Impact of Participating in the Expanded Food and Nutrition Education Program on Food Insecurity

Year: 2001

Research Center: Southern Rural Development Center, Mississippi State University

Investigator: Greer, Betty, and Richard Poling

Institution: Agricultural Extension Service, University of Tennessee, Knoxville

Project Contact:
Betty Greer, Associate Professor
Nutrition Specialist
UT Agricultural Extension Service
P.O. Box 1071
Knoxville, TN 37901-1071
Phone: 865-974-7402


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.