How Adequately are Food Needs of Children

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How Adequately are Food Needs of Children In
Low-Income Households Being Met? Mark
Nord Economic Research Service, USDA Lynn
Parker Institute of Medicine, The National
Academies Presentation at FRAC-A2H National
Anti-Hunger Policy Conference Washington, DC,
March 2008
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Food security, an important foundation For
childrens good nutrition and health
Food Security Access by all people at all times
to enough food for an active, healthy life.
.assured ability to acquire acceptable foods in
socially acceptable ways.
Food Insecurity Limited or uncertain ability to
acquire acceptable foods in socially acceptable
ways.
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Outline of Presentation

• How is food security measured?
• Monitoring and reporting
• Determinants of food insecurity in households
  with children
• Consequences of food insecurity for children

• M
• Adequacy of data
• What do we know?
• What are the gaps?
• D
• Adequacy of data
• What do we know?
• What are the gaps?
• C
• Adequacy of data
• What do we know?
• What are the gaps?

• How does the U.S. compare with Canada?

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How is food security measured?
Food secure
Worry, stretch, juggle
Food insecure
Reduce quality and variety of diet
Hunger
Reduce food intake (adults)
Reduce food intake of children
Severe hunger
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Examples of Food Security Survey Questions
The food that we bought just didnt last, and we
didnt have money to get more. Was that often,
sometimes or never true for you in the last 12
months?
In the last 12 months, did you ever cut the size
of your meals or skip meals because there wasnt
enough money for food?
In the last 12 months, did you ever not eat for a
whole day because there wasnt enough money for
food?
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Examples of Child-Referenced Food Security Survey
Questions
We couldnt feed the children a balanced meal,
because we couldnt affort that. Was that often,
sometimes or never true for you in the last 12
months?
In the last 12 months, did you ever cut the size
of any of the childrens meals because there
wasnt enough money for food?
In the last 12 months, were the children ever
hungry but you just couldnt afford more food?
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Food security status categories
Food secure
Food security among children
Low food security
Low food security among children
Very Low food security
Very Low food security among children
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Monitoring and Reporting -- Data

• Current Population Survey (CPS)
• Conducted by U.S. Census Bureau
• 50,000 households (about 16,000 with children)
• Representative of U.S. civilian households
• Source of employment and poverty statistics
• High quality sample
• Well trained, well managed field staff
• High response rate
• High quality data management

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Monitoring and Reporting -- Reports

• Household Food Security in the United States
• Households with children, number of children
• By household structure, race/ethnicity, income,
  metropolitan residence, region
• Americas Children (childstats.gov)
• Children by education of parents

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Households with children by food security
status, 2006
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Quality of childrens diets as measured by the
Healthy Eating Index
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Monitoring and Reporting Gaps

• Reporting prevalence rates of food insecurity
  among children at State level
• 30 States, 5-year average ???
• Census Division ???
• Larger survey ???
• Reporting a less severe range of food insecurity
  among children

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Food Security in Canada and the U.S.

• Canada Canadian Community Health Survey Cycle
  2.2 (CCHS 2.2)
• 2004
• Provinces except First Nation reserves, Crown
  lands, Canadian Forces, and institutionalized
• 35,000 individuals
• United States Current Population Survey Food
  Security Supplements (CPS-FSS)
• 2003, 2004, 2005
• CANADIAN FOOD SECURITY CLASSIFICATION SAME
  QUESTIONS, DIFFERENT STANDARD

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Prevalence of Food Insecurity in Households with
Children in Canada and the U.S.
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Data available for research on determinants of
food insecurity in households with children

• CPS
• NHANES
• ECLS-K
• ECLS-B
• PSID
• SPD
• other special-purpose and State surveys

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Household-level factors affecting food insecurity
in households with children (Bartfeld and
Dunifon, 2005)

• Low income (lt FPL, but also 1.0 to 1.85 FPL)
• Low education of adults (especially lt HS)
• Black, Hispanic, and Native American
• Renting home
• Living in central city of a metropolitan area
• Three or more children
• Single mother with children
• No employed adult
• No elderly in household
• Disabled household member
• Noncitizen household head
• mediated by employment and income in some
  studies

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State-level factors affecting food insecurity in
households with children (Bartfeld and Dunifon,
2005)

• Low average wages
• High rental cost for housing
• Low summertime participation in NSLP and SFSP
• High unemployment rate
• Residential instability (frequent moves)
• Low participation in Food Stamp Program
• High tax burden on low-income households

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Effects of Food and Nutrition Assistance Programs

• Analysis seriously complicated by selection
  effects
• NSLP, SFSP (Nord and Romig, 2006)
• NSLP (Kabbani and Kmeid, 2005)
• WIC (Herman et al., 2004)

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Further research needed

• Program effects (watch for natural experiments)
• Effects of interarea cost of food
• Role of time constraints (enter the ATUS)
• How some low-income households remain food secure
• Dynamics over longer time periods (5 to 10 years)

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Data available for research on consequence of
food insecurity for children

• NHANES
• ECLS-K
• ECLS-B
• PSID-CDS
• SPD
• C-SNAP
• DELTA NIRI
• Fragile Families and Child Well-being Survey

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What do we know about consequence of food
insecurity for children?

• Poorer general health (9-24 mo 0-36 mo 1-5 y
  6-16 y)
• Higher weight for length (9-24 mo)
• Behavioral problems (9-24 mo preschool
  school-age)
• Iron deficiency anemia (7-36 mo)
• Poorer physical function (3-17 y)
• Poorer psychosocial function (3-17 y 6-16 y
  6-12 y)
• Higher rate of hospitalization since birth (0-36
  mo)
• Depressive disorder and suicidal symptoms (15-16
  y)
• Higher incidence of chronic health problems
• Anxiety/Depression (school-age)

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Consequence of food insecurity for
children (continued)

• More frequent stomaches (4-5 y 6-16 y)
• More frequent headaches (4-5 y 6-16 y)
• More colds in previous 12 months (1-5 y)
• Poorer arithmetic scores (6-11 y)
• More likely to have repeated a grade (6-11 y)

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Research opportunities

• Academic progress (four waves of ECLS-K data)
• Child well-being module (1999 and 2002 SPD)
• Childrens health (NHANES 1999-2000, 2001-02,
  2003-04)
• Mediating mechanisms
• Effects of persistent or recurring food
  insecurity (ECLS-K and SPD)

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For more information. www.ers.usda.gov/briefing/
foodsecurity www.frac.org
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Measuring food insecurity in households with
children
Questionnaire
3 General household questions 7 Adult-referenced
questions 8 Child-referenced questions
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Trends in food insecurity and poverty
Poverty rate
Prevalence rate, food insecurity
Prevalence rate, very low food security
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Reported conditions among children in
food-insecure households

• 81 reported that they relied on only a few
  kinds of low-cost food to feed the children
• 52 reported that they could not afford to feed
  the children a balanced meal
• 25 reported that at times their children were
  not eating enough
• 52 (8.2 percent of all households with
  children) would be classified as having food
  insecurity among the children

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Food insecurity is usually recurrent but not
usually chronic

• Of households with very low food security
• About 1/3 in only 1 or 2 months
• About 30 almost every month
• Typically in 7 months, in 1 to 7 days each month