Identifying and Screening for Food Insecurity: Webinar Takeaways

Hosted Thursday, September 15, 2022

by the Office of Nutrition and Health Promotion Programs, Administration for Community Living

Speakers: Kathryn Tucker, MS, RD, LD, ACL Consultant, and Temitope A. Walker, PhD, 

Georgia Division of Aging Services

Go to the YouTube recording

What is food insecurity? 

• Per USDA: “The limited or uncertain availability of nutritionally adequate and safe foods or 

limited or uncertain ability to acquire acceptable foods in socially acceptable ways.” 

Factors Influencing Food Insecurity

• Income

o Risk of food insecurity increases when money is limited. Limited employment 

opportunities, low wages, and health care expenses limit the ability to buy food.

• Disparities

o Black non-Hispanic households nearly twice as likely to be food insecure than 

national average. 

o Among Hispanic households, prevalence of food insecurity was 18.5%.

o LGBTQ+ individuals’ poverty rate is much higher than national average.

o Divorced seniors, those never married, and older women more likely to be food 

insecure. 

• Food deserts

o Limited access to full-service supermarkets and grocery stores.

o Convenient stores often lack variety and quality food items.

• Transportation

o Distance to grocery stores or food programs can make it difficult to get food.

o Public transportation may be limited, especially in rural areas.

• Social isolation

o Older adults may have limited access to children, family, and their community.

• Homeownership

o Older adults who rent are more likely to be food insecure.

• Education

o Lower literacy skills can have a detrimental impact on nutritional status.

The Impact of Food Insecurity

• Food-insecure older adults are:

o 78% more likely to experience depression. 

o 40% more likely to experience chest pain. 

o 55% more likely to develop asthma. 

o 10% more likely to experience high blood pressure. 

o 21% more likely to experience limitations in activity. 
Identifying and Screening for Food Insecurity Webinar Takeaways | September 2022 | ACL | Page 2 

The Importance of Food Insecurity Screening

• Understanding the extent of food insecurity is crucial to program/policy development.

• States can focus on food insecurity in their regulations, policies and procedures, 

targeting/prioritization, state plan, and/or initiatives. 

• Research on food insecurity of older adults is limited; screening can be critical to

program evaluation.

• Understanding severity/specifics revealed by screening can help with public assistance 

referrals (e.g., emergency food, SNAP).

Validated Food Security Survey Modules

• 18-Item U.S. Household Food Security Survey Module (USDA)

o Administered annually to around 45,000 households in the Food Security 

Supplement of the Census Bureau’s Current Population Survey. 

• 10-Item U.S. Adult Food Security Survey Module (USDA)

o Advantages: less respondent burden, no children’s food security questions, and 

improved comparison of households with and without children.

o Limitation: does not provide information about food security of children.

• 6-Item Short Form of the Household Food Security Survey Module (USDA)

o Advantages: less respondent burden, identifies food insecure and very low food 

security, high specificity and sensitivity, and minimal bias.

o Limitation: does not measure the most severe level of food insecurity.

• Hunger Vital SignTM two-question screening tool (Children’s HealthWatch)

o Advantages: less respondent burden, high specificity and sensitivity, and

validated for children and adults.

o Limitation: does not measure the most severe levels of food insecurity.

Georgia Food Insecurity Measures

• Has used a validated six-item food insecurity measure since 2011. This measure:

o Found statewide statistics of clients comparable to federal statistics.

o Identified critical unmet need for nutrition services.

o Shows contribution of receiving nutrition services to achieve food security.

o Highlights difficulty meeting food and health care needs of food-insecure Georgians.

When to Assess Food Insecurity

• Timepoints based on state and agency requirements.

• Can assess at initial intake, in conjunction with other assessments, when identified by 

concerned staff/volunteer, during reassessments, and/or when services change.

Resources

• Brief Assessment of Food Insecurity Accurately Identifies High-Risk U.S. Adults

(Children’s HealthWatch) 

• Consensus of the Nutrition Screening Initiative: Risk Factors and Indicators of Poor 

Nutritional Status in Older Americans (PubMed)

• Definitions of Food Security (USDA)
Identifying and Screening for Food Insecurity Webinar Takeaways | September 2022 | ACL | Page 3 

• The Effects of Aging Services and the Supplemental Nutrition Assistance Program on 

Food Insecurity among Older Georgians: 2018-2020 (Wiley Online Library) 

• Food Insecurity (Healthy People 2030)

• Food Insecurity and Health Outcomes (Health Affairs) 

• Food Insecurity and Hunger in the United States: An Assessment of the Measure

(National Research Council) 

• Food Insecurity in Older Adults (The Journal of Nutrition) 

• Food Insecurity in Older Adults: Much More than Food – Understanding It Before Taking 

Action (MedCrave) 

• The Food Security Continuum: A Novel Tool for Understanding Food Insecurity as a 

Range of Experiences (SpringerLink) 

• Hunger in Older Adults (Meals on Wheels America)

• Implementing Food Security Screening and Referral for Older Patients in Primary Care: 

A Resource Guide and Toolkit (AARP Foundation and IMPAQ)

• Nutritional and Health Consequences are Associated with Food Insecurity among U.S. 

Elderly Persons (The Journal of Nutrition) 

• Older Americans Act Nutrition Program (ACL)

• Screening for Food Insecurity: Short-Term Alleviation and Long-Term Prevention

(PubMed)