Journal Issue: Welfare to Work Volume 7 Number 1 Spring 1997
Defining Hunger for Policy Purposes
Hunger among children in the United States does not take the form of mass starvation, as it does in some poorer nations, and cases of severe food deprivation are extremely rare. Objective, clinical signs of food deprivation (such as low weight-for-height, or wasting, and low height-for-age, or stunting) generally appear in children (with the exception of infants) only after persistent food deprivation has been a problem for some time. The effects of hunger as they are seen in children in the United States are usually more subtle and challenging to measure: fatigue, irritability, dizziness, frequent headaches, frequent colds and infections, and difficulty concentrating.3
Because of the difficulty in measuring hunger by objective clinical standards, considerable effort has been given to devising alternative measures of hunger, based on a person's self-report of his or her psychological or subjective experience of hunger. This effort has occurred in both the private and public sectors, often with cooperation among government agencies, privately funded advocacy groups, and academic institutions. While the participants may not yet agree on every detail of a single definition of hunger or a single measurement instrument, there has been a notable convergence in thought. For nearly two decades, hunger has been defined, for policy, measurement, and reporting purposes, as "an inadequate amount of food intake due to lack of money or resources"4 or "the mental or physical condition that comes from not eating enough food due to insufficient economic, family, or community resources."5 Hunger, so defined, is referred to as resource-constrained hunger and is closely related to poverty and markedly distinct from the everyday premealtime hunger experienced across the income spectrum.
In the past several years, researchers have placed hunger as defined above within the context of a much broader concept called food insecurity. Food insecurity is a condition in which families or individuals are unable to afford enough adequately nutritious and safe food from socially acceptable sources for an active, healthy life.6 Families or individuals may experience food insecurity in varying degrees of severity, with less severe food insecurity showing up in coping behaviors such as borrowing money for food, obtaining food from charity, or reducing the variety and quality of their diet. More severe food insecurity is experienced as the actual uneasy or painful hunger sensation caused by lack of food as a result of inadequate resources.7
While issues concerning the safety and nutritional adequacy of food and the social acceptability of the sources of food are all elements of food insecurity, the focus in this article is on food quantity. Nutritional adequacy is related but not equivalent to the quantity of food consumed. While most people who are chronically hungry are likely to be malnourished, some malnourished people may not experience hunger, and those experiencing brief episodes of hunger may not become malnourished. (Growth stunting, an indicator of malnutrition, will be addressed in the Summer/Fall 1997 Child Indicators article.) Food safety is also a separate issue from food quantity and is not discussed further in this article. Finally, while the social acceptability of food sources is an important element of food security, and while the reliance by needy people on food obtained from socially unacceptable sources (scavenged from trash bins or received from food pantries, food banks, or soup kitchens) has been documented,8 the relationship between resource-constrained hunger and the use of socially unacceptable food sources is complex and beyond the scope of this article.9
With the focus narrowed to one concept—food quantity—it remains important to recognize that even that relatively simple concept has subjective elements. The concept of an "adequate amount of" or "enough" food can be highly subjective, reflecting not only the nutritive content of food, but other qualities such as variety and personal preferences. In addition, the notion of "inadequate" money or resources also has a subjective component. Because food competes with many other items in household budgets, whether food intake is adequate for a child in a family depends not only on the size of the family budget but also on what else is purchased with limited family resources and for whom.