food security if 5 or more of the child-related questions have food-insecure responses.

The responses to the HFSSM support three summary scales: (1) the 18-item food security scale, sometimes referred to as the combined adult-child scale; (2) the 10-item adult food security scale; and (3) the 8-item child food security scale (see Box 2-1). These are all considered household-level measures because they reflect food-insecure conditions of any person in the household, any adult in the household, or any child in the household.

HISTORY

During the workshop, the history of the development of the HFSSM was described by Frongillo (see Chapter 9 for the rest of his presentation) and Cook (see Chapter 8 for the rest of his presentation). Frongillo explained that the basic definition of food security used in the United States was developed for the American Institute of Nutrition by the Expert Panel on Core Indicators of Nutritional State for Difficult-to-Sample Populations, as documented in Anderson (1990). In Anderson’s work, food security was defined to be “access by all people at all times to enough food for an active, healthy life3 and includes at a minimum: (a) the ready

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2According to Coleman-Jensen et al. (2012), food-insecure responses are indicated by responses of “often” or “sometimes” to questions 1–3 and 11–13; “almost every month” or “some months but not every month” to questions 5, 10, and 17; and “yes” to the other conditions shown in Box 2-1.

3ERS currently uses the first part of this definition to define food security. See http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us.aspx [August 20, 2013].

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×

image

FIGURE 2-1 Core concepts related to nutritional state.

SOURCE: National Research Council (2006:44).

availability of nutritionally adequate and safe foods, and (b) the assured ability to acquire acceptable foods in socially acceptable ways (e.g., without resorting to emergency food supplies, scavenging, stealing, and other coping strategies)” (Anderson, 1990:1560). Frongillo pointed out the basic definition has many different aspects. When the national surveillance effort began, he said, food security was conceptualized as one of the core concepts related to nutritional state (see Figure 2-1).

Frongillo said that at the same time, Congress enacted the National Nutrition Monitoring and Related Research Act (P.L. 101-445) that led to the development of a 10-year plan for assessing the dietary and nutritional status of the U.S. population. Later in the workshop, Cook noted, as described in Bickel, Andrews, and Klein (1996), that the measure was developed by the Food Security Measurement Project (1995–1997), with a multiobjective mandate to develop reliable measures of food security, food insecurity, and hunger that were scientifically valid for the U.S. population, consistent with the goals and policies of the U.S. government.

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×

This project developed the 18-item HFSSM that was first administered in the CPS in April 1995, with minor refinements in 1998, 2005, 2006, and 2007.

Cook noted that researchers use several different scales. The 18-item questionnaire can be used with a 12-month (see Box 2-1) or 30-day reference period. There is also a 6-item abbreviated scale4 and the 10-item adult scale (the top 10 questions in Box 2-1). Of most interest in this workshop, he said, is the 8-item child food security scale (the last 8 questions in Box 2-1), although he pointed out that this scale does not include a question about the affective component of food insecurity or the anxiety or worry that food would run out.

MEASURING FOOD SECURITY5

The HFSSM has been included in a number of national-level periodic surveys. As noted above, the full 18 questions referenced to 12 months have been included in the Current Population Survey Food Security Supplement annually since 1995. For each question, an affirmative response is followed up with a query as to whether the condition or behavior occurred in the previous 30 days.6

The full 18 questions have also been included in the family questionnaire of the National Health and Nutrition Examination Survey since 1999. In addition, from 2001–2010, a subset of the more severe questions with 30-day reference were asked about the sampled person rather than all persons in the household.

The Survey of Income and Program Participation (SIPP) included a nonstandard module with five adult questions and a four-month reference period in wave 8 (the adult well-being module), beginning with the 1996 panel and continuing through the end of the 2013 panel.7 The Survey of Program Dynamics included the standard 18-item module with 12-month reference annually from 1998 to 2002. The Early Childhood Longitudinal Study-Kindergarten (ECLS-K) Cohort included the standard 18-item questionnaire with 12-month reference for four rounds from 1998–2007 when children were in kindergarten, grade 3, grade

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4The 6-item abbreviated scale uses questions 2, 3, 4, 5, and 6 in Box 2-1, plus a follow-up question, like 5, for question 2.

5The information below was provided by email from Mark Nord (ERS) on August 19, 2013. Much of this background is also on the ERS website, at the link shown in footnote 1.

6Prior to 2005, the 30-day follow-up questions were only administered for the more severe questions (those with a yes/no response) in the module.

7The five-item SIPP questions were chosen before the six-item short module was standardized. Subsequent panels continued with the same questions for continuity. The SIPP beginning in 2014 will include the standard six-item short module.

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×

5, and grade 8. The module is also in the new ECLS-K beginning with the kindergarten class of 2010–2011. The Early Childhood Longitudinal Study

-Birth Cohort included the standard 18-item questionnaire with 12-month reference in the panel beginning in 2002. The food security questions were included in surveys in 2002, 2004, 2006–2007, and 2007– 2008. The National Health Interview Survey has included the standard adult 10-item questionnaire with a 30-day reference annually beginning in 2011. The Panel Study of Income Dynamics (PSID) included the standard 18 items with 12-month reference in its child development supplement in 1997, and in the core PSID in 1999, 2001, 2003, 2005, and 2007.

As examples of other uses in large studies, the standard 18-item module was included in multiple waves of the Fragile Families Study and Children’s HealthWatch (previously Children’s Sentinel Nutritional Assessment Program) beginning in 1998. Although neither of these studies is fully nationally representative, they represent large vulnerable populations.

Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 4
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 5
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 6
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 7
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 8
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
Page 9
Suggested Citation:"2 Defining and Measuring Food Security." National Research Council and Institute of Medicine. 2013. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18504.
×
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Section 141 of The Healthy, Hunger-Free Kids Act of 20101 provides funding for 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 and Food and Nutrition Service of the US Department of Agriculture 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, Food and Nutrition Service sought written comments to selected questions through publication of a Federal Register Notice. The second option was to convene a workshop under the auspices of the Committee on National Statistics of the National Research Council and the Food and Nutrition Board of the Institute of Medicine.

Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger is the summary of that workshop, convened in Fall 2012 to examine research gaps and opportunities to advance understanding of the causes and consequences of child hunger in the United States. This report reviews the adequacy of current knowledge, identifies substantial research gaps, and considers data availability of economic, health, social, cultural, demographic, and other factors that contribute to childhood hunger or food insecurity. It also considers the geographic distribution of childhood hunger and food insecurity; the extent to which existing federal assistance programs reduce childhood hunger and food insecurity; childhood hunger and food insecurity persistence, and the extent to which it is due to gaps in program coverage; and the inability of potential participants to access programs, or the insufficiency of program benefits or services.

Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger will be a resource to inform discussions about the public health and medical costs of childhood hunger and food insecurity through its focus on determinants of child food insecurity and hunger, individual, community, and policy responses to hunger, impacts of child food insecurity and hunger, and measurement and surveillance issues.

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