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Hunger and Food Insecurity This is a preview of the Food System Primer, a series of bite-sized readings and resources spanning farm to fork, launching in Spring 2016.

Background “To many people hunger means not just symptoms that can be diagnosed by a physician; it bespeaks the existence of a social, not a medical problem.”1 – President's Task Force on Food Assistance, 1984

Hunger can refer to the discomfort, weakness, illness, or pain caused by a long-term lack of food.2 Although the United States has been called the “land of plenty,” more than 14 percent of U.S. households in 2013 experienced food insecurity at times during the year—a condition that can include household members going hungry because they can’t afford enough food, as well as having to skip meals, compromise on nutrition, or rely on emergency food sources such as food banks, food pantries, or soup kitchens.3

Hunger and food insecurity are large and complex problems, in part because they are closely tied to poverty—a condition that has prevailed since the beginning of recorded history. The presence of hunger and food insecurity in the U.S. raises questions of why they prevail, how they should be addressed, and who should be responsible for addressing them.

Although the United States has been called the “land of

plenty,” more than 14 percent of U.S. households in 2013

experienced food insecurity at times during the year—a

condition that can include household members going hungry

because they can’t afford enough food, as well as having to

skip meals, compromise on nutrition, or rely on emergency

food sources such as food banks, food pantries, or soup

kitchens.3

Photo credit: Michael Milli, Johns Hopkins Center for a Livable

Future.

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Prevalence of undernourishment (percentage) by region.

Globally, malnutrition is the leading cause of mortality,

responsible for an estimated one in seven deaths.4 In parts of

sub-Saharan Africa, more than one in three people suffers

from malnourishment. Hunger and food insecurity are often

the product of poverty, armed conflict, and other barriers that

prevent people from accessing food.

Image adapted from the Food and Agriculture Organization of

the United Nations.5

Federal food and nutrition assistance The first time hunger in the U.S. gained significant attention from policymakers was during the 1930s, when the Great Depression left a quarter of the American workforce unemployed.6 While U.S. farmers were producing more food than they could profitably sell, millions of Americans were hungry—a “paradox of want amid plenty.”7

Hoping to solve both problems, Congress authorized the government to purchase surplus wheat from farmers and donate it to hunger relief efforts.8–10 This represented a major shift in the role of the U.S. government, as hunger relief had traditionally been the role of private charities.9 Critics of the program argued that government “handouts” would undermine America’s work ethic and the dignity of citizens who received them.9

Despite objections against it, federal food and nutrition assistance would expand over the following years. A temporary food stamp program was established in 1939,8 followed by the National School Lunch Program in 1946.11

Such programs were not, however, sufficient to keep hunger at bay. A series of investigations in the 1960s reported evidence of widespread hunger in the rural South, followed by the award-winning CBS News documentary Hunger in America, which used the media to shed light on the issue. The public was shocked to learn of hunger in a country with such an abundant food supply, and reacted with outspoken criticism of federal programs, calling for greater assistance to the poor.9,11,12 The government responded by establishing the School Breakfast Program, free and reduced-price meals in schools, and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). It also expanded the Food Stamp Program, which is now called the Supplemental Nutrition Assistance Program, or SNAP.12

Today, about one in four Americans participates in at least one federal food and nutrition assistance program at some point during the year.13

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Breadline (line of people waiting to receive free food) beside

the Brooklyn Bridge, circa 1930.

In the early years of the Great Depression, free meal programs

were established to help the hungry and unemployed. Some

were funded by cities, but most were funded by private

charities. In the absence of any substantial support from the

federal government, local relief programs were not sufficient

to meet the need. In desperation, many people turned to

stealing, begging, and scavenging in garbage dumps.7

Photo source: Library of Congress.

“Food and nutrition would be at least as important as metals

and munitions.” – President Franklin Roosevelt

In 1940, an estimated two out of five World War II draftees

were deemed unfit for service, most often because of poor

nutrition during childhood.11 The National School Lunch

Program was established six years later in the hopes of

fostering healthier citizens—and more able-bodied soldiers.

Photo public domain.

Every $10 of SNAP benefits (food stamps) generates up to $15

in economic activity.

Federal food and nutrition assistance programs can boost the

economy. The Supplemental Nutrition Assistance Program

(SNAP), for example, encourages participants to spend more

on food. Every dollar’s worth of SNAP benefits generates an

estimated 17 to 47 cents of additional spending, creating jobs

for grocers, farmers, and other businesses.14,15 When SNAP

benefits are accepted at farmers’ markets, they have the

added benefit of supporting local economies.

Image credit: Brent Kim, Johns Hopkins Center for a Livable

Future.

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Emergency food programs During the early 1980s, the U.S. economy entered a severe recession that left many Americans unemployed. Federal budget cuts, meanwhile, weakened many social support programs.16 These events coincided with a dramatic rise in poverty,8 while hunger and homelessness became increasingly apparent.8,16

America’s poor turned to food banks, food pantries, soup kitchens, and other emergency food programs for help. To meet the urgent need, the size and number of emergency food programs multiplied over the course of just a few years; in New York City, 100 new emergency food programs opened in 1983 alone.16 Today, emergency food programs provide assistance, at least during parts of the year, to more than one in 20 Americans.17 Millions of Americans support these programs through donations of food, money, and volunteer labor.16

Some have argued that the proliferation of emergency food programs indicates a failure on society’s part to address the root causes of poverty. The argument goes on to suggest that by making charitable donations, Americans alleviate the discomfort evoked by seeing hunger and poverty, creating a “culture of charity” that allows the government to “dismiss its responsibility for the poor.” This arrangement has been described as “kinder, but less just,” referring to the role of charity in a society that lacks legal obligation to uphold its citizens’ right to food.16

Some have argued that the proliferation of emergency food

programs, such as food banks and soup kitchens, indicates a

failure on society’s part to address the root causes of poverty.

This arrangement has been described as “kinder, but less just,”

referring to the role of charity in a society that lacks legal

obligation to uphold its citizens’ right to food.16

Photo credit: Michael Milli, Johns Hopkins Center for a Livable

Future.

Food insecurity By the time someone experiences hunger, they may already have suffered harm. For this reason, U.S. policymakers and public health advocates have expanded their attention from a narrow focus on hunger to the broader concept of food insecurity, which includes conditions that can lead to hunger.18

Food security means having consistent access to enough safe and nutritious food, and being able to get it without resorting to emergency food programs, scavenging, or stealing.19,20 In Latin, “secure” means “without worry.” A food secure family does not worry about whether they can eat well from day to day, whereas a food insecure family may be forced to skip meals, unable to afford balanced meals, or worried their food will run out before they can afford to buy more .21

Food security in a region depends on three factors: First, does the region produce enough food for its people? Second, is the food supply stable, e.g., robust enough to weather droughts? Third, do

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people have physical and economic access to food?22 In the U.S., where the food supply is abundant and stable, access to food is the primary concern.

Poverty is frequently cited as the root of food insecurity. In the U.S., low-income households are much more likely to be food insecure.21 Unemployment, low wages, physical and mental illness, and other burdens can make it difficult to obtain adequate, nutritious food—particularly when food budgets must compete with other priorities, such as housing, medical, and child-care costs.23

Food insecure households may face greater health risks. Food insecurity has been linked to obesity, diabetes, nutrient deficiencies, low fruit and vegetable intake, and other indicators of unhealthy diets.23 Families that live far from supermarkets and lack access to transportation may be particularly affected.24

Children may be particularly affected by food insecurity.

Studies have found links between food insecurity and poorer

academic performance, school absences, suspension from

school, involvement in fights, headaches, depression, and

other physical, emotional, and behavioral concerns.23,25–27

Photo credit: Richard Phillip Rücker, 2006. Wikimedia. Some

rights reserved.

The community food security movement "You do not solve the hunger problem by feeding people. … The problems of hunger and malnutrition can be solved only by ensuring that people can live in dignity by having decent opportunities to provide for themselves.” – George Kent, Freedom from Want4

While federal food and nutrition assistance and emergency food programs provide much-needed nourishment in times of need, the community food security movement strives to build self-reliance, empowering people with the means to procure food for themselves.18

Educational programs, for example, can teach people how to grow, preserve, and prepare produce for themselves and their community. With small loans and entrepreneurial training, community members can start up small businesses that produce food for farmers’ markets, stores, and restaurants. The movement also works to improve access to healthy food by establishing community gardens, urban farms, and farmers’ markets.18

These examples demonstrate how the community food security movement strives to promote local decision making and grassroots citizen engagement, in contrast to “top-down” programs shaped by decisions made by the federal government.18,22

Unlike programs that focus only on eating, the community food security movement takes a “systems approach”—bringing together representatives from across the food system (e.g., farmers,

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chefs, community members, and policymakers), and accounting for how and where food is produced, processed, distributed, and sold.18,28

Community garden in Baltimore.

The community food security movement strives to build self-

reliance, empowering people to obtain food for themselves.

The movement also promotes local decision making and citizen

engagement. Food policy councils, for example, unite

community members with farmers, chefs, policymakers, and

other local food system representatives to improve access to

healthy food (among other goals).

Photo credit: Brent Kim, Johns Hopkins Center for a Livable

Future.

“Give a person a fish and feed him for a day. Teach him to fish

and feed him for a lifetime.” This frequently quoted saying

oversimplifies the problem of hunger. “It implies that people

don’t have enough to eat simply because they don’t know how

to fish or how to grow food… [ignoring] factors that cause

hunger more often than ignorance or a lack of tools.” Find

theologian Justo González’s full essay in the Resources section.

Photo public domain.

"You do not solve the hunger problem by feeding people. …

The problems of hunger and malnutrition can be solved only

by ensuring that people can live in dignity by having decent

opportunities to provide for themselves.” – George Kent,

Freedom from Want4

Photo credit: Michael Milli, Johns Hopkins Center for a Livable

Future.

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References 1. President’s Task Force on Food Assistance. Report of the President’s Task Force on Food Assistance.

Washington, DC; 1984.

2. USDA Economic Research Service. Food Security in the United States: Definitions of Hunger and Food Security. 2011.

3. Coleman-Jensen A, Gregory C, Singh A. Household Food Security in the United States in 2013. USDA Economic Research Service; 2014.

4. Kent G. Freedom from Want: The Human Right to Adequate Food. (Twiss SB, Kelsay J, Coonan T, eds.). Washington, D.C.: Georgetown University Press; 2005.

5. U.N. Food & Agriculture Organization. FAOSTAT. 2013.

6. McElvaine RS. The Great Depression: America, 1929-1941. Random House Digital, Inc.; 1993.

7. Poppendieck J. Breadlines Knee Deep in Wheat: Food Assistance in the Great Depression. Rutgers University Press; 1986.

8. Andrews M, Clancy K. The Political Economy of the Food Stamp Program in the United States. In: Pinstrup-Anderson P, ed. Political Economy of Food and Nutrition Policies. Washington, DC: International Food Policy Research Institute; 1993.

9. Roth D. FOOD STAMPS: 1932 –1977: From Provisional and Pilot Programs to Permanent Policy. USDA ERS

10. Lambert CR. Herbert Hoover and Federal Farm Board Wheat. Herit Gt Plains. 1977;10(1).

11. Levine S. School Lunch Politics: The Surprising History of America’s Favorite Welfare Program. Princeton, NJ: Princeton University Press; 2008.

12. Parker L. The role of clinicians in helping patients achieve food security. Nutr Clin Care. 2002;5(4):149-151.

13. USDA. Food Assistance and Nutrition Programs. 2011.

14. Hanson K. The Food Assistance National Input-Output Multiplier (FANIOM) Model and Stimulus Effects of SNA.; 2010.

15. USDA. The Benefits of Increasing the Supplemental Nutrition Assistance (SNAP) Program Participation in Your State.; 2011.

16. Poppendieck J. Sweet Charity?: Emergency Food and the End of Entitlement. New York, NY: Penguin Group; 1999.

17. Coleman-jensen A, Nord M, Andrews M, Carlson S. Household Food Security in the United States in 2010: Statistical Supplement.; 2011.

18. Allen P. Reweaving the food security safety net: Mediating entitlement and entrepreneurship. Agric Human Values. 1999:117-129.

19. Life Sciences Research Office, Federation of American Societies for Experimental Biology. Core indicators of nutritional state for difficult-to-sample populations. J Nutr. 1990;120(Suppl 11):1559-1600.

20. Andrews M, Nord M, Bickel G, Carlson S. Household food security in the United States, 1999. USDA ERS. 2000.

21. Coleman-Jensen A, Nord M, Andrews M, Carlson S. Household Food Security in the United States in 2010.; 2011.

22. Hamm MW, Bellows AC. Community food security: background and future directions. J Nutr Educ Behav. 2003;35(1):37-43.

23. Haering SA, Syed SB. Community Food Security in United States Cities. Baltimore, MD; 2009.

24. Ver Ploeg M, Breneman V, Farrigan T, et al. Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences: Report to Congress. USDA Economic Research Service; 2009.

25. Murphy JM, Wehler CA, Pagano ME, Little M, Kleinman RE, Jellinek MS. Relationship between hunger and psychosocial functioning in low-income American children. J Am Acad Child Adolesc Psychiatry. 1998;37(2):163-170.

26. Alaimo K, Olson CM, Frongillo Jr EA. Food insufficiency and American school-aged children’s cognitive,

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academic, and psychosocial development. Pediatrics. 2001;108(1):44-53.

27. Alaimo K, Olson CM, Frongillo EA. Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. J Nutr. 2002;132(4):719-725.

28. Winne M, Joseph H, Fisher A. Community Food Security: A Guide to Concept, Design and Implementation. Venica, CA; 1997.