Food Insecurity, Hunger and Children's Health

An estimated 10 million children under age 18 live in food insecure homes — where they have trouble finding the money to keep food on the table. Food security and hunger expert Dr. John Cook of Boston University discusses the causes of food insecurity in America.

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ROBERT SIEGEL, host:

In our series this week, we've heard about people who experience both hunger and also what's called food insecurity. Dr. John Cook of Boston University Medical School led a team that developed food security and hunger measures that are used by the US Department of Agriculture and by the Census Bureau. He joins us from Boston.

Welcome, Dr. Cook.

Dr. JOHN COOK (Boston University Medical School): Thank you. Glad to be here.

SIEGEL: Is the problem of food insecurity in the US today reflected in the public health of the country?

Dr. COOK: It certainly is, especially for children. In many ways, in the first three years of their life, they are developing very rapidly, and even very minor nutrient deficiencies can have profound effects.

SIEGEL: Where might our preschool teachers or elementary school teachers see the effects of food insecurity in a youngster who enters school?

Dr. COOK: Well, a lot of it is invisible, but the places that it's most likely to be seen is in lethargy, failure of the child to engage, to seem to be drooping, not paying attention. And then in the older children, elementary and middle school-aged children, food insecurity's associated with acting out behaviors, externalizing behaviors, much more frequent reports of behavior problems.

SIEGEL: What percent of American schoolchildren, do you think, have suffered from food insecurity?

Dr. COOK: Well, we know that 38 million people live in food-insecure households, and we know that about 13 million of those are children, children of some age under 18. So that'll give you an idea. Probably in the range of 10 million children who are school age are dealing with this problem.

SIEGEL: Now I have to ask you, it is said that to a hammer, everything looks like a nail. To somebody who teaches--who does research into pediatric malnutrition, does everything look like it's caused by food insecurity? That is, to attribute poor school performance might also reflect other factors in a poor household besides diet. It could reflect a whole variety of social deficits that child might experience.

Dr. COOK: That's true, and that's a very good observation. But in the research that we've conducted, we control for income level and we still see the effects of food insecurity on the behavior problems, the social development and so forth.

SIEGEL: Is it possible on, say, a food budget of under $200 a month to feed, let's say, two young children well so that they are not suffering from the diet they receive?

Dr. COOK: It's not likely that a family could do that. The Department of Agriculture has what it refers to as a Thrifty Food Plan, and that is a food plan, including menus and a food basket, that has been estimated to provide a minimally nutritious diet for families of different sizes. And it's priced out. And for a family of four in 2004, the monthly cost of that food basket was close to $500; it was $497 a month. In the Boston area, we went to nine grocery stores of different sizes in three different neighborhoods and found that for that amount of money, you could not purchase the food that's listed in the Thrifty Food Plan food basket.

SIEGEL: So the cost of a Thrifty food basket--that is, an economical way of feeding a family of four--might vary on where you live in the country, for one thing.

Dr. COOK: That's right. It may vary by region, across states. It depends on the cost of food, but more importantly, it depends on costs of other necessities, primarily housing, energy. We have seen a phenomenon in the Boston area we refer to as `heat or eat' in the winter periods, when families buy less food and feed their children less food during the winter months in order to be able to afford heating fuel. That's quite common in this area, in the colder regions.

SIEGEL: Dr. Cook, thank you very much for talking with us today.

Dr. COOK: You're welcome.

SIEGEL: That's Dr. John Cook of Boston University.

For an overview of hunger in America, the groups who are most vulnerable and the different challenges faced by urban, rural and suburban families, you can go to our Web site, npr.org.

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