Hunger is the physiologic sensation that we all feel at regular intervals; it does not threaten health unless the body's need for food is consistently not met. Because scientists who evaluate the association or causal relationship of chronic hunger with child well-being are not able to reliably measure this sensation over time, the measure of food security/insecurity has become the criterion standard in such research. As assessed by an 18-item survey instrument,1 food insecurity is defined as, “limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire acceptable foods in a socially acceptable way.”2 This definition, which includes both the quantity and quality of food, acknowledges the need for families to have adequate physical and financial resources to obtain sufficient good-quality foods to meet nutritional needs in a consistent and sustainable way.3 As documented in the annual US Department of Agriculture survey, 14.6% (17 million US households) were food insecure in 2008, up from 11.1% (13 million US households) in 2007.1,4 This change represents the greatest increase documented in 1 year and the highest rate of food insecurity found since the survey began in 1995. The data among households with children are even more grim. The prevalence of food insecurity among all households with children was 21% in 2008; 37% of female-headed households with children were food insecure. A total of 50.3% of families with children in which household income was at or below the poverty level reported food insecurity in 2008. While data are not yet available for 2009, joblessness and cuts in family support programs may have increased food insecurity even further. Families in food-insecure households spend less per person on food each week ($33.33 vs $45) than those in food-secure households and they are more likely to use the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps; 56.25% vs 43.8%).1
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