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10 Million Americans Underfed, Study Says

4 million of the hungry are children, the majority from families with at least one wage earner.


WASHINGTON — Easily overlooked amid the numerous signs of a flourishing economy is a new study that offers a disturbing glimpse of the other America. Federal researchers report in the current issue of the American Journal of Public Health that 10 million Americans, more than 4 million of them children, do not have enough to eat. The majority are members of families in which at least one person is working.

Researchers at the National Center for Health Statistics and Cornell University analyzed data collected between 1988 and 1994 for the third National Health and Nutrition Examination Survey (NHANES). The survey, which involved 30,000 people, found that those who said they were sometimes or often hungry were more likely to lack health insurance and more likely to live in families in which the head of the household had not graduated from high school.

This study and a recently published Agriculture Department survey are the first national research efforts to quantify the extent of hunger in the United States. Both surveys came up with similar results. According to the NHANES data, low-income families headed by women were 5.5 times more likely to be hungry than those headed by men. In nearly 3% of families surveyed, children younger than 17 had skipped meals or eaten less at least once during the previous month because of a lack of money.

"The general cruelty of a rising economy and the rich getting richer and the poor getting poorer is so unjust that it should be a major national priority," said Marion Nestle, chairwoman of the department of food studies at New York University. "The problem is that everyone is so inured to it.

"What's alarming is the number of children involved," Nestle said. Poor or inadequate nutrition in childhood, scientists say, can permanently stunt physical and intellectual development.

"It's easy to underestimate the role of food in educational achievement," said John T. Cook, research director for the Tufts University Center on Poverty and Hunger. "Even before a child exhibits signs of malnutrition, inadequate food affects the ability to pay attention, to perform in school, to achieve."

Katherine Alaimo, formerly a nutritionist at NCHS and lead author of the survey, said she was surprised by the large number of families that reported having too little to eat. Alaimo, now a doctoral candidate at Cornell University, noted that 53% of those who said they were hungry were members of working families.

Even in families well above the federal poverty line--$15,150 for a family of four--hunger was a problem. Alaimo said 4.3% of those in four-person families with incomes between $20,000 and $28,000 reported going hungry.

"It was shocking to me to see the number of people who reported this who were married, working and living in families with children," she said.

When asked why they had too little food, more than 98% of those surveyed said they didn't have enough money to buy it or had run out of food stamps or vouchers for the Women, Infants and Children (WIC) program.

Alaimo said the study underscores a finding of increasing interest to researchers: the interrelationship between the lack of health insurance and hunger.

"Having health insurance is an additional buffer for those families," she said. "Universal health insurance would help the problem of hunger because families would no longer have to choose between paying medical bills or buying food."

The prevalence of hunger varied by race and region, the study showed. The prevalence rate among Mexican Americans was the highest (15.2%), followed by blacks (7.7%) and whites (2.5%). Those reporting too little food were most likely to live in the West (5.6%), followed by the South (3.9%), the Northeast (3.6%) and the Midwest (3.5%).

NYU's Nestle notes that hunger was popularly identified as a contemporary social problem in 1967, when members of the Physician Task Force on Hunger in America fanned out across the country, visiting Appalachia and the Mississippi Delta, among other places, and discovering Americans, many of them children, who were literally starving to death.

In a 1985 book, task-force members described what they found in the 1960s.

"We saw children whose nutrition and medical condition was shocking even to a group of doctors whose work involved them daily with disease and suffering," they recalled.

"In child after child, we saw evidence of vitamin and mineral deficiencies, severe anemia, eye, ear and bone diseases associated with poor food intake. We found children who were listless, suffering from fatigue and exhaustion, children who got no milk to drink and who never ate fruits and vegetables. They lived on grits and bread."

As a result of what the task force found, the WIC program was founded and the federal food-stamp program was strengthened. "That was then, the era of the Great Society," Nestle noted.

When the task force revisited the same communities a decade later, in 1977, its members said they still saw "immense poverty" but not "widespread hunger and malnutrition." The problem of hunger had dramatically abated.

Less than a decade later, concern about hunger resurfaced. In the mid-1980s, food banks and soup kitchens sprang up in many communities and the federal government gave away surplus cheese.

Although hunger was widely believed to be a growing problem, it wasn't until the third NHANES study, begun in 1988, that it was officially quantified.

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