Skip to main content
×
×
Home

Brief assessment of food insecurity accurately identifies high-risk US adults

  • Craig Gundersen (a1), Emily E Engelhard (a2), Amy S Crumbaugh (a2) and Hilary K Seligman (a2) (a3)
Abstract
Objective

To facilitate the introduction of food insecurity screening into clinical settings, we examined the test performance of two-item screening questions for food insecurity against the US Department of Agriculture’s Core Food Security Module.

Design

We examined sensitivity, specificity and accuracy of various two-item combinations of questions assessing food insecurity in the general population and high-risk population subgroups.

Setting

2013 Current Population Survey December Supplement, a population-based US survey.

Subjects

All survey participants from the general population and high-risk subgroups.

Results

The test characteristics of multiple two-item combinations of questions assessing food insecurity had adequate sensitivity (>97 %) and specificity (>70 %) for widespread adoption as clinical screening measures.

Conclusions

We recommend two specific items for clinical screening programmes based on their widespread current use and high sensitivity for detecting food insecurity. These items query how often the household ‘worried whether food would run out before we got money to buy more’ and how often ‘the food that we bought just didn’t last and we didn’t have money to get more’. The recommended items have sensitivity across high-risk population subgroups of ≥97 % and a specificity of ≥74 % for food insecurity.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Brief assessment of food insecurity accurately identifies high-risk US adults
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Brief assessment of food insecurity accurately identifies high-risk US adults
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Brief assessment of food insecurity accurately identifies high-risk US adults
      Available formats
      ×
Copyright
Corresponding author
* Corresponding author: Email hilary.seligman@ucsf.edu
References
Hide All
1. American Academy of Pediatrics Council on Community Pediatrics, Committee on Nutrition (2015) Promoting food security for all children. Pediatrics 136, e1431e1438.
2. American Diabetes Association (2016) Standards of medical care in diabetes – 2016. Diabetes Care 39, S1S103.
3. Alley, DE, Asomugha, CN, Conway, PH et al. (2016) Accountable health communities – addressing social needs through medicare and medicaid. N Engl J Med 374, 811.
4. Coleman-Jensen, A, Rabbitt, M, Gregory, C et al. (2016) Household Food Security in the United States in 2015. Economic Research Report no. ERR-215. Washington, DC: US Department of Agriculture, Economic Service Research.
5. Tarasuk, V, Cheng, J, Oliveira, N et al. (2015) Health care costs associated with household food insecurity in Ontario. CMAJ 187, E429E436.
6. Gundersen, C & Ziliak, JP (2015) Food insecurity and health outcomes. Health Aff (Millwood) 34, 18301839.
7. US Department of Agriculture, Economic Service Research (2012) US Household Food Security Survey Module: three-stage design, with screeners. https://www.ers.usda.gov/media/8271/hh2012.pdf (accessed December 2016).
8. US Department of Agriculture, Economic Service Research (2012) US Household Food Security Survey Module. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/survey-tools/#household (accessed December 2016).
9. Hager, ER, Quigg, AM, Black, MM et al. (2010) Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics 126, e26e32.
10. Young, J, Jeganathan, S, Houtzager, L et al. (2009) A valid two-item food security questionnaire for screening HIV-1 infected patients in a clinical setting. Public Health Nutr 12, 21292132.
11. Alberg, AJ, Park, JW, Hager, BW et al. (2004) The use of ‘overall accuracy’ to evaluate the validity of screening or diagnostic tests. J Gen Intern Med 19, 460465.
12. Children’s Health Watch (2016) The Hunger Vital Sign™. http://childrenshealthwatch.org/public-policy/hunger-vital-sign/ (accessed December 2016).
13. Wolfe, WS, Frongillo, EA & Valois, P (2003) Understanding the experience of food insecurity by elders suggests ways to improve its measurement. J Nutr 133, 27622769.
14. Nord, M (2015) Six-item Short Form of the Food Security Survey Module. http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/survey-tools.aspx#six (accessed December 2016).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed