Improving federal efforts to assess hunger and food insecurity

The current debate about welfare reform has often hinged on the impact of welfare policies on the poor. Reliable monitoring of the effects of such reform, including changes in the prevalence of domestic hunger, will be an important aspect of future policy-making. The most recent USDA surveys, based on data from the late 1980's and early 1990's, indicate that about 2 to 4 percent of households in the United States report not getting enough to eat. Yet other studies show hunger to range from 11 to 13 percent for the same time period. Such discrepancies have given rise to recent efforts to improve the way hunger in this country is defined and monitored (see box). A new national survey will help assess the nature and extent of hunger in America and provide detailed information on how people cope with it.

But is there really hunger in America? For those who don't live it, or face it, the phrase "hunger in America" must sound like an oxymoron. The United States, after all, has the world's largest economy and historically has given away more food than any other country. Hunger should be something associated with nations on the receiving end of this food aid - certainly not with the world's largest donor.

To the average person, doubt about the existence of hunger in America surely stems from more than just aggregate commodity flows. We are a nation of dieters, constantly reminded that an overweight condition is unhealthy and undesirable - and now, more common than ever. A recent national survey estimated that one-third of Americans are overweight, up from one-fourth in the late 1970's. Surveys indicate that over 61 percent of adult women and 48 percent of adult men are currently trying to lose or maintain weight. How could there be hunger in a nation so obsessed with being overweight?

The short answer is that "hunger" in America is often hidden. The strength of the U.S. economy belies the inequality of income distribution, which has grown since the 1970's. About 39 million Americans, 15.1 percent of the population, lived in poverty (annual income under $14,763 for a family of four) in 1993, up by almost a quarter from 12.3 percent in 1975 [ILLUSTRATION FOR FIGURE 1 OMITTED]. Households with the lowest incomes spend a higher proportion of their income on shelter than does the average U.S. household, leaving less money for food and other needs. And, the poor are often limited to jobs paying the minimum wage, which has not kept pace with the rising cost of food [ILLUSTRATION FOR FIGURE 2 OMITTED]. Given these circumstances, it is not surprising that for some people, getting adequate meals can be a daily challenge.

Hunger in America is also hidden because those who experience it may not show the obvious symptoms associated with severe malnutrition. Hunger is often periodic, taking the form of some days without food, or it can be prolonged but low level, including, for example, the chronic skipping of meals. Hunger can also involve poor adaptations, such as reliance on low-quality diets that have little variety and may be lacking in nutrients.

A Profile of Those Who Do Not Get Enough To Eat

In the past, Government-sponsored surveys have not been designed to measure the extent of hunger in the United States. The most recent USDA evidence-on this topic comes from answers gleaned from one specific question asked in USDA's 1989-91 Continuing Survey of Food Intakes by Individuals (CSFII), which shows that at least 2.5 percent of U.S. households sometimes or often do not get enough to eat. The survey asked a nationally representative sample of 6,718 households which statement best described the food eaten in their household: (1) "Enough of the kinds of food we want to eat," (2) NCHS show that about 4 percent of individuals, or about 9 million people, lived in families that reported sometimes or often not getting enough to eat.

Yet these data do not tell the whole story. FRAC's surveys did not use a nationally representative sample; estimates based on their work could be overstated if the groups surveyed were worse off than the national norm. Although based on national samples, the NCHS and USDA surveys did not include American Indians living on reservations, the homeless, or those living in institutions. Also, USDA sample design did not include Hawaii or Alaska. The Government estimates cited above could be understated if hunger rates are higher among these population groups.

In addition to concerns about sampling, many have expressed concerns about accepting a self-reported answer to a single question about household food supplies as evidence of hunger. This concern has motivated researchers to develop a battery of questions to assess the complex and interrelated issues of hunger and food insecurity, which is loosely defined as the uncertain ability to acquire enough food that is nutritionally adequate, safe, and acceptable (see box).

New Monitoring Tool To Get Better Estimates

Researchers have included questions about many of the facets of hunger and food insecurity in localized surveys. But until recently, there has been no attempt to address more than a few of the dimensions of hunger and food insecurity in a nationally representative survey.

In April 1995, the Census Bureau, under contract with USDA's Food and Consumer Service (FCS, formerly the Food and Nutrition Service), included a series of questions on hunger and food insecurity as a supplement to the nationally representative Current Population Survey. (The monthly survey polls approximately 57,000 households, primarily to obtain labor-force participation data.) These questions focused on various aspects of hunger, including food expenditures, participation in Government food-assistance programs, food scarcity, coping mechanisms, and other related issues. People most likely to experience food insecurity were asked not only about their own behaviors, but also whether and how often other adults and children in the household had to skip meals, cut back on the size of meals, or go for days without eating because they could not afford enough food. There are also a number of questions about borrowing money for food, sending children to a friend's house to eat, receiving emergency food aid, or eating at soup kitchens.

This new survey effort is the result of a collaboration of researchers, program administrators, and others from a wide variety of institutions, including various Federal agencies, universities, and public-advocacy groups.

Determining the extent of hunger and food insecurity in the United States is part of a larger Government effort to monitor the Nation's nutritional status. The work undertaken by USDA and DHHS is part of the Ten-Year Comprehensive Plan of activities sanctioned by the National Nutrition Monitoring and Related Research Act of 1990. One of the main goals is to provide ongoing and timely information that is useful for policymakers.

The use of a standard hunger and food insecurity questionnaire will allow researchers to identify national hunger trends and high-risk groups and locations that may need expanded or improved food-assistance or nutrition-intervention programs.

The wealth of information that will be collected in the new FCS-sponsored survey presents an opportunity to obtain a much better understanding of the extent of hunger and food insecurity in the United States. This will be an important step in improving public policymaking to coordinate an effective response to alleviating hunger in this country.

References

Food Research and Action Center. Community Childhood Hunger Identification Project: A Survey of Childhood Hunger in the United States. Washington, DC. 1991.

Journal of Nutrition Education: Hunger in the '80s and '90s, Special Supplement Issue, A.N. Maretzki, J.M. Dodds, S.L. Parker, and P.S. Haines, eds. Vol. 24, No. 1, Jan.-Feb. 1992.

Life Sciences Research Office, Federation of American Societies for Experimental Biology. "Core Indicators of Nutritional State for Difficult-to-Sample Populations," S.A. Anderson, ed. Journal of Nutrition, Vol. 120 (Supplement), pp. 1559-1600, Nov. 1990.

Physician Task Force on Hunger in America. Hunger in America: The Growing Epidemic. Middletown, CT: Wesleyan University Press. 1985.

President's Task Force on Food Assistance. Report of the President's Task Force on Food Assistance. Washington, DC. 1984.

Select Committee on Hunger, U.S. House of Representatives. "Food Security and Methods of Assessing Hunger in the United States," Hearing held March 23, 1989, Serial No. 101-2, Washington, DC, 1989.

U.S. Department of Agriculture, Food and Consumer Service, and U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Conference on Food Security Measurement and Research: Papers and Proceedings, Washington, DC, Jan. 21-22, 1994.

Rose is an economist and nutritionist with the Food and Consumer Economics Division, Economic Research Service, USDA. Basiotis and Klein are economists with the Center for Nutrition Policy and Promotion, USDA. Margaret Andrews and Gary Bickel, economists at FCS, contributed to this article.

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