Evidence Tools
Food Sufficiency
Introduction
This toolkit summarizes content from the Food Sufficiency Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.
From the MCH Block Grant Guidance. In 2021, 12.8% of children lived in food insecure households.1 Food insecurity had been decreasing since the Great Recession, but the number of children in food insecure households increased by 10% in 2020 due to the COVID-19 Pandemic. The percentage sharply declined by 20% in 2021, the lowest prevalence on record since 1998. There were several temporary measures taken as part of the Public Health Emergency response to expand benefits and access to programs such as SNAP, WIC, and the National School Lunch Program plus general economic relief.1,2 Large disparities exist by race/ethnicity, disability status, urbanicity, and family structure.3 Food insecurity among children is associated with poor health status, mental health problems, behavioral and socio-emotional problems, and poor educational performance and academic outcomes.4
Goal. To increase the percent of children whose households are always able to afford to eat good nutritious food.
Note. Access other related measures in this Population Domain through the Toolkits page.
New. Innovative Strategies to Improve Food Sufficiency in State Title V Programs: A Resource Guide to Enhance Food Access Through Title V. This resource guide lists some strategies that Title V programs in ten states and the District of Columbia are currently using to increase food sufficiency following the Individual plus Policy, System, and Environmental (I+PSE) Conceptual Framework.
Detail Sheet: Start with the MCH Block Grant Guidance
DEFINITION
Numerator: Number of children, ages 0 through 11, whose households are reported by a parent to have always been able to afford to eat good nutritious food in the past year.
Denominator: Number of children, ages 0 through 11
Units: 100
Text: Percent
HEALTHY PEOPLE 2030 OBJECTIVE
Related to Nutrition and Weight Status Objective 01: Reduce household food insecurity and hunger (Baseline: 11.1% of households were food insecure in 2018, Target: 6.0%)
Related to Nutrition and Weight Status Objective 02: Eliminate very low food security in children (Baseline: 0.59% of households with children under 18 years had very low food security among children in 2018, Target: 0.0%)
DATA SOURCES
National Survey of Children’s Health (NSCH)
MCH POPULATION DOMAIN
Child Health
MEASURE DOMAIN
Social Determinants of Health
1. Accelerate with Evidence—Start with the Science
The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.
Evidence-based/Informed Strategies: MCHbest Database
The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.
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Evidence-Based |
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Mixed Evidence |
Emerging Evidence |
Expert Opinion |
Moderate Evidence |
Scientifically Rigorous |
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Also check out the Breastfeeding Evidence Accelerator, as lactation support is a positive contributing factor for food sufficiency.
Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub
Cutting Edge:
- Capacity and Systems Building Program (WI)
- Faith-Based Health Promotion (IN; 2024)
Emerging:
Promising:
2. Think Upstream with Planning Tools—Lead with the Need
The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.
Move from Need to Strategy
Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.
Planning Tools: Use these tools to move from data to action
3. Work Together with Implementation Tools—Move from Planning to Practice
The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.
Additional MCH Evidence Center Resources: Access supplemental materials from the literature
- Find field-based resources focused on increasing food sufficiency relevant to Title V programs in the MCH Digital Library.
- Search the Established Evidence database for peer-reviewed research articles related to strategies for increasing food sufficiency.
- Request Technical Assistance from the MCH Evidence Center
- MCH Evidence Center Frameworks and Toolkits:
Implementation Resources: Use these field-generated resources to affect change
Practice. The following tools can be used to translate evidence to action to advance this NPM:
- Innovative Strategies to Improve Food Sufficiency in State Title V Programs: A Resource Guide to Enhance Food Access Through Title V. This resource guide lists some strategies that Title V programs in ten states and the District of Columbia are currently using to increase food sufficiency following the Individual plus Policy, System, and Environmental (I+PSE) Conceptual Framework.
- Community Food Security Assessment Toolkit (Economic Research Service). This resource provides standardized measurement tools for assessing food security.
- Food and Nutrition Security Primer (Association of State Public Health Nutritionists). This resource aims to deepen understanding of food and nutrition security terms.
- Hunger Vital SignTM (Children’s HealthWatch). This validated 2-question tool helps to identify households at risk for food insecurity.
- Food Sufficiency: From Need to National Measure (Association of State Public Health Nutritionists). 50 minute webinar outlining the new NPM.
Partnership. The following organizations focus efforts on advancing food sufficiency:
- National Center for Chronic Disease Prevention and Health Promotion. Provides resources and case studies to improve food security.
- American Academy of Pediatrics. Houses research and recommendations to improve the lives of children facing food insecurity.
- Association of State Public Health Nutritionists. Provides state and national leadership on food and nutrition policy, programs, and services.
References
Introductory References: From the MCH Block Grant Guidance
1 Coleman-Jensen, Alisha, Matthew P. Rabbitt, Christian A. Gregory, Anita Singh, September 2022. Household Food Security in the United States in 2021, ERR-309, U.S. Department of Agriculture, Economic Research Service. https://www.ers.usda.gov/webdocs/publications/104656/err-309.pdf
2 U.S. Department of Agriculture. FNS Responds to COVID-19. (n.d.) https://www.fns.usda.gov/coronavirusotnote>
3 Ullmann H, Weeks JD, Madans JH. Children Living in Households That Experienced Food Insecurity: United States, 2019-2020. NCHS Data Brief. 2022;(432):1-8.
4 Food Research and Action Center (FRAC). The impact of poverty, food insecurity, and poor nutrition on health and well-being. 2017 December. https://frac.org/wp-content/uploads/hunger-health-impact-poverty-food-insecurity-health-well-being.pdf