CHILDREN AND ISSUES OF FOOD SECURITY IN SARASOTA COUNTY, FLORIDA

Transcription

1 CHILDREN AND ISSUES OF FOOD SECURITY IN SARASOTA COUNTY, FLORIDA

2 ON THE EDGE Prepared by Edumetrics Resources Group, Inc. for All Faiths Food Bank Supported by Gulf Coast Community Foundation Research Team Bruce Jones, Ph.D. and George MacDonald (2014) 2

3 Introduction Each year taxpayers spend over $200 billion in direct and indirect costs that are associated with the food security problem in the United States. An estimated 49 million Americans live in households that are food insecure, which includes over 16 million children who live in poverty (Chilton & Rose, 2009; U.S. Department of Agriculture, 2013). Food insecurity is defined as having limited or uncertain availability of, or inability to acquire, nutritionally adequate, safe, and acceptable foods due to financial resource constraint. More specifically, food insufficiency refers to an inadequate amount of food intake due to resource constraint (Jyoti, Frongillo, & Jones, 2005, p. 2831). Chilton and Booth (2007) report,... the experience of food insecurity (without and with hunger) is, at its core, an experience of suffering (p. 117). While economic- poverty 1 is a major contributor to the food security problem that we face in the United States, it is not the only contributor. For example, a Feeding America study by Gundersen, Waxman, Engelhard, Del Vecchio,, Satoh & Lopez- Betanzos (2012) revealed that unemployment might lead to a household condition of food insecurity. Households that experience unemployment may become at- risk of falling below the poverty line but they are not necessarily below the poverty line. In a much earlier study, Rose (1999) revealed that there are a number of households 1 On understanding the longstanding correlation between hunger and poverty see Ashiabi & O Neal (2007); Bhattacharya, Currie & Haider (2004); Brown (1970); Brown, & Gershoff (1989); Center on Hunger and Poverty (2002); Cook & Jeng (2009); Feeding America (2012); Kabbani & Kmeid (2005); Lewit & Kerrebrock (1997); and Terpstra, Rynell, Carrow, Nogaski, & Roberts (2010). 3

4 in the United States that may be food insecure that are above the poverty line. For example, Households headed by a single parent or those containing individuals with disabilities may not be households living below the poverty level but may be households that are food insecure. (p. 518S) In this respect, a comprehensive understanding of food security issues must focus on populations who live below the poverty line and secondarily a subset of the population that lives above the poverty line. Purpose of Study In moving toward the need to develop a comprehensive understanding of food security issues in the Sarasota region of Florida, the All Faiths Food Bank, with the support of the Gulf Coast Community Foundation, advanced one national study and launched one local study. The first study, which was developed and implemented with the support of food banks across the nation, was initiated and sponsored by Feeding America. This 2013 study focused on collecting data about the nature and extent of adult hunger (Feeding America, 2014, forthcoming). The All Faiths Food Bank served as an institutional participant in this national study. The data from the national Feeding America study that pertains specifically to Sarasota County may be used to inform hunger policy discussion and strategies on the adult population. The second study, which focused on childhood hunger, is embodied in this report. The key purpose of the child hunger study was to systematically gather information 4

5 about food security issues directly from the perspectives of children in Sarasota County by administering a food security survey to a subset of elementary, middle and high school students. This is in contrast to traditional assessments about the extent and nature of childhood hunger, which have been inferred from household surveys such as the nationally administered Core Food Security Module (see Gunderson and Kreider, 2009, p. 972). The researchers also determined that the nine item Child Food Security Survey Module (CFSSM) would be administered to the students in the Title I, high- poverty, elementary, middle, and high schools as the primary means for collecting data about food security issues among low- income children in Sarasota County. The researchers moved forward with the usage of the CFSSM knowing: (1) the CFSSM was developed with extreme research rigor (high statistical validity and reliability) by Connell, Nord, Lofton, and Yadrick (2004) and (2) the CFSSM was used in 2009 to determine levels of food insecurity among children in Cook County, Illinois. 2 Poverty and Hunger Although poverty is not the sole contributor to hunger and food insecurity in the United States it is a major contributing factor (see Ashiabi & O Neal, 2007; Bhattacharya, Currie & Haider, 2004; Brown, 1970; Brown, & Gershoff, 1989; Center 2 See Terpstra, A., Rynell, A, Carrow, L., Nogaski, A., & Roberts (2010). Running on Empty: Nutritional Access for Children in Cook County, IL. Chicago, IL: Social IMPACT Research Center. 5

6 on Hunger and Poverty, 2002; Cook & Jeng, 2009; Feeding America, 2012; Kabbani & Kmeid, 2005; Lewit & Kerrebrock, 1997; and Terpstra, Rynell, Carrow, Nogaski, & Roberts, 2010). This is particularly disconcerting given the general population rise in poverty in Sarasota between 2007 and 2010 (see Sword, 2011, November 29). Figure One below shows a dramatic growth trend between 1990 and 2010 in the percentage of citizens in Sarasota living below poverty. 3 The percentage of citizens below poverty almost doubled from 6.8% in 1990 to 12.8% in 2010 (Sarasota County, 2012). Figure One Percent of Total Population Below Poverty in Sarasota County % Percent of Population 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% Percent 0.00% Percent Poverty By Year (Source: Sarasota County, 2012) 3 A family of four is considered to be living in poverty if income is less than $23,201 per year. 6

7 Additionally, while the median household income for Sarasota County remains slightly higher than the overall state median household income, Sarasota County fell behind the national median Just four years ago, Sarasota County enjoyed a much lower poverty rate than most everywhere in the nation. But from 2007 to 2010, its poverty rate jumped 62%... That is a 5 percentage point rise at a time when the national rate rose 2 percentage points David Sword, Herald Tribune household income level between 2000 and 2010 (see Figure Two). In 2000, the Sarasota County median household income was $41,957 and the U.S. median household income was $41,994 - virtually the same for both. By 2010, the Sarasota median household income rose to $45,641 but the U.S. median household income surpassed this figure to $50,046. Figure Two Sarasota County, Florida, and U.S. Median Household Income 2000 and 2010 Census Data $60,000 Median Household Income $50,000 $40,000 $30,000 $20,000 $10, $0 Sarasota Florida U.S. Median Household Income By County, State, and Nation (Source: Sarasota County, 2012) 7

8 The Status of Children and Poverty in Sarasota County The deleterious impact of the trends shown above is revealed in the poverty data on children in Sarasota County. Over a 10 The number of children living below the poverty line in Sarasota County nearly doubled between 2000 and 2010 Sarasota County, Planning Services Division year period, between 2000 and 2010, the number of children living below the poverty level in Sarasota nearly doubled. In 2000 the percentage of children living below the poverty line was 12.9%. By 2010 this percentage rose to 21.5% (see Figure Three). This doubling trend mirrors the overall poverty trend in Sarasota County. Figure Three Percentage of Population by Age Group Below the Poverty Level In Sarasota County 2000 and % Percent of Population 20.00% 15.00% 10.00% 5.00% % Under Over 65 Percent Below Poverty By Age Group (Source: Sarasota County, 2012) 8

9 According to a report by the Planning Services Division of Sarasota County, one of every five children in Sarasota County is living below the poverty level. Overall Results of the Sarasota Research Study The alarming trends in poverty and food insecurity in Sarasota County mirror the nation and the state. In addition, Florida holds the distinction of joining five other states with the highest Child Food Insecurity Rates in the United States. 4 As federal programs to feed children in poverty, such as the Supplemental Nutrition Assistance Program (SNAP), are being slashed, the trends may get much worse (White, 2013, September). 5 The diminishing national, state, and local investments in child hunger will potentially have a devastating impact on children in poverty and children who are experiencing food insecurity in Sarasota County. An example of the significance of this impact is provided by Gundersen and Kreider (2009), who report: The central vehicle for helping alleviate food insecurity among children is the Food Stamp Program, now called the Supplemental Nutrition Assistance Program (SNAP) (U.S. Department of Agriculture, Food and Nutrition). This 4 See state- by- state food insecurity table inside: Feeding America, 2012, pp According to Banjo & Gasparro (2013) and Rampell (2013), Congress will cut spending on the SNAP program by $5 billion in 2014 and an additional $6 billion between 2015 and

10 program directly augments a household s resources available for purchasing food. Prior research has suggested that SNAP leads to reductions in food insecurity (p. 971). Against this backdrop, the research in this report reveals: There are alarming numbers of children in poverty in Sarasota County who fall into the category FOOD INSECURITY WITHOUT HUNGER. These children experience extreme worry about matters of food and the availability of food in their homes. There may also be issues that concern the nutritional value of food that the children are eating. Based on the data presented in this report and food insecurity trends with national divestments in hunger prevention, these children are on the brink of falling into higher levels of food insecurity than they currently face. In this respect, it is clear that the children in high poverty schools and households in Sarasota County are ON THE EDGE. - Edumetrics Resources Group, Inc. 10

11 Children and Issues of Food Security in Sarasota County Sample Schools A total of 16 Title I elementary, middle, and high schools in Sarasota County with a student enrollment of 13,019 were invited to administer the nine item Child Food Security Survey Module. Approximately 15% (n=1,900) of the targeted student population responded to the survey. The highest number of student respondents came from the elementary schools (n=918) followed by the high schools (n=765) and the middle schools (n=217) (See appendix, Method Section: Data Collection and Analysis, for more detail about the targeted and actual school participants in the study). Key Definitions Associated with the Child Hunger Study According to Bickel, Nord, Price, Hamilton, and Cook (2000, p. 6), Cook and Jeng (2009, p. 9), Jyoti, Frongillo, & Jones (2005, p. 2831), and the National Research 11

12 Council (2006, p. 2), the distinctions between (1) Food Secure (2) Food Insecure Without Hunger, and (3) Food Insecure With Hunger is as follows: Food Secure: The condition of having regular access to enough nutritious food for a healthy life. Food Insecure Without Hunger: The condition of not having regular access to enough nutritious food for a healthy life. High and low levels of food insecurity without hunger are differentiated based on the duration and severity of food insecure periods. Food Insecure With Hunger: Characterized as the uneasy or painful sensations caused by a lack of food that occurs when food intake is reduced below normal levels. Food insecurity with hunger is both a motivation to seek food and an undesirable consequence of lack of food. Though experienced by everyone episodically, food insecurity with hunger becomes a social problem when the means of satisfying the drive to seek food and of relieving the uncomfortable or painful sensations that accompany hunger, are not available or accessible due to lack of resources. More often than not, when we speak to issues of hunger in the United States we are speaking to issues of food insecurity without hunger as opposed to issues of food insecurity with hunger. Bickel, Nord, Price, Hamilton, & Cook (2000) report, the United States is less likely to face issues of food insecurity with hunger because of the attention given to hunger concerns that date back to the post- depression era: The success of the nation's nutrition- assistance safety net, beginning with the National School Lunch Program in 1946 and later under- girded by the Food 12

13 Stamp Program and special programs for unusually vulnerable groups, has meant that extreme forms of hunger, common in Third- World countries, have been virtually eliminated in the United States. However, less severe forms of food insecurity and hunger - deprivation in basic need for food - are still found within the U.S. and remain a cause for concern. (p. 1) General Findings In order to report the survey results, the data was scaled using the following procedures: (1) The mean was scaled to 300 points and a standard deviation was scaled to 50 points, and (2) The score was rescaled so that 0 represented the lowest hunger scale score and 600 represented the highest hunger scale score. Through a modified Angoff procedure the researchers established cut- off scores allowing for the survey results to show tendencies toward food security, food 13

14 insecurity and hunger among the student population. Figure Four illustrates the cut- off demarcations. Hunger scale scores between 0 and 270 tend toward a Figure Four Hunger Scale Cut Scores Food Secure/Food Insecure Without Hunger/Food Insecure With Hunger Lowest/Best Highest/Worst Food Secure Food Insecure Without Hunger Food Insecure With Hunger condition of being Food Secure; hunger scale scores between 271 and 440 tend toward a condition of being Food Insecure Without Hunger, and hunger scale scores between 441 and 600 tend toward Food Insecure With Hunger. Table One provides the hunger scale scores by survey question. Overall, the hunger scale scores tend toward an alarming number of student respondents dealing with issues of food insecurity without hunger (hunger scale scores between 271 and 441 ) as this concerns the hunger scale scores on each question. None of the 14

15 student respondents are dealing with issues of ongoing hunger (hunger scale scores between 441 and 600 ). Table One Child Food Security Survey Module (CFSSM) Hunger Scale Scores for Each Item Questions or Items on CFSSM On-Line Survey (See Table Ten) Hunger Scale Score Result CFSSM Item #1 (Worry) 287 (Food Insecure) CFSSM Item #2 (Run Out) 271 (Food Insecure) CFSSM Item #3 (Balanced Meal) 257 CFSSM Item #4 (Cheap Foods) 293 (Food Insecure) CFSSM Item #5 (Meals Been Cut) 247 CFSSM Item #6 (Eat Less) 264 (Food Insecure- Borderline) CFSSM Item #7 (Skip A Meal) 215 CFSSM Item #8 (Hungry) 227 CFSSM Item #9 (Not Eat Whole Day) 192 Note1. Ranked A-Lot to Never where A-Lot is a high score and never is a low score. Note2. An * indicates the result was actually lower than the floor for the score of 0. Table Two provides the hunger scale scores (HSS) by question ordered by rank. In this respect, the question that raises the most concern about the student respondents and Overall, the hunger scale scores tend toward an alarming number of student respondents dealing with issues of food insecurity. issues of food insecurity is question #4 (HSS=293): Item #4: Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? Two more items on the survey raise concern about the student respondents and issues of food insecurity question #1 (HSS=287) and question #2 (HSS=271): 15

16 Table Two Child Food Security Survey Module (CFSSM) Hunger Scale Scores for Each Item Ordered by Rank Questions or Items on CFSSM On-Line Survey (See Table Ten) Hunger Scale Score Result By Rank CFSSM Item #4 (Cheap Foods) 293 (Food Insecure) CFSSM Item #1 (Worry) 287 (Food Insecure) CFSSM Item #2 (Food Run Out) 271 (Food Insecure) CFSSM Item #6 (Eat Less) 264 (Food Insecure Borderline) CFSSM Item #3 (Balanced Meal) 257 CFSSM Item #5 (Meals Been Cut) 247 CFSSM Item #8 (Hungry) 227 CFSSM Item #7 (Skip A Meal) 215 CFSSM Item #9 (Not Eat Whole Day) 192 Note1. Ranked A-Lot to Never where A-Lot is a high score and never is a low score. Note2. An * indicates the result was actually lower than the floor for the score of 0. Item #1: Did you worry that food at home would run out before your family got money to buy more? Item #2: Did the food that your family bought run out before your family had money to buy more? An item that is on the border of food insecurity is item #6 (HSS=264): Item #6: Did you ever eat less because your family didn t have enough money to buy food? 16

17 Race/Ethnicity, Grade Level, and School Overall Research Analysis Table One and Table Two provide the data benchmarks for the remainder of the research analysis. Based on the data provided in these tables, Item #4, Item #1, and Item #2 provide hunger scale scores that reveal food insecurity (hunger scale scores between 271 and 441). Given this, Table Four (hunger scale scores by race), Table Five (hunger scale scores by grade level), and Table Six (hunger scale scores by school) will focus on these three items. In addition, the researchers take note in the research findings of notable differences 6 between students (as this concerns race/ethnicity data comparisons); grades (as this concerns grade level comparisons); and schools (as this concerns school- level comparisons). Comparisons rise to the level of notable difference when said differences are 40 points and above (see Table Three). 6 On Notable Differences see Cohen (1988). 17

18 Table Three Hunger Scale Score Comparison Ranges On Race/Ethnicity, Grade-Level, and School by School Results Point Difference Definition No Effect 0-9 No difference Small effect A non-trivial difference Medium Effect Seen often Large Effect 40 and above A Notable Difference Race/Ethnicity Although there are no notable differences by race/ethnicity on item #4 (HSS=293); item #1 (HSS=287) and item #2 (HSS=271), Hispanic and African American (Black) children in the schools sampled approach the highest hunger scale scores on these items when compared to other racial and ethnic groups (see Table Four). With specific regard to item #4 (cheap foods), Hispanic (HSS=299) and African American (Black) (HSS=297) children in the schools sampled approach the highest 18

19 hunger scale scores when compared to other racial and ethnic groups on this item, which is: Item #4: Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? Table Four Hunger Scale Scores by Item (CFSSM Questions) and Race/Ethnicity Asian Black Hispanic Multi Native** Other White I I I I I I I I- 8 * I- 9 * Note1. Ranked A-Lot to Never where A-Lot is a high score and never is a low score. Note2. An * indicates the result was actually lower than the floor for the score of 0. Note3. **A decision was made not to interpret these results because sample size was too small. As with item #4 and issues of food insecurity, African American (Black) (HSS=306; 298) and Hispanic children (HSS=303; 290) have the highest hunger scale scores (HSS) on item #1 and item #2, which are: Item #1: Did you worry that food at home would run out before your family got money to buy more? 19

20 Item #2: Did the food that your family bought run out before your family had money to buy more? Grade Level The researchers did find that there are notable differences in food insecurity between grade levels. For example, the hunger scale score (HSS) on item #4 (cheap foods) is highest among student respondents who were enrolled in the 12 th grade (HSS=314), followed by student respondents who were enrolled in the 9 th grade (HSS=309), followed by students who were enrolled in the 3 rd grade (HSS=309) and 4 th grade (HSS=306) (see Table Five). When you compare these hunger scale scores with the hunger scale scores at the middle school level (6 th, 7 th, and 8 th grades) the differences are notable (over a 40 point difference - see Table Five). Item #4: Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? This indicates that the highest levels of food insecurity as this concerns item #4 tends to have been among 12 th, 9 th, 3 rd and 4 th graders within the total sample of the 16 Title I schools. In addition, given the notable differences, food insecurity tended to be more of a serious issue among the high school and elementary grade respondents when compared to the middle school respondents. 20

21 Table Five Hunger Scale Scores by Item (CFSSM Questions) and Grade (GR) GR 3 GR 4 GR 5 GR 6 GR 7 GR 8 GR 9 GR 10 GR 11 GR 12 I I I I I I I I I The hunger scale scores (HSS) on item #1 (worry) were highest among the 3 rd (HSS=302) and 4 th (HSS=300) graders compared to all other grades in the 16 Title I schools. Notable differences (over a 40 point difference - see Table Five) did emerge between 10 th graders and all other grades on this item. The 10 th grade respondents (HSS=261) tended to be the least concerned about this item when compared to all other respondents. Item #1: Did you worry that food at home would run out before your family got money to buy more? Although there were no notable differences between grade levels on item #2 (food run out), the hunger scale scores (HSS) on item #2 were highest among the 12 th (HSS=292) and 11 th (HSS=282) graders (see Table Five). 21

22 Item #2: Did the food that your family bought run out before your family had money to buy more? There was an overall pattern of food insecurity concern among high school students followed by elementary school- aged students when compared to students at the middle level. Hunger scale scores tended to be slightly higher around the issue of cheap foods (item #4), which raises nutrition concerns, for these students in the upper and lower grade levels. School Level Notable differences emerged between the hunger scale score (HSS) at Atwater Elementary School (HSS=348), as this concerned item #4 (cheap foods), when compared to all other hunger scale scores of the Title I schools (see Table Six). Item #4: Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? Notable differences in hunger scale scores (HSS) on item #1 (worry) emerged between Wilkinson Elementary School (HSS=419) and all other schools in the Title I sample. With a hunger scale score of 419 at Wilkinson, food insecurity registered on 22

23 Table Six Hunger Scale Scores by Item (CFSSM Questions) and Schools Alta Vista Atwater Booker Brentwood Cranberry Glen Allen Heron Creek North Port Toledo Blade Wilkinson Q Q Q Q Q Q Q Q Q Note 1. Schools listed above are only those schools that provided sufficient student response size for analysis. Therefore, EE Booker, Lamarque, and Tuttle Elementary and Woodland Middle schools are excluded from this analysis because of small student response data (see Table Eight for all student respondent size data). Note 2. Caution is warranted in viewing and interpreting data results from Atwater and Wilkinson because of moderate student response size (see Table Eight for all student respondent size data). Note3. Ranked A-Lot to Never where A-Lot is a high score and never is a low score. item #1 at Wilkinson as the highest among all other items (questions) on the CFSSM survey. This would seem to indicate that student enrollees at Wilkinson Elementary hold the most extreme concern or worry (compared to the other schools) about food running out at home. Alta Vista Elementary and Atwater Elementary also registered high hunger scale scores (see Table Six). Item #1: Did you worry that food at home would run out before your family got money to buy more? 23

24 Atwater (HSS=296) and Alta Vista (HSS=287) held the highest hunger scale scores (HSS) as this concerns item #2 (food run out) on the CFSSM child hunger survey. A notable difference did occur between Glen Allen Elementary School and all other schools in the Title I sample. The hunger scale score at Glen Allen on item #2 is 167. This would seem to connote that the student enrollees at Glen Allen Elementary School are less concerned about running out of food when compared to all other schools in the Title I Sample (see Table Six). Item #2: Did the food that your family bought run out before your family had money to buy more? National and Local Implications of Findings Direct and Indirect Costs to U.S. Economy and Social Stability The direct costs of food insecurity to our society is staggering. According to the U.S. Department of Agriculture (2013, March 15), over $100 billion in federal dollars was expended in fiscal year 2012 in support of food and nutrition assistance programs across the United States. According to the report, the five major food and nutrition programs that accounted for 97 percent of the expended federal funds are: 24

25 The Supplemental Nutrition Assistance Program (SNAP); The National School Lunch Program (NSLP); The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); The School Breakfast Program (SBP); The Child and Adult Care Food Program (CACFP). In addition, Chilton and Rose (2009) report that food insecurity costs an estimated $90 billion annually in increased medical care costs, lost educational attainment and worker productivity, and investment burden into the emergency food system. (p. 1203) Summary of Findings The research data clearly show the following: 1. Of the nine items on the Child Food Security Survey Module (CFSSM), the most concern around issues of food insecurity registered with the following three items: Item #4: Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? (HSS=293) Item #1: Did you worry that food at home would run out before your family got money to buy more? (HSS=287) Item #2: Did the food that your family bought run out before your family had money to buy more? (HSS=271) 25

26 The three items above had the highest hunger scale scores (HSS), which placed them into the food insecurity category (see Figure Four). 2. Although there are no notable differences (see Table Four) between students as this concerns race and ethnicity on food insecurity, African Americans (Blacks) and Hispanics (Latinos) consistently scored the highest hunger scale scores when compared to the other hunger scale scores from other ethnic and racial groups. This would seem to indicate that issues of food insecurity as this concerns item #4, item #2, and item #1 on the CFSSM child hunger survey are most severe for the African American (Black) and Hispanic (Latino) students. 3. Overall, hunger scale scores (HSS) were highest among students at the upper high school and elementary school grade levels as this concerns food insecurity and item #4, item #2, and item #1 on the CFSSM child hunger survey (see Table Five). 4. Atwater Elementary, Alta Vista Elementary, and Wilkinson Elementary consistently emerged as the schools with the highest hunger scale scores. This would seem to indicate that issues of food insecurity as this concerns item #4, item #2, and item #1 are most severe in these schools when compared to the other schools in the Title I sample (see Table Six). Also, given these data findings, the decision by the All Faiths Food Bank to launch a School- Based Pantry Program in Alta Vista Elementary was a needed decision (All Faiths Food Bank, 2013). 26

27 Preliminary Recommendations The Issue of Nutrition (HSS=293) Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? (CFSSM: Item #4) Without question, issues of nutrition plague children and families who suffer from food insecurity (Gundersen & Kreider, 2009). The value of food nutrition programs such as the Supplemental Nutrition Assistance Program (SNAP) and the National School Lunch Program (NSLP) and the School Breakfast Program have been repeatedly shown to provide the essential nutrients that children (particularly low- income children) need to develop healthy minds and bodies (see Kennedy & Cooney, 2001). However, despite these food and nutrition program offerings, serious issues remain as this concerns children, food and nutritional intake. Nutrition Education Programs More is needed in the way of nutrition education programming in schools as offerings for students, teachers, parents and guardians. Adults (i.e., teachers, parents and child- guardians) need to model for children appropriate nutrition intake practices as children look to adults as role models for behavior. O Connell, 27

28 Buchwald, and Duncan (2011) point out that too often individuals with limited financial resources may choose to purchase cheap energy- dense foods to maximize their spending power. (p. 1375) Powell (2012) reports on the significance and need to promote nutrition education programming as evidenced by legislative action at the federal level. In 2004 Congress passed the Child Nutrition Reauthorization Act, mandating that all schools participating in the federal school meal program develop comprehensive wellness policies focusing on the following: (1) What children and adolescents eat in school, (2) How physically active students are in school, and (3) In- school health and nutrition education programming. (p. 249) Access to Fresh Nutritious Foods and Supermarket Outlets According to the U.S. Department of Agriculture (USDA), over 20 million Americans live in areas that are characterized as food deserts. A food desert is defined as urban neighborhoods and rural towns without ready access to fresh, healthy, and 28

29 affordable food. Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options. (United States Department of Agriculture, 2013). The official food desert designation is restricted to low-income and low-access communities. Communities with a poverty rate of 20 percent or more and or a median family income at or below 80 percent of the area median family income are considered poor. Low- access communities are characterized by those areas whereby it is determined that at least 500 individuals and/or at least 33% of the census tract s population in an urban setting live one mile or more from a supermarket or large grocery story and 10 miles in the case of a rural setting (United States Department of Agriculture, 2013). Table Seven reveals that there are nine census tract areas in Sarasota County that are officially characterized as food deserts, whereby urban residents live one mile or more and rural residents live 10 miles or more from a supermarket or large grocery store. The tracts listed are largely White with median household incomes between $31,947 and $48,160. The tracts range in population size between 2,311 and 4,872 residents. 29

30 Table Seven Sarasota County Food Deserts By 2010 Census Tract Numbers Food Deserts at One (Urban) and Ten (Rural) Miles Sarasota County: Census Tract Number City Population Median Household Income Predominant Race/Ethnicity Sarasota 3,166 $37,754 W=71.5%; B=19.2% ,984 $32,873 W=71.7%; B=20% No. Sarasota 4,872 $34,417 W=59.6%; B=29%; H=22.2% Kingsington Park 3,880 $41,788 W=82.5%; H=26.5% ,979 $48,160 W=87.4%; H=14.4% Gulf Gate 3,750 $38,382 W=95.2% Estates ,898 $42,009 W=91.3% ,993 $31,947 W=89.2% ,311 $40,950 W=95.5% Source #1: (Mr. V. Breneman, USDA Bureau Chief, personal communication, December 19-23, 2013) Source #2: USA.com (2013) B=Black; H=Hispanic; W=White; Racial and Ethnic Minorities Our research study makes particular note of issues of food insecurity and malnutrition as this concerns the relatively high hunger scale scores among African American (Black) and Hispanic student respondents in the Title I schools. This finding is consistent with the national data on food insecurity by race and ethnicity. For example, according to Khan, Calloway, Maida, and Rakel (2012): Adult obesity rates for Blacks and Latinos were higher than for Whites in at least 40 states and the District of Columbia. (p. 74) 30

31 High obesity rates signal problems that are associated with poor nutrition. 7 In their research study on the devastating impact of malnutrition and its impact on African American children as this concerns impaired physical and mental growth, Rank and Hirschl (2009) report: 89.9% of black children will be in a household receiving food stamps by the time they reach age 20 years (compared with 37.3% for white children)... Such children are by definition experiencing poverty and are also quite likely to experience food insecurity... The consequence is that children in such households frequently face dietary and nutritional problems, along with a variety of challenges and stressors that accompany poverty. (p. 997, 998) Issue of Worrying and Running Out of Food (HSS=287/HSS=271) Did you worry that food at home would run out before your family got money to buy more? (CFSSM Item #1) Did the food that your family bought run out before your family had money to buy more? (CFSSM Item #2) 7 Also see Tarusuk (2000). 31

32 The hunger scale scores on item #1 and item #2 revealed that an alarming number of children in the Title I schools are in a state of worry about food and the possibility that they may not be fed. There is an extensive body of literature on the impact of worry on the human body - both mentally and physically. Chronic worrying may lead to excessive anxiety to the point whereby the body cannot function at its full potential. In this latter regard, children who are food insecure may move into a state of chronic worry and anxiety because of the feeling or belief that food may not be forthcoming they are never totally sure. Children who suffer from chronic worry and anxiety may have difficulty concentrating in school and may resort to behavioral outbursts or become withdrawn with negative consequences (i.e., smoking, drinking, drug usage, overeating). These negative consequences may be employed as a means of alleviating the worry and anxiety. In their research on family and child food insecurity, Dunifon and Kowaleski- Jones (2003) allude to the correlation between worry and food insecurity in reporting on how food insecurity is associated with decreased levels of positive behavior. Jyoti, Frongillo, & Jones (2005) report on the literature that established links between food insecurity and academic performance. Among 6- to 12- year old children, food insufficiency has been associated with poorer mathematics scores, grade repetition, absenteeism, tardiness, visits to a psychologist, anxiety, 32

33 aggression, psychosocial dysfunction, and difficulty getting along with other children. (p. 2831) Additional Preliminary Recommendations Be Strategic Support food nutrition programs and their strategic expansion. One Size Does Not Necessarily Fit All Develop specific (targeted) approaches to alleviating and ultimately eliminating child hunger in order to solve the hunger problem while maximizing a community- return on investment. 33

34 Focus on the Children Subscribe to institutional practices that increase student resilience and coping strategies around issues of individual, family, and community hunger. Prevention as a Critical Dimension Focus on prevention as a critical dimension. Help children and families through education initiatives to engage in preventative action and healthy choices around food insecurity and diet. Create Success by Impacting a Critical Mass Institutions must work to impact a critical mass of people around issues of food insecurity. For example, it does no good to impact a group of 15 students in a middle school if all 800 students in the middle school are experiencing food insecurity work to impact the entire school. Strive to develop neighborhood and regional approaches to tackling food insecurity in the effort to impact a critical mass of children and families. 34

35 APPENDIX METHOD SECTION: DATA COLLECTION AND ANALYSIS 35

36 Children and Issues of Food Security in Sarasota County APPENDIX METHOD SECTION: DATA COLLECTION AND ANALYSIS On December 12, 2012 Sandra Frank of the All Faiths Food Bank in Sarasota County and Dr. Bruce Jones and George MacDonald of Edumetrics Resources Group, Inc. began discussion about the development and implementation of a research study on child hunger in Sarasota and DeSoto counties. 8 With primary support from the Gulf Coast Community Foundation, the research study was officially launched in January Dr. Jones and Mr. MacDonald embarked on securing Institutional Review Board- Human Subjects Approval (IRB- HS) through the Western Institutional Review Board (WIRB) during the spring During this same period, the researchers sought approval to conduct research in the Sarasota County Schools by completing the Sarasota County Schools Request to Conduct Research Application.. Parental notifications about the purpose of the research and procedures for exempting children from the research were distributed to the parents in each Title I school. Through this notifications, parents were informed that the children who 8 The DeSoto Child Hunger Study appears as a separate report. 36

37 participated in the research would remain anonymous as individual student responses to the survey would be confidential. After completing the Institutional Review Board- Human Subjects process (IRB- HS) and the Sarasota County Schools Research Review process, the researchers released the electronic link to the on- line child hunger survey (CFSSM) 9 on May 20 21, 2013 to the 16 schools. At the time of the release of the on- line survey there were 13,019 students enrolled in the 16 Title I high poverty schools whereby student free and or reduced lunch figures stood at 61% and higher (see Table Eight: Targeted Schools). The CFSSM-Survey Student Respondents Approximately 15 percent (n=1,900) of the students in the Title I schools responded to the on- line survey. This number entailed students at the elementary level, 217 students at the middle school level and 765 students at the high school level (see Table Nine). Ultimately, student survey responses came from 14 of the 16 Title I schools. Gocio Elementary and Booker Middle schools did not respond to the on- line survey (see Table Nine). Among the remaining 14 schools, EE Booker, Lamarque, and Tuttle Elementary and Woodland Middle schools were removed from the data analysis 9 CFSSM is the Child Food Security Survey Module. 37

38 Table Eight Sarasota County Schools Child Hunger Study Targeted Schools Elementary and Secondary Schools with Student Enrollment F/RL Over 61 Percent Number of Schools: N=16 School Free Reduced Paid TOTAL Elementary Alta Vista Atwater Brentwood Cranberry EE Booker Glenallen Gocio Lamarque Toledo Blade Tuttle Wilkinson Middle Booker Heron Creek Woodland High Booker North Port 1, ,216 TOTAL- TARGETED 8,416 1,043 3,560 13,019 because of the small number of students who responded to the CFSSM survey (see note on Table Six and see Table Nine). In addition, the researchers recommend caution in interpreting the results concerning Atwater and Wilkinson Elementary schools because of the moderate student size response from these schools (see Table Nine). 38

39 Table Nine Sarasota County Schools Child Hunger Study Actual School Participants School Number of Student Respondents Percent of Total Elementary Alta Vista % Atwater % Brentwood % Cranberry % EE Booker 4 0.2% Glenallen % Gocio No Respondents 0% Lamarque 6 0.3% Toledo Blade % Tuttle 3 0.2% Wilkinson % Subtotal Elementary % Middle Booker No Respondents 0% Heron Creek % Woodland % Subtotal Middle % High Booker % North Port % Subtotal High % TOTAL-ACTUAL 1, % 39

40 About the Survey: The Child Food Security Survey Module (CFSSM) In 1990 the U.S. Congress passed the National Nutrition Monitoring and Related Research Act. With the passage of this act, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) were charged with establishing a standardized method for collecting data about the food security status of households in the United States. As a result, the systematic collection of survey data about household- food security began in 1995 with the U.S. Census Bureau annual administration of the 18 item Food Security Core- Module Questionnaire (Bickel, Nord, Price, Hamilton, & Cook, 2000) (see Table Ten). Nearly a decade after the establishment and implementation of the 18- item Food Security Core- Module Questionnaire, Connell, Nord, Lofton, and Yadrick (2004) developed a way to document, assess and understand food security among children and youth. The Child Food Security Survey Module (CFSSM) (see Table Eleven) is specifically designed to gather information about hunger and food security from the mouths of the youth. Prior to the establishment of the CFSSM, there was no survey for addressing specific issues of child hunger. 40

41 Table Ten Core Food Security Module (CFSM) 18 ITEM ADULT SURVEY ON FOOD SECURITY/INSECURITY IN HOUSEHOLDS (U.S. Department of Agriculture) 1. We worried whether our food would run out before we got money to buy more. Was that often, sometimes, or never true for you in the last 12 months? 2. The food that we bought just didn t last and we didn t have money to get more. Was that often, sometimes, or never true for you in the last12 months? 3. We couldn t afford to eat balanced meals. Was that often, sometimes, or never true for you in the last 12 months? 4. We relied on only a few kinds of low-cost food to feed our children because we were running out of money to buy food. Was that often, sometimes, or never true for you in the last 12 months? 5. In the last 12 months, did you or other adults in the household ever cut the size of your meals or skip meals because there wasn t enough money for food? (Yes /No) 6. We couldn t feed our children a balanced meal, because we couldn t afford that. (Yes/No) 7. In the last 12 months, did you ever eat less than you felt you should because there wasn t enough money for food? (Yes /No) 8. (If yes to Question 5) How often did this happen? Almost every month, some months but not every month, or in only 1 or 2 months? 9. The children were not eating enough because we just couldn t afford enough food. Was that often, sometimes, or never true for you in the last 12 months? 10. In the last 12 months, were you ever hungry, but didn t eat, because you couldn t afford enough food? (Yes /No) 11. In the last 12 months, did you lose weight because you didn t have enough money for food? (Yes /No) 12. In the last 12 months, did you ever cut the size of any of the children s meals because there wasn t enough money for food? (Yes /No) 13. In the last 12 months did you or other adults in your household ever not eat for a whole day because there wasn t enough money for food? (Yes /No) 14. In the last 12 months, were the children ever hungry but you just couldn t afford more food? (Yes /No) 15. (If yes to Question 13) How often did this happen? Almost every month, some months but not every month, or in only 1 or 2 months? 16. In the last 12 months, did any of the children ever skip a meal because there wasn t enough money for food? (Yes /No) 17. (If yes to Question 16) How often did this happen? Almost every month, some months but not every month, or in only 1 or 2 months? 18. In the last 12 months did any of the children ever not eat for a whole day because there wasn t enough money for food? (Yes /No) 41

42 Table Eleven Child Food Security Survey Module (CFSSM) 9 ITEM CHILD SURVEY ON FOOD SECURITY/INSECURITY (Connell, Nord, Lofton, & Yadrick, 2004) 1. Did you worry that food at home would run out before your family got money to buy more? Never Sometimes A lot 2. Did the food that your family bought run out and you didn t have money to get more? Never Sometimes A lot 3. How often were you not able to eat a balanced meal because your family didn t have enough money? Never Sometimes A lot 4. Did your meals only include a few kinds of cheap foods because your family was running out of money to buy food? Never Sometimes A lot 5. Has the size of your meals been cut because your family didn t have enough money for food? Never Sometimes A lot 6. Did you have to eat less because your family didn t have enough money to buy food? Never Sometimes A lot 7. Did you have to skip a meal because your family didn t have enough money for food? Never Sometimes A lot 8. Were you hungry but didn t eat because your family didn t have enough food? Never Sometimes A lot 9. Did you not eat for a whole day because your family didn t have enough money for food? Never Sometimes A lot 42

43 The researchers moved forward with the usage of the CFSSM knowing: (1) the CFSSM was developed with extreme research rigor (high statistical validity and reliability) by Connell, Nord, Lofton, and Yadrick (2004) and (2) the CFSSM The CFSSM allows children s voices to be heard directly about hunger issues as opposed to indirectly through the voices of their adult guardians. was used in 2009 to determine levels of food insecurity among children in Cook County, Illinois. 10 The researchers also recognized that the problem with the Core Food Security Module- adult survey for assessing child hunger is two- fold: (1) The perspectives of child hunger on the survey came from the adults not the children, and (2) The data on the adult survey focused on the household as opposed to individuals within the household. This is problematic, according to Gunderson and Kreider (2009, p. 972) who report that household surveys may be misleading when using such surveys to assess the hunger status of individuals within the household. Some studies, for example, may show high levels of food security within the overall household but probing deeper may reveal that the parent is not eating to ensure that their children are eating well. 11 In this instance, the household survey failed to show that the parent is experiencing food insecurity although the children are not. The CFSSM allows 10 See Terpstra, A., Rynell, A, Carrow, L., Nogaski, A., & Roberts (2010). Running on Empty: Nutritional Access for Children in Cook County, IL. Chicago, IL: Social IMPACT Research Center. 11 See Chilton and Rabinowich (2012) who report: Many studies report that parents generally protect their children from food insecurity... they will reduce the size of their own meals, or may not eat at all, in order to feed their children. (.p. 1) 43

44 children s voices to be heard directly about hunger issues as opposed to indirectly through the voices of their adult guardians. Data Analysis Once the data were collected from the nine item CFSSM - child hunger on- line survey, the data were analyzed using Item Response Theory (IRT) and in particular, IRT (2- PL). In order to report the survey results, the data were scaled using the following procedures: (1) The mean was scaled to 300 points and a standard deviation was scaled to 50 points, and (2) The score was rescaled so that 0 represented the lowest hunger scale score and 600 represented the highest hunger scale score. Through a modified Angoff procedure the researchers established cut- off scores, allowing for the survey results to show tendencies toward food security, food insecurity and hunger among the student population. Figure Four illustrates the cut- off demarcations. Hunger scale scores between 0 and 270 tend toward a condition of being Food Secure; hunger scale scores between 271 and 440 tend toward a condition of being Food Insecure, and hunger scale scores between 441 and 600 tend toward Hunger. 44

45 The researchers pointed to large notable differences in the data concerning food security with respect to the key categories of the study - race/ethnicity differences; grade levels differences, and school level differences using the criteria set forth by Cohen (1988) on statistical power analysis. References All Faiths Food Bank (2013, January- March). Featured program: Alta Vista school- based food pantry. Food for Thought, 7(1). Aron, L. & Loprest, P. (2012, Spring). Disability and the education system. The Future of Children, 22(1), Ashiabi, S.G. & O Neal, K.K. (2007). Food insecurity and adjustment problems in a national sample of adolescents. Journal of Children and Poverty, 13(2), pp Banjo, S. & Gasparro, A. (2013, November 4). Retailers brace for reduction in food stamps: Expiration of added benefits will remove $11 billion in aid over three years. Business Section: The Wall Street Journal. Bhattacharya, J., Currie, J., & Haider, S. (2004). Poverty, food insecurity, and nutritional outcomes in children and adults. Journal of Health Economics, 23, Bickel, G., Nord, M., Price, C., Hamilton, W., & Cook, J. (2000). Measuring food security in the United States: Guide to measuring household food security. Washington, D.C.: U.S. Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition, and Evaluation. Brown, L. (1970). Hunger USA: The public pushes Congress. Journal of Health and Social Behavior, 11(2), pp Brown, J.L., & Gershoff, S.N. (1989). The paradox of hunger and economic prosperity in America. Journal of Public Health Policy, 10(4), pp Center on Hunger and Poverty (2002, June). The consequences of hunger and food insecurity for children: Evidence from resent scientific studies. Waltham, MA: Heller School for Social Policy and Management. 45