FOOD INSECURITY and Hunger in the United States

AN ASSESSMENT OF THE MEASURE

Panel to Review the U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger

Gooloo S. Wunderlich and Janet L. Norwood, Editors

Committee on National Statistics

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
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Food Insecurity and Hunger in the United States: An Assessment of the Measure FOOD INSECURITY and Hunger in the United States AN ASSESSMENT OF THE MEASURE Panel to Review the U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger Gooloo S. Wunderlich and Janet L. Norwood, Editors Committee on National Statistics Division of Behavioral and Social Sciences and Education NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

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Food Insecurity and Hunger in the United States: An Assessment of the Measure THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, 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. 43-3AEM-3-80125 between the National Academy of Sciences and the U.S. Department of Agriculture. Support of the work of the Committee on National Statistics is provided by a consortium of federal agencies through a grant from the National Science Foundation (Number SBR-0112521). 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. Library of Congress Cataloging-in-Publication Data Food insecurity and hunger in the United States : an assessment of the measure / Panel to Review U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger ; Gooloo S. Wunderlich and Janet L. Norwood, editors. p. cm. Includes bibliographical references and index. ISBN 0-309-10132-8 (pbk.)—ISBN 0-309-65805-5 (pdfs) 1. Food supply—United States. 2. Hunger—United States. I. Wunderlich, Gooloo S. II. Norwood, Janet Lippe. III. National Research Council (U.S.) Panel to Review U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger. TX360.U6F677 2006 363.80973—dc22 2006005691 Additional copies of this report are available from National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu Printed in the United States of America Copyright 2006 by the National Academy of Sciences. All rights reserved. Suggested citation: National Research Council. (2006). Food Insecurity and Hunger in the United States: An Assessment of the Measure. Panel to Review the U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger, Gooloo S. Wunderlich and Janet L. Norwood, Editors, Committee on National Statistics, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

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Food Insecurity and Hunger in the United States: An Assessment of the Measure THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine 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 Academy has a mandate that requires it to advise the federal government 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 charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, 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. Wm. A. Wulf 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 providing 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. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Food Insecurity and Hunger in the United States: An Assessment of the Measure PANEL TO REVIEW THE U.S. DEPARTMENT OF AGRICULTURE’S MEASUREMENT OF FOOD INSECURITY AND HUNGER JANET L. NORWOOD (Chair), The Conference Board, New York ERIC T. BRADLOW, Wharton School, University of Pennsylvania J. MICHAEL BRICK, Westat, Rockville, MD EDWARD A. FRONGILLO, JR., Division of Nutritional Sciences, Cornell University PAUL W. HOLLAND, Research and Development Division, Educational Testing Service, Princeton, NJ MICHAEL D. HURD, Center for the Study of Aging, RAND, Santa Monica, CA HELEN H. JENSEN, Department of Economics, Iowa State University NANCY MATHIOWETZ, Department of Sociology, University of Wisconsin-Milwaukee SUSAN E. MAYER, Irving B. Harris Graduate School of Public Policy Studies, University of Chicago DONALD DIEGO ROSE, Department of Community Health Sciences, Tulane University GOOLOO S. WUNDERLICH, Study Director MICHELE VER PLOEG, Study Director (until October 2004) LANCE HUNTER, Senior Program Assistant

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Food Insecurity and Hunger in the United States: An Assessment of the Measure COMMITTEE ON NATIONAL STATISTICS 2006 WILLIAM F. EDDY (Chair), Department of Statistics, Carnegie Mellon University KATHARINE G. ABRAHAM, Joint Program in Survey Methodology, University of Maryland ROBERT BELL, AT&T Research Laboratories, Florham Park, NJ ROBERT M. GROVES, Survey Research Center, University of Michigan, and Joint Program in Survey Methodology, University of Maryland JOHN HALTIWANGER, Department of Economics, University of Maryland PAUL W. HOLLAND, Educational Testing Service, Princeton, NJ JOEL L. HOROWITZ, Department of Economics, Northwestern University DOUGLAS S. MASSEY, Department of Sociology and Public Policy, Princeton University VIJAYAN NAIR, Department of Statistics and Department of Industrial and Operations Engineering, University of Michigan DARYL PREGIBON, Google Incorporated, New York SAMUEL PRESTON, Population Studies Center, University of Pennsylvania KENNETH PREWITT, School of International and Public Affairs, Columbia University LOUISE M. RYAN, Department of Biostatistics, Harvard School of Public Health NORA CATE SCHAEFFER, Department of Sociology, University of Wisconsin-Madison CONSTANCE F. CITRO, Director

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Food Insecurity and Hunger in the United States: An Assessment of the Measure Acknowledgments The Panel to Review the U.S. Department of Agriculture’s Measure ment of Food Insecurity and Hunger acknowledges with appreciation the contributions of the many persons who gave generously of their time and knowledge to this study. Support for the study was provided by the Economic Research Service (ERS) and the Food and Nutrition Service (FNS) of the U.S. Department of Agriculture (USDA). We particularly wish to thank Mark Prell, chief, Food Assistance Branch, who served as project officer of the study. He and his colleagues, particularly Mark Nord and Margaret Andrews, were helpful in providing information about the research undertaken in the development and implementation of the measures of food insecurity and hunger and answering the many questions from the panel and staff. We acknowledge Susan Offutt, administrator, and Phil Fulton, former associate administrator of ERS; Steven Carlson, director, family programs staff, Office of Analysis, Nutrition, and Evaluation, Food and Nutrition Service; Betsey Kuhn, director of the Food Economics Division (FED), ERS; and David Smallwood, deputy director for food assistance and nutrition research, FED, for recognizing the need and initiating and supporting this important study. In addition, we acknowledge the many federal and nonfederal government officials and those from the research and academic community who gave expert presentations to the panel at its initial meeting and participated in the workshop on the measurement of food insecurity and hunger. We are grateful to the authors of the papers prepared for the workshop. Their

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Food Insecurity and Hunger in the United States: An Assessment of the Measure names and the subjects of their papers are listed in Chapter 1. The papers were used by the panel and staff to guide them in drafting this report. A number of people in the Committee on National Statistics (CNSTAT) and the Division of Behavioral and Social Sciences and Education (DBASSE) provided support and assistance to the study panel. We acknowledge with gratitude the contributions of the staff. The panel wishes to thank Shelly Ver Ploeg, who as study director until October 1, 2004, was chiefly responsible for developing and organizing the workshop during the first phase of the study. The panel also appreciates the fine work of Gooloo Wunderlich who was responsible for preparing the drafts of the reports and responding to the many comments from the reviewers on behalf of the panel. Lance Hunter handled administrative matters. Throughout, the panel benefited from the advice and collaboration provided by Connie Citro, CNSTAT director. Christine McShane, senior editor of the DBASSE reports office, provided professional editing advice, and Kirsten Sampson Snyder efficiently shepherded the report through the report review and production process. In addition we would like to thank Linda Meyers, director, Board on Food and Nutrition, Institute of Medicine, who made available the 1990 legislation and early documents in the development of the food security measure and for being available throughout to answer questions related to the development of the measure and nutrition. Finally, I would like to thank the members of the panel for their generous contributions of time and expert knowledge to the deliberations and preparation of this report. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: Jay Bhattacharya, Stanford Medical School, Stanford University; Peter Eisinger, Department of Urban Politics and Economic Development Policy, Wayne State University; Jean-Pierre Habicht, Division of Nutritional Sciences, Cornell University; William L. Hamilton, Abt Associates, Cambridge, MA; William D. Kalsbeek, Department of Biostatistics and Survey Research Unit, University of North Carolina; Valerie Tarasuk, Department of Nutritional Sciences, University of Toronto; Howard Wainer, Measurement Consulting, National Board of Medical Examiners, Philadelphia; and Catherine E. Woteki, Scientific Affairs, Mars, Incorporated, McLean, VA.

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Food Insecurity and Hunger in the United States: An Assessment of the Measure Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by David M. Betson, Department of Economics and Policy Studies, Notre Dame University, and John C. Bailar III, Department of Health Studies (emeritus), University of Chicago. Appointed by the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. Janet L. Norwood, Chair Panel to Review the U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger

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Food Insecurity and Hunger in the United States: An Assessment of the Measure Contents     Executive Summary   1 1   Introduction   13      Objectives of the Measure,   16      The Panel’s Study,   17      Organization of the Report,   21 2   History of the Development of Food Insecurity and Hunger Measures   23      Early Efforts to Define Hunger,   23      The 1980s: The President’s Task Force on Food Assistance,   24      The 1990s: A Period of Transition,   26      Food Security Supplement to the Current Population Survey,   30      Uses of the Household Food Security Survey Module in Other Surveys,   36 3   Concepts and Definitions   41      Food Insecurity, Hunger, Malnutrition, and Undernourishment,   41      Concept and Definition of Food Insecurity,   43      Adverse Outcomes of Food Insecurity,   46      Concept and Definition of Hunger,   47      Application of the Concepts and Definitions for Measurement,   49      Labels of Food Insecurity,   51

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Food Insecurity and Hunger in the United States: An Assessment of the Measure 4   Survey Measurement of Food Insecurity and Hunger   55      Current Approach to Measurement,   55      Relationship Between Concepts and Questions,   59      Question Design Issues,   63 5   Item Response Theory and Food Insecurity   71      Brief History of Latent Variable Models,   72      Structure of Latent Variable Models,   73      Use of Estimated IRT Models for Measuring Food Insecurity,   86      Better Match Between the Measurement Model and the Data Collected,   92      Conclusions and Recommendations,   96 6   Survey Vehicles to Measure Food Insecurity and Hunger   99      Key Features of Selected Surveys,   100      Relative Advantages and Disadvantages,   105 7   Applicability of Food Insecurity Outcomes for Assessment of Program Performance   108      Food Security as a Measure of Program Performance,   108 8   Closing Remarks   113     References   115     Acronyms and Abbreviations   125     Appendixes     A   Current Population Survey Food Security Supplement Questionnaire, December 2003   127 B   Biographical Sketches of Panel Members and Staff   134     Index   139