Differentiating Between Food Security and Insecurity Karen H. Morin, PhD, RN, ANEF, FAAN
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aving enough food to meet one’s nutritional requirements is critical for normal functioning and growth. However, during 2012, approximately 15% of households or approximately 49 million people in the United States experienced some degree of food insecurity (United States Department of Agriculture Economic Research Services [USDA ERS], 2014a). Approximately 25% of veterans reported experiencing food insecurity during the previous year, with 12% reporting very low food security (Widome, Jensen, Bangerter, & Fu, 2014). Understanding differences between food security and insecurity as well as between
Food insecure households are those in which limited or lack of financial resources result in worry that food will be depleted before they can replenish supplies, food supplies actually do run out, and meals are not balanced. Very low food security adult households also report disrupted eating patterns and reduced intake (USDA ERS, 2014b). Prior to 2006, definitions of food insecurity included reference to hunger. However, “food insecurity is a house-hold level economic and social condition of limited access to food, while hunger is an individual-level physiological condition that may result from food insecurity” (USDA
In 2012, approximately 15% of households in the United States experienced some degree of food insecurity. these two terms and hunger is important when assessing for their presence and when planning appropriate interventions. How are food security and insecurity defined? Both food security and insecurity are defined within the context of households, and on a scale of ease of accessibility to food, anxiety, and eating patterns. Food security, at the higher end of the scale, is present when households have access to safe and nutritious food, are not anxious about accessing food, and acquire food in the typical manner, that is, members of a household do not have to access food banks, forage in garbage, or steal food in order to meet their nutrition needs. Food security is categorized as either high (no issues) or marginal (typically some shortage of food with associated anxiety about sufficient food supply). Food insecurity, at the lower end of scale, ranges from low to very low food security. November/December 2014
ERS, 2014b, p. 2). This distinction is important to acknowledge as the word hunger can vary in meaning. Are there health consequences associated with food insecurity?
Recent investigations lend beginning support to the hypothesis that food insecurity may have health consequences. Berkowitz, Baggett, Wexler, Huskey, and Wee (2013) in their cross-sectional analysis of 2,557 persons with diabetes found that poor glycemic control was significantly associated with food insecurity, even when adjustment for factors such as body mass index and age were made. Cook at al. (2013) report that even marginal food security has serious health consequences. They found that caregivers in households reporting either marginal food security or food insecurity experienced more depressive symptoms and poorer health than those in households with food security. Children were more
likely to be hospitalized following birth, and less likely to have “well child” child status. What does this mean for nurses?
Assessing a patient’s access to food can easily be undertaken during any interaction. Questions such as “Do you ever worry that you will not have enough money to buy the food you need?” and “Has this happened during the past year?” may be the opening a patient needs to seek assistance. Nurses will find a list of potential questions to ask at the USDA ERS Web site; the Web site concerning measurement is particularly helpful. ✜ Karen H. Morin is a Professor and Director of the PhD program, University of Wisconsin–Milwaukee, and an Editorial Board Member of MCN. She can be reached via e-mail at [email protected] The author declares no conflict of interest. DOI:10.1097/NMC.0000000000000080 References Berkowitz, S. A., Baggett, T. P., Wexler, D. J., Huskey, K. W., & Wee, C. C. (2013). Food insecurity and metabolic control among U.S. adults with diabetes. Diabetes Care, 36(10), 3093–3099. doi:10.2337/dc13-0570 Cook, J. T., Black, M., Chilton, M., Cutts, D., Ettinger de Cuba, S., Heeren, T. C., . . ., Frank, D. A. (2013). Are food insecurity’s health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers. Advances in Nutrition, 4(1), 51–61. doi:10.3945/an.112.003228 United States Department of Agriculture Economic Research Services. (2014a). Frequency of food insecurity. Retrieved from www.ers.usda.gov/topics/food-nutritiona s s i s t a n c e / f o o d - s e c u r i t y- i n - t h e - u s / frequency-of-food-insecurity.aspx United States Department of Agriculture Economic Research Services. (2014b). Measurement. Retrieved from www.ers. usda.gov/topics/food-nutrition-assistance/ food-security-in-the-us/measurement.aspx Widome, R., Jensen, A., Bangerter, A., & Fu, S. S. (2014). Food insecurity among veterans of the US wars in Iraq and Afghanistan. Public Health Nutrition, 1–6. doi:10.1017/S136898001400072X MCN
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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aving enough food to meet one’s nutritional requirements is critical for normal functioning and growth. However, during 2012, approximately 15% of households or approximately 49 million people in the United States experienced some degree of food insecurity (United States Department of Agriculture Economic Research Services [USDA ERS], 2014a). Approximately 25% of veterans reported experiencing food insecurity during the previous year, with 12% reporting very low food security (Widome, Jensen, Bangerter, & Fu, 2014). Understanding differences between food security and insecurity as well as between
Food insecure households are those in which limited or lack of financial resources result in worry that food will be depleted before they can replenish supplies, food supplies actually do run out, and meals are not balanced. Very low food security adult households also report disrupted eating patterns and reduced intake (USDA ERS, 2014b). Prior to 2006, definitions of food insecurity included reference to hunger. However, “food insecurity is a house-hold level economic and social condition of limited access to food, while hunger is an individual-level physiological condition that may result from food insecurity” (USDA
In 2012, approximately 15% of households in the United States experienced some degree of food insecurity. these two terms and hunger is important when assessing for their presence and when planning appropriate interventions. How are food security and insecurity defined? Both food security and insecurity are defined within the context of households, and on a scale of ease of accessibility to food, anxiety, and eating patterns. Food security, at the higher end of the scale, is present when households have access to safe and nutritious food, are not anxious about accessing food, and acquire food in the typical manner, that is, members of a household do not have to access food banks, forage in garbage, or steal food in order to meet their nutrition needs. Food security is categorized as either high (no issues) or marginal (typically some shortage of food with associated anxiety about sufficient food supply). Food insecurity, at the lower end of scale, ranges from low to very low food security. November/December 2014
ERS, 2014b, p. 2). This distinction is important to acknowledge as the word hunger can vary in meaning. Are there health consequences associated with food insecurity?
Recent investigations lend beginning support to the hypothesis that food insecurity may have health consequences. Berkowitz, Baggett, Wexler, Huskey, and Wee (2013) in their cross-sectional analysis of 2,557 persons with diabetes found that poor glycemic control was significantly associated with food insecurity, even when adjustment for factors such as body mass index and age were made. Cook at al. (2013) report that even marginal food security has serious health consequences. They found that caregivers in households reporting either marginal food security or food insecurity experienced more depressive symptoms and poorer health than those in households with food security. Children were more
likely to be hospitalized following birth, and less likely to have “well child” child status. What does this mean for nurses?
Assessing a patient’s access to food can easily be undertaken during any interaction. Questions such as “Do you ever worry that you will not have enough money to buy the food you need?” and “Has this happened during the past year?” may be the opening a patient needs to seek assistance. Nurses will find a list of potential questions to ask at the USDA ERS Web site; the Web site concerning measurement is particularly helpful. ✜ Karen H. Morin is a Professor and Director of the PhD program, University of Wisconsin–Milwaukee, and an Editorial Board Member of MCN. She can be reached via e-mail at [email protected] The author declares no conflict of interest. DOI:10.1097/NMC.0000000000000080 References Berkowitz, S. A., Baggett, T. P., Wexler, D. J., Huskey, K. W., & Wee, C. C. (2013). Food insecurity and metabolic control among U.S. adults with diabetes. Diabetes Care, 36(10), 3093–3099. doi:10.2337/dc13-0570 Cook, J. T., Black, M., Chilton, M., Cutts, D., Ettinger de Cuba, S., Heeren, T. C., . . ., Frank, D. A. (2013). Are food insecurity’s health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers. Advances in Nutrition, 4(1), 51–61. doi:10.3945/an.112.003228 United States Department of Agriculture Economic Research Services. (2014a). Frequency of food insecurity. Retrieved from www.ers.usda.gov/topics/food-nutritiona s s i s t a n c e / f o o d - s e c u r i t y- i n - t h e - u s / frequency-of-food-insecurity.aspx United States Department of Agriculture Economic Research Services. (2014b). Measurement. Retrieved from www.ers. usda.gov/topics/food-nutrition-assistance/ food-security-in-the-us/measurement.aspx Widome, R., Jensen, A., Bangerter, A., & Fu, S. S. (2014). Food insecurity among veterans of the US wars in Iraq and Afghanistan. Public Health Nutrition, 1–6. doi:10.1017/S136898001400072X MCN
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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