1. Food Access and Security Assessment: A County Comparison Study
Cheryl Gaddis, DrPH, MPH, CHES
Mercer University College of Health Professions – Department of Public Health
Results
Abstract
Methods
Background: In 2012, food insecurity affected 14.5% of households in the United States. Georgia currently ranks sixth and tenth in the nation for low food security households and very low food security households respectively. However, food security and access assessments conducted on a county level are limited. This study was conducted in two of 13 counties within one of Georgia's health districts to identify levels of household food security and social determinants which lead to this issue, and to inform the determination of food insecurity interventions.
Methods: Data was collected through a total of 400 face-to-face surveys, 200 in each county. Questions were adapted from the Household Food Security Survey (HFSS) developed by the US Department of Agriculture. The survey contained 24 questions determining demographics, and severity, prevalence, and determinants of food status, access, and security.
Results: The study revealed that determinants of food insecurity include having an annual income less than $30,000); residing in zip codes without access to grocery stores within 1 mile; and receiving government food assistance (99%). Approximately, one-third of households identified as low food secure and as very low food secure across both counties.
Conclusions: The data suggests that food security is a serious issue within the health district requiring further evaluation within the counties assessed in this project, as well the more rural counties within the district which have less access to sufficient food sources. Social determinants such as low income, decreased government food assistance, and lack of access to stores and affordable food provide opportunities for public health to address food insecurity through program and policy development.
Survey Development
The data for this assessment was collected using the U. S. Department of Agriculture’s Household Food Security Survey. The 24 item survey was used to assess the prevalence of food security in Bibb and Houston County at each measurable level of severity. The surveys consisted of six questions designed to capture demographic data (zip code, race, gender, household income, household size, and age) and 18 core questions which were broken down into five stages to identify the individuals’ appropriate household food status:
Household (HH) Stage 1- assessed household food eaten in the last 12 months
Adult (AD) Stage 2- assessed the personal food situation of adults in the last 12 months
Adult (AD) Stage 3 -assessed if adults did not eat for a whole day over the last 12 months because there was not enough food to eat
Child (CH) Stage 1- identified the food eaten for household children in the last
12 months
Child (CH) Stage 2 - assessed the personal food situation of all children in the last 12 months
Recruitment
Participants were recruited using flyers that were developed and distributed to community members living in public housing in each county. The Resident Coordinator for the Macon Housing Authority (MHA) (Bibb) and the Houston County Housing Authority (HCHA) assisted with the recruitment process by ensuring each resident received a flyer via and by posting the notice in the community office at each site. The information on the flyer consisted of a brief description of the purpose of the assessment, requirements for participation, addresses, dates, and times for the survey administration sites, and the amount of the incentive given for completing the survey. All participants were required to be over the age of 18 and residents of Houston or Bibb County living on the MHA or HCHA properties.
Survey Administration
Surveys were administered at two MHA sites, Buck Melton Community Center and The Family Investment Center, in Bibb County. Residents from all MHA sites were allowed to come to one of the two sites to complete their survey. Surveys were administered in the community center at five HCHA sites which were selected by the HCHA Resident Coordinator based on number of residents and residents where children and seniors resided. There were 200 surveys collected for each site.
Data Analysis
Analysis of the 400 surveys was conducted using the USDA methodology which includes determining the number of affirmative responses for each household survey and then using the USDA’s food security scale to determine the food status of each household. The scale ranged from 0 to 10 if the household did not contain children or 0 to 18 if the household contained one or more children under the age of 18.
Comparison of Results by County
(n=200/county)
Survey Question
Bibb County
Houston County
Participants with incomes <$30,000
82%
88%
Participants receiving some form of governmental assistance (WIC, SNAP, TANF)
99%
97%
HH3. “The food that we bought just didn't last, and we didn't have money to get more.”
77%
80%
AD5. In the last 12 months, did (you/you or other adults in your household) ever not eat for a whole day because there wasn't enough money to buy food?
26%
21%
CH3. “(My child was/The children were) not eating enough because we just couldn't afford enough food.”
32%
CH5. “Did (your child/ any of the children) ever skip meals because there wasn't enough money for food?”
11% 4%
CH7. “Did (your child/any of the children) ever not eat for a whole day because there wasn't enough money for food?” 5% 3%
Recommendations/Conclusion
Recommendations
Further research to determine the extent and causes of food insecurity in Bibb and Houston County and to determine food security levels in the district’s rural counties
Development of a food policy council to educate policy makers on the important food issues impacting the community and to create civic engagement
Educate the public on food programs, food preparation, and nutrition
Determine appropriate placement of food pantries, grocery stores, and other food resources, particularly for community members without transportation
Conclusion
Hunger among American households due to insufficient resources is a challenge that continues to exist in the United States. Implementation of food programs has eliminated many forms of extreme hunger, while less severe forms of food insecurity still exist. The results indicate that, just as food access and security remain a problem at the national level; it also exists at the county level. It is important to further assess this issue on the county level in order to generalize the results to the county for development of specific interventions at multiple levels of society. In order to be eliminated as more extreme forms of hunger have been, food insecurity must be addressed at the policy, community, and individual level as indicated by the recommendations that have been provided.
Introduction
Food insecurity and hunger are typically associated with third world countries; however, these are pressing issues also found within the United States today. Food security is defined as “access by all people at all times to enough food for an active, healthy life. Food security includes at a minimum: (1) the ready availability of nutritionally adequate and safe foods, and (2) an assured ability to acquire acceptable foods in socially acceptable ways (e.g., without resorting to emergency food supplies, scavenging, stealing, or other coping strategies)” (Bickel, Nord, Price, Hamilton, & Cook, 2000).
The United States Department of Agriculture (USDA) provides annual reports for each state regarding the status of food security which is defined as “food access by all people at all times to enough food for an active and healthy life” (Coleman-Jensen, Nord & Singh, 2013). In 2012, the USDA reported that 85.5 % of the households in the United States were considered to be food secure throughout the year (Coleman-Jensen, Nord & Singh, 2013). Households without access to food at all times throughout the year are considered to be food insecure.
According to the USDA data, the national percentage of households considered food insecure has approximately doubled over the past 16 years, increasing from 7.5% in 1995 to 14.5% in 2012 (Coleman-Jensen, Nord & Singh, 2013). Georgia currently ranks sixth in the nation for households having low food security and tenth for households with very low food security, at 16.9% and 6.9%, respectively; both of which are higher than the national averages (Food Research Action Center, 2010; Coleman-Jensen, Nord & Singh, 2013). This increase is alarming and warrants serious attention because food insecurity can undermine healthy or optimal development, and is related to malnutrition and social and physical problems.
With the increase in food insecurity on a national and state level, it is necessary to identify food security status on a county-level in states with high food insecurity rates. Few food security and access assessments have been conducted at the county level. Therefore, the North Central Health District 5-2 contracted with Mercer University Department of Public Health to conduct two pilot studies to gain insight on the status of food security within the district, specifically Bibb County and Houston County, Georgia, the two largest and most urban communities in the district.
Results
The four possible outcomes for household food status based on participant results include: Food Secure – no evidence of food insecurity; Marginally Food Secure - evidence of food insecurity among household members and concerns about adequate food supply and management; Low Food Secure - food intake is occasionally reduced and members have experienced hunger at some point; Very Low Food Secure - repeatedly suffer from severe reductions in food intake and hunger.
References
Bickel, G., Nord, M., Price, C., Hamilton, W., & John C. Guide to Measuring Household Food Security, Revised 2000 (2000). U.S. Department of Agriculture, Food and Nutrition
Cohen, Barbara. Community Food Security Assessment Toolkit (2002). United States Department of Agriculture. Retrieved From.
Coleman-Jensen, A., Nord, M., & Singh, A. (2013, September). Household Food Security in the United States Retrieved from:
Food Research Action Center. (2010).Prevalence of Household-Level Food Insecurity and Very Low Food Security by State Retrieved from:
Household Food Status Outcomes by County
(n=200/county)
Household Food Status
Bibb
Houston
Food Secure
12%
14.5%
Marginally Food Secure
16%
16.5%
Low Food Secure
38%
27.5%
Very Low Food Secure
34%
41.5%