Scientific Rigor and Effective Advocacy: The Historical Challenge of Defining Food Insecurity and Hunger in America

Since the late 1960s, biomedical scientists and others have been documenting the hunger problem in America. These efforts have informed policy debates and legislation on food assistance and welfare programs. Documenting hunger in America represents a dual challenge. On one hand is the importance of getting a scientifically defensible estimate of the magnitude of the problem with only limited amounts of information. On the other hand is the need to provide a policy‐relevant indicator that is easily understood and made available in a timely fashion. Initially, hunger was often equated with malnutrition and estimates relied on knowing the size of the population in poverty. These early estimates were rough, missing the nuances that hunger occurs before obvious symptoms of malnutrition, and that income status is an inadequate proxy for those affected by hunger. Since the mid‐1990s, estimates of hunger have been linked to household food insecurity and derived from direct measures using experiential‐based survey questions in a nationally representative sample. As techniques for estimating food insecurity and hunger have become more refined, there has been increased demand for more precision in the definition and measurement of the hunger condition. This paper traces the history of defining hunger, along with the challenges involved, and suggests new directions for balancing scientific rigor with effective advocacy.