Food Insecurity and the Behavioral and Intellectual Development of Children: A Review of the Evidence

Abstract

Household food insecurity (HFI) is defined in the USA as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.”1 HFI is currently conceptualized as a progression of events that may start with household members being worried about not being able to access their needed food in the future due to socioeconomic uncertainties, followed by first sacrificing the quality of the diet and when food insecurity reaches its more severe form reducing the amount of calories consumed.1 The current HFI paradigm posits that adults tend to buffer children with adults experiencing the more severe forms of food insecurity before children do.1 The instruments most commonly used for examining risk factors and consequences of HFI are based on the US Household Food Security Survey Module (HFSSM) and/or scales derived from it. The complete HFSSM is an 18-item experience-based scale in which an individual who has knowledge of the food situation in the household responds to questions about worries related to food deprivation, as well as to questions about dietary quality and food insufficiency experienced by adults and/or children living in the household. Based on the number of affirmative responses, an additive score is computed for each household, thus allowing each household to be classified as experiencing food security, low food security, or very low food security.1 The HFSSM and related (sub)scales allow for assessing the food (in)security situation in the whole household but do not provide information regarding the food (in)security experience among specific members of the household.1 Data collected with the HFSSM indicate that, in 2010, 14.5% (17.2 million) of US households were food insecure at some point during the year. Risk factors for HFI include: household income near or below the federal poverty line; single-headed households with children; and black and Hispanic households. Given that an alarming 1 in 5 children are at risk of hunger (1 in 3 among black and Latino children) and that 3.9 million households with children were food insecure in 2010,2 it is crucial to understand how HFI affects the present and future development and well- being of our children.