**U.S. HOUSEHOLD FOOD SECURITY SURVEY MODULE:**

**THREE-STAGE DESIGN, WITH SCREENERS**

**Economic Research Service, USDA**

**Revised 2006**

**[Revision Notes:]{.underline}** The food security questions are
essentially unchanged from those in the original module first
implemented in 1995. The following changes were made in 2006:

-   Minor changes were introduced to standardize wording of the resource
    constraint in most questions to read, "...because there wasn\'t
    enough money for food."

-   Question order was changed to group the child-referenced questions
    following the household- and adult-referenced questions. The
    Committee on National Statistics panel that reviewed the food
    security measurement methods in 2004-06 recommended this change to
    reduce cognitive burden on respondents. Conforming changes in
    screening specifications were also made. NOTE: Question numbers were
    revised to reflect the new question order.

-   Follow up questions to the food sufficiency question (HH1) that were
    included in earlier versions of the module have been omitted.

-   User notes following the questionnaire have been revised to be
    consistent with current practice and with new labels for ranges of
    food security and food insecurity introduced by USDA in 2006.

**[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.

**[Optional USDA Food Sufficiency Question/Screener: Question
HH1]{.underline} (This question is optional. It is not used to calculate
any of the food security scales. It may be used in conjunction with
income as a preliminary screener to reduce respondent burden for high
income households).**

HH1. \[IF ONE PERSON IN HOUSEHOLD, USE \"I\" IN PARENTHETICALS,
OTHERWISE, USE \"WE.\"\]

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

\[2\] Enough but not always the [kinds]{.underline} of food we want

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

\[4\] [Often]{.underline} not enough to eat

\[ \] DK or Refused

**[Household Stage 1: Questions HH2-HH4]{.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.\"\]

HH2. 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

HH3. "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

HH4. "(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

**[Screener for Stage 2 Adult-Referenced Questions:]{.underline}** If
affirmative response (i.e., \"often true\" or \"sometimes true\") to one
or more of Questions HH2-HH4, OR, response \[3\] or \[4\] to question
HH1 (if administered), then continue to ***Adult Stage 2;*** otherwise,
if children under age 18 are present in the household, skip to ***Child
Stage 1,*** otherwise skip to ***End of Food Security Module.***

**[NOTE:]{.underline}** In a sample similar to that of the general U.S.
population, about 20 percent of households (45 percent of households
with incomes less than 185 percent of poverty line) will pass this
screen and continue to Adult Stage 2.

**[Adult Stage 2: Questions AD1-AD4]{.underline} (asked of households
passing the screener for Stage 2 adult-referenced questions).**

AD1. 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 AD1a)

\[ \] DK (Skip AD1a)

AD1a. \[IF YES ABOVE, ASK\] 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

AD2. 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

AD3. In the last 12 months, were you every hungry but didn\'t eat
because there wasn\'t enough money for food?

\[ \] Yes

\[ \] No

\[ \] DK

AD4. In the last 12 months, did you lose weight because there wasn\'t
enough money for food?

\[ \] Yes

\[ \] No

\[ \] DK

**[Screener for Stage 3 Adult-Referenced Questions:]{.underline}** If
affirmative response to one or more of questions AD1 through AD4, then
continue to ***Adult Stage 3;*** otherwise, if children under age 18 are
present in the household, skip to ***Child Stage 1,*** otherwise skip to
***End of Food Security Module.***

**[NOTE:]{.underline}** In a sample similar to that of the general U.S.
population, about 8 percent of households (20 percent of households with
incomes less than 185 percent of poverty line) will pass this screen and
continue to Adult Stage 3.

**[Adult Stage 3: Questions AD5-AD5a]{.underline} (asked of households
passing screener for Stage 3 adult-referenced questions).**

AD5. 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)

AD5a. \[IF YES ABOVE, ASK\] 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

**[Child Stage 1: Questions CH1-CH3 (Transitions and questions CH1 and
CH2 are administered to all households with children under age
18)]{.underline}** Households with no child under age 18, skip to ***End
of Food Security Module.***

SELECT APPROPRIATE FILLS DEPENDING ON NUMBER OF ADULTS AND NUMBER OF
CHILDREN IN THE HOUSEHOLD.

**[Transition into Child-Referenced Questions:]{.underline}**

Now I\'m going to read you several statements that people have made
about the food situation of their children. For these statements, please
tell me whether the statement was OFTEN true, SOMETIMES true, or NEVER
true in the last 12 months for (your child/children living in the
household who are under 18 years old).

CH1. "(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

CH2. "(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

CH3. \"(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

**[Screener for Stage 2 Child Referenced Questions:]{.underline}** If
affirmative response (i.e., \"often true\" or \"sometimes true\") to one
or more of questions CH1-CH3, then continue to ***Child Stage 2;***
otherwise skip to ***End of Food Security Module.***

**[NOTE:]{.underline}** In a sample similar to that of the general U.S.
population, about 16 percent of households with children (35 percent of
households with children with incomes less than 185 percent of poverty
line) will pass this screen and continue to Child Stage 2.

**[Child Stage 2: Questions CH4-CH7]{.underline} (asked of households
passing the screener for stage 2 child-referenced questions).**

**[NOTE:]{.underline}** In Current Population Survey Food Security
Supplements, question CH6 precedes question CH5.

CH4. 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

CH5. 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 CH5a)

\[ \] DK (Skip CH5a)

CH5a. \[IF YES ABOVE ASK\] 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

CH6. In the last 12 months, (was your child/were the children) ever
hungry but you just couldn\'t afford more food?

\[ \] Yes

\[ \] No

\[ \] DK

CH7. 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 MODULE**

**User Notes**

**[(1) Coding Responses and Assessing Household Food Security
Status:]{.underline}**

Following is a brief overview of how to code responses and assess
household food security status based on various standard scales. For
detailed information on these procedures, refer to the *Guide to
Measuring Household Food Security, Revised 2000,* and *Measuring
Children's Food Security in U.S. Households, 1995-1999.* Both
publications are available through the ERS Food Security in the United
States Briefing Room.

Responses of "yes," "often," "sometimes," "almost every month," and
"some months but not every month" are coded as affirmative. The sum of
affirmative responses to a specified set of items is referred to as the
household's raw score on the scale comprising those items.

-   Questions HH1 through CH7 comprise the U.S. Household Food Security
    Scale (questions HH1 through AD5a for households with no child
    present). Specification of food security status depends on raw score
    and whether there are children in the household (i.e., whether
    responses to child-referenced questions are included in the raw
    score).

    -   For households with one or more children:

        -   Raw score zero---High food security

        -   Raw score 1-2---Marginal food security

        -   Raw score 3-7---Low food security

        -   Raw score 8-18---Very low food security

    -   For households with no child present:

        -   Raw score zero---High food security

        -   Raw score 1-2---Marginal food security

        -   Raw score 3-5---Low food security

        -   Raw score 6-10---Very low food security

> Households with high or marginal food security are classified as food
> secure. Those with low or very low food security are classified as
> food insecure.

-   Questions HH1 through AD5a comprise the U.S. Adult Food Security
    Scale.

    -   Raw score zero---High food security among adults

    -   Raw score 1-2---Marginal food security among adults

    -   Raw score 3-5---Low food security among adults

    -   Raw score 6-10---Very low food security among adults

-   Questions HH2 through AD3 comprise the six-item Short Module from
    which the Six-Item Food Security Scale can be calculated.

    -   Raw score 0-1---High or marginal food security (raw score 1 may
        be considered marginal food security, but a large proportion of
        households that would be measured as having marginal food
        security using the household or adult scale will have raw score
        zero on the six-item scale)

    -   Raw score 2-4---Low food security

    -   Raw score 5-6---Very low food security

Questions CH1 through CH7 comprise the U.S. Children's Food Security
Scale.

-   Raw score 0-1---High or marginal food security among children (raw
    score 1 may be considered marginal food security, but it is not
    certain that all households with raw score zero have high food
    security among children because the scale does not include an
    assessment of the anxiety component of food insecurity)

-   Raw score 2-4---Low food security among children

-   Raw score 5-8---Very low food security among children

**[(2) Response Options:]{.underline}** For interviewer-administered
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, "don't know" is presented as a response
option.

**[(3) Screening:]{.underline}** The two levels of screening for
adult-referenced questions and one level for child-referenced questions
are provided for surveys in which it is considered important to reduce
respondent burden. In pilot surveys intended to validate the module in a
new cultural, linguistic, or survey context, screening should be avoided
if possible and all questions should be administered to all respondents.

To further reduce burden for higher income respondents, a preliminary
screener may be constructed using question HH1 along with a household
income measure. Households with income above twice the poverty
threshold, AND who respond \<1\> to question HH1 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
households, 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 question HH1 is not needed for research purposes, a preferred
strategy is to omit HH1 and administer Adult Stage 1 of the module to
all households and Child Stage 1 of the module to all households with
children.

**[(4) 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 AD1a, AD5a,
and CH5a must be changed to read as follows:

AD1a/AD5a/CH5a \[IF YES ABOVE, ASK\] In the last 30 days, how many days
did this happen?

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

\[ \] DK