125p. · What were the Characteristics of Soup Kitchen Users? 41. What were the Characteristics of...

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Wehler, Cheryl A.; And OthersA Survey of Childhood Hunger in the United States.Community Childhood Hunger Identification Project.Food Research and Action Center, Washington, D.C.Kraft General Foods Foundation, Glenview, IL.Mar 91125p.Food Research & Action Center, 1875 ConnecticutAvenue, N.W. #540, Washington, DC 20009.Reports Research/Technical (143)

MF01/PC05 Plus Postage.Breakfast Programs; Child Health; *Children; *ChildWelfare; *Disadvantaged Youth; EconomicallyDisadvantaged; Employment Level; *FamilyCharacteristics; Family Life; Federal Programs;*Hunger; *Poverty; Public Policy; Social Services;Surveys*Food Assistance Programs; Food Stamp Program; SchoolLunch Program; Women Infants Children SupplementalFood Program

This report presents results from the CommunityChildhood Hunger Identification Project (CCHIP), a research projectthat used survey techniques to document the extent of hunger amonglow-income families with at least one child under the age of 12. Thereport's six chapters provide: (1) an overview of the project,

identifying its major components; (2) results from the seven localCCHIP surveys (conducted in Hennepin County, Minnesota; Pontiac,Michigan; Suffolk County, New York; Hartford, Connecticut; CentralValley, California; Polk County, Florida; and Sumter County,Alabama), and a description of the characteristics of hungry familiesand the effects of hunger on children; (3) a description of foodassistance programs administered by the federal government, includingthe Food Stamp Program, the National School Lunch Program, and theSummer Food Service Program for Children; (4) a discussion of

emergency food programs that focuses on characteristics of those who

use them; (5) an analysis of the relationship between hunger andpoverty; and (6) an analysis of the relationship between employmentstatus and hunger. The report summarizes key findings and suggestspolicy recommendations for ending childhood hunger. The 10 appendixesinclude descriptions of the pilot and demonstration projects; ofCCHIP survey sites and survey methods; of methods for estimatingnational hunger rates; and of a sample design for the Pontiac,Michigan, CCHIP survey. (MM)

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FOOD RESEARCH AND ACTION CENTELBoard of Directors

\larshall I,.Nlatz. Chairman David I. (;recithert... Matthew \feinted'Attorney at Law V:ce President. (;,\ eminent I. \eciitive DirectorI lolland & Knight .\tt:iirs ( :owlet:tient .\,soei:ifion for\Vasliington. 1) C. - Philip,NInrris t :olirimines Inc I Ionian :-.1eivices

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Carol Tucker ForemanPartnerhireman leidcpriemWashington, D.(:.

Ruth R. Ilarhin.Mtornev at Law

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Ilelen IlerslikoffAssociate Legal Director

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Johnnie I. PerryLimed l'hnnine\\":tshine,ton, :

John (i. Polk1..thton. CT

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\V;ishingtn. I) CJohn T. JoycePresidentInternattonai ofkileklavers and Allied Craftsmen\\*.ishington. 1).(:

Clinton LvoitsExecutive DirectorThe National Legal Aid &I )etender Association\ ;ishington, D.(:.

Daniel NlarcusAttorney at Law\Viliner. Cutler Pickering1Vishington.'D

.\aron Shirley. NI.D.Project DirectorJackson-I finds ComprehensiveI lealth Center.1,ickson.

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Johnny V. Thoulp.ollFAuctiviv, Vice Prc.iticil(I limIc hornet. Inc

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Robert J. lersit Edward. 1. CooneyEkecutive Director Deputy Director

3

4

Community

Childhood

Hunger

Identificaticii

Project

A Survey ofChildhood Hunger inthe United States

March 1991

Food Researchand Action Center1875 Connecticut Avenue, N.W.#540Washington, D.C. 20009tel (202) 986-2200fax (202) 986-2525

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Table of Contents

IntroductionForewordAcknowledgements ii

Executive Summary

Chapter 1The Community Childhood HungerIdentification Project (CCHIP) 1

Introduction 1

How is Hunger Defined?How is Hunger Measured?Components of the Community Childhood HungerIdentification Project 1

Phase I - DevelopmentPhase II - Replication and Evaluation 3CCHIP Surveys Conducted in Phase II Which areContained in this Report 3

Evaluation 3

Summary 7

Chapter 2Hunger Among Low-Income Families with Children 9

What is the Extent of Hunger in the CCHIP Survey Sites? 9

Methods of Projecting the Extent of Hunger in the United States 9

How Many Children Suffer From Hunger in the United States? 11

What Percentage of Families in the United StatesSuffer from Hunger? 12

How Many Days per Month do Hungry FamiliesSuffer from Various Aspects of Food Insufficiency? 12

What are the Characteristics of Hungry Families? 14

Economic Characteristics 14

Demographic Characteristics 14

Program Participation and Reliance on Emergency Food Providers 14

What is the Impact of Hunger on Children? 14

Summary 16

Chapter 3Federal Food Assistance Programs 19

Introduction 19

What is the Food Stamp Program? 19

What were the Characteristics of Food StampParticipants in CCHIP Surveys'What were the Food Expenditures and Hunger Ratesof Food Stamp Participants in CCHIP Surveys 10

What were the Barriers to Participationin the Food Stamp Program? 23

What Changes in the Food Stamp Program areNeeded to Reduce Childhood Hunger? 23

What is the Special Supplemental Food Program forWomen, Infants and Children (WIC)? 25

What were the Characteristics of WIC Participantsin CCHIP Surveys? 25

What were the Barriers to the WIC Program? 27What is the National School Lunch Program?What is the School Breakfast Program? 27

What were the Characteristics of the HouseholdsWhose Children Participated in the School Lunch Program? 29What were the Characteristics of Households WhoseChildren Participated in the School Breakfast Program? 29What were the Barriers to Participation in theSchool Breakfast Program Among Eligibles? 32What is the Impact of School Meal Participation? 32

What is the Summer Food Service Program for Children? 32What were the Characteristics of Participants in theSummer Food Service Program for Children? 33What were the Barriers to Participation in the SummerFood Service Program for Children? 33

What is the Impact of Federal Food AssistanceProgram Participation on Hunger? 33Summary 36

The Food Stamp Program 36The Special Supplemental Foot, Program for Women,Infants and Children (WIC) 37The National School Lunch and School Breakfast Programs 37The Summer Food Service Program for Children 38

Chapter 4Emergency Food Programs 41

Introduction 41

What were the Characteristics of Soup Kitchen Users? 41What were the Characteristics of Food Pantry Users? 43How Does Participation in Food Stamps Compare withReliance on Emergency Food Programs? 43Is Demand for Emergency Food from Soup Kitchensand Food Pantries a Reliable Indicator of a CommunityHunger Problem Among Low-Income Families? 46Summary 46

Chapter 5Hunger and Poverty: The RelationshipBetween Income and Expenses 51

How is Poverty Defined? 51

What are the Trends in the Poverty Rate? 51

How Do Rates of Poverty and Hunger Relate? 53

7

The Hunger Equation: What is the RelationshipBetween Income and Expenses? 53

How Much Do Low-Income Families Spendon Food and Shelter? 58

What is the Monthly Budget for HouseholdsBelow the Poverty Level? 58

Summary 61

Chapter 6Employment Status and Hunger 63

Introduction 63

Economic Recovery and Low Wage Jobs 63

What are the Characteristics of Employment StatusDifferences Among CCHIP Households? 65

How Are Family Budgets Affected by Unemployment? 67What are the Barriers to Employment for Single Parents? 67

How are Family Budgets Affected by Full-Time Employment? 71

How Do These Families Compare? 71

Summary 73

Key Findings 75

Policy Recommendations 79

Short-Term Steps to Ending Childhood Hunger 79

Longer Term Vision 82

Endnotes 85

AppendicesA. Description of the Pilot Project 91

B. Description of the Demonstration Project 92

C. Description of Seven CCHIP Survey Sites 93

.D. CCHIP Survey Methods 97

E. Methods for Estimating National Hunger Rates 98

F. Health and School Absenteeism Characteristics ofHungry Families Compared to Non-Hungry Families 99

G. Sample Design for the Pontiac, Michigan, CCHIP Survey 100

H. CCHIP Sites and Contacts 101

I. CCHIP Site Acknowledgements 102

J. CCHIP Technical Advisory Committee 104

COMMUNITY CHILDHOOD HUNGER

IDENTIFICATION PROJECT

The CCHIP Report was written by:

Cheryl A. Weh ler, Director.National Community Childhood Hunger Identification Project

Richard Ira ScottCCHIP ConsultantAssociate Professor of Sociology and Associate Director of theHonors College, University of Central Arkansas

Jennifer J. AndersonCCHIP Statistical ConsultantStatistician and Associate Research Professor of Medicine in theArthritis Center, Boston University School of Medicine

The Policy Recommendations were written by:

Lynn ParkerDirector, Nutrition Policy and ResearchFood Research and Action Center

The CCHIP Report was prepared by:

National CCHIP staff:

Cheryl A. Weh ler, Project DirectorRichard Ira Scott. ConsultantJennifer J. Anderson, StatisticianValerie J. Wehler, Research AssistantJohn M. Anthony, Computer ProgrammerIona A. Wehler. Support StaffG. Ted Fairchild, ConsultantSara B. Ducey, Consultant

Food Research and Action Center staff:

Robert J. Fersh. Executive DirectorAnn K. Kittlaus. Communications DirectorLynn Parker, Director, Nutrition Policy and Research

We would like to thank the following reviewers for their insightful com-ments: Dr. Victor Sidel, Cynthia Thomas and Helen Ward of the CCHIPTechnical Advisory Committee; Robert Greenstein and Kathryn Porterof the Center on Budget and Policy Priorities; Dr. J. Larry Brown, ofthe Center on Hunger, Nutrition and Poverty at Tufts University: andDavid Super of FRAC.

Introduction

()rewordAIL. Millions of kids are hungry in

America. This is the dramaticbut inescapable conclusion thatemerges from the national reportof the Community ChildhoodHunger Identification Projectthe most rigorous and compre-hensive study of childhoodhunger ever conducted in thiscountry.

The results of the seven localCCHIP studies provide an indica-tion of the extent of hungeramong children and families inthe United States. In a nationwhose wealth and resources arethe envy of the world, literallymillions of children do not getenough to eat on a regular basis.

Hunger hurts everyone. Itrobs children of proper physicaldevelopment and the ability tolearn. It causes health problemsand increases education costs.Hungry children who cannotconcentrate in school are lesslikely to reach their potentialand become fully productiveadults which ultimatelymeans that our society will beless competitive in the worldmarketplace.

Among our key findings:

An estimated 5.5 millionchildren under age 12 in thiscountry are hungry.

An estimated 11.5 millionchildren under age 12 are hungryor at risk of hunger.

Hungry children are two tothree times more likely than

children from non-hungry low-income families to have sufferedfrom individual health problemssuch as unwanted weight loss,fatigue, irritability, headaches,and inability to concentrate inthe six month period prior to thesurvey.

Hungry children are absentfrom school one and a half timesas many days than children fromnon-hungry families.

The study paints a disturbingpicture of the day-to-day struggleof low-income households tomaintain a nutritionally ade-quate diet. It shows that shelter(housing and utility) costs domi-nate the budgets of most of theseiiouseholds, leaving little moneyfor food and other necessities. Itshows that many working fami-lies, including those with amember employed full time, can-not escape Hunger. It shows thatlow-income families are quiteresourceful in marshalling publicand private food assistance, yetoften cannot meet their families'needs. And that when hungerhits a family, the parents areusually the first to do withoutfood so their children can cat.

The widespread childhoodhunger found in this study is anational shame: but fortunatelyit is a shame that can he ended.

In the long run, pursuit of var-ious strategies to reduce the leveland pain of poverty will reducehunger among American chil-dren. But, kids can't wait for thelong run.

There is a wealth of evidence,including new findings in thisstudy, that suggest that bystrengthening an array of federalprograms already in place, muchof the childhood hunger problemin this country can be elimi-nated. They include suchchildren's programs as theSpecial Supplemental FoodProgram for Women, Infants andChildren (WIC); the SchoolBreakfast Program; the NationalSchool Lunch Program; and, theSummer Food Service Programfor Children. Many of these pro-grams are underfunded orunderutilized. In addition, fewpeople realize that 51 percent ofall Food Stamp Program recipi-ents are children and that 83percent of all food stamp benefitsgo to families with children.Food stamp benefits are low andbarriers to participation preventmillions of children and familiesfrom receiving program benefits.

Program improvements rec-ommended at the conclusion ofthis report provide the center-piece of a Campaign to EndChildhood Hunger that we atFRAC, in partnership with anti-hunger groups across thecountry, are launching with therelease of this report. It is along-term public education andpublic policy advocacy effortthat has the ultimate goal ofgaining food security for all chil-dren and families in the UnitedStates. We invite all readers ofthis report to contact us formore information.

If we are truly committed toensuring that no child goes hun-gry in the United States, we mustbegin to develop as careful and

comprehensive a battle plan forthe fight against childhoodhunger as we have for politicalcampaigns and military opera-tions. We have the resourcesand the knowledge to do somuch good for our children.

Through publication of thisreport and the launch of theCampaign we hope to inspire anational debate on childhoodhunger and immediate action toremedy it for no child goeshungry by choice and no onegains when a child goes hungry.If not for moral reasons alone,then for pragmatic economicreasons, we must put an end tochildhood hunger. It is impera-tive that we begin now.

AcknowledgementsWe at FRAC are proud to have

completed the enormous under-taking that the CCHIP studyrepresents. The cost to our orga-nization alone over the pastthree years has been in excess ofa half million dollars; whenadded to the costs of our localsites, the total study costsexceed one million dollars.

CCHIP has been fundedalmost exclusively from privatesources. While a full list ofnational and local contributors isincluded elsewhere in the fullreport, special recognition is duethe Primerica Foundation for ini-tiating this project in 1984. Theproject had the active support ofthen Chairman and CEO ofPrimerica, William S. Woodside,who now serves as Chairman ofSky Chef, Inc., Peter Goldberg,

now the President of thePrudential Foundation and thenVice President for PublicResponsibility for Primerica,played a major role in conceptu-alizing and actualizing thisproject.

Special thanks also are duethe Kraft General FoodsFoundation, the largest under-writer of the CCHIP study andthis report. Kraft General FoodsFoundation has also joined inthe Campaign to End ChildhoodHunger providing invaluableassistance at the national andlocal levels.

Other support at the nationallevel has been generously pro-vided for CCHIP by:

The Pillsbury Foundation

Burlington Northern Foundation

The Ford Foundation

Mazon: A Jewish Response toHunger

Sara Lee Foundation

William T. Grant Foundation.

Thanks is also due to dozensof foundations, corporations andothers who contributed to indi-vidual CCHIP studies.

The role of state and localgroups across the country hasbeen essential to the success ofthis project. Many of the groupsconducting CCHIP surveys arevery small with limited bud-gets and already overextendedstaffs. The rigorous sciencerequired in the CCHIP method-ology meant that raising themoney and managing the studywere enormous challenges. Thegroups conducting these studies

are specifically acknowledgedelsewhere in the full report, butwe want to reinforce our grati-tude for the tremendouscontribution of all who partici-pated at the local levelincluding project supervisors.interviewers and the familiesinterviewed.

One statewide organizationthe Connecticut Association forHuman Services deserves spe-cial praise. It was this groupthat had the foresight and gump-tion to initiate CCHIP in 1984.It was CAHS that conducted theoriginal pilot test in New Haven,Connecticut and also played astrong supportive role in the sub-sequent Hartford survey.Matthew Melmed, the ExecutiveDirector of CAHS, and HelenWard, the Director of Research,deserve the primary credit forpioneering CCHIP. LauraCohen, Director of theConnecticut Anti-HungerCoalition, has been instrumentalin following through on theirwork.

We are also deeply indebted toan eminent group of academi-cians anu researchers for servingas the Technical AdvisoryCommittee (TAC) for CCHIP.

While all TAC members arelisted elsewhere in the fullreport, special mention is war-ranted for Dr. Victor W. Sidel,who chaired the committee.The TAC members gave gener-ously of their time and talent toassure the credibility and sound-ness of the study's methodologyand the accuracy of its findings.

Finally, recognition is duethose who actually made CCHIPhappen on the national level.Although all FRAC staff havebeen involved, Lynn Parker, ourDirector of Nutrition Policy andResearch, planted the seeds forthis project in the mid-1980s bybringing together for the firsttime academicians who wereinterested in working together tofigure out how to documenthunger at the community level.She deserves special praise forcoordinating many aspects ofthis project and serving as liai-son to the CCHIP staff.

Members of the CCHIP staff,however, are those who have lit-erally lived and breathed thisproject for over three years.Through sheer hard work, greatpersonal sacrifice, and tremen-dous dedication, this lean staffhas compiled a remarkable

14

record of achievement.Invaluable contributions havebeen provided by staff membersValerie J. Wehler, Dr.-Richard I.Scott, Dr. Jennifer J. Anderson,John M. Anthony, Iona A. Wehlerand Sara B. Ducey. Drs. Scottand Anderson also served on theTechnical Advisory Committee.

Ultimate praise and credit forthe completion of the CCHIPstudy rests with Project DirectorCheryl A. Wehler. She hasbrought extraordinary intelli-gence and perseverance to theoverwhelming task of completingthis project. This has requirednrft only sophisticated researchskills and an ability to interpretcomplex data, but also strongmanagement capabilities torecruit and supervise the CCHIPstaff and to assist small, grass-roots groups in conducting thiscomplicated study. More thananyone else, the completion ofthis CCHIP study is a tribute toCheryl Wehler's skill and dedica-tion.

Robert J. FershExecutive DirectorFood Research andAction CenterMarch 1991

iii

Executive Summary

The national results included in this reportwere derived from CC111P surveys conductedin seven sites across the nation. Each of theseven surveys was representative of thepopulation of low-income families (at orbelow 185% of poverty) with at least onechild under 12 in the geographic areasampled. The results from the combinedsamples can be used as a basis for projectingnational estimates of the r amber of childrenhungry or at risk of hunger, although thecombined samples are not statisticallyrepresentative of this population in theentire United States.

The CCIIIP sites are located in seven of thenine Census Bureau divisions and all four ofthe Census Bureau regions of the UnitedStates. Since the sites were chosen toaccomplish representation of states thatvaried with regard to geographic size,population size, urbanness/ruralness,economic structure and geographic location,it is reasonable to expect the sample of2,335 randomly-selected households mayreflect similar characteristics of other low-income families with at least one child under12 regardless of where they live. If thisassumption holds, we can use a combinedhunger rate, that accounts for povertydistribution and household composition,from the seven CCIIIP surveys to estimatethe percentage of families in the UnitedStates who are hungry or at risk of hunger.This methodology affords us the capability ofproviding at least a credible estimate of themagnitude of the childhood hunger problemin the U.S.

verriew

Millions of kids arehungry in America. But thesechildren often seem invisible. Infact, many Americans areunaware of the dimensions of thetragic but solvable problem ofhunger here at home. It's time tomake childhood hunger anational priority.

During the 1980s, reports fromlocal feeding programs, state net-works, and regional coalitionsspoke painfully about the growingspecter of hunger, especiallyamong families with children. Aneconomic downturn combinedwith cuts in federal safety-netprograms including food assis-tance programs increased thedemand for emergency food.

But many policymakers dis-counted these reports asanecdotal. They questioned thereliability of the information. In1984, the President's Task Forceon Food Assistance concludedthat it could not "report defini-tive evidence on the extent ofhunger" because an acceptablemeasure had not yet been devel-oped.

To document the need, a com-prehensive, scientifically validstudy of hunger among low-income families with childrenunder the age of 12 was devel-oped by the ConnecticutAssociation for Human Serviceswith the assistance of a distin-guished panel of child health andresearch experts. National repli-cation of the study, called the

16

Community Childhood HungerIdentification Project, or CCHIP,was coordinated in seven sitesacross the country by theWashington, D.C.-based FoodResearch and Action Center(FRAC). This report is based onthe results of these seven CCHIPstudies.

Key FindingsIf combined hunger rates from

the seven surveys hold for thenation as a whole, when appliedto the latest and best availablenational data, an estimated 5.5million American childrenunder 12 are hungry. Thismeans that one out of everyeight children under 12 living inthe United States is probablyhungry.

According to the same projec-tions, an additional six millionchildren under 12 are at-risk ofhunger because their families areexperiencing food shortage prob-lems. Taken together, 11.5million American childrenunder are either hungry orat-risk of hunger based on theseestimates. Put differently, oneout of every four children in theUnited States is likely to experi-ence at least one food shortageproblem.

The impact of hunger on chil-dren in families surveyed byCCIIIP manifests itself throughhealth problems, problems whichaffect school attendance. When

compared with children fromnon-hungry low-income families,children from hungry familieswere much more likely to sufferfrom infection-based health prob-lems and were two to three timesmore likely to show symptoms oflow energy stores in the sixmonth period prior to the survey.

In comparison to non-hungrychildren, hungry children are:

more than three times aslikely to suffer from unwantedweight loss;

more than four times aslikely to suffer from fatigue;

almost three times as likelyto suffer from irritability;

more than 12 times as likelyto report dizziness;

more than twice as likely tohave frequent headaches;

almost twice as likely tohave frequent ear infections;

almost three times as likelyto suffer from concentrationproblems; and,

almost twice as likely tohave frequent colds.

And when children become ill,they miss school. Hungry chil-dren are absent from school oneand a half times as many daysthan children from non-hungryfamilies (6.4 vs 4.3).

When applied to the best avail-able national data, the seven siteresults indicate that roughly 12percent of all families with chil-dren under the age of 12 in theUnited States experiencehunger. In addition, 28 percentof all families with childrenunder 12 living in the United

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States are estimated to be hun-gry or at-risk of hunger, usingthese projections.

Local CCHIP Studies:The CCHIP survey of families

with incomes at or below 185percent of poverty with at leastone child under the age of 12 waspilot-tested in New Haven,Connecticut. A demonstrationproject was conducted inWashington state. The resultsfrom these studies were releasedin 1987 and 1988, respectively.

Over an 18 month period,from February 1989 to August1990, FRAC coordinated sepa-rate CCHIP surveys in Alabama,California, Connecticut, Florida,Minnesota, Michigan and NewYork. A total of 2,335 familieswere surveyed door-to-door forthe final CCHIP report. Thenumber of low-income familiessampled per site ranged from 257in Minnesota to 434 in Michigan.The results from these sevensites are included in this report.

The first statewide CCHIP sur-vey was conducted inMassachusetts from October1989 to January 1990. Theresults of this study will bereleased in May 1991.

Defining Hunger:CCHIP defines hunger as the

mental and physical conditionthat comes from not eatingenough food due to insufficient

economic, family or communityresources.

The measurement of hungerdeveloped by CCHIP attempts todetect food insufficiency due toconstrained resources. TheCCHIP survey measures insecu-rity about having the resourcesto procure foods of choice, per-ceived insufficiency of foodintake, actual food shortagesand alteration of eating behav-iors due to restricted orinadequate resources.

To measure hunger, a scalewas formulated composed ofeight questions taken fromthe 105 questions in the survey

that indicate whether adultsor children in the householdexperienced food shortages, per-ceived food insufficiency oraltered food intake due toresource limitations or inade-quate food resources. Thesekey questions, each pertainingto the preceding 12 months, are:

Does your household everrun out of money to buy food tomake a meal?

Do you or adult membersof your household ever eat lessthan you feel you shouldbecause there is not enoughmoney for food?

Do you or adult membersof your household ever cut thesize of meals or skip mealsbecause there is not enoughmoney for food?

Do your children ever eatless than you feel they shouldbecause there is not enoughmoney for food?

Do you ever cut the size ofyour children's meals or do they

ever skip meals because there isnot enough money for food?

Do your children ever saythey are hungry because there isnot enough food in the house?

Do you ever rely on a lim-ited number of foods to feedyour children because you arerunning out of money to buyfood for a meal?

Do any of your childrenever go to bed hungry becausethere is not enough money tobuy food?

These questions were chosenbecause they elicit the extent ofsustained food insufficiency dueto constrained resources. Theyare based on questions tested inprevious surveys, but are moreprecise in language and havebeen tested with low-incomefamilies.

A score of five or more on thescale of zero to eight (that is,five affirmative responses out ofeight) indicates a food shortageproblem affecting everyone inthe household. Therefore, fami-lies answering five or more ofthe eight hunger questions pos-itively are classified as hungry.This is because a score of five ormore:

indicates that five or moredifferent signs of hunger are pre-sent in the household; and,

indicates that at least oneof these signs of hunger directlyaffects the children in thehousehold.

A score of one to four indi-cates that the family is "at risk"of hunger because it shows atleast one sign of a food short-age problem.

Coping With Hunger:Federal programs are already

in place to address hunger in theUnited States. Some are specifi-cally designed to enhance thefood purchasing power of low-income families, while othershelp to increase the intake ofnutritious food by low-incomechildren. These programsinclude the Food StampProgram; the SpecialSupplemental Food Program forWomen, Infants and Children(WIC); the National SchoolLunch and School BreakfastPrograms; the Summer FoodService Program for Children;and, the Child and Adult CareFood Program.

Hungry families in the CCHIPsurvey were significantly morelikely than non-hungry familiesto participate in the Food StampProgram. And, when the pro-grams were available, manyhungry families and the childrenwithin them participated in WICand the school lunch and break-fast programs. Furthermore,households that participated inthe Food Stamp Program weremore likely to participate inWIC.

While hungry families weremore likely than non-hungry toavail themselves of the benefitsof these food assistance pro-grams, many hungry familieswho were eligible for programbenefits encountered barriers toparticipation.

The Food Stamp Program isdesigned to assist low-incomefamilies in purchasing a mini-mally adequate diet. Of the1,922 families surveyed by

LI

CCHIP and eligible for foodstamps, 708 (37%) were not par-ticipating. Of the 2,335households interviewed in theCCHIP surveys, 406 households(17%) had never applied for foodstamp benefits. The most com-monly given reason for notapplying was that the respondentdid not believe the householdwas eligible (65%). An additionalone-fifth (21%) were embar-rassed to use food stamps. Ofthe 263 households that did notapply for food stamps becausethey did not think they were eli-gible, 131 (50%) were probablyeligible for program benefits and140 of them (53%) were found byCCHIP to be hungry or at-risk ofhunger.

Of all the households sur-veyed, 676 (29%) had applied forfood stamp benefits but were notreceiving them at the time of thesurvey. The most often citedreasons for not receiving foodstamps were that householdssaid they did not qualify for foodstamps at the time of application(51%), their benefits had stopped(30%), or they no longer neededbenefits (24%). Of the 204households who said their bene-fits had stopped, 150 (74%) wereprobably still eligible. Of the158 households who said thatthey no longer needed foodstamps, 101 (64%) were probablystill eligible for program benefitsand, more importantly, 106(67%) were found to be hungryor at-risk of hunger.

An analysis was conducted onhouseholds with gross incomesof less than 130 percent of thepoverty line and therefore morelikely to be eligible for foodstamp benefits. On average, par-

vii

ticipants were receiving 52 per-cent of the maximum food stampbenefit level and approximately11 percent of the participatinghouseholds were actually receiv-ing the maximum food stampbenefit level. The average dollarvalue of food stamps per house-hold was $182 per month.

The WIC program, which hasproven to be both successful inimproving the health and nutri-tional intake of participants andcost-effective, currently servesjust over half of those eligiblenationwide. Of the 1,250 low-income families surveyed byCCHIP who were income andcategorically eligible for WIC, 55percent were not receiving WICbenefits. Most important fromthe CCHIP findings, of those eli-gible but not receiving WICbenefits, 31 percent were hun-gry, presumably at dietary riskand in need of the program ben-efits.

Both the school lunch andbreakfast programs are federalentitlements, available to anyschool district wishing to partici-pate in them. However, less thanhalf of the schools nationwideoffering lunch offer breakfast.Within the 2,129 householdswith school-age children inter-viewed by CCHIP, 875 (41%) ofthe children participated in theSchool Breakfast Program. Fifty-nine percent (1,255 households)did not receive school break-fasts. Of the 59 percent of thosefamilies interviewed by CCHIPwhose children did not receiveschool breakfast, nearly one-third were hungry. For most ofthe school-age children who didnot participate in the School

viii

Breakfast Program, the reasonthat they did not participate wasbecause the program was notoffered at their schools.

Children who were eatingboth school breakfast andschool lunch were found to besignificantly less likely to sufferfrom problems usually associ-ated with low energy reserves(fatigue, irritability and inabilityto concentrate) in the sixmonths prior to the survey thanthose who were getting schoollunch only. As noted earlier,hungry children were morelikely to suffer from specifichealth problems than childrenfrom non-hungry families; andchildren who had a specifichealth problem were more likelyto be absent from school thanthose who did not suffer fromany specific health problems.However, all children were lesslikely to have increased schoolabsences if they got breakfast atschool. In addition, childrenwho were at-risk of hunger hadfewer days absent when they gotbreakfast at school than whenthey did not get breakfast atschool.

The Summer Food ServiceProgram for Children is designedto fill the nutritional gap for chil-dren during the summer monthswhen they are not receivingmeals in school. Like the SchoolBreakfast Program, it is under-utilized. Of the familiesinterviewed by CCHIP, only 22percent had children participat-ing in the Summer FoodProgram. Of those families whohad never heard of the programor did not participate in it, 31percent were hungry and 42 per-

1

cent were at risk of hunger.

Relationships BetweenIncome. Shelter Costs.Employment and Hunger:

Of the 2,335 households withchildren under 12 interviewedin the CCHIP survey withincomes at or below 185 per-cent of the federal poverty level,32 percent were hungry. Anadditional 40 percent of thesefamilies were at risk of hunger,one step away from a chronicfood shortage problem.Families that experiencedhunger suffered from it for anaverage of seven days per month.

Of the families interviewed byCCHIP (with incomes at orbelow 185% of poverty), 65 per-cent had incomes below thepoverty line ($12,700 for a fam-ily of four in 1990). Hungryhouseholds were much poorerthan families categorized as non-hungry. The average incomes ofthe hungry households werenearly 25 percent below thepoverty line. While hungryhouseholds spent nearly a thirdof their gross monthly income onfood, they were able to spend anaverade of only 68 cents per per-son per meal.

Not only were their incomesbut high shelter costs also

r.sonsu--led a large portion (anT of 54%) of their monthly

gross income.

The share (percentage) ofincome spent on shelter aver-aged more than 60 percent for

the poorest households (thosewith incomes below 100 percentof the poverty level). This share'was substantially larger than thetypical (or median) Americanhousehold, whose shelterexpen's were 21 percent oftheir gross income in 1989.Thus, the portion of incomespent on shelter was three timesgreater for the poor in thesesurveys than for the typicalAmerican family.

Post shelter income refers tothe amount of income left overafter shelter costs are paid, andincludes the dollar value of MCbenefits and food stamp allot-ments, for those householdsreceiving each program. Foodshare of post shelter income isthe percentage of this remainingincome spent on food. Foodexpenditures refer only to foodpurchases in grocery stores anddo not count the cost of eatingout at restaurants or other eatingestablishments. Poor familiesspent a much higher percentageof their post shelter income onfood than families with higherincomes. Specifically, familieswith incomes below the povertylevel spent. on average. 60 per-cent of their post shelter incomeon food. Nonetheless, thisamounted to an average of only$277 per month for food just68 cents per person per meal.

The Thrifty Food Plan is amarket-basket list of foods devel-oped by the U.S. Department ofAgriculture as its lowest costfood plan. The plan is used indetermining Food StampProgram benefits designed toassist low-income families inpurchasing a minimally adequate

diet. Yet, the average poor fam-ily (with income at or below100% of poverty) in the CCHIPsurveys was able to spend only77 percent of the cost of theThrifty Food Plan on food evenwhen using food stamps and WICbenefits.

Upon examining an averagemonthly budget includingincome minus basic expensesfor poor families (with income ator below 100% of poverty) in allCCHIP surveys, we see how thistranslates into dollars and cents.After paying for shelter and food,poor families were left, on aver-age, with only 8185 a month.This remainder, which amountedto 839 per person per month,had to cover all other expenses

shoes, clothing, medical bills,bus fare, the phone bill, andother basic needs.

CCHIP survey results showthat living below the poverty lineplaces the family budget in atight squeeze, forcing untenablechoices among competing needs.It is clear that being pooradversely affects a family'scapacity to maintain a nutrition-ally adequate diet.

According to data fromPontiac, Michigan (where fami-lies with incomes above 185% ofpoverty were also interviewed),if all family incomes were at leasttwice (200% of) the povertylevel, nearly 95 percent ofhouseholds in this city would nolonger be classified as hungry.

hunger and employment sta-tus are strongly linked. Based onCCIIIP survey results, unem-ployed households hadthree-fourths the average income

n4 t.J

of part-time employed house-holds and just one half theincome of full-time employedhouseholds. Unemployed house-holds were one and one halftimes as likely to be hungry asfull-time employed households.

Conclusion andRecommendations:

Hunger hurts everybody. As asociety, we cannot afford mil-lions of hungry kids, their illnessor their illiteracy.

New and creative thinking isneeded in our efforts to alleviatehunger and poverty. Of vitalimportance is the achievementof Food Security access by allpeople at all times through nor-mal channels to enoughnutritionally adequate food foran active healthy life. The longterm solution lies in quality edu-cation and training; jobs withliving wages; affordable andavailable housing, child care andhealth care; and adequateincome support for those whoneed it.

But, kids can't wait whileadults debate.

Successful government pro-grams are in place that, if fullyimplemented, can alleviatehunger in the United States. Inlight of the findings from CCIIIP,the following immediate policyobjectives are recommended:

1. Ensure that all eligible, low-income women, infants andchildren receive assistancethrough the Special Supple-

ix

mental Food Program forWomen, Infants and Children(WIC).

2. Increase the availability of theSchool Breakfast Program tolow-income children acrossthe country and encouragefederal, state and local poli-cies to ensure that theNational School Lunch

Program remains broadlyaccessible to all such children.

3. Expand the availability ofmeals for low-income childrenwho are not in school throughthe Child and Adult CareFood Program and theSummer Food ServiceProgram for Children.

2,1

4. Improve access to and bene-fits from the Food StampProgram so that low-incomefamilies with children haveenough to eat throughouteach month.

Millions of kids are hungry inAmerica. There are solutions.

it

4.4

(-4

Chapter 1

The Community Childhood Hunger Identification Project (CCHIP)

ntroduction

In the early 1980s, numerousvoices from disparate placesbegan to speak of hunger. Theinitial response to stories ofhunger was one of surprise,because only a few years earlier,researchers, policymakers andadvocates had been celebratingthe diminution of hunger in theUnited States.

Nonetheless, accounts fromlocal feeding programs, state net-works and regional coalitionsspoke painfully of the re-emer-gence of hunger, especiallyamong families with children.During this period of economicrecession, and following severecuts in federal food assistanceprograms, demand for emergencyfood assistance was increasingdramatically. Service providersdocumented this increaseddemand, noting that more fami-lies with children were seekingassistance.

Concern about the return ofhunger to the United States esca-lated following a survey of cityofficials by the U.S. Conferenceof Mayors in 1982. Though noattempt was made to measurehunger directly, this report didprovide data that showed anincrease in demand at local foodpantries, food banks and soupkitchens.

Some policymakers questionedthe reliability of this information,discounting the reports as anec-dotal. As a result, thesepolicymakers were concentratingnot so much on the existence of a

2J

growing hunger problem but onthe reliability of the informationbase. The concern with credibleinformation was highlighted bythe i.984 report from thePresident's Task Force on FoodAssistance. Although the taskforce concluded that hunger wasa problem in the United States,the authors could not assess itsextent, mentioning an inability tomeasure hunger.

In addition to the task force,other studies of hunger weremounted. Attempts inMassachusetts, New York,Arkansas, Utah and elsewherewere undertaken to measurehunger in order to estimate theextent of the problem at thistime. '

Moved both by concern aboutincreased demand for emergencyfood, and by the need for reliablehunger estimates, theCommunity Childhood HungerIdentification Project (CCHIP)was conceptualized in 1984.CCHIP was designed as a system-atic approach to studying theproblem of hunger, particularlyamong families with children. Itaimed at providing sound dataupon which service providersand policymakers could basetheir decisions.

The Community ChildhoodHunger Identification Project,better known as CCHIP, is aresearch project to documentthe extent of hunger among low-income families (incomes at orbelow 185% of the federalpoverty level) with at least onechild under the age of twelve.

How Is Hunger Defined?

CCHIP defines hunger as themental and physical conditionthat comes from not eatingenough food due to insufficienteconomic, family or communityresources.

In some developing nationswhere famine is widespread,hunger manifests itself as severeclinical malnutrition, and theresulting physical and mentalimpairments are easily mea-sured. The United States has ahigher standard of living.Because food production is highand because food assistance pro-grams are in place to help theneedy, starvation seldom occurs.Instead, hunger here meanschronic mild undernutritionskipping meals, eating less andrunning out of food. The subtlemental or physical changes thatoccur in this country from thelong-term, sub-clinical foodintake deficit among the poor areoften difficult to measure.

The measurement of hungerdeveloped by CCIIIP used anindex that attempts to detectfood insufficiency due to con-strained resources, rather thanclinical measures of undernutri-tion. The CCHIP surveymeasures insecurity about hav-ing the resources to procurefoods of choice, perceived insuf-ficiency of food intake, actualfood shortages and alteration ofeating behaviors due torestricted or inadequateresources.

How Is Ilumrer Measured?

To measure hunger, a scale wasformulated, composed of eightquestions that indicate whetheradults or children in the house-hold are affected by anxiety aboutfood resources, food shortages,perceived food insufficiency oraltered food intake due toresource limitations.

The hunger scale used inCCHIP surveys is constructedfrom the answers to eight keyhunger questions, taken from the105 questions in the survey.These questions, each pertainingto the preceding 12 months, are:

Does your household everrun out of money to buy food tomake a meal?

Do you or adult members ofyour household ever eat less thanyou feel you should because thereis not enough money for food?

Do you or adult members ofyour household ever cut the sizeof meals or skip meals becausethere is not enough money forfood?

Do your children ever eatless than you feel they shouldbecause there is not enoughmoney for food?

Do you ever cut the size ofyour children's meals or do theyever skip meals because there isnot enough money for food?

Do your children ever saythey are hungry because there isnot enough food in the'house?

Do you ever rely on a lim-ited number of foods to feed yourchildren because you are run-ning out of money to buy food fora meal?

Do any of your childrenever go to bed hungry becausethere is not enough money to buyfood?

These questions were chosenbecause they ascertain the extentof sustained food insufficiencydue to constrained resources.They are based on questionsused and tested in previous sur-veys, but are more precise inlanguage and have been testedwith low-income families.

A score of five or more on thescale of zero to eight (that is, fiveaffirmative responses out ofeight) indicates a food shortageproblem affecting everyone in thehousehold. Therefore, familiesanswering affirmatively five ormore of the eight hunger ques-tions are considered "hungry." Ascore of five or more:

indicates that five or moredifferent signs of hunger are pre-sent in the household; and,

indicates that at least one ofthese signs of hunger directlyaffects the children in the house-hold.

A score of one to four indicatesthat the family is "at risk of ahunger problem," because itshows at least one sign of a foodshortage problem attributed toresource constraints.

Components of the(Mnmunity (hildhoodHunger IdentificationProject

CCI-HP has two phases, whichwill be discussed in the next fewpages. CCHIP has been guided

"by a Technical AdvisoryCommittee (TAC) chaired by Dr.Victor Sidel, DistinguishedUniversity Professor of SocialMedicine at the MontefioreMedical Center and the AlbertEinstein College of Medicine inthe Bronx, New York. The TACconsists of professionals with abroad range of expertise in vari-ous fields, including medicine,public health policy, nutritionand social science research.Since its inception, the projecthas been under the direction ofCheryl A. Wehler, former directorof the Massachusetts NutritionSurvey. Corporate and privatefoundations have provided fund-ing for the project.

Phase I Development

Phase I was conducted underthe auspices of the ConnecticutAssociation for Human Services(CARS), a statewide research andeducation organization, locatedin Hartford.

During Phase I, CABS assem-bled the Technical AdvisoryCommittee and project staff whodeveloped and pretested a hungermeasure and survey question-naire, and conducted a pilotstudy in New Haven,Connecticut. (See Appendix Afor a description of the pilotstudy).

Phase II Replication &Evaluation

In Phase II, CCIIIP was spon-sored by the Food Research andAction Center, a nationalresearch. education and advo-cacy organization located inWashington, D.C.

During Phase II, the CCHIPstaff, in conjunction with theGovernor's Task Force onHunger, conducted a demonstra-tion project in two sites inWashington state. (See AppendixB for a description of the demon-stration project.)

CCIIIP Surveys Conducted InPhase II Which are Contained inthis Report

Following the demonstrationproject, seven separate CCIIIPsurveys were conducted fromFebruary 1989 to August 1990, insites that represent seven of thenine Census Bureau divisions andall four of the Census Bureauregions of the United States.Only the West South Central divi-sion and the Mountain divisionare unrepresented in this group ofsurveys. (See Figure 1.1.)

Four urban sites, located inConnecticut, Michigan,Minnesota and New York, andthree rural areas from Alabama,California and Florida wereincluded. Each survey has beendesigned to be representative oflow-income families (those withincomes at or below 185% of thefederal poverty level) with at leastone child under 12 years old inan entire county (Minnesota,Florida and Alabama sites) orgroup of counties (Californiasite), a city (Michigan andConnecticut sites), or in townswithin a county (New York site).

The number of low-incomefamilies sampled per site rangedfrom 257 ar the Minnesota site to434 at the Michigan site (SeeTable 1.1). A total of 2,335 fami-lies were interviewed in seven

surveys, combined. (SeeAppendix C for a brief descrip-tion and parameter table of eachlocal survey and the individualsite technical reports for details.)(See Table 1.2 for characteristicsof the composite sample for theseven surveys.)

The CCHIP staff provides com-munity organizations with experttechnical assistance to conducttheir survey among local resi-dents. To accomplish this. theseorganizations employ communitymembers, trained in interviewingtechniques by the CCHIP staff, toconduct approximately 400 onehour, face-to-face interviews.They use the CCHIP communityquestionnaire which wasdesigned and tested by surveyresearch experts, healthresearchers and policy analysts.The information they gather canbe used to inform the communityabout hunger and to assess theneeds of the hungry. (SeeAppendix D for a description ofsurvey methods.)

Evaluation

Evaluations are made on boththe process and the outcome ofthe project. The characteristicsof local organizations associatedwith the successful completionof a CCIIIP survey have beenexamined in the surveys con-ducted in Phase II. In addition,the amount and type of techni-cal assistance needed have beenstudied. This information willbe used to improve the effective-ness of collaborations on futureCCIIIP surveys.

3

Figure 1.1Map of the United States

UNITED STATES, REGIONS, DIVISIONS, AND STATES

NORTHEAST

.0

42 .)-

Table1.1Characteristics of Samples at CCHIP Survey Sites

Site/State

# ofEligibleFamilies 4

# ofInterviewsCompleted h

ResponseRate AmongEligible II 1-1 % Hungry

% HungryorAt-risk

I lennepin County,Minnesota 7,788 257 65% 37% 80%

Pontiac,Michigan 2,474 434 96% 29% 67%

Suffolk County,New York 2,595 361 80% 24% 86%

Hartford,Connecticut 3,833 315 92% 41% 77%

Four Counties inthe Central Valley,California 49,731 335 70% 36% 68%

Polk County,Florida 9,901 274 59% 32% 69%

Sumter County,Alabama 1,106 366 96% 28% 59%

a - Number of eligible families in geographic area represented.

b - Nine interviews were eliminated from the multi-site analysis because of insufficient data (Compositesample = 2,335).

9 "5

Table 1.2Characteristics of Composite Sample of Households

For Seven CCHIP SurveysNumber of Households = 2,335

SOCIODEMOGRAPHICThe average household had 4.6 members with 2.9 children.43 percent of the households were headed by females.43 percent of the families had two parents present.14 percent of these families were either multigenerational, had a single male head, had other adultbesides parents present or had more than one family present.41 percent of the households were Black.29 percent of the households were white.24 percent of the households were Hispanic.Six percent of the households were of another descent.

ECONOMIC46 percent of the households had incomes below 75 percent of poverty.34 percent of the households had incomes between 76 and 130 percent of poverty.20 percent of the households had incomes between 131 and 185 percent of poverty.Over half (55%) of the families in the sample had wage income and 48 percent had at least one full-time employee.

?86

Summary

The Community ChildhoodHunger Identification Project(CCHIP) is a research projectemploying survey techniques todocument the extent of hungeramong low- income-families(those with incomes at or below185% of the federal povertylevel) with at least one childunder the age of 12.

The CCHIP survey was devel-oped in response to the needs ofpolicymakers and serviceproviders for reliable data abouthunger. The need to accuratelydocument the extent of child-hood hunger followed reports inthe early 1980s of increasingdemand for emergency foods byfamilies with young children.

In response to the need forsound information, the

Connecticut Association forHuman Services (CAHS) assem-bled a Technical AdvisoryCommittee composed of promi-nent professionals in the areas ofmedicine, public health, childhealth policy, nutrition, surveyresearch methodology and com-munity advocacy to design ascientifically valid survey instru-ment and methods to documentthe extent of hunger among low-income families with children.CAHS also sponsored a pilotstudy in New Haven,Connecticut.

In 1987, the Food Researchand Action Center, a national,nonprofit, research, educationand advocacy organizationlocated in Washington, DC,decided to use the CCHIP ques-tionnaire and methods toconduct a demonstration project

-29

in two sites in the state ofWashington. Following the com-pletion of the demonstrationproject, the questionnaire andsurvey sampling methodologywere refined and standardized.From February 1989 to August1990, using these standardresearch techniques, seven sepa-rate CCHIP surveys have beenconducted in Minnesota,Michigan, Connecticut, Florida,California, Alabama and NewYork. This report represents acompilation of the results ofthese seven surveys.

In the next chapter, resultsfrom these CCHIP surveys arepresented which show the effectsof hunger on children and thecharacteristics of hungry fami-lies. In addition, these resultsare also used to project hungerrates for the United States.

7

Chapter 2Hunger Among Low-Income Families With Children

I hat is the Extent ofHunger in the CCHIP

Surrey Sites?As described in Chapter 1,

over an 18 month period, fromFebruary 1989 to August 1990,seven separate CCHIP surveyswere conducted in sites that rep-resent seven of the nine CensusBureau divisions and all four ofthe Census Bureau regions of theUnited States.

The hunger rate (the percent-age of families experiencinghunger) among low-income fami-lies ranged from 24 percent inthe Long Island, New York site to41 percent in the Hartford,Connecticut site. (See Table 2.1)We can combine the householdsfrom all seven sites to producean overall measure of the extentof hunger among low-incomefamilies surveyed by CCHIP.(See Figure 2.1)

Of the 2.335 householdsinterviewed in the seven siteswith incomes at or below 185percent of the poverty level andwith at least one child under theage of twelve. 32 percent werehungry. An additional 40 per-cent of these families were at-risk of hunger. Taken together,this means that 72 percent oflow-income families had experi-enced at least one problem withfood availability due to con-strained resources.

Methods of Projecting theExtent of Hunger in theUnited States

Each of the seven surveys wasrepresentative of the populationof low-income families (at orbelow 185% of poverty) with at

Table 2.1Hunger Rates for the Seven CCHIP Sites

Hungry At-Risk Not Hungry

Minnesota 37% 43% 20%

Michigan 29% 38% 33%

New York 24% 62% 14%

Connecticut 41% 36% 23%

California 36% 32% 32%

Florida 32% 37% 31%

Alabama 28% 31% 41%

Combined 32% 40% 28%

9

Figure 2.1Hunger Rates of Low-Income Families Surveyed by CCHIP (All Sites)

40%

10

32

Hungry

M At -Risk

M Not Hungry

least one child under 12 in thegeographic area sampled. Theresults of the combined samplescan be used as a basis for pro-jecting national estimates of thepercent of families with childrenunder 12 who are hungry or atrisk of hunger, even though thecombined samples are not statis-tically representative of thispopulation living in the entireUnited States.

Since the seven sites werechosen to capture national varia-tion in geographic size,population size, proportion ofthe population living in urbanand rural areas, economic struc-ture and geographic location, itis not unreasonable to expectthat the composite sample of2,335 households randomlyselected within their local sitesmay be similar to other low-income families with at least onechild under 12, regardless ofwhere they live.

Poor households (those livingbelow the poverty line) in theCCIIIP surveys are distributed inurban, suburban and rural areasin proportions roughly compara-ble to relevant nationaldistributions. CCHIP house-holds are somewhat larger, and ahigher percentage of them areminorities. Neither householdsize nor race, however, is signifi-cantly associated with hunger inthe CCHIP surveys. Therefore,it is reasonable to assume thatthese discrepancies would havelimo effect on the applicabilityof the combined CCIIIP hungerrates to all low-income familieswith children under 12. In addi-tion, poor households in theCCIIIP samples have nearly thesame percentage of single female

headed households as thenational average. Since having asingle female head is associatedwith hunger, it is accounted forin the CCHIP estimations.

Assuming that the hunger rateseen in the seven CCHIP surveysapplies to all low-income fami-lies (at or below 185% ofpoverty) with children under 12regardless of where they live,then the overall rate from theseven surveys is our best esti-mate of hunger (32%) and risk ofhunger (40%) among low-incomefamilies with children under 12in the United States. Modifyingthis assumption, so that weassume only that the hungerrates seen in the CCIIIP surveyswithin each of six categoriesdefined by poverty level andhousehold composition typehold in the United States as awhole, we can reweigh thesehunger rates to account for dif-ferences between the surveysites and the entire UnitedStates in the representation ofthese six categories. Thisreweighing yields an estimate ofhunger of 29 percent and risk ofhunger of 42 percent among low-income families with childrenunder 12 in the United States.From these estimates we canproject the percentage of all fam-ilies with children, and the totalnumbers of children in theUnited States who are hungry orat risk of hunger. (Details of theprocedures are provided inAppendix E.)

These estimates, as with anyestimates, should he understoodin context. The extent of theiraccuracy and reliability is con-strained by limitations in theavailable data sources.

Nonetheless, these are the bestestimates of hunger that areavailable at this time.

How Many Children SufferFrom Hunger in the I ,zitedStates?

Assuming that the combinedhunger rates from the sevenCCHIP surveys hold for thenation as a whole, they can beapplied to the best availablenational data to provide an esti-mate of the magnitude of thechildhood hunger problem. Theaccuracy of these projectionswill be greatly enhanced whennational data specifying povertydistributions are available fromthe 1990 Census.

We estimate that approxi-mately 5.5 million childrenunder age 12 are hungry.

This means that approxi-mately one out of every eightchildren under age 12 living inthe United States is hungry.

In addition, approximately6.0 million children under age12 are at-risk of hunter becausetheir families are experiencingfood shortage problems.

Taken together. this meansthat approximately 11.5 millionAmerican children under age 12are either hungry or at-risk ofhunger. Put differently, approx-imately one out of every fourchildren under 12 in the UnitedStates lives in a family that hasexperienced at least one foodshortage problem in the pasttwelve months.

11

Thus, for children under 12 inlow-income families in theUnited States in 1989-1990,approximately 5.5 million chil-dren were from families thatwere hungry at some time (in atleast one month) during the 12month period preceding the sur-vey. Moreover, approximately4.7 million low-income childrenwere from families that werehungry in the month precedingthe survey. Since poverty statusmay change from month tomonth, and since recall is moreaccurate for shorter periods, theprevalence estimate for themonth prior to the survey islikely to be a good indicator of a"typical" month. Therefore, ourbest estimate of the number oflow-income children under 12who are hungry on a monthlybasis is approximately 4.7 mil-lion.

;that Percentage ofFamilies in the (nue('States ,Suffer from Ilung.er?

Assuming that the combinedhunger rates from the sevenCCIIIP surveys reflect that oflow-income families (at or below185% poverty) with at least onechild under 12 regardless ofwhere they live, and assumingthat the rate of hunger in familieswith incomes above 185 percentof poverty is not substantial, therate of hunger among low-incomefamilies can be put into contextfor the entire population of fami-lies with young children living inthe United States.

12

CCHIP estimates that approxi-mately 12 percent of familieswith children under age 12 livingin the United States experiencehunger.

In addition, approximately 28percent of all families with chil-dren under age 12 living in theUnited States are hungry or at-risk of hunger.

How .1Mni Dap per .1IonthDo Hungry Families SufferFrom Various Aspects ofFood Msufficienc?

Families experience variousaspects of hunger. There is asequential pattern in the wayhunger manifests itself in house-holds. When resources are tight,households begin to rely on alimited number of low-cost,emergency foods; adults then cutor skip meals, eating less thanthey think they should; whenthey run out of money to buyfood to make a meal, parentsbegin to report that their chil-dren are also eating less thanthey think they should, andmust then cut the size of theirchildren's meals or have the chil-dren skip meals. At this point,when there is little food in thehouse to give them, childrenbegin telling their parents thatthey are hungry, and when thefamily no longer has any food ormoney for food, the children goto bed hungry.

Table 2.2 presents informationthat depicts this sequential pat-tern. For hungry families, food

3

shortages and the ensuing reduc-tion in food intake are notuncommon occurrences. Forexample, virtually all of the hun-gry households (98%) rely solelyon a limited number of foods,such as rice, bread, cereal andbeans, for an average of ten daysper month.

More than two in five familiesreport that their food choices arelimited because of constrainedresources every month of theyear.

Parents and other adult mem-bers in 95 percent of hungryhouseholds cut the size of theirmeals or skip meals altogether,doing so for an average of oneweek per month.

In four out of five hungryhouseholds, parents report hav-ing to cut the size of theirchildren's meals or that theirchildren had skipped meals, foran average of almost seven daysper month.

One-third of hungry house-holds had children who went tobed hungry, averaging nearly sixnights per month.

More than one-fourth of hun-gry families report that theirchildren went to bed hungry onsome days of every month of theyear.

Overall, hungry families expe-rienced hunger an average ofseven days per month and anaverage of six months per year inthe 12 month period prior to theCCHIP survey.

Table 2.2Extent and Duration of Hunger

Among Hungry Families - All Survey SitesNumber of households (HHs) = 750

Avg. # days Avg. # % HHs withPercent in past 30 months problem allYes days per year 12 months

THINKING ABOUT THE PAST 12 MONTHS:

Did your household ever run out ofmoney to buy food to make a meal?

Did you or adult members of yourhousehold ever eat less than youfelt you should because therewas not enough money for food?

Did you or adult members of yourhousehold ever cut the size of mealsor skip meals because there wasnot enough money for food?

Did your children ever eat less thanyou felt they should because therewas not enough money for food?

Did you ever cut the size of yourchildren's meals or did they everskip meals because there was notenough money for food?

Did your children ever say theywere hungry because there was notenough food in the house?

Did you ever rely on a limitednumber of foods to feed yourchildren because you wererunning out of money to buyfood for a meal?

Did any of your childrenever go to bed hungrybecause there was notenough money to buy food?

92% 6.0 6.3 31.1

94% 6.9 6.2 29.3

95% 7.1 6.2 29.3

88% 6.7 5.9 26.6

83% 6.6 6.1 28.4

73% 6.5 6.1 27.7

98% 10.1 7.5 42.0

33% 5.5 5.6 '5.6

13

IThat are the Characteristicsof Hungry Families?Economic Characteristics

Table 2.3 presents the charac-teristics of hungry households.The most striking feature of hun-gry households is how feweconomic resources they have.The average income of hungryhouseholds was well below thepoverty level at 77 percent ofthe poverty line. Because hungryhouseholds are poor, over half(54%) received benefits from theAid to Families with DependentChildren (AFDC) Program.

Expenses for low-income fami-lies in the CCHIP surveys werequite high in relation to theirincome. Hungry householdsspent nearly one-third of theirgross monthly income on food,and yet this amounted to an aver-age of only 68 cents per personper meal. In contrast, the aver-age American family of four spentonly 14.8 percent of its grossincome on food in 1989, but thisyielded an average of $1.32 perperson per meal almost twiceas much as a hungry family.'

As will be shown in more detailin Chapter 5, the major con-straint on food expenses for alllow-income households is thehigh cost of shelter (rent or mort-gage and utilities such as gas, fueloil, electricity, water and sewer).Hungry households spent an aver-age of $410 per month on shelter:this is, on average, 54 percent oftheir gross income. Adding infood expenses, this means thathungry families spent 86 percentof their gross monthly income onthese basic needs.

Demographic Characteristics

Nearly half (49%) of all hungryfamilies were headed by singlemothers. Fifty-three percent ofhungry households had an adultmember with a high schooldiploma and forty-six percenthad wage income.

Hungry households had anaverage of 4.8 members, of which3.1 were children. Seventy-sixpercent of hungry households arenon-white.

Program Participation andReliance on Emergemr FoodProviders

Federal food programs arealready in place, designed to helplow-income families acquirenutritionally adequate diets byenhancing their food purchasingpower. While many hungry fami-lies availed themselves of thebenefits of these food assistanceprograms, there are many hun-gry families who were eligible forprogram benefits but encoun-tered barriers to participation.Of eligible households, seven in10 received food stamps, nearlyhalf received WIC, virtually allreceived school lunch, only halfreceived school breakfast, andjust a quarter received mealsfrom the Summer Food ServiceProgram for Children. Manyfamilies who were hungry madeuse of available public and pri-vate food assistance programs,and still were hungry. Whilehungry households were verypoor and therefore likely to heeligible for and participating in

14 36

food assistance programs, pro-gram benefits did not fullycompensate for their economicdisadvantages. Although theseprograms alleviate the severity ofthe food shortage problem, theydid not eliminate it or ensurefood sufficiency.

One of every seven hungryfamilies (14%) with young chil-dren had visited a soup kitchenfor meals, and over half of thesefamilies (52%) had turned to foodpantries or other commodity dis-tribution centers for foodassistance. The vast majority ofhungry households (82%) reliedon friends and relatives formoney, food and meals whenthey ran out of personalresources for food.

What Is the Impact ofHunger on Children?

What do statistics like thesemean for America's hungry chil-dren? Hunger hurts, even ifthese children do not have thedistended bellies and emaciatedbodies suffered by children infamine-stricken areas of theworld. The impact of hunger onchildren in the United Statesusually manifests itself as healthand nutrition problems and prob-lems which affect schoolattendance.

More than 80 percent of chil-dren from hungry householdsskipped meals or had their foodintake limited by having the sizeof their meals cut.

One child was randomly cho-sen to represent each household

Table 2.3Profile of Hungry Households

Hungry households from the seven CCHIP surveys had the following characteristics in common.

These households had an average of 4.8 members, of whom 3.1 are children.

Almost half (49%) of all hungry households were headed by women.

Seventy-six percent of hungry households were non-white.

Fifty-three percent of hungry households had at least one adult member with a high schooldiploma.

Forty-six percent of hungry households had wage income.

Fifty-four percent of hungry households received Aid to Families with Dependent Children(AFDC) benefits.

The average income of hungry households was at 77 percent of the official poverty line.

Hungry households spent an average of 54 percent of their gross income on shelter costs.

Hungry households spent 32 percent of their gross income (including food stamps andWIC benefits) on food.

Seventy percent of hungry households were eligible for and participating in the FoodStamp Program.

Among hungry households that were categorically and income eligible for WIC benefits, 45percent were participating.

Ninety-five percent of hungry households with school-age children participated in theSchool Lunch Program, while only half (48%) participated in the School BreakfastProgram.

Twenty-six percent of hungry households got meals from the Summer Food ServiceProgram for Children.

15

3

the child with the most recentbirthday. Information on schoolabsenteeism and health prob-lems was collected about thatchild in each household. (SeeAppendix F)

When compared with childrenfrom non-hungry families, chil-dren from hungry families weremuch more likely to suffer frominfection-based health problemsand were much more likely toshow symptoms of low energystores in the six month periodprior to the survey.

In comparison to non-hungrychildren, hungry children were:

more than three times aslikely to suffer from unwantedweight loss,

more than four times aslikely to suffer from fatigue,

almost three times as likelyto suffer from irritability,

more than 11 times as likelyto report dizziness,

more than twice as likely tohave frequent headaches,

almost twice as likely tohave frequent ear infections.

almost three times as likelyto suffer from concentrationproblems, and

almost twice as likely tohave frequent colds.

In addition, compared to chil-dren from non-hungryhouseholds, hungry childrenwere almost twice as likely toreport frequent doctor visits inthe six month period prior to thesurvey. Overall, respondentsfrom three quarters of the hun-gry families report that their

16

children experienced healthproblems during the six monthsprior to the survey.

And when children become ill,they miss school. Children whoreported any specific healthproblems were more likely to beabsent from school than thosenot reporting specific healthproblems, missing almost twiceas many school days (7.0 vs. 3.6days). On average, children inhungry families were absentfrom school six and a half daysin the six months prior to thestudy. Hungry children areabsent from school one and ahalf times as many days as chil-dren from non-hungry families(6.4 vs 4.3)

.SutittnarrUsing a measure of hunger

based on food insufficiency dueto constrained resources, CCHIPestimates that approximately5.5 million American childrenunder age 12 are hungry. Thismeans that approximately oneout of every eight childrenunder 12 living in the UnitedStates is hungry. In addition,approximately six million chil-dren under 12 years are at-riskof hunger because their familiesare experiencing food shortageproblems. Taken together,CCIIIP estimates that approxi-mately 11.5 million Americanchildren under 12 years old areeither hungry or at-risk ofhunger. Put differently, approxi-mately one out of every fourchildren in the United Stateslives in a family that has experi-

enced at least one food shortageproblem.

Overall, hungry families expe-rienced hunger an average ofseven days per month and anaverage of six months per yearin the 12 month period prior tothe CCHIP survey.

The impact of hunger on chil-dren in the United States usuallymanifests itself as health andnutrition problems. When com-pared with children fromnon-hungry, low-income fami-lies, children from hungryfamilies were almost three timesas likely to suffer from unwantedloss of weight and four times aslikely to suffer from fatigue dur-ing the six months prior to thesurvey.

And when children become ill,they miss school. Children whoreport any specific health prob-lems were more likely to beabsent from school than thosenot reporting specific healthproblems, missing almost twiceas many school days. Hungrychildren are absent from schoolone and a half times as manydays as children from non-hun-gry families (6.4 vs 4.3).

If the combined hunger ratesfrom the seven CCHIP.surveyshold for the nation as a whole.CCHIP estimates that approxi-mately 12 percent of all familieswith children under 12 in theUnited States experiencehunger. In addition, approxi-mately 16 percent of all familieswith children under 12 are at-risk of hunger. Altogether,approximately 28 percent ofthese families are estimated tobe hungry or at-risk of hunger.

Hungry households are quitepoor, having average incomesthat were about 25 percentbelow the poverty line. Highshelter costs consumed a largeportion (54%) of their monthlygross income. While hungryhouseholds spent nearly a thirdof their monthly gross income onfood, they were able to spend anaverage of only 68 cents per per-son per meal. In contrast, the

average American family of fourspent only 14.8 percent of itsgross income on food in 1989,but this yielded an average of$1.32 per person per mealalmost twice as much as a hun-gry family.

Federal food programs alreadyin place are designed to helplow-income families acquirenutritionally adequate diets byenhancing their food purchasing

39

power. While some hungry fami-lies availed themselves of thebenefits of these food assistanceprograms, many other hungryfamilies who are eligible for pro-gram benefits encounteredbarriers to participation. In thenext chapter, we draw on datafrom CCHIP surveys to find outwho is served and, for those whoare not served, what barriersimpede their participation.

17

Chapter 3

Federal Food Assistance Programs

IntroductionThe federal government

administers a variety of foodassistance programs that areintended to enhance access tonutritious food by low-incomepersons. Some of these pro-grams directly affect school-agechildren, such as the NationalSchool Lunch Program, theSchool Breakfast Program andthe Summer Food ServiceProgram for Children. There isalso a program to help infantsand toddlers, along with preg-nant and lactating women theSpecial Supplemental FA4odProgram for Women. In Tants andChildren (WIC). The FoodStamp Program is the largestfederal food assistance program,and while not specificallydirected to children, its benefitshave a major impact on chil-dren: more than half of thepersons served by the FoodStamp Program are children,and 83 percent of the benefits goto families with children.4

In this chapter we discussthese programs. Each discus-sion begins with a briefdescription of the programwhich is followed by a presenta-tion of findings from the CCIIIPsurveys. Survey findings illumi-nate the following: the extent ofprogram participation, charac-teristics of participants, barriersto participation and the impactof participation on hunger.

What is the Food StampProgram?

The Food Stamp Program isdesigned to improve the nutri-tion of low-income people byproviding them with governmentcoupons they can spend on foodat stores that sell groceries. Thefederal government pays the fullcost of food stamp benefits andat least half of the program'sadministrative expenses. It isadministered locally by welfareor social service agencies and isavailable in every county in theUnited States.

The Food Stamp Programoperates as an entitlement pro-gram anyone who meets theeligibility requirements is enti-tled to receive its benefits. Inorder to be eligible, householdsgenerally must have grossincomes below 130 percent ofthe poverty line and incomes(after deductions for some basicliving costs) below 100 percentof the poverty line. The applica-tion process for the programincludes filing and completing anapplication form, being inter-viewed, and having verified theinformation provided on theapplication.

In fiscal year 1990, the aver-age monthly participation was19.9 million households. A 1988Congressional Budget Officestudy estimated that only 41 to58 percent of households thatare eligible actually participatein the program.

19

Food stamp recipients receivecoupons on a monthly basis.Program benefits, based on theU.S. Department of Agriculture'sThrifty F'ood Plan, provide anaverage of less than 70 cents permeal per person. Benefits varyaccording to the number of peo-ple in the household and theirnet income. The maximum afamily of four can receive in foodstamps amounts to 96 cents perperson per meal. However, onlyabout 18 percent of food stamphouseholds receive the maxi-mum benefit.

The CCHIP questionnaire askswhether a family has everreceived food stamps andwhether they are currently doingso. When respondents reportthat they are not, they are thenasked about reasons for not par-ticipating in the program. Next,we use this information to profilethe Food Stamp Program partici-pants and to examine barriers toparticipation.

ffhat were the Characteristics ofFood Stamp Participants inCCHIP Surreys?

Based on face-to-face inter-views with 2,335 families withincomes at or below 185 percentof the poverty level from surveysin seven sites around the UnitedStates, we present the character-istics of those families receivingprogram benefits. Of the 2,335families interviewed, 1,214 (52%)were participating in the FoodStamp Program, while 708 (30%)appeared to he eligible but werenot participating, and 413 (18%)appeared to he not eligible forthe program. The remainder ofthis discussion will focus on the1,214 families who were partici-

20

pating in the Food StampProgram. (See Figure 3.1)

Table 3.1 shows householdcharacteristics of Food StampProgram participants. As seen inthe table, participants had anaverage monthly gross per capitaincome of $173. Their incomesaveraged 68 percent of the fed-eral poverty level, well below theincome eligibility requirement.This is in line with national dataon the characteristics of foodstamp participants among eligi-bles. It intimates that programbenefits are targeted to the poor-est households.

Of the households that partici-pated in the Food StampProgram, 57 percent also partici-pated in the WIC program, allfamilies with school-age childrenparticipated in the School LunchProgram, almost half (47%) ofthe families with school-age chil-dren participated in the SchoolBreakfast Program and just overa quarter (27%) get meals fromthe Summer Food Program.Given that a significant numberof food stamp recipients werehungry, these relatively high par-ticipation rates in other foodassistance programs among cur-rent food stamp participants mayreflect the resourcefulness ofhungry families in trying to availthemselves of all forms of foodassistance. It may also reflectthat once a hungry family gainsaccess to one food assistanceprogram, their access to otherprograms is enhanced.

Perhaps the most compellingte..irriony of the unmet need offood stamp participants was thelengths to which they went toreduce their hunger problem.

kr

This is demonstrated by theirreliance on friends, relatives andemergency food providers.Sixty-five percent of householdsreceiving food stamp benefitsrelied on friends and relatives forfood and money to buy food.Furthermore, over half (53%) ofhouseholds receiving foodstamps used emergency foodprograms. These findings sug-gest that food stamp recipientssupplemented their food stampbenefits in an effort to feed theirchildren. (We will examine thisin more detail in Chapter 4.)

What were the FoodExpenditures and Hunger Ratesof Food Stamp Participants inCCHIP Surveys?

Food stamp participants spentan average of 33 percent of theirgross income, including foodstamps and WIC, on food. Thisamounts to merely $64 per per-son per month for food. Put indifferent terms, monthly foodexpenditures for food stamp par-ticipants, which includes cash,food stamp benefits and thevalue of WIC benefits, averagednearly 80 percent of the cost ofthe Thrifty Food PEn. To setthis latter finding in context,results from the U.S. Departmentof Agriculture's National FoodConsumption Survey show thatonly 12 percent of individualspurchasing food valued at theequivalent of (100% of) theThrifty Food Plan were eatingdiets that met the U.S.Recommended DietaryAllowances.' Those spendingjust four-fifths of the equivalentof this plan are most likely,therefore, to be at nutritionalrisk.

Figure 3.1Food Stamp Program Participation Rates (All Sites)

30%

52%

Participating

ill Eligible not Participating

ell Not Eligible

22

Table 3.1Characteristics of Food Stamp Participants

(All Survey Sites)Number of Households = 1,214

ECONOMIC

Income as % of poverty level 68.5%

Household monthly gross per capita income $172.68

Shelter share 55.9%

Per capita food expenditure per month 864.13

Food share 33.0%

AFDC recipient 79.3%

SOCIODEMOGRAPHIC

At least one person employed full-time 19.6%

high school graduate Respondent 46.1%

Household size 4.6

PROGRAM PARTICIPATION

Participation in WIC 56.9%

Participation in School Breakfast 47.4%

Participation in School Lunch 100%

Participation in Summer Food Program 27.3%

Rely on friends and relatives 64.7%

Rely on emergency food programs 53.2%

HUNGER PROBLEM 39.8

44

In fact, approximately two-fifths of households participatingin the Food Stamp Program werehungry. Since food stamp partic-ipants tend to be among thepoorest American households,program benefits did not, itwould seem, fully compensatefor the economic disadvantagesof participating households.While program benefits alleviatefood shortages, receiving foodstamp benefits did not, in itself,eliminate hunger.'

What were the Barriers toParticipation in the Food StampProgram?

Of the 2,335 households inter-viewed in the CCHIP surveys,406 households (17%) had neverapplied for food stamp benefits.The most commonly given rea-son for not applying was that therespondent did not believe thehousehold to be eligible (65%);an additional one-fifth (21%)were embarrassed to use foodstamps. Of the 263 householdsthat did not apply for foodstamps because they thoughtthey were not eligible, 131(50%) were probably eligiblefor program benefits, and 140of them (53%) were hungry orat-risk of hunger.

Of all the households sur-veyed, 676 (29%) had applied forfood stamp benefits but were notcurrently receiving them.Households gave multiple rea-sons for not receiving foodstamps. The most frequentlycited reasons were that house-holds did not qualify for foodstamps at the time of application(51%), their benefits had stopped(30%) or they no longer neededbenefits (24%). Of the 204

households who said their bene-fits had stopped. 150 (74%)were probably still eligible. Ofthe 158 households who saidthat they no longer needed foodstamps, 101 (64%) were proba-bly still eligible for programbenefits and more important,106 (67%) were hungry or at-risk of hunger.

These findings indicate thatlack of information is a key fac-tor inhibiting householdparticipation in the food stampprogram among those who werelikely to be eligible and in needof program benefits. This wasprobably exacerbated becausethe federal government elimi-nated the requirement thatstates conduct outreach activi-ties in 1981 and banned the useof federal funds for that purpose.Although federal matching fundsfor outreach were restored in1988, relatively few states cur-rently conduct active outreachprograms.

Past research on food stampnon-participation has found poorinformation regarding eligibilityto be one of the main barriers.In fact, a 1986 GovernmentAccounting Office review of non-participation, concluded that"...no other factor had thesweeping impact on non-partici-pation as did poor informationconcerning eligibility status."

The CCHIP findings on barri-ers to participation corroboratesearlier research on this matterand points to the need for ade-quate outreach if hunger is to bereduced by increasing participa-tion in the Food Stamp Program.

What Changes in the Food Stamp

45

Program Are Needed to ReduceChildhood Hunger?

We have analyzed food stampparticipation among CCHIP sur-vey households in order to betterunderstand what changes in thisprogram would increase the foodpurchasing power of participat-ing families with children.Because of eligibility require-ments, we have limited theseanalyses to households withgross incomes at or below 130percent of poverty. Table 3.2presents the hunger and foodstamp participation characteris-tics of households with grossincomes at or below 130 percentof poverty. Among these house-holds, 36 percent were hungryand an additional 38 percentwere at-risk of hunger. Takentogether, almost three-quartersof these households had experi-enced at least one problem withfood availability due to con-strained resources.

Of the 1,826 households withchildren under age 12 and withincomes at or below 130 percentof poverty interviewed in theCCHIP surveys, 98 percent ofthe households met both thegross and net income eligibilityrequirements for food stamps.However, there were only 62 per-cent of the households who wereparticipating in the Food StampProgram at the time of the sur-veys. This figure is in line withestimates on the participationrate among eligibles projected bythe Congressional Budget Office(41% to 58%) and by the U.S.Department of Agriculture (58%to 60%) in 1988.8

On average, households withincomes at or below 130 percent

23

24

Table 3.2Hunger and Food Stamp Participation Characteristics

Among Households with Incomes Below 130% Poverty(All Survey Sites)

Number of Households = 1,826

HOUSEHOLDS WITH INCOMESCHARACTERISTIC BETWEEN 0-130% POVERTY

% Hungry 36.4%

% At-Risk 38.3%

% Eligible for food stamps 98.196

% Participating in theFood Stamp Program 62.3%

Value of current foodstamp benefits per household S182.28

Food expenditures as percentof Thrifty Food Plan 77.6%

Percent of maximum benefitsreceived 52.0%

Percent receiving maximumallotment of food stamp benefits 11.3%

Percent with shelter costsexceeding shelter share 66.0%

Percent with shelter costsexceeding shelter shareby more than the applicableshelter cap 34.9%

43'

of poverty were receiving 52 per-cent of the maximum benefitlevel. Approximately 11 percentof the participating householdswere receiving the maximumfood stamp benefit. The averagedollar value of benefits perhousehold was $182 per month.

Under current regulations,food stamp benefit levels takeinto account amounts spent onshelter costs in excess of 50 per-cent of a household's adjustedincome. Net income isdecreased by the amount of thecost of shelter that exceeds 50percent of adjusted income up toa predetermined cap. Benefitlevels are determined based onnet income. Of the CCIIIP sur-vey households with grossincomes at or below 130 percentof poverty, 66 percent spentmore than half of their adjustedincome on shelter costs.Furthermore, in over a third(35%) of these households, theamount spent on shelterexceeded 50 percent of theiradjusted income by an amountgreater than the applicable cap.Since the high cost of housing isone of the major factors con-straining food purchases, moreresources would be available forfood if the shelter cap wereremoved.

11 hat is the ,SpecialSupplemental FoodProgram for Killen. Infantsand Children (11-10%

WIC is a nutrition programthat provides supplemental,

nutritious foods, nutrition edu-cation and access to health carefor low-income women, infantsand children at nutritional risk.The program's goal is to preventhealth problems by enhancingthe nutritional status of its tar-get population, who are athigher nutritional risk due to thephysiological demands of preg-nancy and lactation (women) orgrowth (infants and children).The federal government grantsfunds to state health depart-ments, which in turn fund localsponsors to operate the program

usually local health clinicsand hospitals.

The WIC Program is not anentitlement program. Instead,there is a "cap" on the amountof federal money allocated toWIC, which limits considerablythe number of eligible peoplewho can participate in the pro-gram. In fiscal year 1991,program funds supported theparticipation of only 4.7 millionor about half of all eligiblewomen, infants and children. Inorder to participate in the pro-gram, women must apply forthemselves or their children atthe local health agency that pro-vides WIC services. Eligibilityfor WIC includes three compo-nents: one must be pregnant ora new mother, an infant, or achild under the age of five;household income must bebelow a level set by the statehealth department (between 100and 185 percent of the povertylevel); and the potential partici-pant must be certified as beingat nutritional risk by a healthprofessional.

Most WIC food benefits comein the form of vouchers that can

4"

be exchanged for particularfoods at the grocery store.These foods are specifically cho-sen to meet the dietary needs oflow-income mothers, infants andchildren. The foods containnutrients which have beenfound to be lacking in the dietsof low-income families, andwhich are important duringthese critical periods of growthand development. They includeinfant formula, infant cereal,milk, eggs, cheese, breakfastcereal, juice, dried beans andpeanut butter. The value of thepackage on a monthly basisaverages around $30. WIC alsorefers mothers and their chil-dren to medical care and offersmothers nutrition education.

What were the Characteristics ofWIC Participants in CC1HPSurveys?

We present a profile of somesalient characteristics of familieswho participated in the WICProgram. Of the 2,335 low-income families interviewed inseven sites across the UnitedStates, 560 (24%) received bene-fits from the WIC Program, 690(30%) were not receiving bene-fits even though they wereincome and categorically eligible(pregnant, postpartum or breast-feeding women, infants orchildren under age five), and1,085 (46%) were not eligible forbenefits from the WIC Program.This means that of the 1,250families who were categoricallyand income eligible for the WICProgram, 45 percent werereceiving its benefits. Theremainder of this discussion willfocus on the 560 families whowere participating in the WICProgram. (See Figure 3.2)

25

Figure 3.2WIC Program Participation Rates (All Sites)

46%

26

Participating

in Eligible not Participating

111 Not Eligible

Characteristics of WIC partici-pants are presented in Table 3.3.As seen in this table, WIC parti-cipants had an average monthlygross per capita income of $185,which was 76 percent of the fed-eral poverty level.

Families who receive WICbenefits spent 39 percent of theirgross income including foodstamps and WIC benefits onfood. This amounts to approxi-mately S70 per person permonth for food.

More than three-fourth,- (76%)of WIC participants also partici-pated in the Food StampProgram. All WIC participantswith school age children partici-pated in the School LunchProgram while just over half(52%) participated in the SchoolBreakfast Program and only aquarter (25%) participated in theSummer Food Service Programfor Children.

Fifty-eight percent of WIC par-ticipants said that they must relyon friends and relatives for food.money for food and meals.Almost half (48%) of the familiesparticipating in the WIC Programsupplemented their foodresources by getting food fromsoup kitchens, food pantries orother commodity distributioncenters.

Almost a third (31%) of fami-lies participating in WIC werehungry.

What were the Barriers to theIfle Program%

Of the 2.335 families inter-viewed in the seven CCHIPsurveys, 436 families have neverapplied for WIC benefits. The

most commonly cited reason fornot applying for WIC benefits isthat families did not think thatthey were eligible for programbenefits (58%). Of these house-holds who did not apply for WICbenefits because they did notthink they were eligible to par-ticipate, 81 (33%) were likely tobe categorically and income eli-gible.

Of the 2,335 families inter-viewed, 1,002 (43%) had appliedfor WIC in the past, but did notcurrently receive program bene-fits. The most common reason(76%) given for not currentlyreceiving benefits was that theirchildren were too old to partici-pate in the WIC program. Ofthose who gave this as a reasonfor not currently participating inWIC, 165 (22%) had at least onechild under five years of age andfive (0.7%) had at least one childunder one year old. The secondmost common reason (28%)given by parents for not partici-pating in WIC was that theirchildren do not need the bene-fits. Of those not participatingbecause they said that they nolonger needed the program 80(29%) were hungry and 118(43%) were at-risk of hunger. Ofthe persons who had applied inthe past but did not currentlyparticipate (10%) because theydid not think that they were eli-gible, 51 (53%) were probablyincome and categorically eligiblefor WIC benefits. It wouldappear that there is some misun-derstanding among thesefamilies concerning the criteriaused to determine eligibility forWIC program benefits.

As previously stated, approxi-

4

mately 55 percent of the categor-ically and income eligiblefamilies interviewed in CCHIPsurveys were not receiving pro-gram benefits. This finding issimilar to estimates of WIC eligi-bility made by the U.S.Department of Agriculture(USDA) in 1987. In its study"Estimation of Eligibility for theWIC Program," USDA revealsthat only half of those estimatedto be fully eligible are beingserved.' Funding constraints arethe major barrier to serving ahigher proportion of the eligiblepopulation.

Most important from theCCHIP findings, of those eligiblebut not receiving WIC benefits,31 percent were hungry, andthus presumably at dietary riskand in need of the program ben-efits.

What is the Xational SchoolLunch Program?What is the SchoolBreakfast Program?

The purpose of the NationalSchool Lunch Program, accord-ing to the National School LunchAct, is "to safeguard the healthand well-being of the Nation'schildren...by assisting states,through grants-in-aid and othermeans, in providing an adequatesupply of foods and other facili-ties for the establishment,maintenance, operation, andexpansion of nonprofit school-lunch programs." On avoluntary basis, local schoolhoards contract with their state

17

28

Table 3.3Characteristics of WIC Participants

Number of Households = 560

ECONOMIC


Household monthly gross per capita income $ 184.79

Shelter share 51.8%

Per capita food expenditure per month $70.39

Food share 39.2%


SOCIODEMOGRAPHIC


High school graduate Respondent 52.4%

Household size 5.0


Participation in Food Stamp Program 76.3%






HUNGER PROBLEM 30.9%

5,,

education agencies to operatelunch programs. The federalgovernment pays for most of thecost of operating the lunch pro-gram at the local level. In turn,the schools must meet specificnutritional requirements in thelunches they provide to partici-pating students.

The National School LunchProgram is an entitlement pro-gram, which means that allschools that apply and meet theprogram's eligibility criteria mayparticipate in the program. Allpublic and nonprofit privateschools can participate in thelunch program, and all studentsin participating schools are eligi-ble for the program. Householdincome of the student deter-mines whether a child will pay asubstantial amount of the cost oftheir lunch or will receive areduced-price or free meal. Toreceive a reduced-price meal,the household income must bebelow 185 percent of the povertylevel, and for free meals, it mustfall below 130 percent. In orderto receive free or reduced-pricemeals, families must fill out anapplication provided by theschool which includes questionsabout the total income of thehousehold. About half of the 24million students participating inthe lunch program nationallyreceive free and reduced-pricemeals.

The purpose of the SchoolBreakfast Program is to providestates with funds for the opera-tion of nonprofit schoolbreakfast programs, "in recogni-tion of the demonstratedrelationship between food andgood nutrition and the capacity

of children to develop andlearn...." Like the lunch pro-gram, it is operated by schoolboards who voluntarily contractwith their state education agen-cies to receive federal funds forthe operation of breakfast pro-grams. Like school lunch, thebreakfasts served in this programmust meet specific nutritionalstandards. The breakfast pro-gram is also an entitlementprogram, and has the same eligi-bility criteria as the lunchprogram for schools and stu-dents. Most children whoparticipate in the breakfast pro-gram are low-income. However,less than half of the schools thatparticipate in the lunch programalso have a breakfast program,and less than one-third of thechildren receiving free andreduced-price lunches alsoreceive free and reduced-pricebreakfasts.

What were the Characteristics ofthe Households Whose ChildrenParticipated in the School LunchProgram?

We present some characteris-tics of households whosechildren participated in theSchool Lunch Program (Table3.4). Of the 2,129 householdsinterviewed who had school-agechildren, 1,895 (89%) partici-pated in school lunch and 234(11%) did not receive schoollunch.

Households that had childrenwho participated in the SchoolLunch Program had an averagegross monthly income per per-son of 5208, ave:aging 84percent of the federal povertylevel.

Among families whose chil-dren participated in the SchoolLunch Program, 63 percent alsoparticipated in the Food StampProgram and 46 percent receivedbenefits from the WIC Program.

Less than half of the childrenwho participated in school lunchalso received school breakfast(46%). Twenty-six percent ofchildren who received schoollunch participated in theSummer Food Service Programfor Children.

Thirty-six percent of familieswhose children received schoollunch were hungry.

Every household with school-aged children had a least onechild participating in the SchoolLunch Program. While all of thechildren from CCIIIP surveyhouseholds were eligible for freeor reduced-price meals, sevenpercent of those receivinglunches were not receiving theirmeals free or at a reduced price.

What were the Characteristics ofHouseholds if hose ChildrenParticipated in the SchoolBreakfast Program?

1,Ve present some characteris-tics of households whosechildren participated in theSchool Breakfast Program (Table3.5). Of the 2,129 householdswith school-age children inter-viewed, 875 (41%) participatedin school breakfast, 1,255 (59%)did not receive them.

Households with children whoparticipated in the SchoolBreakfast Program had an aver-age gross monthly income perperson of $185, which is 76 per-cent of the poverty level. It

19

Table 3.4Characteristics of School Lunch Participants

Number of Households = 1,895

ECONOMIC



Shelter share 51.8%

Per capita food expenditure month $60.90

Food share 31.8%


SOCIODEMOGRAPHIC


High school graduate - Respondent 53.4%

Household size 4.8









J4#

30

Table 3.5Characteristics of School Breakfast Participants


ECONOMIC



Shelter share 52.5%


Food share 36.0%


SOCIODEMOGRAPHIC



Household size 5.0









r31

would appear, then, that manyschool breakfasts were served tothe poorest children. In fact, vir-tually all of the children in theCCHIP surveys who participatedin the School Breakfast Programreceived free or reduced-pricebreakfasts.

Among families whose chil-dren participated in the SchoolBreakfast Program, 65 percentalso participated in the FoodStamp Program and 55 percentreceived benefits from the WICProgram.

Every child in the CCIIIP sur-veys who participated in theSchool Breakfast Program alsoparticipated in the Se Lool LunchProgram. Thirty-three percent ofchildren who got school break-fast also participated in theSummer Food Service Programfor Children.

Thirty-nine percent of familieswhose children received schoolbreakfast had a hunger problem.Children who participated in theSchool Breakfast Program needits benefits. Unfortunately, ofthe 58 percent of those familieswho did not receive schoolbreakfast, nearly one third (30%)were hungry.

What were the Barriers toPa ticipation in the SchoolBr: akfast Program AmongEligibles?

At least 1.255 (59%) of theCCIIIP households with school-aged children were not receivingschool breakfast. The primaryreason given for not participatingwas that the school did not spon-sor the program (45%) and 17percent (in states where therewas a program) had not heard of

32

the program; an additional sixpercent were unaware of theireligibility for free or reduced-price meals. Eight percent saidtheir children didn't like the foodand 11 percent stated that theirchildren arrive at school too lateto participate.

When comparing participationdifferences in the two schoolmeal programs, availability wasthe main factor. Fewer than halfof the children receiving schoollunches also received schoolbreakfasts (46%). For householdswith school-age children not par-ticipating in the School BreakfastProgram, by far the most com-monly mentioned barrier wasthat their school did not offer theprogram.

What is the Impact of SchoolMeal Participation?

Having access to both of theschool meal programs appears tohave a number of benefits forschool children. The NationalSchool Lunch Program and theSchool Breakfast Program oftenprovide the best meal of the dayfor low-income children. A U.S.Department of Agriculture studyshows that these children receiveone-third to one-half of theirdaily nutrient intake from schoollunch. iu

Those children in the CCHIPsurveys who were eating bothschool breakfast and lunch weresignificantly less likely to sufferfrom problems usually associ-ated with low energy reserves(fatigue. irritability and inabilityto concentrate) in the sixmonths prior to the survey thanthose who were getting schoollunch only. As shown in Chapter1, hungry children were more

5

likely to suffer from specifichealth problems than childrenfrom non-hungry families andchildren who report a specifichealth problem were more likelyto be absent from school thanthose not reporting specifichealth problems.

Participation in the SchoolBreakfast Program, specifically,carried with it benefits for chil-dren of families in the CCIIIPsurveys. Children were lesslikely to have increased schoolabsences if they got breakfast atschool compared with thosechildren who did not get break-fast at school. In addition,children who were at-risk ofhunger had fewer days absentwhen they got breakfast atschool versus not getting itthere.

'that is the Summer FoodSerrice Program for('hildreii

The Summer Food ServiceProgram for Children providesmeals to low-income childrenduring the summer months whenschool is not in session and theschool meals programs are notavailable. Sponsors of the pro-gram at the local level contractwith their state education agencyor the federal government toreceive federal funds for theoperation of a nonprofit summermeals program for children inlow-income areas. Sponsorsmust serve meals that meet spe-cific nutritional requirements.

The Summer Food Program is

an entitlement program alleligible sponsors approved by thestate education agency may par-ticipate, and all childrenattending a Summer FoodProgram site are eligible to par-ticipate in the program. Eligiblesponsors include public or pri-vate nonprofit schools; units oflocal, municipal, county or stategovernment; and certain privatenonprofit organizations, such asBoys' Clubs, churches, andYMCAs. In order to operate theSummer Food Program, sponsorsmust locate program sites inareas with majority representa-tion by low-income children, ormust enroll a majority of chil-dren who are low-income. Allmeals are free to participatingchildren, regardless of householdincome. According to the U.S.Department of Agriculture, lessthan two million children partic-ipate in the Summer FoodProgram, compared to almost 12million low-income children par-ticipating in the National SchoolLunch Program during theschool year."

What were the Characteristics ofParticipants in the Summer FoodService Program for Children %

In Table 3.6, we present somecharacteristics of householdswhose children participated inthe summer food program. Of the2.335 households interviewed,519 (22%) participated in theSummer Food Service Programfor Children, and 1,816 (78%) didnot participate in the program.

households who had childrenparticipating in the summer foodprogram had an average grossmonthly income per person of8182. This is an average income

of 74 percent of the federalpoverty level.

Seventy-one percent of sum-mer food program participantsalso participated in food stamps,59 percent participated in WIC,57 percent got school breakfastand all of them received a schoollunch.

Thirty-seven percent of thosewho receive meals from theSummer Food Service Programfor Children were hungry. Manyof the children who receive thesemeals were needy; more distress-ing, however, is the unmet need.Of the 78 percent of familieswho did not participate in theSummer Food Service Program.nearly one-third (31%) werehungry.

What were the Barriers toParticipation in the SummerFood Service Program forChildren %

Of the 2,335 households inter-viewed in the CCHIP surveys,1,258 (54%) had not heard of theSummer Food Service Programfor Children. Of those who hadheard of the program, 519 (48%)were participating in the programbut this was less than a quater(22%) of the total sample.

Lack of knowledge of theSummer Food Service Programfor Children is compounded bythe lack of availability of the pro-gram. In fiscal year 1990, theSummer Food Service Programfor Children served meals to1.65 million children in 18,459sites.'' In comparison, theSchool Lunch Program servedfree and reduced-price meals to11.5 million children in 91,440schools.

Among households in theCCHIP surveys who had heard ofthe program but whose childrenwere not participating, 43 per-cent attributed their lack ofparticipation to no local programor difficulties accessing the pro-gram (includes site inconve-nience, scheduling and trans-portation difficulties).

Of the 2,052 who had neverheard of or did not participatein the Summer Food Program atall 1,310 (64%) were hungry orat risk of hunger, and thereforeexperiencing household foodshortages due to constrainedresources.

If fiat is the Impact ofFederal Food AssistanceProgram Participation onHunger?

To explore the impact of fed-eral food assistance programparticipation on hunger, we com-pare two sites that are similar inmany respects, but that differ sig-nificantly in the rates ofparticipation in these programs.Table 3.7 shows socio-economicand program participation results,comparing Sumter County,Alabama and Polk County,Florida. Both are Southern andpredominantly rural.

As is evident in Table 3.7 theyshare other characteristics, aswell. In both samples averagehousehold size was nearly thesame (4.8 for Sumter County,4.6 for Polk County), as was theaverage number of children (2.9for Sumter County, 2.8 for Polk

33

Table 3.6Characteristics of Summer Food Service Program Participants


ECONOMIC



Shelter share 49.1%


Food share 34.6%


SOCIODEMOGRAPHIC



Household size 4.8









34

Table 3.7Comparison of Program Participation and Hunger Differences

at CCHIP Survey Sites in Sumter County, Alabamaand Polk County, Florida

Sumter County,Alabama

Polk County,Florida

Number of Households 358 274

SOCIOECONOMIC

Income as percent of poverty 70% 87%

Female-headed householdsa 43% 38%

Number of persons in households 4.8 4.6

Number of childrena 2.9 2.8

PROGRAM PARTICIPATION RATES

Food Stamp Program 67% 39%

WIC Program 77% 34%

School Lunch Program 100% 94%

School Breakfast Program 91% 44%

HUNGER RATES

Percent hungry 28% 32%

Percent at-risk of hungers 31% 37%

Days per month hungry 10.7 19.3

Days per month hungry or at risk 8.4 16.5

Note: All comparisons are statistically significant at the p < 0.01 level unless otherwise indicated by a.

These findings indicate that lack of information is a key factor inhibiting household participation in the FoodStamp Program among those who were likely to be eligible and in need of program benefits.

The high cost of housing was one of the major factors constraining food purchases: 66 percent spent morethan half of their adjusted income on shelter costs. Furthermore, in over a third of these households, theamount spent on shelter exceeded the amount taken into account when food stamp benefits were deter-mined. Since the high cost of housing is the major factor constraining resources for food, more resourceswould, therefore, be available if the shelter cap were removed.

35

County). Household composi-tion is also similar; about 40percent of the families in eachsite's sample were headed by sin-gle-mothers. The mainsocioeconomic difference is thatthe Alabama families were signif-icantly poorer, on average, thantheir Florida counterparts(incomes averaged 70% of thepoverty level in Sumter County,Alabama and 87% of the povertylevel in Polk County, Florida).

From Table 3.7 it is evidentthat participation rates for fed-eral food assistance programswere significantly higher in theAlabama site than in the Floridasite. Indeed, participation rateswere twice as high in SumterCounty, Alabama than in PolkCounty, Florida for WIC (77%versus 34%), school breakfast(91% versus 44%), and nearlytwice as high for food stamps(67% versus 39%).

Did the higher participationrates in Alabama affect hunger?The Alabama families experi-enced nearly half as many daysper month hungry (10.7) thandid the Florida families (19.3),and almost half as many days permonth hungry or at risk ofhunger (8.4 days) than did theFlorida families (16.5 days).Both of these differences are sta-tistically significant.

The hunger and at-risk ofhunger rates in Sumter County,Alabama are slightly lower thanPolk County, Florida, but the dif-ference is not statisticallysignificant. Apparently, thehigher participation levels in theAlabama sample are not accom-panied by a significantly lowerextent of hunger there, which is

36

not surprising given the greaterlevel of poverty in the Alabamasample. However, the averagemonthly duration of hunger orthe risk of hunger is just half aslong for those experiencing it inthe Alabama sample than in theFlorida sample.

Summan.

The Food Stamp Program

Findings from CCIIIP surveysshow that among 1,922 house-holds that were income eligiblefor the Food Stamp Program,1,214 (63%) were receiving pro-gram benefits. The averageincome of participating house-holds was at 68 percent of thefederal poverty level. Monthlyfood expenditures of Food StampProgram participants, includingcash, food stamps and the valueof WIC benefits averaged justunder 80 percent of the value ofthe Thrifty Food Plan.

Results from the U.S.Department of Agriculture'sNational Food ConsumptionSurvey showed that only 12 per-cent of individuals purchasingfood valued at the equivalent of[100% of] the Thrifty Food Planwere eating diets that met theU.S. Recommended DietaryAllowances. Since food stampparticipants in the CCHIP sur-veys spent less than that only80 percent of the value of thisplan they are most likely atnutritional risk. In fact, approxi-mately 40 percent of householdsparticipating in the Food StampProgram were hungry. Sincefood stamp participants tend to

5

be among the poorest house-holds, program benefits did notfully compensate for the eco-nomic shortfalls of theseparticipating households. Whileprogram benefits alleviate foodshortages, receiving food stampbenefits did not, in itself, elimi-nate hunger.

Among the 1,922 householdsthat appeared to be income eligi-ble, 708 (37%) were not receivingfood stamp benefits. Of the2,335 households interviewed inthe CCHIP surveys, 406 house-holds (17%) had never applied forfood stamp benefits. The mostcommonly given reason for notapplying was that the respondentdid not believe the household tobe eligible (65%). Of the 263households that did not applyfor food stamps because theythought they were not eligible,131 (50%) were probably eligi-ble for program benefits. and140 of them (53%) were hungryor at-risk of hunger.

Of all the households sur-veyed, 676 (29%) had applied forfood stamp benefits but were notcurrently receiving them. Themost frequently cited reasons fornot receiving were that house-holds said they did not qualify forfood stamps at the time of appli-cation (51%), their benefits hadstopped (30%) or they no longerneeded benefits (24%). Of the204 households who said theirbenefits had stopped. 150 (74%)were probably still eligible. Ofthe 158 households who saidthat they no longer needed foodstamps, 101 (64%) were proba-bly still eligible for programbenefits and more important,106 (67%) were hungry or at-risk of hunger.

The Special Supplemental FoodProgram for Women. Infants andChildren (WIC)

Of the 1,250 families thatwere categorically and incomeeligible for the SpecialSupplemental Food Program forWomen, Infants and Children(WIC), 560 (45%) were receivingprogram benefits. WIC Programparticipants had incomes thataveraged 76 percent of the fed-eral poverty level.

Almost a third (31%) of fami-lies participating in WIC werehungry.

Approximately 55 percent ofthe categorically and income eli-gible families interviewed inCCHIP surveys were not receiv-ing program benefits. Thisfinding is similar to estimates ofWIC eligibility made by the U.S.Department of Agriculture(USDA) in 1987. In its study`Estimation of Eligibility for theWIC Program," USDA revealsthat only half of those estimatedto be fully eligible are beingserved.

Most important from theCCHIP findings, of those eligi-ble but not receiving WICbenefits. 31 percent were hun-gry, and thus presumably atdietary risk and in need of theprogram benefits.

The WIC Program is not anentitlement program. Instead,there is a "cap" on the amount offederal money allocated to WIC,which limits considerably thenumber of eligible people whocan participate in the Program.For WIC to function as a preven-tive nutrition program, it wouldhave to he funded at levels where

all those who need program ben-efits can receive them.

The National School Lunch andSchool Breakfast Programs

Of the 2,129 households inter-viewed who had school-agechildren, 1,895 (89%) partici-pated in school lunch, and 234(11%) did not receive schoollunch.

Households that had childrenwho participated in the NationalSchool Lunch Program hadincomes. averaging 85 percent ofthe federal poverty level.

Thirty-six percent of familieswhose children receive schoollunch were hungry.

Of the 2,129 households withschool-age children interviewed,875 (41%)_participated in schoolbreakfast, and 1,055 (59%) didnot receive school breakfast.

Households that had childrenwho participated in the SchoolBreakfast Program had incomesthat averaged 76 percent ofpoverty. It would appear, then.that many school breakfasts areserved to the poorest children.In fact, virtually all of the chil-dren in the CCHIP surveys whoparticipated in the SchoolBreakfast Program received freeor reduced-price breakfasts.

Thirty-nine percent of fami-lies whose children receivedschool breakfast had a hungerproblem, indicating that chil-dren who participated in theSchool Breakfast Program needits benefits.

Less than half of the childrenwho participated in schoollunch also received school

5 ;7)

breakfast (46%). Studies showthat participation in the SchoolBreakfast Program results in sig-nificantly higher achievementtest scores compared to low-income children who are notparticipating in school breakfast.Yet today, less than half of theschools offering lunch also oper-ate a breakfast program.

The CCHIP data on programavailability parallel nationalstudy findings. While there isbroad coverage of the SchoolLunch Program, the majority ofhouseholds (59%) did not partici-pate in the School BreakfastProgram. The overwhelmingmajority of those who did notparticipate in the SchoolBreakfast Program attributedtheir non-participation to thefact their children's school didnot sponsor the School BreakfastProgram.

Approximately one-third ofthose families who did not par-ticipate in the School BreakfastProgram were hungry; presum-ably, their children wouldbenefit from eating breakfast atschool.

Indeed, since children whowere eating both school break-fast and lunch were significantlyless likely to suffer from prob-lems usually associated with lowenergy reserves (fatigue, irri-tability and inability toconcentrate) in the six monthsprior to the survey than thosewho were getting school lunchonly, we can confidently con-clude that the hungry childrenwho did not have access to theprogram would benefit from it aswell. Society may also benefitfrom the provision of school

37

breakfast since school atten-dance was improved whereschool breakfast was provided.

The Summer Food ServiceProgram for Children

Of the 2,335 households inter-viewed, 519 (22%) participatedin the Summer Food ServiceProgram for Children, and 1,815(78%) did not participate in theprogram.

Thirty-seven percent of thosewho receive meals from theSummer Food Service Programfor Children were hungry.Although many of the childrenwho received these meals wereneedy, more distressing is theunmet need. Of the 78 percentof families who did not partici-pate in the summer foodprogram, nearly one third werehungry.

Of the 2,335 households inter-viewed in the CCHIP surveys,1,258 (54%) had not heard of theSummer Food Service Programfor Children. Of those who hadheard of the program, 519 (48%)were participating in the pro-gram, which was less than aquarter (22%) of the total sam-ple.

Of the 2.052 who had neverheard of or did not participatein the Summer Food Program atall, 1.310 (64%) were hungry orat risk of hunger and thereforeexperiencing household foodshortages due to constrainedresources.

Lack of knowledge of theSummer Food Service Programfor Children is compounded bythe lack of availability of the pro-gram. In fiscal year 1990, theSummer Food Service Program

38 6 ;)

for Children served meals to1.65 million children in 18,459sites. In comparison, the SchoolLunch Program served free andreduced-price meals to 11.5 mil-lion children in 91,440 schools.

A comparison of two sites thatwere similar in many respects,but differed significantly in ratesof food assistance program par-ticipation, provided anindication of the impact of theseprograms. Respondents in theCCHIP survey of Sumter County,Alabama were twice as likely toparticipate in WIC, food stampsand school breakfast than weretheir counterparts in the PolkCounty, Florida sample. TheAlabama families experiencedalmost half as many days permonth hungry or at-risk ofhunger than did the Florida fam-ilies.

_. - 11,

.

...2faggia

Chapter 4Emergency Food Programs

ntroductionIn the early 1980s, as the

economy slipped into a reces-sion and the federal governmentretreated from its support of fed-eral food assistance programs,the private sector came forwardto assist those neighbors whowere not able to adequately feedthemselves and their families.Two forms of feeding programs,already in existence in verysmall numbers, expanded expo-nentially in response to the need

soup kitchens and foodpantries.

Soup kitchens generally servemeals to persons who seek theirassistance. Food pantries giveout packages of donated food.Because all of the families in theCCHIP surveys had a home andpresumably had facilities to pre-pare meals, they were muchmore likely to seek assistancefrom food pantries than soupkitchens.

Drawing on information fromthe CCIIIP surveys, in this chap-ter we depict characteristics ofthose who get meals at soupkitchens and those who get foodfrom food pantries. We alsocompare rates of reliance onemergency food programs torates of federal food assistanceprogram participation. We con-clude by discussing the reia-tionship between usage of emer-gency food programs andhunger.

What were theCharacteristics of SoupKitchen Users?

First, in Table 4.1 we presentsome characteristics of house-holds who relied on soupkitchens for meals. Of the 2,335households interviewed, 162(7%) went to soup kitchens formeals, while 2,173 (93%) did notuse soup kitchens.

Families who go to soupkitchens for meals had an aver-age gross monthly income perperson of 5186. This puts theiraverage incomes at 75 percent ofthe federal poverty level.

These very low-income house-holds spent an average of 84percent of their gross incomes(including food stamps and WIC)on food and shelter costs, withshelter costs alone consumingover half of their income.

Forty-three percent of respon-dents from households who visitsoup kitchens had a high schooldegree. One-fourth of soupkitchen users had at least onefull-time employee, while two-thirds received AFDC benefits

Soup kitchen users had anaverage family size of 4.7 per-sons. Slightly more thanthree-fourths (76%) of house-holds going to soup kitchensreceived food stamps, while justover half (51%) participated inthe WIC program. Ninety-six

41

42

Table 4.1Characteristics of Soup Kitchen Users


ECONOMIC FACTORS



Shelter share 53.4%


Food share 30.3%


SOCIODEMOGRAPHIC

At least one person employed full time 25.3%


Household size 4.7




Receive Free or Reduced-Price School Breakfast 40.7%

Receive Free or Reduced-Price School Lunch 96.3%




by

percent of families who usesoup kitchens received free orreduced-price school lunch fortheir school-age children. Farfewer, just 41 percent, receivedfree or reduced-price schoolbreakfast and fewer yet, only 28percent, received meals fromthe Summer Food ServiceProgram for Children.

More than three-fourths(77%) of households who availthemselves of meals at soupkitchens relied on friends andrelatives to increase their foodresources.

Of those households who goto soup kitchens. 67 percentwere hungry.

What were theCharacteristics of FoodPantrr Users?

Next we present some charac-teristics of households whorelied on food pantries toincrease their food resources.These are displayed in Table 4.2.Of the 2,335 households inter-viewed, 877 (38%) used foodpantries and 1,458 (6296) did notuse food pantries.

Households going to foodpantries had a monthly grossincome per person of 8186.Expressed in terms of poverty,their incomes were at 74 per-cent of the poverty level, onaverage.

Households using foodpantries spent over half (55%) oftheir income on shelter costsand an additional one-third of

their income (including foodstamps and WIC) on food expen-ditures.

Approximately half of allrespondents from householdswho visit food pantries had ahigh school degree. Thirty-onepercent of food pantry users hadat least one full-time employee,and 62 percent received AFDCbenefits.

The average household size offood pantry users was 4.6 mem-bers. Slightly more than three-fourths (76%) of families thatget food from food pantries par-ticipated in the Food StampProgram; 55 percent partici-pated in the WIC Program; 98percent got free or reduced-price school lunch, 49 percentreceived free or reduced-priceschool breakfast and only 31percent received summer foodprogram meals. These findingssuggest that they supplementedthe benefits of public assistanceprograms with private emer-gency services in an attempt tobalance the dietary require-ments of their families with thescant resources they had to pur-chase food.

Sixty-seven percent of fami-lies using food pantries relied onfriends and relatives for foodand money for food. however,after turning to all availablesources, nearly half of the foodpantry users still suffered fromfood insufficiency. Forty-fivepercent of households gettingfood at food pantries were hun-gry.

L..

How Does Participation inFood Stamps Compare withReliance on Emergent~Food Programs?

Programs such as soupkitchens and food pantries weredevised as short-term strategiesto meet emergency food needs ofpeople in crisis. The programswere not designed to meet theon-going food needs of low-income families. Nonetheless,during the past five to ten years,demand for emergency food hasbeen so great that these emer-gency food distribution measureshave become virtually institu-tionalized. In the process, manyemergency food providers havebecome overwhelmed by thedemand for their services.

Inundated by increased need,some service providers haveexpressed concern that low-income families may be relyingon food pantries and soupkitchens for assistance instead ofusing federal food assistance pro-grams for which they are eligible.To examine whether low-incomefamilies have been substitutingfederal assistance with relianceon private charity or whetherthey have been supplementingtheir food resources by turningto federal programs as well asemergency food providers, weuse information from theCalifornia CCIIIP survey con-ducted in four counties of theCentral Valley.

Table 4.3 compares urbanrespondents (126 households)with rural respondents (203households) from the four-county California survey. Both

43

44

Table 4.2Characteristics of Food Pantry Users


ECONOMIC FACTORS



Shelter share 55.3%


Food share 32.5%


SOCIODEMOGRAPHIC FACTORS



Household size 4.6



Participation in WIC 55.296

Receive Free or Reduced-Price School Breakfast 48.7%

Receive Free or Reduced-Price School Lunch 98.4%




b5

Table 4.3Comparison of Rural with Urban Respondants in the California CCHIP Site

Urban Respondents(126 households)

Rural Respondents(203 households)

SOCIOECONOMIC

Income as percent of povertya 86% 83%

Female head of household' 21% 18%

Number of persons in household' 5.5 5.5

Number of children" 3.5 3.3

PROGRAM USAGE

Food stamp participants 72% 43%

Emergency food programs 19% 46%

Note: All comparisons are statistically significant at the p < 0.01level unless otherwise indicated by ".

45

subsamples are quite similar interms of socioeconomic charac-teristics. Urban and ruralrespondents had similar incomelevels (incomes were 86% and83% of poverty), household com-positions (21% and 18% ofhouseholds were headed by sin-gle-mothers), household sizes(5.5 persons in each) and num-ber of children in the family (3.5and 3.3).

The main differences betweenthe urban and rural subsamplesfrom the California CCHIP sur-vey are in program usage.Compared with urban respon-dents, rural respondents weresignificantly less likely to partici-pate in the Food Stamp Programand significantly more likely torely on emergency food pro-viders (soup kitchens, foodpantries or other commodity dis-tribution centers).

Figures 4.1 and 4.2 graphicallydisplay the differences in pro-gram usage. Figure 4.1 depictsrates of participation in the FoodStamp Program and rates ofreliance on emergency foodproviders by various poverty lev-els for the 126 urban respondentsfrom the California CCHIP sur-vey; Figure 4.2 does the same forthe 203 rural respondents.

Looking at Figure 4.1, itappears that urban respondentswere not relying on emergencyfood providers instead of foodstamps. Rather, they were sup-plementing their food resourcesby going to emergency food cen-ters. Participation in foodstamps, as would be expected, isclosely associated with incomelevel food stamp participationrates were smaller when family

46

income was higher. However,rates of reliance on emergencyfood providers, while lower thanfood stamp participation rates,changed very little with levels ofincome.

Figure 4.2 demonstrates a dif-ferent pattern for the ruralsubsample. In the rural areas ofthe four-county Central ValleyCCHIP site in California, rates ofreliance on emergency food dis-tribution centers were higherthan food stamp program partici-pation rates for all levels ofincome. Rural respondents doappear to be using private assis-tance rather than public assis-tance.

It is striking that in ruralareas, where families were usingprivate rather than public assis-tance, 77 percent of householdswere either hungry or at-risk ofhunger, while in urban areas,where families were supplement-ing public with private assis-tance, a much smaller percent-age of households 57 percent

were either hungry or at-riskof hunger. This strongly statisti-cally significant difference infood insufficiency rates betweenrural and urban respondentscannot be due to differences inpoverty rates, since the level ofpoverty was nearly the same forboth subsamples.

Is Demand for EmergencyFood from Soup Kitchensand Food Pantries afrReliable Indicator of aCommunity Hunger

6

Problem Among Low-Income Families?

An examination of the rela-tionship between emergencyfood provider usage and theextent of hunger among low-income families with at least onechild under the age of 12 fromthe CCHIP sites provides someinsights. According to standardtechniques of specificity andsensitivity analysis applied toCCHIP survey results, relianceon food pantries and soupkitchens are strong indicators ofhunger in a community. Indeed,emergency food program usage isa very specific indicator of theextent of hunger in families. Inparticular, 94 percent of soupkitchen users and 95 percent offood pantry users were hungry orat-risk of hunger. Among thosewho had no hunger problem(neither hungry or at-risk ofhunger) only three percent werefood pantry users and only 1.5percent were soup kitchen users.Thus, virtually every CCIIIPfamily using a soup kitchen or afood pantry was hungry or at-risk of hunger. This means thathigh demand for emergency foodfrom food pantries or soupkitchens by low-income familieswith children in a given commu-nity is a reliable indicator thatthere is hunger in that commu-nity.

SummaryOf the 2,335 households inter-

viewed in CCIIIP, 162 (7%) wentto soup kitchens for meals and877 (38%) went to food pantries

Figure 4.1Program Usage Rates by Income Level for Urban Respondents "

(Central Valley, California; Number of Households = 126)

100

80

60

40

20

El Food StampsEmergency foods

<50 50-74 75-99 100-124 125-149 150-185Income as percent of poverty level

Figure 4.2Program Usage Rates by Income Level for Rural Respondents "

(Central Valley, California; Number of Households = 203)

100

80

60

40

20

o Food stampsEmergency foods

<50 50-74 75-99 100-124 125-149 150-185Income as percent of poverty level

47

for food. Families using either ofthese emergency programs hadincomes that were approxi-mately 25 percent below thepoverty line. In addition, sheltercosts consumed, on average,over half of these very low-income households' monthlyincomes. These householdsspent approximately one-third oftheir meager incomes (includingfood stamps and the value ofWIC benefits) on food.

Slightly more than three-fourths of households going tosoup kitchens or food pantriesreceived food stamps, and justover half of these families partic-ipated in the WIC Program.Ninety-six percent of familieswho went to soup kitchens, and98 percent of families who wentto food pantries received free orreduced-price school lunch fortheir school-age children. Forty-one percent of soup kitchenusers and forty-nine percent offood pantry users received freeor reduced-price school break-fast. Twenty-eight percent ofthose getting meals at soupkitchens and 31 percent of thefamilies getting food at foodpantries received meals from theSummer Food Service Programfor Children. This suggests thatthey were supplementing thebenefits of these public assis-tance programs with privateemergency services in anattempt to balance the dietaryrequirements of their familieswith the scant resources theyhad to purchase food.

More than three-fourths (77%)of households who avail them-selves of meals at soup kitchens,and 67 percent of food pantryusers, relied on friends and rela-tives for food and money forfood. However, after turning toall available sources, many ofthese families still came up shortand suffered from food insuffi-ciency. Forty-five percent ofhouseholds getting food at foodpantries were hungry. Sixty-seven percent of householdswho go to soup kitchens werehungry.

While emergency food pro-grams were founded as a short-term approach to meeting theemergency food needs of personsin crisis, the crisis continues andthese emergency measures havebecome nearly institutionalized.

A comparison of rural withurban respondents from the fourcounty CCIIIP survey conductedin the Central Valley ofCalifornia showed that urbanrespondents were supplementingpublic assistance with privatecharity, while rural respondentswere substituting public assis-tance with private charity. Therural respondents had a muchhigher rate of hunger or risk ofhunger than the urban respon-dents.

Reliance on food pantries andsoup kitchens, according to stan-dard techniques of specificityand sensitivity analysis appliedto CCIIIP survey results, arestrong indicators of hunger in a

48 FJ

community. Not all communi-ties have emergency feedingprograms available to low-income families. In general, theavailability of services is affectedby the voluntary nature of manyof these programs. Soupkitchens may be open only a fewdays a week for a limited timeperiod. Food pantries, becausethey are frequently staffed bypersons donating their time, maynot be accessible to potentialusers when volunteer staffers arein short supply.

While emergency feeding pro-grams serve a valuable function,soup kitchens and food pantrieshave not been designed to meetthe ongoing food needs of low-income families. If we seek toensure food security, whichrefers to the access by all peopleat all times through normal foodchannels to enough nutritionallyadequate food for an active,healthy life for all of our citizens,then we must take steps toensure adequate food resourcesfor low-income families. Thiswould restore soup kitchens andfood pantries to their originalrole as short-term emergencyfood providers.

If we seek to ensure food secu-rity, then long-term policiesmust address the context ofhunger in the United States,namely, poverty and unemploy-ment. In the next two chapterswe examine the associationbetween hunger and poverty andbetween employment status andhunger.

'4

t,

NI

fj

Chapter 5

Hunger and Poverty: The Relationships Between Income and Expenses

TTow is PovertyDefined?

Hunger is a condition ofpoverty. Recognition of this con-nection has been built into theofficial poverty level, developedby the Social Security Admin-istration in 1964. The basis forthe first poverty index was theU.S. Department of Agriculture's(USDA) "Economy Food Plan".This food plan (now revised asthe "Thrifty Food Plan") was theleast expensive of four food plansdeveloped by USDA. When firstinstituted, the poverty line wasdrawn at three times the cost ofthe Economy Food Plan for afamily of three or more. Thepoverty level is adjusted for fam-ily size, and each year ismodified according to theConsumer Price Index. For afamily of four in 1990, thepoverty line was 512,700.

What are the Trends in thePorerty Bate

Certain historical trends canbe observed since the U.S.Commerce Department's CensusBureau began formally providingpoverty information (tracinghack to 1959). These trends,presented in Table 5.1, are help-ful in evaluating recent develop-ments in the poverty rate.

In 1964, when PresidentLyndon Johnson declared"unconditional war on poverty,"

7i

36.1 million or 19 percent of allAmericans lived below thepoverty line. During the early1970s, the number of people inpoverty declined; in 1973, thepercentage of Americans livingbelow poverty hit an all-time lowof 11.1 percent. The povertyrate remained stable at 11 to 12percent through much of thatdecade.

In 1979, the poverty ratebegan a five year increase, peak-ing at 15.2 percent in 1983.While poverty has decreasedsince that time, its declineslowed considerably in the late1980s. Despite a seven-year eco-nomic recovery, the povertyrate, at 12.8 percent in 1989,remained higher than at anytime during the 1970s. Therewere 5.4 million more Amer-icans living in poverty in 1989than in any year during the pre-vious decade. The economicrecession of 1990-1991 hasincreased the possibility that thepoverty rate will continue to risein the early years of this decade.

Perhaps the most tragic storybehind poverty figures concernschildren. Poverty is concen-trated most heavily amongchildren, who represented 40percent of all Americans living inpoverty in 1989. One child infive was poor in 1989, and forminority children the percentagewas much higher. The 1989 datashow that:

12.6 million children under18 (19.6 percent) were poor.

51

Table 5.1Persons Below the Poverty Level 1959-1989

YearNumber Persons BelowPoverty Line (millions)

Percent of PersonsBelow Poverty

1989 31.5 12.81988 31.9 13.11987 32.3 13.41986 32.4 13.61985 33.1 14.01984 33.7 14.41983 35.3 15.21982 34.4 15.01981 31.8 14.01980 29.3 13.01979 26.1 11.71978 24.5 11.41977 24.7 11.61976 25.0 11.81975 25.9 12.31974 23.4 11.21973 23.0 11.11972 24.5 11.91971 25.6 12.51970 25.4 12.61969 24.1 12.11968 25.4 12.81967 27.8 14.21966 28.5 14.71965 33.2 17.31964 36.1 19.01963 36.4 19.51962 38.6 21.01961 39.6 21.91960 39.9 22.91959 39.5 22.4

Source: L'.S. Census Bureau

52

5.1 million children underage six (22.5 percent) lived inpoverty.

43.7 percent of all Blackchildren under age 18 were poor.

50.1 percent of all Blackchildren under age six lived inpoverty.

36.2 percent of all Hispanicchildren under age 18 were poor.

How Do Rates of Povertyand Hunger Relater

Findings from CCHIP surveysreveal how poverty and hungerare linked for low-income fami-lies with children. What thesefindings show is that living belowthe poverty line puts a tremen-dous strain on a household'sbudget, adversely affecting theability to purchase a nutrition-ally adequate diet. Even familieswhose incomes are somewhatabove the poverty level experi-ence food insufficiency.

Figure 5.1 depicts the hungerrate (percentage of hungry fami-lies) at different levels ofpoverty. This figure presentsinformation for all seven CCIIIPsites, and separately for ruraland urban sites.

The hunger rate differs little,when households below 50 per-cent of poverty are compared tothose with incomes between 50-99 percent of poverty. Thehunger rate, however, is consid-erably lower for households withincomes between 100-149 per-cent of the poverty level and islower yet for households whose

incomes are between 150-185percent of poverty. In general.the pattern of lowered hungerrates for each higher incomelevel is similar for rural andurban sites. What these resultsindicate is that hunger is a con-dition of lack of income, regard-less of rural or urban location.

It is important to point outthat food insufficiency exists forfamilies with incomes even atthe 185 percent poverty level.The question then arises: "Atwhat income level is hunger dueto constrained resources nolonger a problem for families?"To answer this question, it isnecessary to modify the usualCCHIP methodology of samplingfrom only a low-income popula-tion. In Pontiac, Michigan, anadditional sample was drawn offamilies with children under 12whose incomes were above 185percent of poverty. (SeeAppendix G for description ofthe Michigan sample above 185%of poverty.)

Figure 5.2 depicts the relation-ship between hunger rates andpoverty level for both Pontiacsamples, combined. Looking atFigure 5.2, we see once again thesubstantially lower hunger ratesfor families whose incomes arebetween 100-149 percent ofpoverty compared with thosewhose incomes are below 100percent of poverty. When house-holds with higher incomes areincluded, we find no hunger infamilies whose incomes are at orabove 300 percent of poverty.

Pontiac, Michigan, does notnecessarily have the same char-acteristics as the rest of theUnited States, and the results

from this one survey can not bestatistically generalized to theentire country. Lacking any bet-ter information at present,however, we can use theseresults to ask what effect raisingincome levels might have onhunger rates.

Based on the Pontiac data, ifhousehold incomes were nolower than the poverty level(100% of poverty), nearly 85 per-cent of families with childrenwould not be hungry; and ifhousehold incomes were no lessthan 150 percent of poverty,almost 89 percent of familieswith children would not be hun-gry. If all family incomes wereat least twice (200% of) thepoverty level. few families withchildren would be hungry. Infact, nearly 95 percent of house-holds at this income level wouldno longer be hungry. Althoughthese particular numbers cannotbe applied to other places in theUnited States, the importantpoint here is that increasedincomes mean reduced levels ofhunger.

The Hunger Equation: lihatis the Relationship BetweenIncome and Expenses

Despite the strong associationbetween hunger and income, theproblem of hunger is not simplya matter of income; rather, it ismore complex. The difficultyfamilies face stems from the rela-tionship between income andexpenses. When shelter costs(rent or mortgage plus utilities

53

54

Figure 5.1Hunger Rates in Relation to Income Level Is

(All Survey Sites)

50

40 -

30

20

10

0

zr I' 'I'C\I (11

L.r)

MI Seven sites

0 Urban sites0 Rural sites

<50 50-99 100-149 150-185Income as percent of poverty level

Figure 5.2Hunger in Relation to Income Level 16

(Pontiac, Michigan)

<100 100-149 150-199 200-299

Income as percent of poverty level

7 c_

300-600

such as gas, fuel oil, electricity,water and sewer) represent alarge proportion of total familyincome, there is little left overfor other expenses such as food.Figure 5.3, displaying averagemonthly income and expensesfor households at each surveysite, makes plain the regionalvariation in financial resourcesfor low-income families.

We can examine this by focus-ing on three of the urban CCHIPsurvey sites Hartford,Connecticut; Hennepin County,Minnesota; and, Long Island,New York. Average familyincomes vary substantiallyacross all three survey sites.Average gross monthly incomewas $919 in the Hartford sample,$1,032 in the Hennepin Countysample (which includesMinneapolis) and $1,348 in theLong Island sample. Althoughthese average incomes werequite different, shelter costs alsovaried. Shelter costs averaged$436 a month in the Connecticutsite, $459 in the Minnesota site,and 8696 for the survey site onLong Island.

So after taking the cost of shel-ter into account, the amount ofmoney left for food and otherneeds is similar from one placeto the next. Indeed, becausevariation in income is accompa-nied by a similar variation in thecost of living, the budget pinchfrom housing was tight for all thesurvey sites.

The squeeze that housingcosts puts on income can be seenin Figure 5.4, which presentsinformation from all the CCIIIPsurveys. This figure shows thatshelter share, or the percentage

of gross income spent on housingand utilities, was higher for fami-lies having lower incomes. Thischart not only reflects the hugeportion of income spent on shel-ter by families with very lowincomes (shelter share is morethan 50% for those with incomesat or below 75% of the povertylevel), but it also points to thelack of affordable housing, evenfor those with incomes above thepoverty level.

The federal government deemshousing affordable if it costs nomore than 30 percent of thehousehold's income. It is strik-ing to see that shelter share washigher than 30 percent, on aver-age, for households at all levels ofincome up to the 185 percentlevel of poverty in the CCHIPsurveys.

Furthermore, for poor house-holds (those with incomes below100% of poverty) shelter shareaveraged more than 60 percent.This amount stands in sharpcontrast to the typical (ormedian) American household,whose shelter ex-penses were 21percent of their gross income in1989. This means that the por-tion of income spent on shelterwas three times greater for thepoor in these surveys than forthe typical American family.

At what level of income, then,does shelter become affordable?Using the federal government'sdefinition of affordability (spend-ing 30 percent or less of incomeon shelter), we can examine thisfor one CCHIP location by look-ing at the information for allhouseholds from both Pontiac,Michigan, samples (whichinclude all income levels) shown

J

in Figure 5.5. Given the cost ofliving in Pontiac (median hous-ing costs were $514 for a twobedroom apartment in 1989), itwas not until incomes reached150-199 percent of poverty thathouseholds spent, on average, 30percent or less of their grossincome on shelter costs.

It is clear, then, that housingcosts consume a large portion ofthe low-income family budget.What effect does this constrainthave on their ability to purchasefood? Figure 5.6 depicts the foodshare of post shelter income forhouseholds in all the CCHIP sur-veys. Post shelter income refersto the amount of income leftover after shelter costs are paid,and includes the dollar value ofWIC benefits and Food StampProgram allotments, for thosehouseholds receiving each pro-gram. Food share of post shelterincome is the percentage of thisremaining income spent on food.Food expenditures refer only tofood purchases in grocery stores;they do not count the cost of eat-ing out at restaurants or othereating establishments.'"

It is readily apparent fromFigure 5.6 that the poorest fami-lies spent a much higher per-centage of their post shelterincome on food than familieswith higher incomes. In fact,families whose incomes werebelow the poverty level spent anaverage of 60 percent of theirpost shelter income on food.Even so, this amounted to anaverage of only $277 per monthspent on food just 68 centsper person per meal.

The contrast in the percentageof post shelter income spent on

55

Alabama

Florida

California

Connecticut

New York

Michigan

Minnesota

Figure 5.3Monthly Income and Expenses "

(Each Survey Site)

.0

El Total Income

Food+Shelter

III Shelter

0 1000

Dollars per month

Figure 5.4Shelter Costs in Relation to Income '

(All Survey Sites)70 -

60

50 -

40 -

30

2000

25-50 50-75 75-100 100-125 125-150 >150Income as percent of poverty level

w

Figure 5.5Shelter Costs in Relation to Income 19

(Pontiac, Michigan)

t 100..D41)L02

C 80O

C(1.)C. 60 -02

a)E00 40c

01.I 20CUIll

0 I I I I

<100 100-149 150-199 203-299 300-600

Income as percent of poverty

Figure 5.6Food Share of Post Shelter Income by Income Level 21

(All Survey Sites)

.03 Z.)-

-11

(f) T9RI7)0 tn

G. O.E

O tocoC

cu TiU00.

07U9c'CI0 0

tiil 0c.cte, z.-...

eug ELI. g

c

100

80

60-

40

20

0 i

25-49

. 1

50-74

1

75-99

i

100-124

1 .

125-149

1

150-185


7"1 57

food between poor and nonpoorhouseholds is more pronouncedin the expanded income range ofhouseholds from the two Pontiacsamples, seen in Figure 5.7. Theaverage percentage of post shel-ter income spent on food wasmuch lower among householdswhose incomes were more likethat of average American house-holds (those with incomesslightly above 300% of thepoverty line); these familiesspent only about 10 percent ofthis post shelter income on food.On the other hand, after payinghousing and utility costs, thepoorest families spent 70 percentof their remaining income onfood and this remainingincome included food stampsand WIC benefits.

Even though families withhigher incomes spent a smallerpercentage of that money onfood, they spent a significantlygreater number of dollars onfood. Families with incomes thatwere three to six times greaterthan the poverty level spent874.15 per capita on food permonth, while families withincomes below the poverty levelspent less: only 856.62 percapita per month, based on thePontiac results.

How Much Do Low-IncomeFamilies Spend on Food andShelter?

The point of all this is simple.After shelter costs were paid,very little money remained forfood. In all CCIIIP surveys for

58

hungry households, specifically,food expenditures represented62 percent of post shelterincome (the resources remainingafter shelter is paid, even includ-ing the cash equivalent of foodstamps and WIC). And for hun-gry households below 100percent of poverty, food costswere 72 percent of the post shel-ter income.

When shelter and food costswere added, so as to total upexpenses for these two basicneeds, the resulting share ofgross income that goes to pay forfood and shelter was exorbitant.As can be seen in Figure 5.8, thepoorest of the poor drawn fromall the CCIIIP surveys spentnearly all of their income (97%)on these basic needs (food andshelter costs combined).Comparatively, households withhigher incomes spent a smallerpercentage of their resources onfood and shelter costs (amount-ing to just over one-half). Whathappened to the percentage ofincome that remained afterthese basic needs were met?The percentage of remainingincome was substantially largerfor families at higher levels ofincome.

If we examine the broaderincome spread for all the house-holds from the two Pontiacsamples. the disparity in eco-nomic resources that remainedafter basic needs (food and shel-ter) were paid is more readilyevident, as shown in Figure 5.9.Families with incomes belowpoverty expended 87 percent onthese basic needs, leaving a mere13 percent to pay for all of theirother goods and services each

1-4

month. For families withincomes at 300 percent ofpoverty or above, the portionspent on basic needs was far less,24 percent; much more incomeremained (76%) for all otherneeds and wants.

Nat is the Monthly Budgetfor Households Below thePovertv Level?

For poor households, theincome-expense ledger resultedin a paltry bottom line. For poorfamilies, the cost of basic needsleft them basically needy.

Here's what this means in dol-lars and cents. Table 5.2presents a monthly budget ofaverage income and basicexpenses for poor families in allCCHIP surveys." Income fromall sources amounted to 8675 amonth, which changed littleafter adjusting for SocialSecurity Taxes and EarnedIncome Tax Credits. Shelterexpenditures (rent or mortgageplus utilities) took up over three-fifths of income, costing about8364 per month. This left $314.Adding in the dollar value offood stamp allotments and WICvouchers ($148) made a total of8462 available for food and allother expenses. Food expensesaveraged $277 a month, about60 percent of the post shelterincome. (Food expensesamounted to merely $58 per per-son per month.) Poor familieswere then left with $185 amonth, which must cover allother expenses taxes, medi-

Figure 5.7Food Share of Post Shelter Income by Income Level "

(Pontiac, Michigan)

t; a 100

ta

in cc 8000. O.

"6 g60N

.,;2cu0. 40

rn

20

a)E0C <100 100-149 150-199 200-299 300-600


Figure 5.8Percent of Income Spent on Basic Needs by Income Level 23

(All Survey Sites)

ro.0

Ca)CL

E00

O"-6a)

/ // // // /7 /100

80

60 Remainder

i i . Food share

40 II Shelter share

20

12a) 0

Q- 25-49 50-74 75-99 100-124 125-149 150-185


59

60

Figure 5.9Basic Needs in Relation to Income"

(Pontiac, Michigan)

100

a)a)

80:7)as

60Ca)CL

a, 40E8

206Ca)e

Remainder

Food share

Shelter share

7/ /1-7/

EIla

... .

: .... : .

0a)a. <100 100-149 150-199 200-299 300-600


Table 5.2Monthly Budget for Households Below the Poverty Level

(All Survey Sites; Number of Households = 1448)

Gross Monthly Wage Income S 245.45

Gross Monthly Income fromall other sources + S 429.50

Total $ 674.95

Less Social Security - $17.55

Plus Earned Income Tax Credit + $20.59

Adjusted Monthly Income $677.99

Less Shelter - $363.68

$314.31

Plus Food Stamps and WIC + $148M1

Adjusted PostShelter Income $462.32

Less Food - $276.85

Remainder $185.47

()

cal, transportation, clothing,telephone, and so on.

SummaryFindings from CCHIP surveys

presented in this chapter haveshown how poverty and hungerare related for low-income fami-lies with children. Of thefamilies interviewed by CCHIP,who have known income levels,65 percent have incomes belowthe poverty line ($12,700 for afamily of four in 1990). Hungryhouseholds, with averageincomes nearly 25 percentbelowthe poverty line, are muchpoorer than non-hungry house-holds.

The share (percentage) ofincome spent on shelter aver-aged more than 60 percent forpoor households (those withincomes below 100% of poverty).This fraction is substantiallylarger in comparison with thetypical (or median) Americanhousehold, whose shelter

expenses were 21 percent oftheir gross income in 1989. Theportion of income spent on shel-ter was three times greater forthe poor in these surveys thanfor the typical American family.

Post shelter income refers tothe amount of income left overafter shelter costs are paid, andincludes the dollar value of WICbenefits and food stamp allot-ments, for those householdsreceiving each program. Foodshare of post shelter income isthe percentage of this remainingincome spent on food. Foodexpenditures refer only to foodpurchases in grocery stores anddo not count the cost of eatingout at restaurants or other eatingestablishments. Poor familiesspent a much higher percentageof their post shelter income onfood than families with higherincomes. Specifically, familieswith incomes below the povertylevel spent. on average, 60 per-cent of their post shelter incomeon food. Nonetheless, thisamounted to an average of only$277 per month for food just68 cents per person per meal.

8I

Upon examining an averagemonthly budget of income andbasic expenses for poor familiesin all CCHIP surveys, we see howthis translates to dollars andcents. After paying for shelterand food, poor families were leftwith $185 a month. Thisremaining amount, which comesto $39 per person per month,must cover all other expensestaxes, medical, transportation,clothing, telephone, and so on.

If all family incomes were atleast twice (200% of) thepoverty level, few families withchildren would be hungry.CCHIP estimates that nearly 95percent of households at thisincome level would no longer behungry, based on data from thePontiac, Michigan survey.

In the next chapter, the con-nection between income leveland employment status is exam-ined. Specifically, data fromCCHIP surveys are used to ana-lyze the effects of employmentstatus on household income andon the likelihood of experiencinghunger.

61

1

4

It.

ti

0.0

;" "('

fra.4.4!:

rix

)14:(C;P!1

Chapter 6

Employment Status and Hunger

',inductionCommon wisdom has it that

one of the most telling indica-tors of a nation's economichealth is the unemploymentrate. High rates ofjoblessnesscan point to economic recessionand increased impoverishment,as well as hunger. ConsiderTable 6.1, which shows unem-ployment and poverty rates from1979 to 1989.

When reports of the return ofhunger in America began arisingin the early 1980s, bolstered bystudies in Texas, Oklahoma, NewYork, Massachusetts, Arkansas,Florida, Utah and elsewhere,they pointed to hunger's connec-tion with increased joblessness,poverty, and use of emergencyfood providers. Official esti-mates of unemployment andpoverty registered the economicdownturn at that time. Theunemployment rate jumped to9.7 percent by 1982, and thepercentage of persons belowpoverty peaked at 15.2 percentin 1983. Moreover, poverty haddeepened the poorest of thepoor had lost ground."

Most indicators thereafterbegan pointing to a reversal, sig-naling economic growth. Econ-omic recovery was evident by1984, and poverty rates havedropped since, but not by nearlyas much as unemployment rateshave lessened. In fact, in 1989for the third straight year, thepoverty rate failed to respond tothe nation's economic expan-sion. Despite continued

-

decreases in the unemploymentrate (which was 5.3 percent in1989), the poverty rate did notchange significantly from 1987-1988, and from 1988-1989. The1989 poverty rate of 12.8 per-cent, or 31.5 million Americans,remained higher than at anytime during the 1970s, includingperiods of recession. It wouldseem, then, that the tie betweenthese rates has loosened some-what. A careful examination ofthe recent economic recoveryreveals why.

Economic Recoreg andLow Wage Jobs

Economic recovery has meantthe growth of jobs. The jobs thatwere created, however, havebrought with them little in wagegains. Between 1960 and 1969(when poverty was decliningfastest see Table 5.1 inChapter 5), paid compensationto labor per hour of work rose2.7 percent per year, but it fellby 0.4 percent from 1979-1985."Of the 10.7 million jobs added tothe United States economybetween 1979-1985, 48.6 per-cent were paid less than $10,000(in 1985 dollars)." In otherwords, almost half of the newjobs available during this periodwould not have paid enough to ayear-round, full-time worker fora family of four to be above thepoverty level (in 1985, thepoverty line for a family of fourwas nearly $11,000).

63

Table 6.1Unemployment Rates, Persons Below Poverty,

and Percent Below Poverty, 1963-1989

YearUnemploymentRate

# of PersonsBelow PovertyLine (millions)

PercentPoverty

1989 5.3 31.5 12.8

1988 5.5 31.9 13.1

1987 6.2 32.3 13.4

1986 7.0 32.4 13.6

1985 7.2 33.1 14.0

1984 7.5 33.7 14.4

1983 9.6 35.3 15.2

1982 9.7 34.4 15.0

1981 7.6 31.8 14.0

1980 7.1 29.3 13.0

1979 5.8 26.1 11.7

Source: U.S. Bureau of Census and Bureau of Labor Statistics

64

It is evident that the economydid not recover for everyone.Consider two pieces of support-ing information about incomedistributions and about theworking poor. In 1989, the gapbetween the rich and the poorreached its widest point sincethe late 1940s, showing a contin-uation of the pattern of the richgrowing richer throughout the1980s. Poverty data from theU.S. Census Bureau show thatthe aggregate income of thepoorest 20 percent of Americanfamilies remained at only 4.6percent of the nation's totalincome (the same as in 1988).The wealthiest 20 percent offamilies received 46.8 percent ofthe national total, up from 44.0percent in 1988.

For the working poor, themost recent census data indicatethat their plight is worsening.Roughly 16.2 percent of allhousehold heads living inpoverty worked year-round andfull-time in 1989, compared to14.6 percent in 1987. Amongpoor household heads, 48.9 per-cent worked for some period oftime in 1989, up slightly from1988. So, despite the fa thatthe unemployment radN 'asdecreasing and the number ofpoor household heads who wereworking for some period of timewas increasing, wages were inad-equate to lift them out ofpoverty.

There is growing consensusamong researchers that povertyis partly a consequence of unem-ployment or underemployment(defined as too few hours of workor as low wages)." We wouldexpect, then, that if the lack of

well-paid work is the parent ofpoverty, hunger is its grandchild.

What are theCharacteristics ofEmplojent StatusDifferences Among CCHIPHouseholds

Using data from surveys at allCCHIP sites, we can examine theeffects of employment problems.Table 6.2 presents informationabout socioeconomic character-istics of households interviewedfor the CCHIP surveys, based onan employment distinction. Thefull-time employed categoryrefers to a family with one adultor more working full-time; thepart-time category refers tohouseholds with one adult ormore working part-time, and theunemployed category refers tohouseholds in which no one wasreceiving wage income.

The table shows that unem-ployed households were morelikely than part-time employedhouseholds to be headed by afemale (65% vs. 39%), and almostthree times as likely as full-timeemployed households (65% vs.23%). The size of unemployedfamilies was smaller than thesize of full-time employed fami-lies. Many more unemployedhouseholds (57%) had no respon-dent with a high school diplomathan did part-time employedhouseholds (40%) who, in turn,were more likely to have norespondent with a high schooldegree than full-time employed

R

households (34%). Racial differ-ences in employment were notstatistically significant.

Looking at a household'sfinancial resources, monthlyincome for unemployed house-holds was significantly less thanfor part-time employed house-holds, and income for part-timehouseholds was significantly lessthan for full-time employedhouseholds, no matter howincome is measured. For grossincome from all sources, includ-ing AFDC, unemployedhouseholds averaged 8686 amonth, part-time employedhouseholds averaged 8902 amonth, and full-time employedhouseholds averaged 81,225 amonth. This means that theunemployed had three-fourths ofthe income of part-timeemployed households, and just alittle over half of the income offull-time employed households.These income differencesamounted to more than 850 lessper person per month for unem-ployed households, comparedwith part-time employed house-holds, and more than 8100 lessper person per month for unem-ployed households comparedwith the full-time employed. Itis important to note that full-time employed households hadaverage incomes that are abovethe official poverty line, but notby much.

Monthly expenses for shelter(rent or mortgage plus utilities)and food, represented a substan-tially larger fraction of incomefor unemployed households com-pared with full-time employedhouseholds. Households withoutan employee spent nearly three-

65

66

Table 6.2Comparison of Socioeconomic Characteristics Among

Unemployed Households, Part-lime Employed Households,and Full-lime Employed Households; All Survey Sites

(Total Number of Households = 2,335)

CharacteristicUnemployedHouseholds

HouseholdsEmployedPart-time

HouseholdsEmployedFull-time

SOCIODEMOGRAPHICFemale Householder 65% 39% 23%Household Size a 4.5 4.6 4.8Non-white b 58% 66% 59%Not High School Grad.-Resp. 57% 40% 34%

ECONOMICMonthly Income

Gross $686 $902 $1225Gross per capita $165 $219 $272Income as percentof poverty 65% 86% 110%

Monthly ExpensesShelter Share 58% 62% 46%Food Share of Post-

Shelter Income d 73% 69% 44%

HEILTH INSMNCEPrivate 5% 22% 57%Medicaid 87% 57% 19%

Note: All comparisons of differences are statistically significant at the p <0.01 level, except whereindicated. The table can be read as follows: 65% of the unemployed households were headed byfemales, 39% of the households with at least one part-time employee were headed by females, and23% of the households with at least one full-time employee were headed by females.

a) Part-time employed households are not significantly different than either unemployed householdsor full-time employed households.

b) Differences are not statistically significant.

c) Unemployed households are not significantly different than either part-time employed householdsor full-time employed households.

d) Food expenses divided by gross income plus food stamps and WIC minus shelter costs; unem-ployed households are not significantly different than part-time employed households; both, however,are significantly different than full-time employed households.

8C

fifths (58%) of their gross incomeon shelter, compared to justunder one-half (46%) for full-time employed households. Outof the income that remainedafter paying shelter costs, andadding to it the dollar value ofWIC and food stamps, unem-ployed families expended almostthree-fourths (73%) of this postshelter income on food, muchmore than full-time employedhouseholds spent (44%). (See fig-ure 6.1)

One of the main benefits ofworking full-time is privatehealth insurance. Almost three-fifths (57%) of full-time employ-ed families had private medicalinsurance to cover their chil-dren, while only one-fifth (22%)of part-time employed house-holds had this coverage. Just fivepercent of unemployed familieshad private health insurance fortheir children. Due to theincome eligibility requirementsfor Medicaid benefits, the unem-ployed were more likely to haveMedicaid coverage for their chil-dren than households with anyemployment.

Table 6.3 shows informationon program usage and hungerrates, comparing the three cate-gories of employment. Sinceunemployed households haveless income than householdswith any employment, theunemployed were more likely tohe eligible for and participate innearly all the major food assis-tance programs available tothem, and to receive AFDC,compared with the part-timeemployed and the full-timeemployed.

Moreover, relative to the full-

time employed, a significantlyhigher percentage of unem-ployed and part-time employedhouseholds made use of emer-gency food providers (soupkitchens, food pantries, or othercommodity distribution centers)and counted on help fromfriends and relatives (borrowingfood or food money, or sendingtheir children to eat at others'homes). Despite all of this,hunger was more prevalentamong the unemployed morethan one and a half times asmuch as among the full-timeemployed (40% vs 24%). (See fig-ure 6.2)

How Are Family BudgetsAffected by Inemplopient?

The largest portion of theunemployed was made up of sin-gle-parent households, 99percent of which were headed bywomen. -:able 6.4 presents theaverage monthly budget for sin-gle-parent households with noone employed from all CCHIPsurvey sites. The average house-hold size was about four persons,and nearly all were comprised ofa mother and three children.

The primary source of incomefor single-parent households,with no one employed, was Aidto Families with DependentChildren (AFDC). Total incomefrom AFDC and other non-wagesources amounted to an averageof $591 a month. These familiesspent $327 a month on shelter,on average, which was 60 per-cent of their income. This left5264. Adding in the average dol-

lar value of WIC and food stamps($177) produced a total of $441a month to cover food and allother expenses. Food expendi-tures averaged $256 a month,which was 70 percent of theirpost shelter income. This left anaverage of merely $185 a month,approximately $48 per person,available for all remainingexpenses.

Of unemployed single-parenthouseholds. 42 percent werehungry, and 79 percent wereeither hungry or at-risk ofhunger.

/rim/ are the Barriers toEmployment for SingleParents%

Single parents in the CCHIPsurveys reported three main bar-riers to full-time employment.The most commonly given rea-son for not working full-time wasstaying home to care for the chil-dren (49%). The other two mainbarriers that these mothersreported were that the wagesthey would earn would be toolow to support their families(46%) and that a lack of day carekept them from working full-time(40%).

Put another way, women insingle parent families must playa dual role that of nurturer aswell as that of provider for theirchildren. In the main, singlemothers in the CCHIP surveysstressed child care responsibility.A shortage of jobs that paid well,along with a lack of day care,represented key obstacles to

67

Figure 6.1Percent of Monthly Post Shelter Income Spent on Food

by Employment Category

68

SO -

60 -

40 -

20 -

0

50

40

30

20

10

0

CO

Unemployed Part- Time Full-TimeEmployment Status

Figure 6.2Hunger Rates by Employment Status

0

Unemployed Part- Time Full-Time

Employment Status

8F

Table 6.3Comparison of Program Usage and Hunger Rates Among Unemployed Households,

Part-lime Employed Households and Full-Time Employed Households;All Survey Sites (Total Number of Households = 2,335)

CharacteristicUnemployedHouseholds

HouseholdsEmployedPart-time

HouseholdsEmployedFull-time

Public AssistanceProgram Participation

Food Stamps 87% 62% 32%

WIC 54% 48% 35%

Free or ReducedPrice School Lunch 98% 97% 89%

Summer Food 26% 16% 20%

AFDC 81% 39% 11%

Food Acquisition StrategiesReliance on Friendsand Relatives 65% 62% 47%

Reliance on EmergencyFood Providers 53% 45% 25%

HUNGER 40% 37% 24%

Note: All comparisons of differences are statistically significant at the p <0.01 level, exceptwhere indicated. The table can be read as follows: 87% of the unemployed householdsreceived food stamps, 62% of the households with at least one part-time employee receivedfood stamps, and 32% of the households with at least one full-time employee received foodstamps.

9 69

Table 6.4Monthly Budget for Single-Parent Households with No One Employed


Gross Monthly Wage Income $ 0.00Gross Monthly Income from

all other sources including AFDC + $ 591.09

Total $ 591.09

Less Social Security $ 0.00Plus Earned Income Tax Credit + 8 0.00

Adjusted Monthly Income $ 591.09

Less Shelter $ 326.87$ 264.22

Plus Food Stamps and WIC + $ 176.79

Adjusted Post Shelter Income $ 441.01

Less Food $ 255.84

Remainder $ 185.17

70

their labor market participation.

Without wage income, singlemothers relied heavily on AFDC,food stamps, and WIC. Despitethis federal assistance, few finan-cial resources remained afterpurchasing shelter and food.Many of these families must relyon emergency food providers,such as soup kitchens, foodpantries and other commoditydistribution centers (56%) andfriends and relatives (68%) tosupplement food resources.Still, more than two-fifths (42%)of these mothers and their chil-dren were found to suffer fromhunger.

How are Family Budgetsiffeded by Full-TimeEmploiment?

Among the full-timeemployed, the largest percentageis comprised of two-parent fami-lies. Table 6.5 shows the averagemonthly budget for two-parenthouseholds with one full-timeemployee from all CCIIIP surveysites. The average householdsize was about five persons, andnearly all consist of two parentsand three children.

Wage income for two-parenthouseholds with one full-timeemployee averaged 61,141 amonth. All other sources ofincome added up to $157 amonth, on average. Totalincome from all sources, then,amounted to an average ofapproximately $1,300 a month,which dropped to $1,250 amonth after adjusting for Social

Security taxes and EarnedIncome Tax Credits. Sheltercosts represented 45 percent oftheir income, averaging $569 amonth. This left $685. Addingin the dollar value of WIC andfood stamps ($50) made a totalof $735 a month available forfood and all other expenses.Food expenditures averaged$308 a month, which was 42percent of their post shelterincome. This left $426 a month,which was about $83 per person,available for all the rest of theirexpenses.

Of these two-parent familieswith one full-time employee, 22percent were hungry, and 70percent were either hungry orat-risk of hunger.

How Do These FamiliesCompare%

When comparing these twofamily budgets, it is easy to seewhy the hunger rate of singleparent households with no oneemployed was twice that of two-parent households with afull-time employee. Two-parentfamilies with a full-timeemployee had more than twicethe average monthly financialresources of unemployed single-parent families ($1,299 vs $591).

Moreover, two-parent familieshave another advantage. Theyare able, if they wish, to dividethe child care responsibilitiesfrom the financial provisionresponsibilities. Indeed, nearlyall mothers in two-parent fami-lies with one full-time employee

91

stressed child care responsibility,as did their single mother coun-terparts. In two-parent familieswhere her spouse works full-time, the most often cited reasonby mothers for not working full-time was staying home to carefor their children (72%). Thesecond most common reason fornot working full-time was lack ofday care (51%), followed bywages being too low to supporttheir families (26%). These arethe same three reasons for notworking full-time that singlemothers mentioned.

While it is evident that barri-ers to employment were quitesimilar for women in the CCHIPsurveys regardless of whetherthey were in single-parent ortwo-parent households, thefinancial concerns were less dev-astating for two-parent families,as would be expected. In fact,working poor, two-parent fami-lies, were much less likely toreceive AFDC, food stamps orWIC, and were less apt to rely onemergency food providers (26961or on friends and relatives (46%)to supplement food resources.And a far smaller percentage ofthem experienced sustained foodinsufficiency.

With all that said, however,one more point deserves high-lighting. Despite the differencein available financial resources.it is striking that 22 percent oftwo-parent households with afull-time employee were hungry.Although having full-time work isan important factor in reducinghunger, the wage rate for theseworking poor two-parent familiesis equally important. For alltwo-parent families with one full-

71

Table 6.5Monthly Budget for Two-Parent Households with One Full -Tune Employee


Gross Monthly Wage Income S 1141.49Gross Monthly Income from all other sources + $ 157.36

Total $ 1298.85

Less Social Security - S 81.62Plus Earned Income Tax Credit + 8 36.67

Adjusted Monthly Income $ 1253.90

Less Shelter - S 569.16684.74

Plus Food Stamps and WIC + 8 50.20

Adjusted Post Shelter Income 8 734.94

Less Food S 308.46

Remainder $ 426.48

72

time employee in the CCHIP sur-veys, the average wage rate,calculated for year-round work,was $6.85 an hour. At this wage,these families earned barelyenough to be above the officialpoverty level, and more thanone-fifth of them were hungry.Even though they worked full-time, apparently they earned toolittle to be secure.

SummaryUsing information gathered

from all CCHIP survey sites, it isevident that employment statuswas strongly associated with thedegree of constraint on a house-hold's resources which affectedthe likelihood of experiencinghunger. Unemployed householdshad three-fourths of the averageincome of part-time employedhouseholds and just one-half ofthe income of full-time employedhouseholds. Unemployedhouseholds were one and one-half times more likely to behungry than full-time employedhouseholds.

Unemployed households reliedprimarily on AFDC for income,and they were more likely toparticipate in federal food assis-tance programs than part-timeand full-time employed house-holds. Unemployed and part-time employed households weremore likely to have Medicaid tocover their children; full-time

employed households were morelikely to have private medicalinsurance for their children.Moreover, relative to the full-time employed households, ahigher percentage of unem-ployed and part-time employedhouseholds relied on emergencyfood providers and on friendsand relatives to help supplementtheir food stores.

Shelter costs took up a muchlarger fraction of monthlyincome for unemployed house-holds than for full-time employ-ed households. From theincome that remained after pay-ing for shelter, and adding to itthe value of WIC and foodstamps, food costs consumed asubstantially larger portion ofthis post-shelter income forunemployed households than forfull-time employed households.

In the CCHIP survey, the typi-cal unemployed household wasmade up of a single mother andthree children, while the typicalfull-time employed houSeholdwas comprised of two parentsand three children. Single-moth-ers who are unemployed listedthree main reasons for not work-ing full-time: staying home tocare for their children, availablejobs had wages too low to sup-port their families and a lack ofday care facilities. In two-parentfamilies where her spouseworked fug, -time, unemployedmothers reported the same threereasons for not working full-time.

93

Even though mothers in theCCHIP surveys cited the samebarriers to full-time employ-ment, irrespective of whetherthey live in a single-parent ortwo-parent household, it is notsurprising that these employ-ment barriers yield a financialoutcome that fell much harderon single-parent families; the lat-ter had half of the monthlyincome, on average, than didtwo-parent families with a full-time worker. Unemployedsingle-parent families also expe-rienced twice the hunger oftwo-parent full-time employedhouseholds.

Despite having twice thefinancial resources and half the 1,1

hunger rate of single-parent 1

unemployed households, morethan 20 percent of two-parentfamilies with a full-time worker Isuffered from hunger.Apparently, for many of theseworking poor families, wageswere so low that they couldachieve neither financial stabil-ity nor food sufficiency.

If programs were to beenacted that aimed at promotingfinancial stability and food suffi-ciency, such programs would, inall likelihood, require the pas-sage of a number of years torealize their aim. But childrencannot wait. Children's normalgrowth and healthy developmentrequire immediate intervention.while longer term solutions forfinancial stability are enacted.

73

Key Findings

Ireseven sites nationwide, usingthe best methodology cur-

ntly available, a distressinglevel of hunger among low-income families with youngchildren has been documentedby the Community ChildhoodHunger Identification Project(CCHIP). Approximately 5.5million children under 12 areestimated to be hungry and 11.5million are estimated to be eitherhungry or at risk of hunger.

CCHIP also has documentedthat hunger is detrimental tochildren's health.

When compared with chil-dren from non-hungry families,children from hungry familieswere much more lik Ay to sufferfrom infection-based health prob-lems and were much more likelyto show symptoms of low energystores in the six month periodprior to the survey.Concentration problems, fatigue,irritability, dizziness, and fre-quent headaches were muchmore common among hungrychildren, as were unwantedweight loss, frequent ear infec-tions, and frequent colds.

And when children becameill, they missed school. Childrenwhose families reported any indi-vidual health problems weremore likely to he absent fromschool than those not reportingproblems, missing about twice asmany days. hungry children wereabsent from school one and a halfmore days in the six monthsprior to the survey than childrenfrom non-hungry families.

95

One of the most importantand hopeful of all the CCHIPfindings about the relationshipbetween hunger and children'shealth was that children whowere eating both school break-fast and school lunch weresignificantly less likely to sufferfrom problems associated withlow energy reserves (fatigue, irri-tability and inability toconcentrate) than those whowere getting school lunch only.

In addition, children wereless likely to have increasedschool absences if they gotbreakfast at school.

Participation in the federalfood assistance programs byfamilies interviewed was sur-prisingly low surprising whenone considers the high level ofhunger found among these fami-lies. Moreover, even among thefamilies who participated in foodassistance programs, hunger wasoften still a problem.

When they ran out of food.hungry families frequentlydepended on friends and rela-tives to feed their children andwent to food pantries and soupkitchens to obtain food. Yet allof these strategies for gettingmore food or money to purchasefood were still not enough tokeep families from becominghungry.

Quest: is about employmentstatus, income, and expenses.revealed that unemployedhouseholds were one and onehalf times as likely to be hungry

75

as full-time employed house-holds. However, full-timeemployment did not protectfamilies from hunger. One-fifthof two parent families with a full-time worker still suffered fromhunger.

Incomes were very low amongthe families interviewed, and

76

hungry families were muchpoorer than non-hungry house-holds.

In addition to the burden ofpoverty, high shelter costs con-sumed a large portion (onaverage, over half, and for poorfamilies, more than 60%) ofmonthly gross income.

Moreover, families withincomes below the poverty levelspent, on average, 60 percent oftheir income that remained afterpaying for shelter, on food. Thisleft very little money for all otherbasic needs.

1II

/.er-e

'1,

1-

rcs,

Policy Recommendations

ost people wish fora world in whichnot even one child

goes hungry.CCHIP's findings concerning theimpact of hunger on health prob-lems underscore the gravity ofthe problem of childhood hunger.Surely in a country with thebountiful resources of the UnitedStates, over five million hungrychildren under the age of 12 isunacceptable, as is an additionalsix million children only a fewsteps away from being hungry.

Anyone who cares about thequality of children's lives in theUnited States and is concernedabout the nation's future will bedisturbed by the problemsCCHIP has documented amonglow-income families. In the longrun, to fully solve these prob-lems, families must be assisted intheir efforts to attain self-suffi-ciency by making available tothem quality education andtraining, income from work thatlifts them out of poverty, andadequate and affordable housing,child care and health care.However, these long-termchanges will take a long time anda great deal of effort andresources to implement.

Short-Term Steps to EndingChildhood Hunger

The good news is that thereare several effective short-termsteps that can be take c, to help

1

solve the problem of childhoodhunger in the United States.These steps have to do with fed-eral food assistance programsthat are already in place.

If fully utilized, these pro-grams could make an enormousdent in the number of hungrychildren in the United Statesthrough the increased accessthey provide to nutritious food.Yet, many of the families sur-veyed, although eligible for anumber of food programs, andclearly in need of food assis-tance, were not participating inthem. A close review of CCHIP'sfindings, along with an examina-tion of available information onfood program operations at thelocal level, lead to the followingshort-term policy recommenda-tions.

Increase Funding for theSpecial Supplemental FoodProgram for Women, Infantsand Children (WIC).

CCHIP's findings show thatonly 45 percent of those whowere income and categoricallyeligible for WIC were participat-ing in the program. Thesefindings are consistent withnational figures on participationin WIC. The CongressionalBudget Office estimates that,nationally, 54 percent of thoseeligible for WIC are participating.(This is based on a fiscal year1991 participation level of 4.7million women, infants and chil-dren.)

This low participation rate isdue to inadequate funding for

79

the WIC Program. Current fund-ing does not allow for fullparticipation by all who are eligi-ble and desire to participate.

Yet WIC has been documentedrepeatedly to be one of the mostcost-effective federal programs.In fact, a recently released U.S.Department of Agriculture studydemonstrated that every dollarinvested in WIC for pregnantwomen produced Medicaid sav-ings of $1.77 to $3.13. WIC isparticularly important in fightinginfant mortality (where theUnited States' standing in theworld has slipped in recentyears).

A combination of efforts,including increased federal fund-ing, supplemental state funding,and innovative efforts at thestate level to reduce food pack-age costs, can allow WIC to servemore people. However, the mosteffective route to full participa-tion of every eligible woman,infant, and child is a dramaticincrease in federal funding forthe program.

The National Association ofWIC Directors has presented afive year funding plan toCongress recommendingincreases which would permitparticipation by all women,infants and children eligible andwishing to participate. The plan,which is based on CongressionalBudget Office estimates, calls fora fiscal year 1992 funding levelof $2.7 billion ($256 million overthe cost of current services), andsimilar increments in futureyears.

Improve Access and Increase

80

Benefits in the Food StampProgram

The national CCHIP studypoints to two major problems inthe operation of the Food StampProgram: (1) many families whoare probably eligible for the pro-gram and in need, do notparticipate; and (2) benefits tothose who get them are insuffi-cient.

Over one-third of the familiesestimated to be eligible for foodstamps did not participate.According to CCHIP, lack ofinformation about program eligi-bility is a key factor inhibitingparticipation in the Food StampProgram. This finding points toa vital need for improved pro-gram outreach.

Additional barriers to FoodStamp Program participation,according to other research onFood Stamp Program operations,include limited office hours, con-fusing and overwhelmingpaperwork requirements, andimproper determinations of inel-igibility.

Finally, it is widely agreed thatcertain factors used in the deter-mination of program eligibilityare likely to make many peopleineligible who could benefitgreatly from the program. Forexample, the current definitionof a food stamp householdrequires families to applytogether for the program even ifthey do not share resources orbuy and cook together. Thispenalizes many families who areforced to double-up due to lackof affordable housing, often mak-ing them ineligible for food

stamps. Also, many workingfamilies are made ineligible forfood stamps because the carsthey depend on to get to workare worth more than $4500, thelegal limit allowed for FoodStamp Program eligibility.

It is also clear from the CCHIPfindings that many families whoreceive food stamps are still hun-gry. National data from the U.S.Department of Agriculture revealthat over half of the peoplereceiving benefits from this pro-gram are children and 83 per-cent of total benefits go to house-holds with children. Benefitlevels in the Food StampProgram will have to be increas-ed in order to ensure that chil-dren from low-income familieshave enough to eat throughouteach month.

In addition, several calcula-tions used in determining foodstamp benefits contribute totheir insufficiency. For example,food stamp benefits of familieswith children do not fully takeinto account high shelter costs,as is allowed for elderly and dis-abled households. Also,legally-obligated child supportpayments that go out of thehousehold are still included asincome to the household makingthe payment. This reduces theamount of food available to chil-dren living with parents orstepparents who have supportobligations to other households.

The following concrete stepsare recommended to improvethe ability of the Food StampProgram to meet the needs ofhungry families:

Improve and expand out-reach about the Food StampProgram so that all applicantsreceive accurate information oneligibility and participationrequirements.

Lower "administrative"barriers to participation in theFood Stamp Program.

Change both the definitionof a food stamp household forfamilies that double-up, and thelow limit allowed for the value ofa car.

Increase food stamp bene-fits so that families can afford toeat a nutritionally adequate dietthroughout each month.

Change the calculation offood stamp benefits so that highshelter costs are fully accountedfor, and child support paymentspaid out by a household are notcounted as income.

Expand the Availability of theSchool Breakfast Program andMaintain the BroadAccessibility of the SchoolLunch Program.

CCHIP's findings show a seri-ous underutilization of theSchool Breakfast Program. Mostof the families interviewed hadchildren who participated in theSchool Lunch Program, but lessthan half participated in thebreakfast program. The primaryreason given for not participat-ing in the program was that thelocal school did not sponsor aSchool Breakfast Program.

A significant number of fami-lies who were not participatingin breakfast appeared to be inneed. Of those families who didnot participate in the breakfast

program, one-third were hungry.Moreover, according to CCHIP'sfindings, participation in theschool lunch and breakfast pro-grams lessened significantly thelikelihood that children wouldsuffer from fatigue, irritability,and inability to concentrate.CCHIP also revealed that partic-ipation in the breakfast programreduced school absences.

Based on the findings in thisreport, expansion of the SchoolBreakfast Program, so that it isavailable to all low-income chil-dren, appears to be imperativein the effort to end childhoodhunger and its consequences.

Schools across the countrythat do not currently offer theSchool Breakfast Program wouldbe wise to implement this pro-gram as soon as possible.School Breakfast Program fund-ing is available to all public andprivate non-profit schools. Inaddition, the U.S. Department ofAgriculture currently offers $5million in School BreakfastProgram start-up funds to assistschools with needy children.

In addition, because of thelarge proportion of low-incomechildren who participate in theNational School Lunch Program,it is important to ensure thatthis program remains broadlyaccessible, and provides themost nutritious and healthfulmeals possible. Concern aboutthe healthfulness of mealsserved in schools was high-lighted in the Surgeon General'shealth objectives for the year2000, and will be raised again inthe National Academy ofSciences Diet and HealthRecommendations

o o

Implementation Report in themiddle of 1991, and in newdietary guidance for the childnutrition programs which will bereleased by the Departments ofAgriculture and Health andHuman Services in late 1991.

Expand the Availability of theSummer Food ServiceProgram for Children.

Participaticn. in the SummerFood Servic, . Program forChildren was very low amongthe families interviewed. Infact, only 22 percent had chil-dren who participated in theProgram. Moreover, of thosefamilies who had never heard ofthe program or did not partici-pate in it, 31 percent werehungry and 42 percent were at-risk of hunger.

These data lead to the conclu-sion that the families of themillions of low-income childrenwho lose access to school mealsduring the summer months areprobably hard-pressed to find anadequate replacement for thesemeals.

In order to increase low-income children's access tonutritious meals during the sum-mer, schools, governmentalentities, and non-profit agenciesmust be encouraged to sponsorSummer Food Program sites inlow-income communities. OnceSummer Food Program sites arein place, strong outreach isneeded to let families knowabout the existence of the po-grams and what they offer.

Expand the Availability of theChild and Adult Care FoodProgram.

81

Information on participationin the Child and Adult CareFood Program was not collectedin the CCHIP survey. However,because this program subsidizesthe provision of nutritious mealsto preschool children in childcare centers and family day carehomes, it is important to recog-nize its potential for playing asignificant role in amelioratingthe childhood hunger problem.

Preschool children oftenreceive 75 to 80 percent of theirnutritional intake from their daycare providers, and the Childand Adult Care Food Program,according to a government study,does a superior job of ensuringthe meals preschool childrenreceive are nutritionally ade-quate. In addition, the paymentsmade to child care centers andfamily day care homes to subsi-dize children's meals can play animportant role in reducing fami-lies' food costs and/or the cost ofchild care.

Unfortunately, many of thelow-income children who arecared for in family day carehomes do not benefit from par-ticipation by their care-givers inthe Child and Adult Care FoodProgram. Program sponsorsneed to renew efforts to raiseparticipation levels among low-income children in the familyday care portion of the Child andAdult Care Food Program. Thisis essential if hunger problemsare to be reduced amongpreschool children whose par-ents work. The U.S. Departmentof Agriculture is funding fourpilot projects to determine inno-vative techniques for enrollingmore low-income children in the

82

program. The findings of thesepilot projects should be very use-ful in launching an active cam-paign to recruit family day carehomes that take care of low-income children.

Longer Term Vision

The short-term steps dis-cussed so far will make anenormous contribution to end-ing childhood hunger in theUnited States. However, alonger term vision and planmust be developed and imple-mented if this eetrimental andshameful national problem is tobe ended.

The longer-term solutions sug-gested here are directly relatedto the deeper problems uncov-ered in surveying poor familiesin the United States.

Hungry families are muchpoorer than non-hungry fami-lies. In fact, level of incomeplays a major role in determin-ing whether families are hungry.

In one CCHIP site, wheredata were collected for familieswith incomes both below andabove 185 percent of thepoverty level, nearly 95 percentof families with incomes at least200 percent of the poverty levelwere not hungry.

Famii.es headed by a singlemother were more likely to behungry.

Full-time employment doesnot ensure an income level thatwill protect a family fromhunger. One-fifth of two parent

1i

families with a full-time workerstill suffered from hunger.

Jobs with living wages, andmore adequate financial sup-port for those who cannotwork. are essential in the longrun if hunger is to be eradi-cated.

Employment plays a signifi-cant role in determiningwhether a family is hungry.Unemployed households sur-veyed by CCHIP were one andone half times more likely to behungry than full-time employedhouseholds. For those who canwork, more jobs, and effective,carefully targeted job training,are essential to solve the prob-lem of childhood hunger.

One of the main barriers tofull-time employment reportedby the single mothers inter-viewed in the CCHIP surveywas lack of child care.Affordable, quality child care isindispensable for those desiringto enter the workforce.

The basic costs of survivaluse up most of the budgets offamilies surveyed by CCHIP.The high shelter costs of thefamilies interviewed consumeda large portion of their monthlygross income. Moreover, afterfood and shelter were paid for,very little money was left overfor any other needs. The needfor affordable housing has beenraised numerous times in recentpublic policy debates. CCHIPconfirms this need, especially asit relates to hungry families.

In addition, access to afford-able health care could make animportant contribution to end-ing the income shortfalls

low-income families suffer inrelation to their basic livingexpenses.

Adult members of the hungryhouseholds surveyed by CCHH3were less hiEely to have a highschool diploma.. Clearly accessto quality education is vital toending childhood hunger.

This is not an exhaustive list ofall CCHIP's findings, nor of all thepossible solutions to the problemof childhood hunger in theUnited States. However, thisconcluding segment has set outthe major policy recommenda-tions that emerge from a carefulreview of the data collected by

102

CCHIP, in light of what is knownabout local food program opera-tions. This report, both itsfindings and its recommenda-tions, is intended to stir anational debate and help create astrong commitment to ending theproblem of childhood hunger.

83

41;:i .:1.*-

-2

0 5

Endnotes

1. "Food Security in the United States," Select Committee onHunger, U.S. House of Representatives, Committee Report,October 1990.

Arkansas Hunger Project. Winthrop Rockefeller Foundation.October 15, 1984.

Hunger in Dade County, Florida. Metro-Dade CommunityAction Agency. February, 1985.

Massachusetts Nutrition Survey. Division of Family HealthServices, Massachusetts Department of Public Health. 1983.

Hunger Watch - New York State Progress Report, April - July,1983 - August 1983. Montefiore Medical Center. Department ofSocial Medicine.

Profile of "At Risk" Populations and Service Agencies. HungerWatch, February 1984. Montefiore Medical Center, Departmentof Social Medicine.

Oklahoma Impact. Legislation Information Network of theOklahoma Conference of Churches. Winter, 1982-83.

Hunger in Texas: A State of Need. Anti-Hunger Coalition ofTexas. Summer 1982.

Study of Low Income Households, Utah, 1985. Utah NutritionMonitoring Project. Utahns Against Hunger and UtahDepartment of Health. Division of Family Health Services, May1986.

2. Comparison of CCIIIP sample with nationwide low-income fami-lies with children. The table compares characteristics of theCCHIP sample with characteristics of families below poverty andwith children < 18 in the United States in 1989. The data is fromMarch 1990 Current Population Survey, included in Table 23 ofU.S. Bureau of Census, Current Population Reports, Series P-60#168, 1989.

CCHIP NationalSample Sample

Mean household sizefor families 4.7 3.9

Female-headed households 53% 60%

RaceWhite 29% 62%Black 41% 34%Hispanic 24% 19%

0485

86

Other 6%

City population 41% 45%

Suburban population 21% 29%

Rural population 37% 26%

3. "Food Expenditure Survey," U.S. Department of Labor, Bureau ofLabor Statistics. 1989

4. U.S Department of Agriculture, Food and Nutrition Service,Characteristics of Food Stamp Households, Summer 1988.

5. Peterkin, Betty B., Richard L. Kerr and Mary Y. Hama, "NutritionalAdequacy of Diets of Low-Income Households," Journal ofNutrition Education, Volume 14, No. 3 (1982), pp. 102-104.

6. Data from the 1977-78 Nationwide Food Consumption Survey(NFCS) showed that food stamps boosted the average household'sannual food expenditures by $293 per person, and that despite therelative economic advantage of eligible non-participants (eligiblenon-participants tend to be at the higher end of the income eligi-bility requirement), the latter spent less on food and had poorernutrition than did participants. Moreover, food stamp participantsspent less per person on food but got more nutrients per dollarthan did non-participants. The latter finding is from "FoodShopping Skills of the Rich and the Poor." Betty Peterkin andMary Hama. Family Economics Review. 1983. No. 3 pp. 8-12.

7. Government Accounting Office (GAO), "Overview and Perspec-tives on the Food Stamp Program," April 17, 1986, p. 54.

8. Congressional Budget Office, "The Food Stamp Program; Eligibilityand Participation," November 1988.

Doyle, T. and H. Beebout, "Food Stamp Program ParticipationRates," Current Perspectives on Food Stamp ProgramParticipation; Food and Nutrition Service, United StatesDepartment of Agriculture, 1988.

One should note that since CCHIP is a targeted study, the rate ofparticipation among the CCHIP sample is not an accurate partici-pation rate for the general population.

9. U.S. Department of Agriculture, "Estimation of Eligibility for theWIC Program," July 1987.

10. U.S. Department of Agriculture, Consumer Nutrition Center,Human Nutrition, Science and Education Administration. TheNational School Lunch Program and Diets of Participants fromLow-Income Households. Washington, D.C., June 1981.

11. Food Program Update, FY 1990, Food and Nutrition Service, U.S.Department of Agriculture, January 1991.

11 1 :-1_,

12. Ibid.

13. The following are

Income

data corresponding to

Food Stamps

Figure 4.1:

Emergency Food<50 54% 23%

50-74 83% 25%75-99 83% 21%

100-124 61% 11%125-149 45% 9%150-185 0% 13%

14. The following are data corresponding to Figure 4.2:

Income Food Stamps Emergency Food<50 44% 44%

50-74 50% 65%75-99 47% 51%

100-124 29% 32%125-149 17% 28%150-185 0% 27%

15. Urban sites refer to Minnesota, Michigan, Connecticut and NewYork. Rural sites refer to California, Alabama and Florida.

The following are data corresponding to Figure 5.1:

Income Seven sites Urban sites Rural sites Hungry At-risk< 50 40% 43% 39% 40.4% 33.4%50-99 39% 40% 37% 38.8% 39.6%100-149 24% 24% 24% 23.7% 43.3%150-185 15% 16% 11% 14.6% 47.4%


% Poverty Pontiac Hungry Hungry+At risk At-risk<100 36% 35.2% 78.4% 43.2%

100-149 20% 18.4% 52.5% 34.1%150-199 14% 13.3% 48.0% 34.7%200-299 7% 7.0% 31.7% 24.7%300-600 0% 0.0% 24.4% 24.4%

17. The following are data corresponding to Figure 5.3 (total incomeand food & shelter include the value of food stamps and WIC):

Survey Site Shelter Food tk Shelter Total IncomeMinnesota $459 $701 $1,032Michigan $399 $641 $1,029New York $696 $1,016 $1,348Connecticut $436 $713 $919California $394 $704 $1,123Florida $407 $682 $1,023Alabama $240 $524 $956

f tis1

87

88


Income Shelter Share25-49 64%50-74 53%75-99 46%

100-124 37%125-149 37%150-185 39%


% Poverty Shelter Share<100 53%

100-149 34%150-199 27%200-299 20%300-600 16%

20. If ail food expenditures had been totaled, including costs of eatingout at restaurants, differences in food expenditures would likelyhave been far greater between higher and lower income families.This is because the frequency and amount of out-of-home spend-ing on eating is much greater for families with higher incomes.

21. The following are data corresponding to Figure 5.6 (food shareincludes the value of food stamps and WIC):

Income Food Share25-49 94%50-74 56%75-99 41%

100-124 33%125-149 28%150-185 26%

22. The following are data corresponding to Figure 5.7: (food shareincludes the value of food stamps and WIC):

% Poverty Food Share of Post Shelter<100 70%

100-149 27%150-199 19%200-299 15%300-600 10%

23. The following are data corresponding to Figure 5.8 (percent ofincome spent of food and basic needs includes the value of foodstamps and WIC):

Income Basics Food share Shelter Share Remainder25-49 97% 48% 49% 3%

50-74 75% 32% 43% 25%75-99 66% 24% 42% 34%100-124 57% 21% 36% 43%125-149 55% 18% 36% 46%150-185 55% 16% 39% 45%

24. The following are data corresponding to Figure 5.9 (percent ofincome spent of food and basic needs includes the value of food-stamps and WIC):

Income Basics Esmi share Shelter Share Remainder<100 86% 33% 53% 14%100-149 53% 18% 34% 48%150-199 41% 14% 27% 59%200-299 31% 12% 20% 68%300-600 24% 8% 16% 76%

25. The budget items shown are composite averages for all 1,488 fami-lies from all survey sites with incomes below the poverty line.Compared to Figure 5.8, the budget shown in Table 5.2 averagesresults from all families in the lowest three income ranges inFigure 5.8 (25%-49%, 50%-74% and 75%-99%). For anyone doingresearch on households with very low incomes (for example,below 25% of poverty), it is often difficult to be certain that allincome sources are accounted for. In the CCHIP surveys, many ofthese very poor households appeared to have expenses thatexceeded their income. This is not an uncommon finding in stud-ies of the very poor. However, to reduce our doubt about havingmissed some income sources for the poorest of the poor, we haveexcluded from analysis those households with incomes below 25percent of the poverty level. In addition, in any household whereshelter costs exceeded income, the assumption was made thatincome had been undercounted and therefore, the net post shelterincome was set to zero.

26. O'Hare, W.P., "Poverty in America: Trends and New Patterns,"Population Bulletin. Vol. 40, No. 3. March, 1987.

27. Thurow, L.C., "A Surge in Inequality," Scientific American, Vol.256, No. 5, pp. 30 - 37. May, 1987.

28. Ibid.29. Ellwood, D.T., Poor Support: Poverty in the American Family,

1988. New York: Basic Books.

Levitan, S.A. and I. Shapiro, "Working But Poor: America'sContradiction," 1988. Baltimore, MD: The Johns HopkinsUniversity Press.

Beeghley, L., Living Poorly in America, 1983. New York: Praeger.

lu 108 89

Appendix A

escription of thePilot Project

New Haven, Connecticut

The CCHIP pilot study was atargeted, cross-sectional survey,designed to estimate the preva-lence of reported food shortagesdue to insufficient resources(hunger) among families with atleast one child under 12 yearsold. The pilot survey, conductedin New Haven, Connecticut, wasconfined to a low-income neigh-borhood (The Hill), encompass-ing three census tracts.

The sampling frame consistedof the list of addresses of all chil-dren under 12 years of ageattending schools in the schooldistrict serving the Hill andresiding in the neighborhood.Each household was screened todetermine whether there was atleast one child under age 12 andwhether the household incomewas at or below 185 percent ofthe federal poverty level. It wasdetermined that the pool ofhouseholds eligible for the studyincluded 2,171 households. Asystematic sample was drawnusing a random digit start and apredetermined interval.

1 1 0

Interviews were conducted with403 families; 83 percent of theeligible families in the initialsample were interviewed.Sociodemographic informationand information about participa-tion in publicly-funded supple-mental food and income pro-grams was collected throughface-to-face interviews. In thepilot project, 82 percent ofrespondents also agreed to haveheights and weights of the chil-dren measured.

Of the households surveyed,66 percent were headed by a sin-gle parent and 24 percent hadtwo parents. Fifty-five percent ofthe households were Hispanic,42 percent were Black, and threepercent were white. Fifty-sevenpercent of the respondents hadnot completed high school, 18percent of respondents wereemployed full-time and 66 per-cent of households had no oneemployed. The incomes of allhouseholds averaged 75 percentof the federal poverty level.Seventy-five percent hadincomes at or below the povertyline. The hunger rate amongthese families was 18 percentand an additional 47 percentwere at-risk of hunger.

91

Appendix B

Description of theDemonstation Project

Following refinement of thehunger scale, standardized ver-sions of the hunger questionswere incorporated into a demon-stration project in two surveysites. These surveys were con-ducted in the city of Seattle andin Yakima County, Washington,from November 1987 to January1988. Two census tracts inYakima County (one in the cityof Yakima and one containingthe entire city of Wapato) andfour census tracts in Seattle (twoin the Central Area, one inRainier Beach and one in WestSeattle) were selected by identi-fying tracts in which more than33 percent of the householdswere families with children andmore than 33 percent of thosefamilies lived below the povertylevel, according to the 1980Census. The sampling framesused were constructed from thelist of addresses of all children,who were eligible for free andreduced-price lunches (maxi-mum income of 185% of pover-ty), attending public schools inthe district serving each area.The addresses were providedafter confidentiality agreementswere developed with the schooldistricts. Duplicate addresses aswell as addresses that were notin the census tracts to be sur-veyed were deleted from the

92

sampling frame. A systematicsample was drawn using a ran-dom digit start and a predeter-mined interval.

Seattle, Washington

There were 993 families withincomes at or below 185 percentof poverty having at least onechild under 12 years old living inthe selected census tracts.Interviews were conducted with377 families; 93 percent of theeligible families in the initialsample were interviewed.

Fifty-eight percent were singleparent households and 28 per-cent had two parents. Forty-three of the households wereBlack, 23 percent were Asian, 18percent were white, 12 percentwere Hispanic and four percentwere American Indian. Fifty-eight percent of the householdshad at least one adult memberwith a high school diploma, 29percent had at least one full-timeemployee and 63 percent had noone employed. The incomes ofthese households averaged 79percent of the federal povertylevel. Seventy percent of thehouseholds had incomes at orbelow 75 percent of the povertyline. The hunger rate amongthese families was 42 percentand an additional 37 percentwere at-risk of hunger.Participation rates in federalfood assistance programs arenoteworthy: 78 percent of the

1''

eligible households received ben-efits from the Food StampProgram, 78 percent receivedfree or reduced-priced schoolbreakfasts and 91 percentreceived free or reduced-pricedschool lunches.

Yakima County, Washington

The CCHIP survey was con-ducted in Yakima County. Therewere 675 families with incomesat or below 185 percent ofpoverty and having at least onechild under 12 years old living inthe county. Interviews wereconducted with 310 families; 91percent of the eligible families inthe initial sample were inter-viewed.

Twenty-eight percent weresingle parent households and 54percent had two parents. Fifty-three percent of the householdswere Hispanic, 26 percent werewhite and 18 percent wereAmerican Indian and three per-cent were of another race.Thirty-two percent of the house-holds had at least one adultmember with a high schooldiploma, 19 percent had one full-time employee and 54 percenthad no one employed. Theincomes of these householdsaveraged 69 percent of the fed-eral poverty level. The hungerrate among these families was 39percent and an additional 42percent are at-risk of hunger.

Appendix C

Description of Seven (CHIPSurrey SitesAlabama

The CCHIP survey was con-ducted in rural Sumter Countyby the Alabama CoalitionAgainst Hunger. There were1,106 families with incomes at orbelow 185 percent of povertyhaving at least one child under12 years old living in the county.Interviews were conducted with366 families; 96 percent of theeligible families in the initialsample were interviewed.

The average household hadabout five members; 43 percentof the households were headedby females and 37 percent hadtwo parents. Nearly all house-holds (99%) were Black. While75 percent of the householdshad at least one adult memberwith a high school diploma, only59 percent had at least one full-tinie employee and 34 percenthad no one employed. Incomesof these households average 70percent of the federal povertylevel. The hunger rate amongthese families was 28 percentand an additional 31 percentwere at-risk of hunger. The par-ticipation rates in federal foodassistance programs for the sam-ple is noteworthy; 99 percentreceived free or reduced-priceschool lunch, 91 percentreceived free or reduced-priceschool breakfast, 60 percent par-ticipated in the Food StampProgram, and 31 percentreceived WIC benefits.

California

The CCIIIP survey was cen-tered in four counties in the

Central Valley: Fresno,Stanislaus and Tulare. It wasconducted by the CaliforniaRural Legal AssistanceFoundation. There were 49,731families with incomes at orbelow 185 percent of povertyhaving at least one child under12 years old living in these coun-ties. Interviews were conductedwith 335 families; 70 percent ofthe eligible families in the initialsample were interviewed.

The average household hadabout five members; 19 percentof the households were headedby females and 68 percent hadtwo parents. The majority of thehouseholds (76%) were ofMexican American descent.Only 29 percent of the house-holds had at leas', one adultmember with a high schooldiploma, 45 percent had at leastone full-time employee and 47percent had no one employed.Households' incomes averaged84 percent of the federal povertylevel. Thirty-eight percent of thehouseholds had incomes at orbelow 75 percent of the povertyline. The hunger rate amongthese families was 36 percentand an additional 32 percentwere at-risk of hunger.Nonparticipation rates amongthose eligible in federal foodassistance programs is notewor-thy; 41 percent of the eligiblehouseholds did not receive bene-fits from the Food StampProgram, and 44 percent of thecategorically and income eligiblehouseholds did not receive WICbenefits.

Connecticut

The CCHIP survey was con-ducted in Hartford by the

11 2,

Hispanic Health Council. Therewere 3,833 families withincomes at or below 185 percentof poverty having at least onechild under 12 years old living inthe city. Interviews were con-ducted with 315 families; 92percent of the eligible families inthe initial sample were inter-viewed.

The average household hadabout four members; 71 percentof the households were headedby females and 13 percent hadtwo parents. Fifty-six percent ofthe households were Hispanic(Puerto Rican) and 39 percentwere Black. Forty-seven percentof the households had at leastone adult member with a highschool diploma, only 24 percenthad az. least one full-timeemployee and 70 percent had noone employed. The incomes ofthese households averaged 77percent of the federal povertylevel. The hunger rate amongthese families was 41 percentand an additional 35 percent areat-risk of hunger.

Households spent 59 percentof their gross income on sheltercosts (mortgage or rent and utili-ties). Also striking is the factthat children from hungry fami-lies were absent from schoolnearly three times as many daysas children from non-hungryfamilies.

Florida

The CCIIIP survey was con-ducted in Polk County by FloridaImpact. There were 9,901 fami-lies with incomes at or below185 percent of poverty having atleast one child under 12 yearsold living in the county.

93

Interviews were conducted with274 families; 59 percent of theeligible families in the initialsample were interviewed.

The average household hadabout five members; 38 percentof the households were headedby females and 49 percent hadtwo parents. Forty-seven per-cent of the households werewhite and 44 percent wereBlack. Sixty-six percent of thehouseholds had at least oneadult member with a high schooldiploma, 70 percent had at leastone full-time employee and 24percent had no one employed.Incomes of these householdsaveraged 87 percent of the fed-eral poverty level. Forty-sixpercent of the househdlds hadincomes at or below 75 percentof the poverty line. The hungerrate among these families was 32percent and an additional 37percent were at-risk of hunger.Nonparticipation rates amongthose eligible for federal foodassistance programs are note-worthy: 49 percent of theeligible households did notreceive benefits from the FoodStamp Program, which is thehighest nonparticipation rate ofall survey sites. Thirty percentof the categorically and income-eligible households did notreceive WIC benefits.

Michigan

The CCHIP survey was con-ducted in the city of Pontiac bythe Hunger Action Coalition.There were 2,474 families withincomes at or below 185 percentof poverty having at least onechild under 12 years old living inthe city. Interviews were con-ducted with 434 families; 95:5

94

percent of the eligible families inthe initial sample were inter-viewed.

The average household hadbetween four and five members;50 percent of the householdwere headed by females and 40percent had two parents. Forty-seven percent of the householdswere Black, 35 percent werewhite and 13 percent wereHispanic. Sixty-five percent ofthe households had at least oneadult member with a high schooldiploma, 42 percent had at leastone full-time employee and 50percent had no one employed.The incomes of these householdsaveraged 91 percent of the feder-al poverty level. Forty-nine per-cent of the households were at orbelow 75 percent of the povertyline. The hunger rate amongthese families was 29 percent,and an additional 39 percentwere at-risk of hunger. Of thehouseholds with at least oneschool-age child, 95 percentwere participating in theNational School Lunch Program.Furthermore, 88 percent wereeligible for and receiving free orreduced-price lunches. Sincethere was no School BreakfastProgram in Pontiac, no one wasparticipating, although 88 per-cent of the families surveyedwould be eligible to receivebreakfasts free or at a reducedprice. Pontiac had the highestrate of participation in theSummer Food Service Programfor Children among all the sur-vey sites; 37 percent of the fami-lies participated.

Minnesota

The CCHIP survey was con-ducted in Hennepin County

(which includes Minneapolis) bythe Minnesota Food Educationand Resource Center. There were7,788 families with incomes at orbelow 185 percent of poverty hav-ing at least one child under 12years old living in the county.Interviews were conducted with257 families; 65 percent of theeligible families in the initial sam-ple were interviewed.

The average household hadabout four members; 46 percentof the households were headedby females and 36% had two par-ents. Forty-five percent of thehouseholds were white and 34percent were Black. Seventy-sixof the householdS had at leastone adult member with a highschool diploma, 36 percent hadat least one full-time employeeand 51 percent had J oneemployed. The incomes of thesehouseholds averaged 88 percentof the federal poverty level. Thehunger rate among these familieswas 37 percent, and an addi-tional 43 percent were at-risk ofhunger. Fifty-two percentreported that they got food atfood pantries. It is noteworthythat households spent 53 per-cent of their income on sheltercosts.

New York

The CCHIP survey was con-ducted in two Long Island towns,Riverhead and Brookhaven, bythe Nutrition Consortium of NewYork State. There were 2,595families with incomes at orbelow 185 percent of povertyhaving at least one child under12 years old living in thesetowns. Interviews were con-ducted with 361 families; 80percent of the eligible families in

the initial sample were inter-viewed.

The average household hadabout four members; 32 percentof the households were headedby females and 54 percent hadtwo parents. The majority of thehouseholds were white (67%), 17percent were Black and 11 per-cent were Hispanic.Seventy-nine percent of thehouseholds had at least oneadult member with a high schooldiploma, 57 percent had at leastone full-time employee and 30percent had no one employed.

The incomes of these householdsaveraged 122 percent of the fed-eral poverty level. The hungerrate among these families was 24percent, and an additional 62percent were at-risk of hunger.Low-income families living inthese towns spent a striking 64percent of their income on shel-ter costs. It is noteworthy that61 percent of those who were eli-gible for free or reduced-pricebrealriacts did not receive them.They have the lowest participa-tion rate for school breakfastamong those eligible of the six

Ir

survey sites that have a breakfastprogram.

The First Statewide CCHIPSurvey: Massachusetts

The first statewide CCHIP sur-vey was a joint undertakingbetween Project Bread, theMassachusetts Anti-HungerCoalition, the MassachusettsDepartment of Public Health andthe national CCHIP project. Thesurvey analyses are being com-pleted and the report will bereleased in May 1991.

95

PARAMETERS

Site

Urban/Rural

Region

Dates ofsurvey

Geographicarea

# people

Target Pop. (N)

SamplingFraction

SampleDesign

PSU

ListingScreeningSchool List

CompletionRate amongeligibles

Refusal Rateamongcontacts

NEN

HennepinCounty

urban

midwest

2/89-6/89

1 county

987,900

7,788

1/30 (3%)

Parameter Tables for all Survey Sites

MI NY

Pontiac SuffolkCounty

urban

midwest

6/89-9/89

1 city

1,025,800

2,474

1/6 (16%)

2-stage simpleprobability randon

census tract

noyesyes yes

urban

mid-atlantic

5/90-8/90

2 towns

1,312,000

2,595

1/7 (14%)

2-stageprobabilty

block groups

yesyesno

CT CA FL AL

Hartford Central Polk SumterValley County County

urban rural rural rural

northeast west southeast south

9/89-7/90 3/90-6/90 12/89-7/90 3/90-7/90

1 city 4 counties 1 county 1 county

825,200 1,277,400 377,200 16,100

3,833 49,731 9,901 1,106

1/12 (8%) 1/148 (.6%) 1/36 (3%) 1/3(33%)

2-stage 2-stage simple simpleprobability probability random random

block croups census tracts

yes someyes some --no most yes yes

65%* 95.5% 80% 80% 70% 5996 96%

10% 3% 0% 0% 6% 4% 3%

° Number interviewed that were eligible/eligibles

1 1 3

96

Appendix D

CCHIP Survey Methods

What Methods Are Used InConducting A CCHIP Survey?

The CCHIP Questionnaire

The core CCHIPQuestionnaire contains 105questions on the following top-ics: household composition,socioeconomic information,shopping and eating patterns,food emergencies, participationin various publicly-funded pro-grams, household financialinformation and the health statusof children.

The Survey Population

The objective of the project'ssampling design is to sample low-income families (income at orbelow 185% of the FederalPoverty Level) with at least onechild under 12 years old livingwithin a specified geographicarea. Either a simple randomsample or a two-stage, area prob-ability sampling strategy with astandard cluster design isemployed. If the latter were tobe used, primary sampling units(PSUs) would be selected, withprobability proportionate to esti-mated size, following domainformation, using available demo-graphic information.Door-to-door screening is con-ducted to build a sampling framein each PSU consisting of allhouseholds with, incomes at orbelow 185 percent of the povertylevel and having at least onechild under 12. Finally, qualify-ing households are randomly

selected into the sample for eachPSU, with a probability in eachPSU determined so as to achievean overall, equal probability ofselection.

Sample Size

The required sample size wasdetermined using standard tech-niques. In a large population, asample of at least 400 is neces-sary to allow for the detection ofthe prevalence of hunger, with amargin of error (95% confidenceinterval) of no more than + 5 per-cent. We drew an initial samplesize of 500, 25 percent more thanthe 400 interviews needed toensure an appropriate confidenceinterval for the estimated hungerprevalence.

Data Collection

Community residents with noprior research experience areemployed for interviewing posi-tions. National CCHIP staffprovide extensive training for thefield supervisors and the inter-viewers. Interviewers directlycontact households in the sam-ple. Four call-backs to anaddress are required on two dif-ferent days, including at least oneevening or weekend day, before ahousehold is classified as non-responsive.

Data Analysis

All of the analyses describedin this report were performedusing the SAS StatisticalSoftware Package. Univariatesummaries and bivariate analy-ses were conducted.

1 1 6

Quality Control

There are three levels of qual-ity control of the data. First,field supervisors review thequestionnaires for completenessand correct skip patterns. A sec-ond edit of each questionnaire isconducted by the central staffwho post-code specific questionsand follow a series of proceduresto detect invalid and nonsensicalcodes. Second, a double-entryinputting process with field-by-field verification is employed.Third, a computerized cleaningroutine that includes skip pat-tern and consistency checks, aswell as recode assignments, isperformed.

Weighted Analyses

Univariate frequency percent-ages and means are weighted totake nonresponse into accountwhere necessary.

Calculation of Standard Error

Standard errors for prevalenceestimates are calculated usingthe collapsed stratum estimationmethod when the surveyemploys a two-stage clusterdesign. To use this collapsedstratum method, domains(strata) are paired before analysisaccording to demographic char-acteristics of the selected PSU.

Standard errors are calculatedusing standard methods includinga sampling fraction adjustmentwhen needed when a simple ran-dom sample design is used.

97

Appendix E

Methods for EstimatingNational Hunger Rates

From CCHIP surveys carriedout in seven sites during 1989-1990 we have overall hungerrates for low-income families (ator below 185% of poverty).Rates are also defined for house-holds in each of six categoriesdefined by income category(< 75% poverty, 75-124% poverty,and 125-185% poverty) andhousehold structure (female-headed and other).

We derive estimates of hungerin low-income families in theUnited States as weighted combi-nations of these rates, where theweights are estimated proportionof households in each of the sixcategories in the nation as awhole. These proportions areobtained from March 1990Current Population Survey data(published in Current PopulationReports P-60 #168 'MoneyIncome and Poverty Status inthe United States 1989' Table23) which yields the number ofhouseholds of each type (female-headed and other) in each of thepoverty categories of interest.

Once national hunger rateswere determined for low-incomefamilies and children in low-income families, the percentageof all families with children andthe number of all children under12 who were hungry or at-risk of

98

hunger were determined usingnational population estimates byage and poverty status (fromCurrent Population Reports P-60#168 and P-25 #1058 'StatePopulation and Household esti-mates'). For these estimates it isassumed, conservatively, thatthere is no hunger or risk ofhunger among families or chil-dren in families with incomes ator above 185 percent of thepoverty level.

Each of the seven surveys wasrepresentative of the populationof low-income families (at orbelow 185% of poverty) with atleast one child under 12 in thegeographic area sampled. Theresults of the combined samplescan be used as a basis for pro-jecting national estimates of thepercent of families with childrenunder 12 who are hungry or atrisk of hunger, even though thecombined samples are not statis-tically representative of thispopulation living in the entireUnited States.

Since the seven sites werechosen to capture national varia-tion of geographic size,population size, proportion ofthe population living in urbanand rural areas, economic struc-ture and geographic location, itis not unreasonable to expectthat the sample of 2,335 house-holds randomly selected withintheir local sites may be similar to

1 7

other low-income families withat least one child under 12regardless of where they live.

Poor households (those livingbelow the poverty line) in theCCHIP surveys are distributed inurban, suburban and rural areasin proportions roughly compara-ble to relevant nationaldistributions. CCHIP house-holds are somewhat larger and ahigher percentage of them areminorities. Neither race nor sizeof the household, however, is sig-nificantly associated with hungerin the CCHIP surveys.Therefore, it is not unreasonableto assume that these discrepan-cies would have little effect onthe applicability of the combinedCCHIP hunger rates to all low-income families with childrenunder 12. In addition, poorhouseholds in the CCHIP sam-ples have nearly the samepercentage of single female-headed households as thenational average. Since having asingle female-head is associatedwith hunger, it is accounted forin the CCHIP estimations.

These estimates, as with anyestimates, should be understoodin context. The extent of theiraccuracy and reliability is con-strained by limitations in theavailable data sources.Nonetheless, these are the bestestimates of hunger that areavailable at this time.

Appendix F

Health and School Absenteeism:Characteristics of Hungry Families Compared

to Non-Hungry Families

Variable

In six months prior to survey:

Child Experienced

Hungry Non-Hungry

Unwanted Weight Loss 14% 5%

Any Symptoms of LowEnergy Stores ' 45% 20%

Any Infection-BasedHealth Problems 62% 42%

Any Health ProblemsExcl. School Absences 73% 50%

# of Days AbsentFrom School 6.4 4.3

Note: All comparisons of differences are statistically significant at the p < 0.01 level

'Low energy stores refer to fatigue, irritability and inability to concentrate.

'Infection-based health problems refer to dizziness, frequent headaches, frequent ear infections,frequent colds, other infections and frequent visits to the doctor.

`Any health problem refers to unwanted loss of weight, fatigue, irritability, dizziness, frequentheadaches, frequent ear infections, inability to concentrate, frequent colds, other infections and fre-quent visits to the doctor.

99

Appendix G

Sample Design for thePontiac. MichiganCCHIP Surrey

A Simple Random Sample ofTwo Populations

In order to examine the rela-tionship between income leveland the rate of hunger, a simplerandom sample of householdswith at least one school-agedchild was drawn after stratifyingby income. Households with atleast one child under 12 wholived and attended school inPontiac, Michigan were dividedinto two groups: those withincomes at or below 185 percentof poverty and those withincomes above 185 percent ofpoverty.

Of the 2,474 households withincomes at or below 185 percentof poverty and at least oneschool-aged child under 12, an

100

initial sample of 497 householdswas drawn and 436 interviewswere completed. Two interviewswere later rejected due to miss-ing data, thus the analyses oflow-income families consisted of434 households.

In addition to this sampledrawn from the population oflow-income families (at or below185% of poverty), Pontiac fami-lies with at least one child underage 12, wliGce incomes weregreater than 185 percent ofpoverty were also sampled. Theprincipal objective of samplingthis population was to determinethe income at which resourceswere no longer constrainedenough to result in food short-ages. Because this objective ismet by combining the low-income and non-low-incomesamples, and because the non-low-income sample does notshare the constraints of a sample

size required to give acceptablemargins of error for an estimatedsample prevalence, an initialsample size of 300 was deemedsufficient for the non-low-income sample.

Of the 2,553 non-low-incomehouseholds in the population, asimple random sample of 300households was drawn. Thesehouseholds had incomesbetween 186 percent of povertyand 600 percent of poverty(incomes averaged 286% of thepoverty level). One hundred andseventy-two households wereinterviewed and these analysesare based on the results of 169complete household interviews.

Analyses combining the twosamples in Pontiac (e.g., Figure5.2 and 5.9) are weightedaccording to the inverse of theselection probabilities for thetwo strata.

Appendix H

CCHIP Sites and Contacts

New Haven, Connecticut (pilot)Matthew MelmedConnecticut Association forHuman ServicesHartford, CT(203) 522-7762

Washington state (demonstra-tion project)

Linda StoneWashington Food PolicyAction CenterSpokane, WA(509) 484-6733

Hennepin County, Minnesota(includes Minneapolis)

Ann HamreMinnesota Food Education andResearch CenterMinneapolis, MN(612) 348-4968

Pontiac, MichiganShirley PowellHunger Action CoalitionDetroit, MI(313) 963-7788

Hartford. ConnecticutGrace DamioHispanic Health CouncilHartford, CT(203) 527-0856

Polk County. FloridaDebra SusieFlorida ImpactTallahassee, FL(904) 222-3470

Sumter County, AlabamaGerald SandersAlabama Coalition AgainstHungerAuburn, AL(205) 821-8336

120

Suffolk County, Long Island,New York

Tricia MacEnroeNutrition Consortium of NYSAlbany, NY(518) 436-8757

California (Central Valleycounties)

Marion StandishCalifornia Rural LegalAssistance FoundationSan Francisco, CA(415) 863-3520

Massachusetts (statewide)Annette Rubin CasasProject BreadBoston, MA(617) 723-5000

101

Appendix I

CCHIP SiteAcknowledgements

Survey Development andPilot Study

Connecticut (New Haven)Connecticut Association forHuman Services (CAHS)Individuals:Matthew MelmedHelen WardCheryl WehlerAida Galarza

Funder:Primerica Company

Foundation

CCHIP Survey SitesAlabama

Alabama Coalition AgainstHungerIndividuals:Gerald SandersCarol GundlachWendell ParrisEdmond Bell

Funders:Mazon: A Jewish Response

to HungerCommunity Food andNutrition Program

CaliforniaCalifornia Rural Legal

Assistance FoundationIndividuals:

Marion B. StandishLaurie TrueMargaret AumannNancy Martinez

Funders:Mazon: A JewishResponse to hunger

ConnecticutHispanic Health CouncilIndividuals:

Grace Damio

102

Laura Cohen,CAHSGeorgine BurkeLani DavisonAdelina DiazCandida Flores

Funders:State of ConnecticutEnsworth FoundationMethodist Church, Boardof Global MinistriesPresbyterian Hunger

Project

FloridaFlorida ImpactIndividuals:

Debra SusieSophia DavisGovernor Lawton ChilesLt. Governor Buddy McKayDorothy Monterio

Funders:General Mills Restaurants,

Inc.Presbyterian Church (USA)Mazon: A JewishResponse to Hunger

MassachusettsProject BreadMassachusetts Department

of Public HealthMassachusetts Anti-Hunger

CoalitionIndividuals:Annette Rubin CasasMitchell RosenbergShoshana PakciarzRuth PalumboNathaniel Winship

Funders:The Boston FoundationThe Hyams FoundationThe Boston GlobeFoundation

Project Bread

121

MichiganHunger Action CoalitionIndividuals:

Shirley PowellJacquelin WashingtonNaida Donar

Funders:Detroit EdisonMazon: A JewishResponse to Hunger

Michigan Coalition onFood and Nutrition

Michigan Department ofPublic Health

Pontiac-Area Urban League

MinnesotaMinnesota Food Education

and Resource CenterIndividuals:Ann HamrePeter RodeDenise DevaanPaula DonnellyLerae Finn

Funders:The Pillsbury CompanyFoundation

Cargill, Inc.General Mills, Inc.Land O'Lakes, Inc.

New YorkNutrition Consortium of

New York StateIndividuals:

Tricia MacEnroeliana SametsSherry BrandsemaJoan Ward

Funders:New York StateDepartment of Health

Mazon: A JewishResponse to Hunger

Long Island CommunityFoundation

Washington (demonstrationproject)Governor's Task Force onHunger (now WashingtonFood Policy Action Center)Inaividuals:

Linda StoneDonald K. North

Rita BroganGovernor Booth Gardner

Funder:Burlington NorthernFoundation

In-Kind Support:Washington MutualFinancial Group

122

US WEST CommunicationsWashington Water PowerCompany

Security Pacific BankWashington State Food

Dealers' Association

103

Appendix J

CGIIP Technical AdvisoryCommittee

Dr. Victor Sidel, Chairman, isDistinguished UniversityProfessor of Social Medicine atMontefiore Medical Center andthe Albert Einstein College ofMedicine in The Bronx, NewYork. He is the Past President ofthe American Public HealthAssociation and the recipient ofits 1987 Award for Excellence.

Dr. Jennifer Anderson is aStatistician and AssociateResearch Professor of Medicinein the Arthritis Center of theBoston University School ofMedicine.

Dr. Janice Dodds is anAssociate Professor of Nutritionat the School of Public Health ofthe University of North Carolinaat Chapel Hill.

1 04

G. Ted Fairchild. R.D.,M.P.H., is the former Director ofthe Utah WIC Program and theUtah Nutrition MonitoringProject.

Amy Fine is a Maternal andChild Health Consultant with theAssociation of Maternal andChild Health Programs.

Dr. Lorraine V. Klerman is aProfessor of Public Health at theYale University School ofMedicine, Department ofEpidemiology and Public Health.

Dr. Milton Kotelchuck is theChairman of the Department ofMaternal and Child Health at theSchool of Public Health of theUniversity of North Carolina atChapel Hill.

Kathryn Porter is theResearch Director for the Centeron Budget and Policy Priorities, anonprofit research and analysisorganization located inWashington, D.C.

Dr. Richard Scott is anAssociate Professor of Sociologyand Associate Director of theHonors College at the Universityof Central Arkansas.

Dr. Cynthia Thomas isAssistant Professor ofEpidemiology and SocialMedicine at the Albert EinsteinSchool of Medicine and SeniorResearcher at MontefioreMedical Center.

Helen Ward is DeputyDirector of the ConnecticutAssociation for Human Services,a state-wide nonprofit research,analysis and public educationorganization.

ABOUT FRAC

The Food Research and Action Center (FRAC), a 501(c)(3) nonprofit organization, is widely recognized asthe leading national group working for more effective public policies to eradicate domestic hunger and under-nutrition. Established in 1970, FRAC today uses a variety of strategies at the national, state, and local levelsto bring about an end to hunger in the United States.

FRAC provides information, training and leadership to a network of hundreds of local groups acrossthe country, and is coordinating the Campaign to End Childhood Hunger in partnership with thosegroups.

FRAC engages in ground-breaking research to measure the extent of hunge/'r and its impact on low-income families with children.

FRAC analyzes federal food assistance policy and serves as a watchdog of regulations and programsaffecting the poor.

FRAC is an authoritative source of information on hunger for the news media, public officials and theAmerican public.

Contributions to FRAC are tax-deductible to the extent permitted by law.

Photographs by Joe Crachiola

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