RESEARCH PROPOSAL

ASSESSING FOOD INSECURITY

(FOOD-ACCESS INEQUALITY)
IN SOUTHEAST SAN DIEGO
HOUSEHOLDS

3/20/2012
UNIVERSITY OF CALIFORNIA, SAN DIEGO
SOCIOLOGY 139 FINAL PAPER
SABRINA STRINGS (INSTRUCTOR)
JESSICA BALTMANAS (STUDENT)

Research Proposal- Sociology 139

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TABLE OF CONTENTS
I.
II.

Abstract3
Introduction to Problem...3-7
Background of Southeast San Diego....4-5
Background of the Study..5-7
Research Questions......7
Hypothesis....7
Significance of Study...7

III.
IV.

Literature Review.7-8
Methodology...8-10
Research Design...8-9
Population....9
Sampling and Sampling Technique.9
Data Collection.......9-10
Data Analysis.10

V.
VI.
VII.

Anticipated Findings/Impact....10-11
References....11-13
Appendix..13-26

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Assessing Food Insecurity (Food-Access Inequality):

In Southeast San Diego Households
I.

Abstract

Although an estimated 85.5% of American households were considered food secure in 2010,
about 48.8 million people werent (Andrews et al.). These households struggled with being able
to access proper and enough food for the members of their home to have healthy growth and
development. In the proposed study, I seek to assess the degree to which households in Southeast
San Diego are food secure by measuring their level of access to healthy foods. Results will place
households on a continuum developed by the United States Department of Agriculture (USDA)
to have high, marginal, low, or very low food security compiled by the USDA Economic
Research Service and listed in Appendix A. The access to food I will be focusing on is the
proximity to sufficient grocery stores. I will be assessing the sufficiency of grocery stores in
providing healthy food options, the availability of supermarkets, and geographical limitations to
accessing these goods (such as transportation). By using research tools of surveys, interviews,
online databases, and mapping, I will be able to assess a households access to healthy foods and
determine the number of households and members in these households who have low access to
healthy foods. The household interview in Appendix B will be analyzed to find trends of needs
and suggestions for ways to improve the community. The survey of grocery stores in Appendix
C will be analyzed independently to find possible trends of the availability and unavailability of
certain food products. By also assessing the general racial/ethnic demographics of Southeast San
Diego, I will be able to study how the degree of food access may disproportionately affect people
of color. A second part to this research must be conducted to study the affordability of the healthy
foods that these communities can access, with respect to race/ethnicity. A third part to the
research must study the health consequences of the disparity of food access and affordability,
with respect to race/ethnicity. The fourth part to this research project must be conducted to cater
solutions to the problems of food access, affordability, and health disparities discovered in
Southeast San Diego communities, with respect to race/ethnicity.

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II.

Introduction to Problem

Background of the Southeast San Diego Region

Southeast San Diego is a 21.2 square mile area in the city of San Diego that is highly urbanized
from the core to the west and hilly from the core to the
east. Official use of Southeast San Diego has been

Figure 1

abandoned by the City Council since 1992 due to the

names cultural association of being a crime-ridden
and disadvantaged area. However, the reference
continues among locals and residents and for this
reason is being used for this proposal. Southeast San
Diego is represented by the communities east of
downtown, south of Martin Luther King Jr. Freeway,
west of California Route 125, east of Interstate 5, and
north of California Route 54, surrounding the
communities by freeways. The communities in the San
Diego Central Neighborhood include Barrio Logan, Grant Hill, Logan Heights, Memorial,
Sherman Heights, and Stockton. The San Diego Southeastern Neighborhoods consist of Alta
Vista, Bay Terraces, Broadway Heights, Chollas View, Emerald Hills, Encanto, Jamacha, Lincoln
Park, Lomita Village, Mount Hope, Mountain View, OFarrell, Paradise Hills, Shelltown, Skyline
Hills, Southcrest, and Valencia Park. Figure 1 shows a map of the boundaries of the Southeast
San Diego neighborhoods.
Race/Ethnicity and Class
The main racial/ethnic groups living in this area consist of Latin@s/Hispanics, AfricanAmericans, and Filipinos where the overall population is more than 195,000 people. These
communities are categorized by rich ethnic histories ranging from refugees fleeing from the
Mexican Revolution in the 1850s and economic crisis in the early 1900s, discriminatory
restrictions in purchasing real estate in the first half of the twentieth century, White Flight in
the 1960s and 70s, and the influx of Filipino immigrants joining the Navy following the
Vietnam War to the 1990s. While Whites make up 49% of the City of San Diego, they constitute
a 4% majority in Samuel F.B. Morse High School in Skyline that serves as an example of the
Research Proposal- Sociology 139

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areas diversity. 63% of the students are also eligible for free or reduced lunch, reflecting the
working class and low-income status of the majority of
residents in Southeast San Diego (Burke and Cavanaugh).

Figure 2

Background of the Study

Food insecurity is not an inequality limited to developing countries but
rather manifests itself globally and locally. There are multiple
definitions for food insecurity and it can be assessed on different
magnitudes of scale ranging from global, national, local, to the
household. I will focus on the household level of food insecurity in
Southeast San Diego, but first will lay out the other analyses of food
insecurity.
The Global
The World Food Summit in 1996 defined food insecurity as the
lack of physical and economic access to sufficient, safe and nutritious

Figure 3
food

to meet their dietary needs and food preferences for an active and
healthy life (FAO). On a global scale, one in seven people do not
have access to adequate food (Siegenbeek van Heukelom).
The National
Food insecurity is demonstrated in national statistics of measuring
how many people are food insecure. The USDA uses the definition of food
insecurity as, limited or uncertain availability of nutritionally adequate
safe foods or limited or uncertain ability to acquire acceptable foods
socially acceptable ways (Coleman-Jensen, Nord). As demonstrated in
Figure 2, 9.1% of U.S. households had low food security and 5.4% had very
low food security in 2010. These food-insecure households
demonstrate an effect on 48.8 million people, including 16.2
million children.

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and
in

Figure 3 demonstrates the prevalence of food insecurity in 2010 by household composition,

race/ethnicity of the head of the household, the income-to-poverty ratio, area of residence, and
census region. One will notice that the most food insecure household composition type is first
single women with children followed by single men with children. The racial/ethnical groups
that have the highest rates of food insecurity are Hispanics followed by Black non-Hispanics.
The income-to-poverty ratios most affected are those under 1.00 followed by those under 1.30.
The areas of residence most affected by food insecurity are those in principal cities followed by a
close tie between areas inside and outside metropolitan areas. Lastly, the census region most
affected is the South followed by the West.

Figure 4 shows the prevalence of food insecurity as

an average between 2008 and 2010. The varying

Figure 4

levels of the prevalence of food insecurity are

demonstrated in the different colors representing food
insecurity below, near, and above the U.S. average.
One will notice the states that are above the U.S. food
insecurity average are mainly southern states, Ohio,
and California.
The Local
The local in this case of this study is being defined as San Diego
County which Southeast San Diego is part of. The San
Diego Food Bank has defined food insecurity to mean that little or no food is available at home
and they will face times when they will not know where their next meal will come from (San
Diego Hunger Facts). Of the 3.1 million residents of San Diego County, more than 446,000 are
considered to be food insecure.
The Household
I will be using the working definition of household food insecurity from the Economic Research
Service of the USDA, defining food insecurity as the lack of access by all people at all times to
enough food for an active, healthy lifeis one of several conditions necessary for a population
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to be healthy and well nourished (Andrews, et al.). Access will be measured by proximity to a
grocery store and the sufficiency of goods in that store. The household will also be assessed for
their racial/ethnic category.

Research Questions
How food-secure are households in Southeast San Diego? Is there a trend in race and the levels
of food security?
Hypothesis
Most households in Southeast San Diego are food insecure, meaning they lack sufficient access
to sources of healthy and fresh foods in a convenient distance from their homes. There is a
relationship with race and their positions in communities with limited access to food.
Significance of Study
This study is significant because it could expose levels of food insecurity specific to Southeast
San Diego communities. As a result of discovering potentially high levels of low or very low
levels of food insecurity, solutions can be proposed to remedy these problems, ensuring optimal
human growth and development of these residents by access to one of the most basic elements of
life: food. By also collecting data on the racial/ethnic constitution of these populations, we might
be able to discover a connection between food security and race/ethnicity, potentially exposing a
type of racism within the food system.

III.

Literature Review

The Center for a Livable Future within the Johns Hopkins Bloomberg School of Public Health
compiled a survey in 2009 of relevant scientific literature on community food security in United
States cities. This compilation of literature by various professionals provides a comprehensive
understanding of the definitions and aspects of food security and insecurity. It gives a brief
history of policy of food security in the United States, magnitude and predictors of food security,
consequences of food insecurity, the coupling of poverty and food insecurity, obesity and food
insecurity, human rights and food security, and health care and food security. It goes on to
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provide food security measurement tools, discusses agriculture and food security, and
interventions to build food security and eliminate hunger. It ends with a useful provision of
literature search methods and programs and organizations concerned with food security and
hunger in the United States. The booklet can be located online searching for Community Food
Security in United States Cities: A Survey of the Relevant Scientific Literature.
The literature provided in this booklet is helpful for understanding general knowledge on
food security and useful in providing survey samples. However, the literature focuses more on
household food security trends in cities and the United States generally, instead of
neighborhoods. For this reason, new literature is needed on community-specific food security.
Our assessment of the Southeast San Diego area comes out of a desire for further understanding
food security on a community and household level.

IV.

Methodology

Research Design

First, data for measuring the level of household food security will be measured using the USDAs
household food security measurement survey. A surveyor will administer the survey to an adult
in a household as well as any children they have in the home. The survey is listed in Appendix A.

To understand the needs of the community outside of a scalable measure, an interview will be
conducted with a surveyor and a household member to answer questions about their ability to
access foods. This interview questionnaire is listed in Appendix B.

To discover the sufficiency of grocery stores in providing adequate foods, a survey must be
conducted of all grocery stores. The grocery store questionnaire is listed in Appendix C.

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To discover the racial/ethnic constitution of the Southeast San Diego community, a census must
be taken. An example of census data provided by the California Health Interview Survey is listed
in Appendix D.

Population

The surveys, questionnaires, and census data will be conducted in the neighborhoods of
Southeast San Diego, listed in Section II: Background to the Problem, Background to Southeast
San Diego.

Sampling and Sampling Technique

In order to sample an ample population that will represent general trends in the community, there
must be a minimum of 25% of households in a given community (ex: Encanto, Chollas View,
etc) surveyed and interviewed. 5% of the surveys and interviews conducted must be from the
eastern, northern, western, southern, and core centers of the community in order to get a
representative sample of information.

The grocery stores will entirely be surveyed in all the communities of Southeast San Diego in
order to realize trends of the foods they are lacking on a total scale.

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To sample the racial/ethnic constitution, we will also ask those being surveyed and interviewed
their race/ethnicity in order to avoid generalized census findings of race/ethnicity.

Data Collection

Data will be collected through a fieldwork research team over a period of three months. The
researchers will be responsible for finding 25% of households to survey in the five parts of each
of the 18 communities. In ethical consideration, any questions that the interviewee doesnt feel
comfortable answering, we will refrain from asking. We will take into account the lack of
responses to certain questions in our final data analysis. One of the household surveys is from the
USDA Economic Research Service and does not need to be adapted, listed in Appendix A. The
answers to this data represent the level of food security that households fall into. The household
questionnaire interview does not need to be adapted from the questions in Appendix B.
Most of the data we collect will be through household surveys, interviews, and observation of
grocery stores. We will not be using existing data sets in order to get the most updated data
information.
Data Analysis
The household survey will yield results of the households place on the continuum of food
security from high to very low. These results are directly interpreted by calculating the value of
responses listed in Appendix A.
The responses to the household interview questionnaire will be sent to the City Council and other
policy-making agencies to be used as action-based research for improving the community with
new grocery stores and general better access to healthy foods.
Understanding the racial/ethnic categories of households will allow for a specific analysis of the
racial composition of these households and their level of food security. After conducting the

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survey and questionnaire, we will be able to chart general trends that may exist about the
household level of food security and race/ethnicity.
The data acquired from the grocery store surveys will be used to establish a general trend by
entering responses into an excel document. The responses will then be analyzed to understand if
there is any majority of responses in certain communities (>50%). The results of this data are
also to be used for action in getting healthier food items into the grocery stores.

V.

Anticipated Findings/Impact

I attempt to find that a large proportion of residents will be of minority groups. By also
previously visiting the Southeast San Diego neighborhoods, I presume that our findings will
realize the trends of grocery stores to be inadequate in providing residents with healthy foods. I
also anticipate finding that more than 50% of the total households surveyed will be considered to
have low or very low food security through the USDA Household Interview Survey.

I anticipate the impact of the results of the research to be useful for understanding the
intersection of food access and race that can be used for further research projects. I also
anticipate the findings to impact the situation on the ground for the households in the Southeast
San Diego communities by future policies and infrastructure development to elevate low and
very low food secure households to have positions of marginal and high levels of food security.
The results we aim for are the development of grocery stores that provide healthy food sources
and the addition of healthy foods into already-existing grocery stores.
This research is important because it will show light on the food security situation in the most
diverse part of the City of San Diego. The research is being conducted in anticipation for action
and advocacy to take place after general trends of food insecurity are established. If the results
do not show that a majority of residents in Southeast San Diego have low or very low food
security, the data created will provide a basis for other research projects out in the field.

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VI.

References

Andrews, Margaret, Carlson, Steven, et al. Household Food Security in the United States in
2010. USDA, Economic Research Service. Access online 3/16/12:
http://www.ers.usda.gov/Publications/ERR125/err125.pdf.
Burke, Megan and Cavanaugh, Maureen. Census Reveals Big Changes In San
Diego Neighborhoods. (3/22/11). KPBS. Access online 3/20/12:
http://www.kpbs.org/news/2011/mar/22/census-reveals-big-changes-san-diegoneighborhoods/.
Coleman-Jensen, Alisha, and Nord, Mark. Food Security in the United States: Measuring
Household

Food Security. USDA, Economic Research Service. 11/16/2009. Access

online 3/16/12.
http://www.ers.usda.gov/Briefing/FoodSecurity/measurement.htm#and.
Dr. Lee, Rebecca. Where You Live Can Affect What you Weigh. The Grio via Associated
Press. 08/10/2009. Access online 3/13/12:

http://www.thegrio.com/2009/08/social-

and-environmental-factors-dictate.php.
Food Access & Affordability. Food Research and Action Center. 2010. Access online
3/17/2012: http://frac.org/reports-and-resources/food-hardship-access-to-fruits-andvegetables/.
Food and Agriculture Organization of the United Nations (FAO). (2009b). The State of Food
Insecurity in the World. Rome: FAO.
Haering, Stephen, MD, MPH and Syed, Shamsuzzoha, MD, MPH, DPH. Community Food
Security in United States Cities: A Survey of the Relevant Scientific Literature. Center
for a Livable Future, Johns Hopkins Bloomberg School of Public Health. Fall 2009.
Access online 3/16/12:

http://www.jhsph.edu/clf/PDF_Files/FS_Literature

%20Booklet.pdf.

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San Diego Community Profile: Southeastern San Diego. The City of San Diego. Access online
3/16/12:
http://www.sandiego.gov/planning/community/profiles/southeasternsd/index.shtml.
San Diego Community Profile: Southeastern San Diego: Commercial Element. The City of San
Diego. Access online 3/16/12:
http://www.sandiego.gov/planning/community/profiles/southeasternsd/pdf/sesdcpplnco
mmelem.pdf.
SANDAG Census Profile (2000). Southeastern San Diego Community Planning Area. City of
San Diego. Access online 3/16/12:
http://profilewarehouse.sandag.org/profiles/cen00/sdcpa1469cen00.pdf.
Siegenbeek van Heukelom, Tim. A Human Approach to Food Security: Land Grabs in the
Limelight. Journal of Human Security, vol. 7, no. 1, 2011.
The Interaction of Neighborhood and Household Characteristics in
Explaining Areas With

Limited Access (Chapter 3). Access to Affordable

and Nutritious Food: Measuring and

Understanding Food Deserts and

Their Consequences, USDA. Access online 3/17/2012:

http://www.ers.usda.gov/Publications/AP/AP036/AP036c.pdf.
The Jacobs and Cushman San Diego Food Bank. Hunger Facts and Statistics,
San Diego Hunger Facts. Access Online 3/16/12.
http://www.sandiegofoodbank.org/about/hunger/.
Whyte, Talia. Gross Inequality in Access to Healthy Food. The Grio via Associated Press.
8/28/2009. Access online 3/13/2012: http://www.thegrio.com/opinion/access-

to-

healthy-food-is.php.

VII. Appendix
A. HOUSEHOLD FOOD SECURITY SURVEY MODULE: THREE-STAGE DESIGN,
WITH SCREENERS, Economic Research Service, USDA, July
2008..14-23
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B. FOOD ACCESS COMMUNITY INPUT, HOUSEHOLD INTERVIEW

..24-25
C. FOOD STORE SURVEY....26

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APPENDIX A:
U.S. HOUSEHOLD FOOD SECURITY SURVEY MODULE:
THREE-STAGE DESIGN, WITH SCREENERS
(Compiled by the Economic Research Service, USDA, July 2008)

Summary: The following survey questions are about the food eaten in a household in the last 12
months, since (current month) of the last year and whether they were able to afford the food they
needed. The answers to their questions will generate a raw score that ranges from 0-18 for
households with one child or more and from 0-10 for households with no children. The scores
determine which category they fall into: high, marginal, low, or very low food security. Those
with low or very low food security are categorized as food insecure.
Source: http://www.ers.usda.gov/briefing/foodsecurity/surveytools/hh2008.pdf

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Household Stage 1: Questions HH2-HH4 (asked of all households; begin scale items).

[IF SINGLE ADULT IN HOUSEHOLD, USE "I," "MY," AND YOU IN

PARENTHETICALS; OTHERWISE, USE "WE," "OUR," AND "YOUR HOUSEHOLD."]

HH2. Now Im going to read you several statements that people have made about their food
situation. For these statements, please tell me whether the statement was often true,
sometimes true, or never true for (you/your household) in the last 12 monthsthat is,
since last (name of current month).

The first statement is (I/We) worried whether (my/our) food would run out before (I/we)
got money to buy more. Was that often true, sometimes true, or never true for (you/your
household) in the last 12 months?
[]

Often true

[]

Sometimes true

[]

Never true

[]

DK or Refused

HH3. The food that (I/we) bought just didnt last, and (I/we) didnt have money to get more.
Was that often, sometimes, or never true for (you/your household) in the last 12 months?

[]
[]

Often true
Sometimes true

[]
[]

Never true
DK or Refused

HH4. (I/we) couldnt afford to eat balanced meals. Was that often, sometimes, or never true
for (you/your household) in the last 12 months?

[]

Often true

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[]

Sometimes true

[]

Never true

[]

DK or Refused

Screener for Stage 2 Adult-Referenced Questions: If affirmative response (i.e., "often true" or
"sometimes true") to one or more of Questions HH2-HH4, OR, response [3] or [4] to question
HH1 (if administered), then continue to Adult Stage 2; otherwise, if children under age 18 are
present in the household, skip to Child Stage 1, otherwise skip to End of Food Security Module.

NOTE: In a sample similar to that of the general U.S. population, about 20 percent of
households (45 percent of households with incomes less than 185 percent of poverty line) will
pass this screen and continue to Adult Stage 2.

Adult Stage 2: Questions AD1-AD4 (asked of households passing the screener for Stage 2
adult-referenced questions).

AD1. In the last 12 months, since last (name of current month), did (you/you or other adults in
your household) ever cut the size of your meals or skip meals because there wasn't
enough money for food?
[ ] Yes
[ ] No (Skip AD1a)
[ ] DK (Skip AD1a)

AD1a. [IF YES ABOVE, ASK] How often did this happenalmost every month, some months
but not every month, or in only 1 or 2 months?

[ ] Almost every month

[ ] Some months but not every month
[ ] Only 1 or 2 months
[ ] DK

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AD2. In the last 12 months, did you ever eat less than you felt you should because there wasn't
enough money for food?
[ ] Yes
[ ] No
[ ] DK

AD3. In the last 12 months, were you every hungry but didn't eat because there wasn't enough
money for food?
[ ] Yes
[ ] No
[ ] DK

AD4. In the last 12 months, did you lose weight because there wasn't enough money for food?
[ ] Yes
[ ] No
[ ] DK

Screener for Stage 3 Adult-Referenced Questions: If affirmative response to one or more of

questions AD1 through AD4, then continue to Adult Stage 3; otherwise, if children under age 18
are present in the household, skip to Child Stage 1, otherwise skip to End of Food Security
Module.

NOTE: In a sample similar to that of the general U.S. population, about 8 percent of households
(20 percent of households with incomes less than 185 percent of poverty line) will pass this
screen and continue to Adult Stage 3.

Adult Stage 3: Questions AD5-AD5a (asked of households passing screener for Stage 3
adult-referenced questions).
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AD5. In the last 12 months, did (you/you or other adults in your household) ever not eat for a
whole day because there wasn't enough money for food?
[ ] Yes
[ ] No (Skip 12a)
[ ] DK (Skip 12a)

AD5a. [IF YES ABOVE, ASK] How often did this happenalmost every month, some months
but not every month, or in only 1 or 2 months?

[ ] Almost every month

[ ] Some months but not every month
[ ] Only 1 or 2 months
[ ] DK

Child Stage 1: Questions CH1-CH3 (Transitions and questions CH1 and CH2 are
administered to all households with children under age 18) Households with no child under
age 18, skip to End of Food Security Module.

SELECT APPROPRIATE FILLS DEPENDING ON NUMBER OF ADULTS AND NUMBER

OF CHILDREN IN THE HOUSEHOLD.

Transition into Child-Referenced Questions:

Now I'm going to read you several statements that people have made about the food situation of
their children. For these statements, please tell me whether the statement was OFTEN true,
SOMETIMES true, or NEVER true in the last 12 months for (your child/children living in the
household who are under 18 years old).

CH1. (I/we) relied on only a few kinds of low-cost food to feed (my/our) child/the children)
because (I was/we were) running out of money to buy food. Was that often, sometimes,
or never true for (you/your household) in the last 12 months?
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[]

Often true

[]

Sometimes true

[]

Never true

[]

DK or Refused

CH2. (I/We) couldnt feed (my/our) child/the children) a balanced meal, because (I/we)
couldnt afford that. Was that often, sometimes, or never true for (you/your household)
in the last 12 months?

[]

Often true

[]

Sometimes true

[]

Never true

[]

DK or Refused

CH3. "(My/Our child was/The children were) not eating enough because (I/we) just couldn't
afford enough food." Was that often, sometimes, or never true for (you/your household)
in the last 12 months?

[]

Often true

[]
[]

Sometimes true
Never true

[]

DK or Refused

Screener for Stage 2 Child Referenced Questions: If affirmative response (i.e., "often true" or
"sometimes true") to one or more of questions CH1-CH3, then continue to Child Stage 2;
otherwise skip to End of Food Security Module.

NOTE: In a sample similar to that of the general U.S. population, about 16 percent of
households with children (35 percent of households with children with incomes less than 185
percent of poverty line) will pass this screen and continue to Child Stage 2.

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Child Stage 2: Questions CH4-CH7 (asked of households passing the screener for stage 2
child-referenced questions).
NOTE: In Current Population Survey Food Security Supplements, question CH6 precedes
question CH5.
CH4. In the last 12 months, since (current month) of last year, did you ever cut the size of (your
child's/any of the children's) meals because there wasn't enough money for food?
[ ] Yes
[ ] No
[ ] DK

CH5. In the last 12 months, did (CHILDS NAME/any of the children) ever skip meals because
there wasn't enough money for food?
[ ] Yes
[ ] No (Skip CH5a)
[ ] DK (Skip CH5a)

CH5a. [IF YES ABOVE ASK] How often did this happenalmost every month, some months
but not every month, or in only 1 or 2 months?

[ ] Almost every month

[ ] Some months but not every month
[ ] Only 1 or 2 months
[ ] DK

CH6. In the last 12 months, (was your child/were the children) ever hungry but you just
couldn't afford more food?

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[ ] Yes
[ ] No
[ ] DK

CH7. In the last 12 months, did (your child/any of the children) ever not eat for a whole day
because there wasn't enough money for food?

[ ] Yes
[ ] No
[ ] DK

END OF FOOD SECURITY MODULE

User Notes

(1) Coding Responses and Assessing Household Food Security Status:

Following is a brief overview of how to code responses and assess household food security status
based on various standard scales. For detailed information on these procedures, refer to the
Guide to Measuring Household Food Security, Revised 2000, and Measuring Childrens Food
Security in U.S. Households, 1995-1999. Both publications are available through the ERS Food
Security in the United States Briefing Room.

Responses of yes, often, sometimes, almost every month, and some months but not
every month are coded as affirmative. The sum of affirmative responses to a specified set of
items is referred to as the households raw score on the scale comprising those items.

Questions HH2 through CH7 comprise the U.S. Household Food Security Scale (questions
HH2 through AD5a for households with no child present). Specification of food security
status depends on raw score and whether there are children in the household (i.e., whether
responses to child-referenced questions are included in the raw score).
o For households with one or more children:
Raw score zeroHigh food security

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Raw score 1-2Marginal food security

Raw score 3-7Low food security
Raw score 8-18Very low food security

o For households with no child present:

Raw score zeroHigh food security
Raw score 1-2Marginal food security
Raw score 3-5Low food security
Raw score 6-10Very low food security
Households with high or marginal food security are classified as food secure.
Those with low or very low food security are classified as food insecure.

Questions HH2 through AD5a comprise the U.S. Adult Food Security Scale.
Raw score zeroHigh food security among adults
Raw score 1-2Marginal food security among adults
Raw score 3-5Low food security among adults
Raw score 6-10Very low food security among adults

Questions HH3 through AD3 comprise the six-item Short Module from which the Six-Item
Food Security Scale can be calculated.
Raw score 0-1High or marginal food security (raw score 1 may be
considered marginal food security, but a large proportion of households that
would be measured as having marginal food security using the household or
adult scale will have raw score zero on the six-item scale)
Raw score 2-4Low food security
Raw score 5-6Very low food security

Questions CH1 through CH7 comprise the U.S. Childrens Food Security Scale.
Raw score 0-1High or marginal food security among children (raw score 1
may be considered marginal food security, but it is not certain that all
households with raw score zero have high food security among children
because the scale does not include an assessment of the anxiety component of
food insecurity)
Raw score 2-4Low food security among children
Raw score 5-8Very low food security among children

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(2) Response Options: For interviewer-administered surveys, DK (dont know) and

Refused are blind responsesthat is, they are not presented as response options, but marked if
volunteered. For self-administered surveys, dont know is presented as a response option.

(3) Screening: The two levels of screening for adult-referenced questions and one level for
child-referenced questions are provided for surveys in which it is considered important to reduce
respondent burden. In pilot surveys intended to validate the module in a new cultural, linguistic,
or survey context, screening should be avoided if possible and all questions should be
administered to all respondents.

To further reduce burden for higher income respondents, a preliminary screener may be
constructed using question HH1 along with a household income measure. Households with
income above twice the poverty threshold, AND who respond <1> to question HH1 may be
skipped to the end of the module and classified as food secure. Use of this preliminary screener
reduces total burden in a survey with many higher-income households, and the cost, in terms of
accuracy in identifying food-insecure households, is not great. However, research has shown that
a small proportion of the higher income households screened out by this procedure will register
food insecurity if administered the full module. If question HH1 is not needed for research
purposes, a preferred strategy is to omit HH1 and administer Adult Stage 1 of the module to all
households and Child Stage 1 of the module to all households with children.

(4) 30-Day Reference Period: The questionnaire items may be modified to a 30-day reference
period by changing the last 12-month references to last 30 days. In this case, items AD1a,
AD5a, and CH5a must be changed to read as follows:
AD1a/AD5a/CH5a
happen?

[IF YES ABOVE, ASK] In the last 30 days, how many days did this

______ days

[ ] DK

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APPENDIX B:
FOOD ACCESS COMMUNITY INPUT
HOUSEHOLD INTERVIEW
Summary: This survey will allow us to learn where households do their
shopping, why they shop there, if they get food from other sources, if they
find certain foods difficult to get, what kind of transportation they usually use
to get their groceries, and what changes they would suggest to make food
easier to get in their communities.
Source:
http://www.foodsecurity.org/SacramentoFoodAccessCommunityInputMeetingFormat.pdf
1) Where do you do currently do your food shopping and why do you
choose to shop there? (20 minutes)
a) Are there other stores you use besides your main food store?
b) What are the reasons you shop at these other stores?
c) How do different stores compare in terms of price, quality, service,
selection, convenience (try to draw specific examples from people, make
sure alternate recorder knows to write down these stories with as much
detail as possible)
d) When do you shop (time of day/time of month), who does the
shopping?
e) Is there anything else that influences where you shop?
f) Is there anything else that we need to record about shopping in this
area?
2) Is there any other way you get food? (10 minutes)
a) For instance, do you garden at home or have fruit trees? Do you
participate in the
SHARE program? (for those of you who are not familiar with SHARE, it
is a
COOP buying program where you pay $15 at the beginning of the
month and
receive a bag of food worth $30-45 at the end of the month. If you are
interested
we have more information that we can give you tonight)
b) We know there are currently no Farmers Markets in the immediate
area, but do
you go to the one downtown on the weekends or the one at Country
Club Plaza?
(We also have more information on Farmers Market locations)
3) Are there foods you find difficult to get? Why? (10 minutes)

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a) Do you sometimes not buy certain foods because they are too
expensive or the quality
is bad?
b) Do you find there are some foods that you cant find in the stores
even when they are in season (referring to perishable items)?
c) Is there not enough selection of some product to let you make the
most nutritious choice?
4) In general, what kind of transportation do you use to get your
groceries and get home? (10 minutes)
a) How far do you have to go to shop? (how far away from your home
is the nearest
grocery store- do you have to use a car or bus or is it close
enough to walk?)
b) Do you have difficulty getting transportation to get to the store?
c) If transportation wasnt an issue, where would you shop? (where
there is babysitting,
major grocery outlets such as Costco)
5) What changes in the community would make it easier to get food?
(10 minutes)
a) What small things could be changed to make it easier to get food?
b) Are there some system changes (bus routes, location of food
sources) that need to be addressed?
c) What do you feel are the most important issues that the community
needs to discuss?

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APPENDIX C:
FOOD STORE SURVEY
Summary: The following survey can be adapted to Southeast San Diego stores to measure how
much healthy and fresh foods customers can access there.
Source: http://www.foodsecurity.org/cfa/survey_fresno_store.pdf

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