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This paper will introduce the topic of food insecurity and hunger in the United States. According to the definition approved by the 1996 World Food Summit, “food security exists when…all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active and healthy life”.(Simon, 2012, p. 4-5) Food insecurity therefore, is the inability to acquire adequate food intake for all household members as the result of insufficient resources. Food Insecurity is also the official term used to describe the United States Department of Agriculture’s (USDA) measurement for all the possible variations that a family or house might experience while getting insufficient to sufficient food. The USDA measures the degree to which good food is available and how nutritious that food actually is. So while some members of a family might be getting food most of the time, some of the time some members are getting no food, others are getting food that is not very good and sometimes no one is eating at all. All these variations are taken into account and measured. Food insecure households are not necessarily food insecure all of the time and food insecurity may also reflect the trade-offs a household needs to make between paying the bills and purchasing nutritionally adequate food. (“NYC Food Insecurity,” 2014) Not surprisingly, low-income families are more likely to experience food insecurity than middle or higher income families.
There are four dimensions to food security: availability, accessibility, utilization and stability. So food insecurity occurs when there is: a lack of food (no availability); a lack of resources (no access to food); an improper use (no proper utilization of food); or changes in availability, accessibility or utilization (no stability with regards to food). (Simon, 2012, p. 5-8)
The United States produces more food than it could ever use for domestic consumption. Yet despite the ability to produce all this food, food insecurity is still a problem in the United States. American hunger is the result of economic poverty, when some people literally do not have enough funds to purchase food. But levels of income and poverty do not fully predict food insecurity. This suggests that other things (such as the ability to budget resources), are important in determining whether or not someone will be food insecure. (Gowda, Hadley, & Aiello, 2012, p. 1586) In 2008, 17 million US households were considered to be food insecure.(Gowda et al., 2012, p. 1579) In 2010, household food insecurity in the US was at its highest level since measurements began in 1995.(Fram et al., 2011, p. 1114) Also in 2010, over one-fifth of U.S. children lived in food-insecure homes. The problem was considered serious enough at the time that President Barack Obama publicly pledged to end child hunger by 2015.(Fram et al., 2011, p. 1114)
Today, food insecurity is combated by both government programs and aid from the private sector. And while both types of aid have increased in this century, hunger relief by the government has outpaced that provided by the private sector.(Gowda et al., 2012, p. 1583) However, this was not always the case, and for many people throughout American history people were essentially on their own.
The prospect of food insecurity is a constant part of the human condition and in the United States has been a concern for as long as people have been living in North America. The European colonists who first settled in North America faced the prospect of severe hunger much of the time. Transplanting crops brought from Europe and trying to grow native crops was difficult. In the early days of the first colonies, many settlers watched their crops fail and ultimately died of starvation or the effects of starvation. But many other settlers were saved from starvation through the generosity of Native Americans. Over time the colonists adapted and they either copied, continued or created farming methods that were successful. In the process of doing this, they discovered that the land in North America was very fertile.(Eisinger, 1998, p. 32-34)
They were so successful that despite the rugged environment and violence, hunger in North America was already becoming less severe than the level of hunger found throughout Western Europe. Improved food security had the effect that despite the dangers of life in the colonies, by 1776 American colonists enjoyed a higher life expectancy than their European cousins. The average life expectancy in North America at that time was 51 years; in Great Britain 37 years; in France only 26 years.(Eisinger, 1998, p. 44) A big factor in the food security experienced by North Americans though was that in addition to good fertile land, there was also a low population level. There was also no shortage of jobs. With low unemployment levels and plenty of work, any able-bodied person was prevented from suffering from the effects associated with unemployment, such as low income and the resulting inability to access food.(Fogel, 2004, p. 14-15)
But conditions changed by the early 19th century when good land (or at least access to good land) became more scarce, usually available only to those who already had with wealth. It had also become harder to make a living from public land or by owning and operating a small farm. Poor economic conditions forced many small farmers off their land, making them homeless. With a growing population of homeless people, America’s first homeless shelters (which also provided food), were set up, called Poorhouses.(“The Poorhouse,” 2012) In some areas city officials would also “hand out” emergency cash to the starving to buy food, but this did not stop the overall rise in poverty or hunger. By 1850 living conditions had fallen so low that in America that life expectancy had dropped to 43 years. It is thought that by 1865, as many as 1 in 5 Americans could have been suffering from food insecurity.(Fogel, 2004, p. 36)
After the Civil War, the industrial revolution began to change this situation to some degree. Factory jobs provided more access to income for workers and by the 1870’s there was less hunger and homelessness in the U.S. Of course most of these jobs were low wage and workers suffered in terrible conditions, but there were more jobs to choose from (and therefore less unemployment) so that at least people could earn enough money to eat. Though these “sweat shops” with their bad working conditions were the engine driving the “Gilded Age” the overall result was that they improved economy. This in turn created even more (and better) jobs being created outside of the factories as consumers had more money to spend. One side effect however, was that life for the poorest of the poor actually got worse. Many wealthy Americans opposed the idea of government intervening to help the hungry, thinking this would only create masses of lazy unemployed people. They also thought that it would somehow sabotage the growth of the free market. Laissez Faire capitalism was thought to be the appropriate response to the starving poor. But at the same time, the private sector began to provide help to the poor by creating America’s first soup kitchens.(DePastino, 2005, p. 22)
In the early 20th century there was a revolution in farming with the creation of the first methods of mechanized agriculture.(Janick, 2014) Ironically, although this lead to an increase in rural unemployment it also created a surplus of food which helped lower food prices in the United States. As a result, during and after the first World War (1914-1918), the United States sent about 20 million tons of food to a war ravaged Europe. And since World War I the United States has continued to be a world leader for relieving hunger.(Vernon, 2007, p. 242)
In the 1920’s America’s economy was booming, but the stock market crash of 1929 and the Great Depression that followed reversed much of the progress that the United States had made in reducing domestic hunger. But as a result of the Great Depression, the issue of American hunger became a major issue for the government. In time both the government and the private sector responded to the needs of the American people. More private soup kitchens and bread lines were opened and the “New Deal” program of government relief was launched. Some government programs like the Works Progress Administration (or WPA) tried to reduce unemployment by providing much needed jobs. Other programs tried to reduce poverty by raising wages. Another government program, the Federal Surplus Relief Corporation tried to provide poor people with food and bought surplus food from farmers. By the 1940’s the New Deal programs had improved the economy and seemed to have reduced most of the hunger in the United States. Until the late 1960s, many Americans considered hunger in their nation to be a solved problem.(Poppendieck, 1999, p. 11) So much so that some states even ended the practice of distributing federal food surpluses for free. Instead they provided an early form of food stamps but there was a price charged and since many could not pay for them, more people began to suffer from severe hunger again.(Poppendieck, 1999, p. 10)
As American society rediscovered hunger, more private charity groups opened soup kitchens and the first modern food bank was created in 1967.(Poppendieck, 1999, p. 112) The so-called “Hunger Lobby” was also launched to petition politicians to improve welfare for the hungry. By 1967 senate hearings were held on hunger and in 1969 President Nixon called on Congress to end hunger in the U.S. once and for all.(Melnick, 1994, p. 311)
In the 1970s, U.S. federal hunger relief grew substantially with food stamps distributed free of charge. Though these efforts again helped combat food insecurity, eventually the federal government again reduced welfare spending.(Dando, 2012, 177–178) The private sector again responded with grass roots relief agencies, essentially in the form of bigger and better food banks.(Dowler, 2012, p. 1)
Food Insecurity Interventions
America’s heritage of food insecurity provides an interesting look at the cycle within which food insecurity rises and falls. By now the relationship between economics and food insecurity seems pretty well documented: as the economy gets worse, poverty increases and with more people experiencing poverty, more experience food insecurity. Sadly, government policy, again operating in cycles, provides some initial, emergency, short term assistance but then eventually seems to blame the victims for their own deprivations and ends assistance. To be realistic about ending hunger in America, we must acknowledge that no matter how good the economy might ever get, there should always be interventions already in place to prevent food insecurity in the first place and to provide food to the hungry in preparation for the next big economic downturn.
As a nurse viewing food insecurity as a public health issue, there are three types of interventions in the field of healthcare: primary, secondary and tertiary prevention. Primary preventions try to protect healthy people from developing a problem to begin with. Secondary preventions happen after an illness has already been diagnosed, with the goals being to halt or slow the progress of the illness. Tertiary preventions try to help an ill patient cope with the long term issues associated with an already exiting, full blown condition that cannot be reversed.(“Primary, secondary and tertiary prevention,” 2006)
Primary Interventions: Creating Food Security/Measuring American food insecurity
Community food security is created through several avenues like nutrition education, public health, sustainable agriculture and anti-hunger activism. And as a modern public health issue, a primary intervention used to try and prevent food insecurity from occurring, is to track it using reliable and precise methods of measurements. With accurate statistics, policy makers and organizations can address problems before they get worse. The only way to really do this is to get statistics about what demographic is accessing food programs, and the circumstances which caused them to have to do this. The USDA is the government agency which has been tasked with tracking and fighting food insecurity and in 1994, the USDA organized a conference to try and figure out the best way to track food insecurity. The conference identified the appropriate basis for a nationwide measure and agreed that the best way to take such a measure was with nationwide surveys.(“History & Background,” 2014) This conference resulted in the creation of the U.S. Food Security Measurement Project (USFSMP), and current food security statistics are based on the survey measure the USFSMP developed. In 1995, the U.S. Census Bureau first carried out a field test of the first food security survey called the Current Population Survey Food Security Supplement. The Food Security Supplement was repeated again from 1996 to 2001 and has been continued annually ever since. Taking the data from these surveys and using the highly sophisticated statistical techniques, USFSMP created “an accurate scale that measures the severity of deprivation in basic food needs as experienced by U.S. households.”(“History & Background,” 2014)
So a major component of primary intervention is already in place by tracking and measuring food insecurity. But the second half of this prevention-oriented approach for community food security is to take those statistics and addresses a diverse range of issues such as: “food availability and affordability; direct food marketing; diet-related health problems; participation in and access to Federal nutrition assistance programs; ecologically sustainable agricultural production; farmland preservation; economic viability of rural communities; economic opportunity and job security; community development and social cohesion.”(“Food Security In The US,” 2014) According to the USDA themselves, primary intervention should also support the development of long term strategies: “To improve access of low-income households to healthful nutritious food supplies. To increase the self-reliance of communities in providing for their own food needs. To promote comprehensive responses to local food, farm, and nutrition issues.” (“Food Security In The US,” 2014)
Some of these issues can be addressed directly by the USDA but some can only be address in conjunction with or solely by other government agencies and policy makers. For example, the USDA has no say in influencing “economic opportunity and job security” but at least it can provide other agencies that do, with feedback as to how their policies may or may not be working. It seems unrealistic to think that the USDA alone can end food insecurity and clearly the magnitude of the problem – and the power it would take to prevent it – is beyond the scope of the USDA as it currently exists. But at least this primary intervention is in place and can be used in the future to continue trying to prevent hunger from happening and, until preventing it completely, to act as an alarm for strengthening secondary interventions.
While primary interventions for food insecurity involve the policy and decision making that affects poverty in America, the interventions that most of us associate with food insecurity are those involving tangible hunger relief that provides food to the hungry. Modern secondary interventions include the following:
Food pantries. The most common food aid establishments in the U.S., food pantries collect food from donors and give out actual parcels of food to those in need. Although used by anyone, they are designed to help families have enough food for a few meals which will be eaten at home.
The food closet. The food closet has the same purpose as a food pantry, but is not big enough to be in a building of its own. The food closet will be a closet or room in something like a church and is often found in more remote communities.
Soup kitchens. Soup kitchens are also called food kitchens and meal centers, all of which provide hot cooked meals for the hungry. These meals are prepared and eaten in the soup kitchen building (not at home). Soup kitchens are the second most common food aid establishment in the U.S.
The food bank. The food bank is the third most common food aid establishment. in the U.S. Most food banks usually warehouse food and distribute it to other agencies like food pantries, instead of giving it directly to the hungry. They get their supply of foods from large farms, manufacturers, supermarkets and the federal government.
Food rescue organizations also warehouse food and distribute it to other agencies but they operate on a smaller scale than food banks and get their food from different sources – restaurants, smaller shops and small farms.
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