1. Food Insecurity and Hunger: Implications for MCH Programs April 2002 Noel Chavez, PhD, RD, LD, University of Chicago Kristine Siefert, PhD, University of Michigan Angie Tagtow, MS, RD, LD, Iowa Dept. of Public Health

2. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Session Objectives Describe the distribution and determinants of food insecurity and hunger in MCH populations. Describe findings from recent research on the health consequences of food insecurity and hunger in MCH populations. Discuss the implications of these findings for policies and programs to address food insecurity and hunger in MCH populations. Describe strategies used by an exemplary program to address food insecurity and hunger.

3. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Definition of Food Security Access by all people at all times to enough food for an active, healthy life. Food security includes: The ready availability of nutritionally adequate and safe foods, and 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). Life Sciences Research Organization. Core indicators of nutritional status for difficult-to-sample populations. J Nutr. 1990; 120 (suppl):1559-1600.

4. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Definition of Food Insecurity Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways Life Sciences Research Organization. Core indicators of nutritional status for difficult-to-sample populations. J Nutr. 1990; 120 (suppl):1559-1600.

5. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Definition of Hunger Uneasy or painful sensation caused by a lack of food. The recurrent and involuntary lack of access to food. Is a potential consequence of food insecurity Leads to nutritional, health and developmental problems Life Sciences Research Organization. Core indicators of nutritional status for difficult-to-sample populations. J Nutr. 1990; 120 (suppl):1559-1600.

6. Angie Tagtow, MS, RD, LD Iowa Department of Public Health How Far Have We Come? 1984 - President’s Task Force on Food Assistance 1990 - National Nutrition Monitoring and Related Research Act 1992 – Food Security Measurement Project 1994 & 1999 – Food Security Measurement and Research Conference 1995 – Radimer/Cornell Hunger and Food Insecurity Measure

7. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Influences on Food Security Limited income at the household level Household size Limited access to food resources at the community level Limited social networks Food and nutrition policy Seasonal

8. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Household Food Security Continuum Food Secure Food Insecure w/o Hunger Food Insecure with Hunger

9. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Radimer/Cornell Hunger and Food Security Measures Household Individual Adult Child(ren) Extent of food insecurity is determined when the respondent selects “sometimes true” or “often true” to any of the ten statements

10. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Household Level Items I worry whether my food will run out before I get money to buy more. The food that I bought just didn’t last and I didn’t have money to get more. I ran out of the foods that I needed to put together a meal and I didn’t have money to get more food. We eat the same thing for several days in a row because we only have a few different kinds of foods on hand and don’t have money to buy more.

11. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Adult Level Items I can’t afford to eat properly. I am often hungry, but I don’t eat because I can’t afford enough food. I eat less than I think I should because I don’t have enough money for food.

12. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Child Level Items I cannot give my child(ren) a balanced meal because I can’t afford that. My child(ren) is/are not eating enough because I just can’t afford enough food. I know my child(ren) is/are hungry sometimes, but I just can’t afford more food.

13. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Estimates of Food Insecurity & Hunger Economic Research Service/USDA. Current Population Survey Food Security, US Census

14. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Investigating Food Security Among Iowa WIC Participants 2000 15% random sample (9194) 2731 responses (30% response rate) Household level food security Descriptive analysis 1997 10% convenience sample (6633) 3383 responses (51% response rate) Individual and household level food security Descriptive analysis

15. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Household Food Insecurity Determined when the respondent selected “sometimes true” or “often true” to one or more of the following statements: I worry whether my food will run out before I get money to buy more. The food that I bought just didn’t last and I didn’t have money to get more. I ran out of the foods that I needed to put together a meal and I didn’t have money to get more food. We eat the same thing for several days in a row because we only have a few different kinds of foods on hand and don’t have money to buy more.

16. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Change in Household Food Security from 1997 to 2000

17. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Food Security Between English and Spanish-Reading Respondents

18. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Food Security and Age

19. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Iowa WIC Survey Summary Respondents experienced greater food insecurity in 2000 than in 1997. Younger respondents experienced greater food insecurity than older respondents. Spanish respondents experienced greater food insecurity than English respondents.

20. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Potential Influences on Food Security Among WIC Participants Welfare Reform Decrease Food Stamp and TNF Minimum wage misaligned with cost of living Adequate food and nutrition referrals Holes in the nutrition safety net Public policy

21. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Domestic Food Security Resources USDA Food Security Initiative www.reeusda.gov/food_security/foodshp.htm USDA Economic Research Service – Food Security in the United States www.ers.usda.gov/briefing/foodsecurity/ USDA Food and Nutrition Services – Food Security Resources www.fns.usda.gov/fsec/ American Dietetic Association – Domestic Food and Nutrition Security www.eatright.org/adap0398a.html America’s Second Harvest http://secondharvest.org/ Food Research and Action Center www.frac.org/index.html

22. Angie Tagtow, MS, RD, LD Iowa Department of Public Health Angie Tagtow, MS, RD, LD Iowa Department of Public Health Bureau of Nutrition 515.281.7096 atagtow@idph.state.ia.us For more information…