Household Food Insecurity Shows Associations with Food Intake,Social Support Utilization and Dietary Change among Refugee Adult Caregivers Resettled in the United States

Forced migration puts families at risk of household food insecurity and economic hardship. We administered a questionnaire to examine household food insecurity in a sample of 49 recently legally resettled Sudanese refugees with at least one child under age 3 years. Of households polled, 37% had experienced household food insecurity and 12% reported child hunger within the previous month. Increasing severity of household food insecurity was associated with decreased consumption of high-cost, high-nutrient-density food items and increased consumption of some low-cost traditional Sudanese foods by adult caregivers of young children. Furthermore, household food insecurity was associated with decreased household and per capita food expenditure, indicators of more limited dietary change with migration, and indicators of increased social support.     

Food insecurity of low-income lone mothers and their children in Atlantic Canada

OBJECTIVE: To examine the occurrence and predictors of hunger and food insecurity over the past year and month among low-income mother-led households in Atlantic Canada. METHOD: The Cornell-Radimer Questionnaire to Estimate the Prevalence of Hunger and Food Insecurity was administered weekly for a month, with modifications, to a community sample of 141 lone mothers who took part in a larger dietary intake study. Eligible women included those living alone with at least two children under the age of 14 years in the four Atlantic Provinces and having an annual income less than or equal to Statistics Canada's low-income cut-off. RESULTS: Food insecurity over the past year occurred in 96.5% of households. Child hunger was similar to maternal hunger over the one-month study period (23%), however, it was lower than maternal hunger over the past year. On multiple logistic regression analysis, maternal hunger over the past year was predicted by maternal age over 35 years (p < 0.0005), and Nova Scotia residence (p = 0.03). Child hunger over the past year was also predicted by maternal age over 35 years (p = 0.009). Families from New Brunswick experienced less food insecurity over the past month at both the household (p = 0.01) and maternal levels (p < 0.0005). DISCUSSION: Provincial policies that might contribute to the regular occurrence of food insecurity in these families should be investigated.     

Food insecurity is highly prevalent and predicts underweight but not overweight in adults and school children from Bogotá, Colombia

The aims of this study were to determine the sociodemographic and dietary correlates of household and child food insecurity in Bogotá, Colombia and to examine whether food insecurity is a risk factor for underweight or overweight in this population. We analyzed data from 2359 families with 2526 children 5-12 y of age who completed a cross-sectional survey conducted in 2006. The survey was representative of low- and middle-income families who had children enrolled in the public primary school system of Bogotá. We used a 16-item food insecurity scale, modified from the United States Household Food Security Survey Module, assessed children's dietary intake with a FFQ, and measured their height and weight. Mothers' anthropometry was obtained through self-report. We estimated adjusted prevalence ratios and 95% CI from binomial regression models. Household food insecurity with hunger and child food insecurity were each positively associated with maternal age, parity, and single parent status and inversely related to mean household income and number of home assets. Animal protein and snack food intake were inversely related to child food insecurity. In multivariate analyses, food-insecure children were 3 times more likely to be underweight than food-secure children (95% CI = 1.6, 5.4; P = 0.0007). Hunger in the household was significantly associated with maternal underweight. Food insecurity was not related to child stunting, child overweight, or maternal overweight. The prevalence of food insecurity in Bogotá is high and related to poverty. Food insecurity does not necessarily predict overweight in countries undergoing the nutrition transition.     

Household food insecurity with hunger is associated with women's food intakes, health and household circumstances

This study investigated food intake patterns and contextual factors related to household food insecurity with hunger among a sample of 153 women in families seeking charitable food assistance in Toronto. Women in households characterized by food insecurity with severe or moderate hunger over the past 30 d (as assessed by the Food Security Module) reported lower intakes of vegetables and fruit, and meat and alternatives than those in households with no hunger evident. Women were more likely to report household food insecurity with hunger over the past 12 mo and 30 d if they also reported longstanding health problems or activity limitations, or if they were socially isolated. The circumstances that women identified as precipitating acute food shortages in their households included chronically inadequate incomes; the need to meet additional, unusual expenditures; and the need to pay for other services or accumulated debts. Women who reported delaying payments of bills, giving up services, selling or pawning possessions, or sending children elsewhere for a meal when threatened with acute food shortages were more likely to report household food insecurity with hunger. These findings suggest that expenditures on other goods and services were sometimes foregone to free up money for food, but the reverse was also true. Household food insecurity appears inextricably linked to financial insecurity.     

Assessment of food insecurity among low income households in kuala lumpur using the radimer/cornell food insecurity instrument - a validation study

Food insecurity exists whenever people are not able to access sufficient food at all times for an active and healthy life. This study used the Radimer/Cornell hunger and food insecurity instrument to assess food insecurity and to determine the risk factors and consequences of food insecurity among low-income households in Kuala Lumpur. One hundred and thirty-seven Malay pre-school children (4-6 years old) from Taman Sang Kancil were measured for their weights and heights. Questionnaires were used to collect food security and socioeconomic information on the households. The findings indicated that 34.3% of the households were food secure, while 65.7% experienced some kind of food insecurity, (27.7% households were food insecure, 10.9% individuals were food insecure and 27.0% fell into the child hunger category). The prevalence of underweight, stunting and wasting were 44.5%, 36.5% and 30.7% respectively. The prevalence of high weight-for-height (overweight) was 13.1%. Based on multinomial logistic regression, larger household size (OR=1.418; p<0.01) and lower educational level of mothers (OR=0.749; p<0.01) and fathers (OR=0.802; p<0.05) were found to be significant risk factors for food insecurity. The study, however, did not find any significant difference in children's nutritional status according to household food security levels. It is recommended that for the Malaysian population, the Radimer/Cornell hunger and food insecurity instrument should be modified and further validated with various ethnic groups in a variety of settings. The validation should include the appropriateness of the statements to the target grounds and their different risk factors and outcomes of food insecurity.     

Food Insecurity: Its Relationship to Dietary Intake and Body Weight among Somali Refugee Women in the United States

ObjectiveTo examine the association between food insecurity, dietary intake, and body mass index among Somali refugee women living in the United States.MethodsCross-sectional study utilizing the snowball sampling method.ResultsMost (67%) participants experienced some level of food insecurity, which was common among recent arrivals and those who spoke only Somali at home (P < .05). Intake of meat and eggs was higher, whereas intake of fruits and vegetables was lower, among food insecure than secure participants. Food insecurity was positively related to overweight and obesity (odds ratio: 2.66; confidence interval: 1.25-5.69; P < .01).Conclusions and ImplicationsSomali refugees experienced high levels of food insecurity upon resettlement. Poor dietary habits and the high overweight/obesity rate among insecure families call for future research in understanding what role family structure, cultural norms, and food preference play in predicting food security and dietary habits among Somali and overall African refugees in the United States.     

Food security status of households in Appalachian Ohio with children in Head Start

This study measured food security and hunger of households involved in Head Start in a rural Appalachian county and assessed factors that could affect food security and hunger. A convenience sample of households with children enrolled in the Head Start program in Athens County, Ohio, were sampled (n=710), with adults from 297 (42%) households responding. The survey instrument included the 18-question US Household Food Security Survey Module for measuring hunger and food insecurity. Of those responding, 152 households (51.2%) were food secure and 145 (48.8%) were food insecure. Ninety (30.3%) had experienced hunger in the previous 12 months, and 41 (13.8%) households were classified as food insecure with childhood hunger. Hunger was related to a variety of household characteristics and associated with several factors, including participation in food banks, dependence on family members and friends outside of the household for food, lacking reliable transportation, and not having a garden.     

Food insecurity is associated with diet and bone mass disparities in early adolescent males but not females in the United States

Food insecurity is associated with decreased nutrient intake and poor health and possibly low bone mass in children. The purpose of this study was to formally investigate the relationship of diet, bone mass, and food insecurity among children aged 8-19 y (n = 5270). The data used in this cross-sectional study were drawn from children participating in the NHANES 2001-2004. Data were collected from homes and NHANES mobile examination centers across the United States. Food security status was classified using the US Children's Food Security Scale and the US Household Food Security Scale. Dietary measures were quantified by 24-h dietary recall and bone mineral content (BMC) was determined with whole body DXA. Results indicated that males 8-11 y from households with food insecurity among children were 2.5 times [OR = 2.5 (95% CI = 1.1-5.8)] more likely to have fewer than the USDA Food Guide recommended servings of dairy foods, 2.3 times [OR = 2.3 (95% CI = 1.3-4.0)] more likely to have less than the estimated average requirement for calcium intake, and more likely to have a significantly lower estimated total body (P = 0.04), trunk (P = 0.05), lumbar spine (P = 0.02), pelvis (P = 0.05), and left arm (P = 0.05) BMC compared with males 8-11 y old from households with food security among children. Calcium-related dietary factors and BMC did not differ among females by food security status. These results are evidence that health disparities persist among 8- to 11-y-old, food-insecure boys. Successful interventions to improve diet and bone health and reduce food insecurity among children are a continuing need in the United States.     

Position of the American Dietetic Association: domestic food and nutrition security

In 2000, over 10% of United States (US) households, including more than 33 million people, experienced food insecurity. Food insecurity negatively affects the dietary intake and nutritional status of adults leading to poor health and increased risk for the development of chronic diseases. Food insecurity also negatively affects children's health, psychological and cognitive functioning, and their academic achievement. It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the US. Immediate and long-range interventions, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, are key to ending domestic food insecurity. Dietetics professionals can play a key role in ending food insecurity not only through competent and collaborative practice, but also through advocacy efforts at the local, state, regional, and national levels.     

Child-specific food insecurity and overweight are not associated in a sample of 10- to 15-year-old low-income youth

In the United States, 17% of children and adolescents are overweight and 20% live in a food insecure household. Previous studies examining the association between household food insecurity and overweight among children have been inconclusive but are limited insofar as they did not assess child-specific measures of food insecurity and overweight. In response, this study examined the association between food insecurity and child overweight status when these variables were measured for the same child using information on children (n = 1031) aged 10-15 y from the Three-City Study. Approximately 8% of the children were food insecure, whereas 50% were either at risk of overweight or overweight. Bivariate analyses indicated that there were no significant differences in the prevalence of at risk of overweight and overweight between food secure and food insecure children. Gender, race, and income showed similar patterns. Results from logistic regression analyses also indicated that the likelihood of being overweight or at risk of overweight was not significantly different for food secure and food insecure children. Although child-specific food insecurity was not associated with overweight in this sample of low-income children, food insecurity and overweight coexist among these low-income children, because approximately 25% of the food insecure children were overweight. Additional research is needed to explore the potential relationships between food insecurity and overweight and to better inform policy that attempts to address these issues among low-income households with children.     

Food insecurity is associated with dietary intake and body size of Korean children from low-income families in urban areas

OBJECTIVE: This study examined household food insecurity of urban low-income families in Korea and the associations of the food insecurity with children's dietary intake and body size. DESIGN: Cross-sectional study. SETTING: Low-income neighborhoods in large cities. SUBJECTS: Included 370 children aged 4-12 y, who had all records on dietary intake and anthropometry as well as household food insecurity measures. RESULTS: Using the 10-item Radimer/Cornell Scale, 62.7% of the households showed some degree of food insecurity (8.6% for food insecure for family, 28.4% for food insecure for adults and 25.7% for child hunger households). Food insecurity was linearly and negatively associated with household economic conditions as well as the caretaker's use of nutrition knowledge. There were also significant associations of food insecurity with the children's dietary intakes, indicating the largest amount of nutrients for the children from the household food insecure, followed by those from the food secure, adult food insecure and child hunger groups. The household food insecure children were fatter than the food secure children. The fatter condition of the former children appeared to be related to more frequent intakes of low-quality foods. CONCLUSION: This study reports curvilinear associations between the status of household food insecurity and children's food intakes and fatness. SPONSORSHIP: This work was funded by a grant of the 2001 Korea Health Promotion Research Program, the Ministry of Health & Welfare, Republic of Korea.     

Position of the American Dietetic Association: food insecurity and hunger in the United States

It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the United States. The Association believes that immediate and long-range interventions are needed, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, to end food insecurity and hunger in the United States. Food insecurity continues to exist in the United States, with over 38 million people experiencing it sometime in 2004. Negative nutritional and nonnutritional outcomes have been associated with food insecurity in adults, adolescents, and children, including poor dietary intake and nutritional status, poor health, increased risk for the development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievement. Dietetics professionals can play a key role in ending food insecurity and hunger and are uniquely positioned to make valuable contributions through provision of comprehensive food and nutrition education, competent and collaborative practice, innovative research related to accessing a safe and secure food supply, and advocacy efforts at the local, state, regional, and national levels.     

Narratives of Food Insecurity in Tippecanoe County,Indiana: Economic Constraints in Local Meanings of Hunger

Food insecurity and its most extreme form, hunger, have increased exponentially in the United States since 2006. This essay seeks to contribute to our understanding of hunger by attending to the context of the financial crisis as an organizing frame for understanding local meanings of hunger. Within a broader framework of the culture-centered approach (CCA) that works to identify and develop locally rooted solutions to food insecurity, we describe through locally grounded stories of food insecurity the financial climate where large percentages of U.S. households have been cast into poverty because of the crash of an unregulated economy. These local understandings of hunger in the context of the economy offer entry points for organizing a food-insecure coalition that seeks to address the stigma around food insecurity.     

Hunger of the body and hunger of the mind: African American women's perceptions of food insecurity, health and violence

OBJECTIVE: This qualitative study examined the relationship between health, hunger, and food insecurity among African American women in Philadelphia. DESIGN: Four focus groups and 12 individual in-home, semistructured interviews were conducted. SETTING: 3 food pantries in Philadelphia, Pennsylvania. PARTICIPANTS: 34 women recruited from 3 food pantries. PHENOMENON OF INTEREST: Interview topics included participants' experiences of food insecurity, food sources, and the relationship between food, hunger, and health. ANALYSIS: A phenomenological coding scheme and network analysis was developed based on themes emerging from qualitative data. RESULTS: The experience of food insecurity was related to violence and poor mental health. Women described 2 kinds of hunger: "hunger of the body" and "hunger of the mind." Hunger of the body referred to the outright painful sensation of hunger caused by insufficient funds. Hunger of the mind was related to trauma, encompassing feelings of depression and hopelessness. Both forms of hunger may be a physical manifestation of structural and interpersonal violence. CONCLUSIONS AND IMPLICATIONS: There is a need for a broader framework to examine the health effects of food insecurity that addresses women's safety, economic independence, and physical and emotional well-being.     

Experiences of Latino immigrant families in North Carolina help explain elevated levels of food insecurity and hunger

Household food insecurity is higher among minority households in the U.S., but few data exist on households of recent minority immigrants, in part because such households are difficult to sample. Four studies of a total of 317 Latino immigrant families were conducted in different regions and during different seasons in North Carolina. A Spanish translation of the 18-item U.S. Food Security Survey Module was used to assess the prevalence of food insecurity and hunger. In 3 of the studies, a total of 76 in-depth interviews were conducted to gather information on immigrants' experiences of food insecurity. Households in the 4 studies classified as food secure ranged from 28.7 to 50.9%, compared with 82.4% in the U.S. in 2004. Food insecurity without hunger ranged from 35.6% to 41.8%, compared with 13.3% in the U.S. The highest rates of hunger reported were 18.8% (moderate hunger) and 16.8% (severe hunger) in an urban sample. Qualitative data indicate that food insecurity has both quantitative and qualitative effects on diet. Immigrants experience adverse psychological effects of food insecurity. They report experiencing a period of adjustment to food insecurity leading to empowerment to resolve the situation. Reactions to food insecurity differ from those reported by others, possibly because immigrants encounter a new and not chronic situation. Overall, these findings suggest that immigrant Latinos experience significant levels of food insecurity that are not addressed by current governmental programs.     

The impact of holiday clubs on household food insecurity—A pilot study

This research investigates whether holiday clubs have the potential to reduce food insecurity among households in the United Kingdom. We survey parents (n = 38) of children attending seven different holiday clubs to estimate the percentage of children in those programmes who come from food insecure households. Results suggest that 42% (16 out of 38 respondents) of children come from households defined as “food insecure” and 24% (9 out of 38 respondents) come from households that are “food insecure with hunger.” When secure and insecure households are compared, we discover that food insecure households benefit the most from holiday clubs, which suggests that they may play an important role in mitigating household food insecurity.     

Child and parental poor health among families at risk for hunger attending a community health center

BACKGROUND: Hunger is prevalent in low-income families. Community clinics offer an opportunity to identify families who experience hunger and to address hunger-related health problems. METHODS: Parents of pediatric patients seen in an urban clinic completed a single question hunger screen. A subsample of parents participated in an interview. Patient and parental medical and mental health diagnoses were collected from medical records. RESULTS: Children from families reporting hunger were more likely than those from families not reporting hunger to be obese and to have more documented medical diagnoses. Parents reporting hunger were also more likely to have mental health problems noted and to describe poor health status. CONCLUSION: Hunger is associated with specific health problems among children and parents in a low-income community clinic. A simple screen to identify hungry families in clinics may assist in recognition of hunger's contribution to child and parental poor health and development of targeted interventions.     

Speaking of Hunger and Coping with Food Insecurity: Experiences in the Afro-Ecuadorian Highlands

Using examples from an Afro-Ecuadorian community, we analyze indicators of household food insecurity and discuss them in terms of household structure and different time frames. We found that perceptions of hunger vary independently over time and are expressed differently in different types of households. We also found that definitions, although variable within the population, can be framed in five conceptual categories: a) an experience filled with anguish or despair; b) hunger as an economic issue; c) a concern over child welfare; d) an experience of the physical body; e) hunger as the experience of not having any food rather than not having variety in what is eaten; and f) those individuals who indicated they had never experienced hunger. We also learned that individuals act and react in a variety of ways to food insecurity. Our study highlights the way people attempt to adjust to fluctuations in food and resources, how they can feel helpless and alienated, and how they attempt to do the best they can with dignity and hopefulness.     

Speaking of Hunger and Coping with Food Insecurity: Experiences in the Afro-Ecuadorian Highlands

Using examples from an Afro-Ecuadorian community, we analyze indicators of household food insecurity and discuss them in terms of household structure and different time frames. We found that perceptions of hunger vary independently over time and are expressed differently in different types of households. We also found that definitions, although variable within the population, can be framed in five conceptual categories: a) an experience filled with anguish or despair; b) hunger as an economic issue; c) a concern over child welfare; d) an experience of the physical body; e) hunger as the experience of not having any food rather than not having variety in what is eaten; and f) those individuals who indicated they had never experienced hunger. We also learned that individuals act and react in a variety of ways to food insecurity. Our study highlights the way people attempt to adjust to fluctuations in food and resources, how they can feel helpless and alienated, and how they attempt to do the best they can with dignity and hopefulness.     

Relationship of Hunger and Food Insecurity to Food Availability and Consumption

Objective To describe the relationship of new measures of hunger and food insecurity to household food supplies and individual food and nutrient intake.Design and Setting A questionnaire containing the Radimer/Cornell hunger and food insecurity items and questions on eating patterns and the frequency of fruit and vegetable consumption was administered to subjects during a personal interview in their homes. A 24-hour diet recall and a household food inventory were conducted at the initial interview and at a follow-up visit.Subjects Participants were 193 women drawn from a random sample of 308 women who had completed a previous health census in a rural New York State county. Subjects’ ages ranged from 15 to 40 years. All had children living at home and less than 16 years of education.Statistical analyses Regression analysis was used to test for linear trends across food insecurity groups for the household food inventory scores and for the frequency of consumption of fruits and vegetables, t Tests were used to assess differences between the food secure and food insecure groups for nutrient and food group means. A χ² test for trend was used to examine differences in the distribution of nutrient and fruit and vegetable intake between the food secure and food insecure groups.Results A significant decrease in the frequency of consumption of fruits and vegetables and the amount of food in the household and a significant increase in scores indicative of disordered eating patterns were associated with a worsening of food insecurity status. Potassium and fiber intake and fruit consumption differed significantly between the food secure and food insecure groups. The percentage of respondents consuming less than the Recommended Dietary Allowance for vitamin C and fewer than five fruits and vegetables per day was significantly greater among food insecure respondents than food secure respondents.Applications/conclusions The quantity of food available in households and consumption of fruits and vegetables decreased with increasingly severe problems with food insecurity and hunger. In this rural population, the Radimer/Cornell measures were useful in identifying households experiencing food insecurity and providing information about the nature of the food supply and the dietary intake problems experienced by food insecure households and persons, suggesting that these measures may be useful on community surveys designed to examine food insecurity issues. J Am Diet Assoc. 1996; 96:1019-1024.