**FOOD-SECURITY/HUNGER CORE MODULE:**

**3-STAGE DESIGN, WITH SCREENERS**

**USDA, Food and Nutrition Service and Economic Research Service --
6/23/99**

**[Transition into Module]{.underline} (administered to all
households):** These next questions are about the food eaten in your
household in the last 12 months, since (current month) of last year and
whether you were able to afford the food you need.

**[USDA Food Sufficiency Question/Screener: Questions 1, 1a,
1b]{.underline} (Optional, these questions are not used to calculate the
food-security/hunger scale. Question 1 may be used in conjunction with
income as a preliminary screener to reduce respondent burden for high
income households).**

1\. \[IF ONE PERSON IN HOUSEHOLD, USE \"I\" IN PARENTHETICALS,
OTHERWISE, USE \"WE.\"\]

Which of these statements best describes the food eaten in your
household in the last 12 months: \--enough of the kinds of food (I/we)
want to eat; \--enough, but not always the [kinds]{.underline} of food
(I/we) want; \--sometimes [not enough]{.underline} to eat; or,
\--[often]{.underline} not enough to eat?

\[1\] Enough of the kinds of food we want to eat (SKIP 1a and 1b)

\[2\] Enough but not always the [kinds]{.underline} of food we want
(SKIP 1a)

\[3\] Sometimes [not enough]{.underline} to eat \[SKIP 1b\]

\[4\] [Often]{.underline} not enough \[SKIP 1b\]

\[ \] DK or Refused (SKIP 1a and 1b)

1a. \[IF OPTION 3 OR 4 SELECTED, ASK\] Here are some reasons why people
don\'t always have enough to eat. For each one, please tell me if that
is a reason why YOU don\'t always have enough to eat. \[READ LIST. MARK
ALL THAT APPLY.\]

YES NO DK

\[ \] \[ \] \[ \] Not enough money for food

\[ \] \[ \] \[ \] Not enough time for shopping or cooking

\[ \] \[ \] \[ \] Too hard to get to the store

\[ \] \[ \] \[ \] On a diet

\[ \] \[ \] \[ \] No working stove available

\[ \] \[ \] \[ \] Not able to cook or eat because of health problems

1b. \[IF OPTION 2 SELECTED, ASK\] Here are some reasons why people
don\'t always have the quality or variety of food they want. For each
one, please tell me if that is a reason why YOU don\'t always have the
kinds of food you want to eat. \[READ LIST. MARK ALL THAT APPLY.\]

YES NO DK

\[ \] \[ \] \[ \] Not enough money for food

\[ \] \[ \] \[ \] Kinds of food (I/we) want not available

\[ \] \[ \] \[ \] Not enough time for shopping or cooking

\[ \] \[ \] \[ \] Too hard to get to the store

\[ \] \[ \] \[ \] On a special diet

**[Stage 1: Questions 2-6]{.underline} (asked of all households; begin
scale items).**

\[IF SINGLE ADULT IN HOUSEHOLD, USE \"I,\" \"MY,\" AND "YOU" IN

PARENTHETICALS; OTHERWISE, USE \"WE,\" \"OUR,\" AND \"YOUR
HOUSEHOLD.\"\]

2\. Now I'm going to read you several statements that people have made
about their food situation. For these statements, please tell me whether
the statement was [often]{.underline} true, [sometimes]{.underline}
true, or [never]{.underline} true for (you/your household) in the last
12 months, that is, since last (name of current month).

> The first statement is "(I/We) worried whether (my/our) food would run
> out before (I/we) got money to buy more." Was that [often]{.underline}
> true, [sometimes]{.underline} true, or [never]{.underline} true for
> (you/your household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

3\. "The food that (I/we) bought just didn't last, and (I/we) didn't
have money to get more." Was that [often]{.underline},
[sometimes]{.underline}, or [never]{.underline} true for (you/your
household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

4\. "(I/we) couldn't afford to eat balanced meals." Was that
[often]{.underline}, [sometimes]{.underline}, or [never]{.underline}
true for (you/your household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

\[IF CHILDREN UNDER 18 IN HOUSEHOLD, ASK Q5 - 6; OTHERWISE SKIP TO
1^st^-Level Screen.\]

5\. "(I/we) relied on only a few kinds of low-cost food to feed (my/our)
child/the children) because (I was/we were) running out of money to buy
food." Was that [often]{.underline}, [sometimes]{.underline}, or
[never]{.underline} true for (you/your household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

6\. "(I/We) couldn't feed (my/our) child/the children) a balanced meal,
because (I/we) couldn't afford that." Was that [often]{.underline},
[sometimes]{.underline}, or [never]{.underline} true for (you/your
household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

**[1^st^-level Screen]{.underline}** (screener for Stage 2): If
affirmative response to any one of Questions 2-6 (i.e., \"often true\"
or \"sometimes true\"), OR, response \[3\] or \[4\] to Question 1 (if
administered), then continue to Stage 2; otherwise, skip to end.

**[Stage 2: Questions 7-11]{.underline} (asked of hh\'s passing the
1^st^-level Screen: estimated 40% of hh\'s [\<]{.underline} 185%
Poverty; 5.5% of hh\'s \> 185% Poverty; 19% of all households).**

\[IF CHILDREN UNDER 18 IN HOUSEHOLD, ASK Q7; OTHERWISE SKIP TO Q8\]

7\. \"(My/Our child was/The children were) not eating enough because
(I/we) just couldn\'t afford enough food.\" Was that
[often]{.underline}, [sometimes]{.underline}, or [never]{.underline}
true for (you/your household) in the last 12 months?

\[ \] Often true

\[ \] Sometimes true

\[ \] Never true

\[ \] DK or Refused

8\. In the last 12 months, since last (name of current month), did
(you/you or other adults in your household) ever cut the size of your
meals or skip meals because there wasn\'t enough money for food?

\[ \] Yes

\[ \] No (Skip 8a)

\[ \] DK (Skip 8a)

8a. \[IF YES ABOVE, ASK\] How often did this happen\-\--almost every
month, some months but not every month, or in only 1 or 2 months?

\[ \] Almost every month

\[ \] Some months but not every month

\[ \] Only 1 or 2 months

\[ \] DK

9\. In the last 12 months, did you ever eat less than you felt you
should because there wasn\'t enough money to buy food?

\[ \] Yes

\[ \] No

\[ \] DK

10\. In the last 12 months, were you every hungry but didn\'t eat
because you couldn\'t afford enough food?

\[ \] Yes

\[ \] No

\[ \] DK

11\. In the last 12 months, did you lose weight because you didn\'t have
enough money for food?

\[ \] Yes

\[ \] No

\[ \] DK

**[2^nd^-level Screen]{.underline}** (screener for Stage 3): If
affirmative response to any one of Questions 7 through 11, then continue
to Stage 3; otherwise, skip to end.

**[Stage 3: Questions 12-16]{.underline} (asked of hh\'s passing the
2^nd^-level Screen: estimated 7-8% of hh\'s \< 185% Poverty; 1-1.5% of
hh\'s \> 185% Poverty; 3-4% of all hh\'s).**

12\. In the last 12 months, did (you/you or other adults in your
household) ever not eat for a whole day because there wasn\'t enough
money for food?

\[ \] Yes

\[ \] No (Skip 12a)

\[ \] DK (Skip 12a)

12a. \[IF YES ABOVE, ASK\] How often did this happen\-\--almost every
month, some months but not every month, or in only 1 or 2 months?

\[ \] Almost every month

\[ \] Some months but not every month

\[ \] Only 1 or 2 months

\[ \] DK

\[IF CHILDREN UNDER 18 IN HOUSEHOLD, ASK 13-16; OTHERWISE SKIP TO END.\]

13\. The next questions are about children living in the household who
are under 18 years old. In the last 12 months, since (current month) of
last year, did you ever cut the size of (your child\'s/any of the
children\'s) meals because there wasn\'t enough money for food?

\[ \] Yes

\[ \] No

\[ \] DK

14\. In the last 12 months, did (CHILD'S NAME/any of the children) ever
skip meals because there wasn\'t enough money for food?

\[ \] Yes

\[ \] No (Skip 14a)

\[ \] DK (Skip 14a)

14a. \[IF YES ABOVE ASK\] How often did this happen\-\--almost every
month, some months but not every month, or in only 1 or 2 months?

\[ \] Almost every month

\[ \] Some months but not every month

\[ \] Only 1 or 2 months

\[ \] DK

15\. In the last 12 months, (was your child/ were the children) ever
hungry but you just couldn\'t afford more food?

\[ \] Yes

\[ \] No

\[ \] DK

16\. In the last 12 months, did (your child/any of the children) ever
not eat for a whole day because there wasn\'t enough money for food?

\[ \] Yes

\[ \] No

\[ \] DK

**END OF FOOD-SECURITY/HUNGER CORE MODULE**

**User Notes**

**[(1) Response Options:]{.underline}** For interview surveys, DK
("don't know") and "Refused" are blind responses - that is, they are not
presented as response options, but marked if volunteered. For
self-administered surveys, DK is presented as a response option.

**[(2) Screeners:]{.underline}** The two levels of screener are provided
for survey designers wishing to reduce respondent burden for households
not manifesting: (a) *any* level of food insecurity (1^st^-level
screener); or (b) any signs of *hunger* (2^nd^-level screener).

To further reduce burden for higher-income respondents, a preliminary
screener may be constructed using Q1 along with a household income
measure. Households with income above twice the poverty threshold, AND
who respond \<1\> to Q1 may be skipped to the end of the module and
classified as food secure. Use of this preliminary screener reduces
total burden in a survey with many higher-income household, and the
cost, in terms of accuracy in identifying food insecure households, is
not great. However, research has shown that a small proportion of the
higher-income households screened out by this procedure will register
food insecurity if administered the full module. If Q1 is not needed for
research purposes, a preferred strategy is to omit Q1 and administer
Stage 1 of the module to all households. Administration time for Stage 1
is very nearly the same as administration time for the preliminary USDA
food sufficiency question/screener.

**[(3) 30-Day Reference Period:]{.underline}** The questionnaire items
may be modified to a 30-day reference period by changing the "last
12-month" references to "last 30 days." In this case, items 8a, 12a, and
14a must be changed to read as follows:

8a/12a/14a \[IF YES ABOVE, ASK\] In the last 30 days, how many days did
this happen?

\_\_\_\_\_\_ days

\[ \] DK

**[(4) Food-Security/Hunger Scale:]{.underline}** Questions 2-16 provide
a complete, validated set of food-insecurity/hunger indicator variables
for use in: (1) scaled measurement of the severity of household food
insecurity and hunger; (2) classification of households by severity
level of food insecurity and hunger; and (3) comparison of
food-insecurity and hunger prevalence with national benchmark data. To
request guidance materials for calculating these measures, contact the
U.S. Department of Agriculture, Food and Nutrition Service, Office of
Analysis, Nutrition, and Evaluation, Alexandria, VA (703-305-2125), or
the U.S. Department of Agriculture, Economic Research Service,
Washington, DC (202-694-5433).