Getting on the Bus with Material Hardship

This is the third post in a series of three on the measurement of poverty in the U.S.

Hunger takes this bus, too. 1 in 6 Americans struggle with hunger. This attention-grabbing sign began appearing on buses around Boston and other major American cities last year. The sign, and accompanying television and print advertisements, is part of a marketing blitz by the largest domestic hunger-relief charity, America’s Second Harvest, to raise money for food banks around the nation.

Capturing the attention of a fickle public is always challenging, but something about hunger clearly resonates with many people. The average American may not have a clear grasp of what poverty is, especially “official poverty,” but there is nothing abstract about hunger. Skipping meals, going to bed on an empty stomach, avoiding visits to the grocery store for lack of money – these are very tangible fears that plague many American households.

What is true for the general public may also be true for scholars and policymakers: perhaps when we study poverty we should be focusing on the concrete consequences of not having sufficient resources, and not simply the income threshold for sufficiency. In my last post I argued that defining poverty is difficult not only because we sometimes lack adequate data to compare differences in the standard of living between groups and time periods, but also because the very basis for comparison requires controversial judgments about adequate resources. Can we get any closer to a value-free measure of poverty by focusing on hunger and other hardships?

Bringing Material Hardship into the Picture

Respondents to major social surveys including the SIPP are asked whether they have adequate food, shelter, clothing, medical care, and transportation to get to work and school. A simple and intuitive way to conceptualize material hardship is the lack of at least one of these basic necessities. In fact, some researchers have defined families that report that they experience at least one of these conditions as living with a material hardship. Others have tried to create either a count of these conditions, or an index that weights each condition by its relative severity.

Although the underlying measures are intuitive, some problems with comparison and measurement arise immediately. What basis do we have for determining the weights for different conditions? Should we weight most heavily those outcomes that most increase the risk for poor outcomes such as mortality? Should we ask the public, or those living in conditions of hardship which outcomes are most important? Should we consider the persistence of these problems, or focus more on transitory, but acute problems such as temporary food insecurity? (A nice summary of these issues is described in this 2005 Health and Human Services Report)

Hungry or Food Insecure?

To be a bit more specific, let’s consider the measurement of food insecurity – arguably the most well studied hardship affecting low-income families in the United States.

According to the United States Department of Agriculture, 48.8 million people lived in food-insecure households (similar to the share in 2009). This is the putative basis for the claim that 1 in 6 people are hungry. The risk of food insecurity is higher for families with children, minorities, and single-parent households. Risk of food insecurity also decreases monotonically with income.

The USDA defines food insecurity as: “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.” Many good things can be said about this nuanced definition, but one thing that we should be clear about is that food insecurity is not hunger, as the dictionary would define it (the USDA is quite explicit on this point, saying: “Food insecurity is a household-level economic and social condition of limited access to food, while hunger is an individual-level physiological condition that may result from food insecurity”).

The USDA actually defines four conditions: high food security (no problems, or anxiety about, consistently accessing adequate food), marginal food security (problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of food intake was not substantially reduced), low food security (reduced the quality, variety, and desirability of diets, but the quantity of food intake and normal eating patterns were not substantially disrupted), and very low food security (eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food).  The survey modules used to derive these measures can be found here. Conventionally, only those in the low food security or very low food security categories are considered food insecure.

Food security is an interesting case to consider because we can readily compare reports of food security with data on dietary intake, including calories consumed and types of food that families eat. So we know, for example, that adults defined as food insecure also receive more calories from fatty foods and fruit juices. Establishing the links between food insecurity and nutrition intake is a helpful way of showing how food insecurity has real consequences linked to health outcomes, but the experience of food insecurity as such seems to be a subject of intense policy concern. Part of this concern may arise from a worry that even if there are no further negative health consequences from food insecurity, it is intrinsically bad for some families to not be able to meet their own perceived dietary needs.

Hardship or Deprivation?

I have previously commented that Americans and Europeans think about these issues very differently: Europeans focus much more on relative deprivation or social deprivation. This is borne out by European social surveys that ask about the ability to consume diets that conform to the standards and norms of each country, such as eating at least two servings of meat per week.

There are deeply entrenched political and cultural reasons why Americans may never abandon hardship-based measures, including a general resistance to communitarian or collective arguments for social welfare. Still, there is something important about articulating a standard of living appropriate to the needs of a particular social context and a particular society. This may take us well beyond a standard of necessity or sufficiency. As Adam Smith said better than anyone else about the standards of his own era:

“By necessaries I understand not only the commodities which are indispensably necessary for the support of life, but what ever the customs of the country renders it indecent for creditable people, even the lowest order, to be without. A linen shirt, for example, is, strictly speaking, not a necessary of life. The Greeks and Romans lived, I suppose, very comfortably, though they had no linen. But in the present times, through the greater part of Europe, a creditable day-laborer would be ashamed to appear in public without a linen shirt, the want of which would be supposed to denote that disgraceful degree of poverty which, it is presumed, nobody can well fall into, without extreme bad conduct. Custom, in the same manner, has rendered leather shoes a necessary of life in England.”

Life has become more complex than 18th century England, because the conditions of living have become more diverse and more transitory than in other times. People are able to buy more things and obtain more experiences than ever before, but they are also in grave danger of losing these resources through the vicissitudes of a global economy. What standards should guide our understanding in an age of both abundant consumption and abundant insecurity? 

About Brendan Saloner

I am a postdoctoral fellow at the University of Pennsylvania in the Robert Wood Johnson Health and Society Scholars Program. I completed a PhD in health policy at Harvard in 2012. My current research focuses on children's health, public programs, racial/ethnic disparities, and mental health. I am also interested in justice and health care.
This entry was posted in Articles and tagged , , , . Bookmark the permalink.

3 Responses to Getting on the Bus with Material Hardship

  1. Pingback: How the Other Half Eats - A Glance at Eating and Inequalities in the U.S.

  2. Pingback: How the Other Half Eats | The Eaten Path

  3. Pingback: Adding Health Care Spending to the Poverty Equation | Inequalities

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.