Considerable research has been conducted to develop a
conceptual definition of food security, food insecurity,
and hunger. Based on this definition, an instrument
was developed to measure the prevalence of food insecurity
and hunger among U.S. households. It is important
to know if participation in nutrition education
classes reduces food insecurity and if individuals in
food-insecure households have poorer health status
than individuals in food-secure households.
The objectives of this research were to (1) examine the
relationship between food insecurity and participation
in nutrition education, (2) examine the relationship
between food insecurity and health status, and (3)
determine factors associated with food insecurity. The
authors compared rates of food insecurity between an
intervention group—individuals enrolled in the
Expanded Food and Nutrition Education Program
(EFNEP)—and a nonintervention group—individuals
who were eligible for EFNEP but who either had not
enrolled or had completed only one lesson in the
program. Participants were classified as food secure,
food insecure, or food insecure with hunger, based on
their responses to the 18-item household food security
questionnaire. Respondents also reported whether their
general health was excellent, very good, good, fair, or
poor. Demographic variables collected in the interviews
included race, age, educational level, participation
in food assistance programs, number of children,
marital status, county type—calculated using
Tennessee census classification of rural and urban
counties—gender, and income. The majority of the
subjects in the study were female, and more than half
lived in an urban community.
The authors used descriptive analysis and logistic
regression to study the association between participation
in EFNEP and food insecurity. In the logistic
regression, an individual’s food security status was
estimated to be a function of the rurality of county of
residence, race, age, educational level, participation in
food programs, health status, number of children,
marital status, gender, and income. A forward logistic
regression analysis was conducted to examine the
point at which the independent variables enter the
equation. Odds ratios were determined for variables
included in the model.
The intervention and comparison groups were not
significantly different from each other in terms of their
race, gender, marital status, education, or number of
children in the family. There were also no significant
differences in the rurality of the county of residence of
the intervention and comparison groups. However, the
intervention group was significantly older (by an
average of 2 years), and the two groups differed significantly
based on the food security score. The respondents
who had participated in more lessons in the
EFNEP educational program were more food secure
than the respondents who had not yet started or who
had completed only one lesson in the EFNEP program.
Most of the subjects who reported excellent, very
good, or good health were food secure, while most of
the subjects who reported fair or poor health were food
insecure. The variables significantly associated with
food insecurity were health, income, nutrition education
intervention, food program participation, and
marital status. The subjects who had not participated
in the EFNEP program were more likely to use food
assistance programs and were half as likely to have
excellent health status. Divorced and separated households
were more likely to be food insecure than
married-couple households.
The authors found that participation in a series of
nutrition education programs that teach basic nutrition,
food resource management, and basic cooking skills
was associated with lower food insecurity. They also
found that individuals who were food insecure had
poorer health status than those who were food secure.
Health was the first variable that loaded into a forward
stepwise logistic regression model, and food-insecure
individuals with severe hunger were half as likely to
report excellent health as food-secure individuals. The
exact nature of the association between food security
and health status needs further study. It is well established
that poor diets contribute to poor health and that
low-income individuals are at greater risk for poor
health than higher income people.
The findings in this study support the need for multisession
nutrition education for low-income households,
focusing on teaching basic nutrition, food
shopping, and cooking skills. These programs are
associated with higher levels of food security and
promote more efficient use of food resources and
better health. The authors suggest that the study be
replicated in other nutrition education programs to
determine if similar results are found or if other variables
contribute to the success of the program in
decreasing food insecurity.