"The narrower conceptual space may be termed food insufficiency and is distinguished by restricted household food stores, too little food intake among adults or children in the household, and direct reports or perceptions of hunger among household members. The broader conceptual space may be termed food insecurity. This term subsumes food insufficiency and extends to include resource insufficiency, the inability to acquire enough nutritious food through culturally normalized means, and anxiety about this inability, along with various attempts to augment or stretch the food supply." (Scott & Wehler, 1998).
Hunger, food insufficiency and food insecurity are serious problems in the United States, the effects of which reach beyond obvious concerns such as basic nutrition.
Issues related to food access, nutrition and food distribution are cornerstones of research currently being conducted by several U-M SSW faculty members. Researchers at the School have been working to address many food access issues faced by members of society, as well as complications that result, at least in part, from food insufficiency, food instability and hunger.
Professor Larry Gant ('81, PhD '86) is tackling the complex issue of food distribution. "Collecting the food is the easy part," he says. "It's getting the proper nutritional elements to public and private sites that operate food pantries and kitchens that is the difficult part of the job." To aid in the distribution of nutritious meals, the School of Social Work has begun a pilot program called "SouperTech" to provide meal sites with computer systems, software, internet access and training that will allow staff to determine what's available and how to order nutritionally balanced goods for their clients.
"It's our hope that better communication between organizations that are focused on providing food to hungry people will result in better nutrition and more satisfying meals, which will in turn result in better outcomes, in general, for children and adults than we were seeing before more complete nutrition was available to them," says Gant.
One obstacle that is linked clearly to food insecurity and insufficiency is poverty; and according to researchers at the School's NIMH Center for Research on Poverty, Risk and Mental Health, preliminary findings support further research regarding the relationship between household food insufficiency and major depression. Research is underway to learn more about "the relationship between epidemiologically assessed household food insufficiency and major depression in low-income women".
According to Ribar and Hamrick: "Food insufficiency among U.S. households varies along social and demographic lines. Female-headed households are more likely to experience food insufficiency and are more likely to remain food insufficient than are other households. Disability status and changes in household composition, such as a change in the number of household members, are both associated with entry into food insufficiency. Completing high school increases the likelihood of exiting food insufficiency . .. research found that food insufficiency depends on more than just poverty status, indicating that poverty and food insufficiency capture fundamentally different dimensions of economic hardship." (p. 2, 2003).
Professor Kristine Siefert ('75) has been exploring the connections between poverty and outcomes for women and children for much of her career. Through her research, she seeks to identify specific and modifiable social and environmental risk factors for poor health and mental health among low-income women and children in diverse racial/ethnic populations. "The links we're finding between food insecurity and major depression could affect practice and future research in profound ways. Additionally, these findings could inform policies to reduce the public health burden of major depression in food-insufficient households," she says.
Professor Edie Kieffer conducts community-based participatory research related to prevalence, risk factors and interventions to reduce ethnic and geographic disparities in health, including obesity and diabetes. "Studies have demonstrated that risk for diabetes, other chronic diseases and their severe complications can be reduced by moderate levels of physical activity, healthy eatingincluding vegetables, fruits and high fiber foods-and, for overweight people, modest weight loss." Within three projects, she works with community residents and organizations to develop and implement practical family, social and community interventions to reduce the risk of diabetes and its complications among Latino and African American residents of eastside and southwest Detroit.
One project, Healthy Mothers on the Move (Healthy MOMs), aims to demonstrate the effectiveness of a healthy lifestyle intervention tailored to the needs of pregnant and postpartum African American and Latina women. Planned by community women and organizations, the program provides pregnancy education, knowledge, skills and practice related to healthy eating, exercise and stress management in a support group format. "In addition to behavioral changes, we believe that Healthy MOMs participants will be more likely to have appropriate weight gains during, and decreased weight retention after, pregnancy. I'm hopeful that this project will contribute to improved child and family health, both through healthy pregnancies and knowledge and skills they model," Kieffer says.
The Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership's linked community, social support, health system and family interventions aim to develop the capacity and resources needed by community residents and organizations to reduce the prevalence of diabetes and its complications. Kieffer and Professor Michael Spencer direct the research, collaborating with REACH grantee Community Health and Social Services (CHASS). Kieffer states that "trained community resident REACH staff increase community awareness of diabetes risk factors and develop resources such as recreation programs, community gardens and diabetes support groups. They work with people with diabetes, their families and doctors to increase health-related knowledge, behaviors and resources needed for diabetes self-management."
A related project, Promoting Healthy Eating in Detroit (PHED), is conducted in collaboration with the School of Public Health, the Detroit Department of Health & Wellness Promotion and the REACH Detroit Partnership. It focuses on developing and sustaining supportive community environments and policies aimed at increasing access to, and demand for, healthy foods. PHED assists community organizations to host mini-markets where high-quality fresh produce is sold at wholesale prices. PHED conducts healthy food demonstrations, allowing people to taste new and traditional recipes prepared with healthy cooking techniques and foods. PHED works with restaurants, stores and organizations to create healthy food options on their menus, shelves and meetings.
"One of the obstacles to healthy eating in Detroit is lack of access to healthy foods in many neighborhoods," says Kieffer. "Our work through PHED will empower residents to make healthier food decisions for themselves and their children because they will know how to find and use other options."
-Terri D. Torkko is editor of Ongoing. For more information on research in the School, visit ssw.umich.edu.