Validation studies of food security instruments have
reported strong relationships between food insecurity
and (1) declines in household food supplies, (2) infrequent
fruit and vegetable consumption, (3) unemployment
and participation in food assistance programs,
and (4) disordered eating behaviors. Validity testing of
the Federal 18-item food security instrument has
supported its usefulness for monitoring food insecurity
and hunger in the general U.S. population. However,
researchers conducting studies among Hawaiian and
Pacific Islanders have questioned the validity of
applying the categorical measure of food insecurity to
that population. Similar research has not been
conducted among Latinos.
The main goal of this study was to validate the 18-item
food security instrument in a Latino population. The
authors also developed and tested a cultural framework
that links food insecurity to nutritional outcomes in
Latino families with young children, primarily of
Mexican descent. This research may contribute to
more effective monitoring of food insecurity and
hunger in the United States and for the design of nutrition
education programs in diverse cultural groups.
The authors used data from a cross-sectional survey,
carried out between February and May 2001, of
approximately 250 low-income Latino households in
six California counties. Prior to the survey, 4 focus
groups were conducted to examine cultural interpretation
of the 18 food security questions. The survey
included the following instruments: (1) the 18-item
food security instrument, (2) a 171-item self-reported
household food inventory, (3) a 66-item food
frequency questionnaire, and (4) a 16-item family
demographic record form. All families included in the
study self-identified as Latino, Mexican, or Mexican-
American and had at least one healthy child, between
3 and 5 years old. Trained bilingual interviewers
recruited subjects from a variety of community-based
agencies, including those that administer the Special
Supplemental Nutrition Program for Women, Infants,
and Children (WIC) and Head Start, migrant camps,
the local public health department, local health centers,
and family resource centers. Subjects were interviewed
in a private clinic room or in their homes. Statistical
procedures included Pearson correlations, the Kruskal-Wallis test (for nonparametric data), and the Mantel
Haenzel chi-square. About 80 percent of the survey
respondents were primarily Spanish-speaking and of
Mexican descent. Seventy-nine percent were enrolled
in the WIC program, and 25 percent received Food
Stamps. Forty-four percent of the families (n=105)
reported food insecurity without hunger, 13 percent
reported moderate hunger (n=30), and 3 percent
reported severe hunger (n=8).
Across the four levels of food security (food secure,
food insecure with no hunger, food insecure with
moderate hunger, and food insecure with severe
hunger), the frequency of affirmative responses to each
of 18 food security items increased as the level of food
insecurity became more severe. However, within a
given level of food insecurity, the frequency of affirmative
responses did not always decline as expected as
the severity of the items increased. In particular,
subjects tended to respond positively more often to
some of the child hunger items than to some of the
adult hunger items.
The food insecurity scale measure was negatively
associated with all categories of household food
supplies: dairy, fruit, grains, meat, snack foods, and
vegetables. Similarly, the categorical measure of food
insecurity was significantly associated with lower
household food stores. Neither the scale nor categorical
measure of food security was correlated with daily
servings of fruits or vegetables among preschool children.
However, child fruit and vegetable intakes were
significantly correlated with household supplies of
those foods. Food insecurity was associated with
declines in household supplies of many nutritious
foods (carrots, tomatoes, whole wheat bread, apples,
and oranges), as well as several less nutritious foods
(soda, cookies, and chocolate powder). Household
supplies of traditional Mexican foods, including beans,
corn tortillas, and chili, tended to remain stable, as did
supplies of several relatively high-fat or inexpensive
food items (hot dogs, ice cream, Kool-Aid, and instant
soup).
The authors conclude that their research findings indicate
that the 18-item instrument used to monitor food
insecurity and hunger in the United States is valid for
use in the Latino population. However, they note that
the Latino subjects responded more sensitively than
expected to some of the child hunger items in comparison
to the adult items, suggesting that the tool may be
unable to detect the subtle differences between the
quantity of foods available in these households and the
nutritional quality of the food available. This research
may contribute to more effective monitoring of food
insecurity and hunger in the United States and to the
design of nutrition education programs for diverse
cultural groups.