Collaborative Study of Persons

Receiving Emergency Food

In

Twelve California Counties

Preliminary Summary

May 1998

California Food Security Monitoring Project

California Food Policy Advocates

with

California Catholic Charities:

Monterey

Orange

Sacramento

San Diego

Santa Rosa

Fresno

Sacramento City & County Hunger Commission

St. Anthony Foundation, San Francisco

Camarillo Community Church, Ventura

Catholic Social Services, Solano County

I.  Introduction

Food stamps constitute the largest and most comprehensive hunger-prevention safety net for California's poor and immigrant children, families, and individuals. About 2.2 million persons (868,000 households) in California receive food stamps, of which 70% are children. Despite surviving welfare reform as a federal entitlement, the food stamp program took the deepest reductions in the federal welfare bill (cuts that were unrelated to reforms, but simply budget balancing mechanisms) and underwent sweeping rule changes. In the next several years, denial of benefits to several large classes of recipients, and dozens of welfare reform-related changes will create major barriers to utilization of food stamps, and threaten household food security for many low-income Californians.

Denial of food stamp benefits to most legal immigrants and to thousands of jobless single adults constituted the largest and most immediate cuts in the 1996 federal welfare law.

California took the brunt of these cuts, since the state is home to nearly half the legal immigrants in the nation (241,000 of whom lost their food stamps on September 1, 1997) and at least 120,000 jobless adults, most of whom lost benefits on Thanksgiving 1997.

Immigrants and single adults are not the only groups impacted by food stamp changes. The implementation of the state’s new welfare law, California Work Opportunity and Responsibility to Kids (CalWORKs), includes a lump-sum diversion option, time limits, and numerous bars and sanctions which could affect the food purchasing power of 2.3 million Californians, including 1.6 million children, currently enrolled, and those who will apply. In states that are further into welfare reform implementation, food stamp caseloads have dropped in what GAO calls a "dramatic and surprising fashion."

While some of this decline is clearly attributable to improved economic conditions obviating the need for food stamps, evidence suggests that households terminated from cash welfare could lose food stamps for which they are still eligible. In the coming years, various groups in California are at risk of losing access to critical food assistance due to changes in welfare rules. These include: applicants subject to up front job search or work requirements; persons formally or informally diverted from CalWORKS with lump sum cash assistance or simple discouragement or referrals; persons subject to CalWORKS sanctions or terminated due to time limits or new earnings; persons not seeking CalWORKS due to stigma, misinformation, or low-wage work.

As welfare recipients join the ranks of the working poor, food stamps can offer a critical nutrition lifeline -- but only if these households can easily and equitably access the program. Yet even before welfare reform, studies have shown that only about 50% of eligibles ever participate in the food stamp program. While many people know of the Food Stamp Program, those at greatest risk of hunger and its health effects - migrant and seasonal farmworkers, elderly homeowners, low-wage workers and the homeless - mistakenly believe they are ineligible for program benefits. Language, literacy, alien status, transportation, welfare office closures, program complexity, fear and pride all serve as formidable barriers to participation. As CalWORKS and immigration reforms roll out at the county level, it is unlikely that these barriers will be lowered.

When food stamp participation (and/or cash assistance) ends, the lost food purchasing power (ranging from $71 to $150 per month per person in the case of wholesale terminations) can have severe and complex consequences. Some families will cope, some will go hungry, most will do both. Poor and near-poor households, when faced with reduced income and basic needs assistance, will reduce or curtail food purchasing and intake in order to avoid more immediate dangers such as loss of utilities, eviction, doubling up, homelessness, or criminal activities. These households will run out of food sooner, begin to skip meals, and many may end up sending their children to bed hungry. The long term results of these coping behaviors include increasing rates of chronic undernutrition, childhood anemia and other nutritional deficiency diseases, school failure and lack of job readiness.

The California Food Security Monitoring Project (CFSMP) was designed by California Food Policy Advocates to measure the prevalence of food insecurity and hunger in the state’s low-income population over several years. Food insecurity, which can now be accurately defined and appropriately measure, can be considered an "early warning" sign of problems that may result from the implementation of the welfare reform.

Because legal immigrants were the largest category to be cut from the federal food stamp program, the monitoring efforts give special consideration to that population. In addition, the project attempts to track another large group losing food stamps: the so-called Able Bodied Adults without Dependent Children, ABAWDS, who are jobless, single adults. This group may receive food stamps for only three months during any 36-month period if they are not participating in a work or workfare activity or live in a waived county. All waivers expire this year and many counties in this study do not offer ABAWDs workfare.

An earlier study in this series, The Impact of Legal Immigrant Food Stamp Cuts in Los Angeles and San Francisco Counties, measured food insecurity and hunger among legal immigrants in two large urban counties during the months of November 1997, and January and March 1998. These results were reported in May 1998, and indicated an alarming prevalence of hunger among legal immigrant households, including families with children, with strong evidence that hunger rates were increasing among households whose food stamp benefits were reduced due to welfare reform.

Periodic descriptive surveys of clients seeking emergency assistance from charitable organizations can provide valuable information about households who are dropping from state welfare caseloads, but may not be faring as well as some policymakers may believe. The second study of the CFSMP series is therefore designed to obtain information about how welfare policy is affecting the general low-income population in California, particularly those who may no longer be participating in formal cash or food assistance programs.

II. Survey Methods

The USDA Food Security Measure

The survey tool selected for the CFSMP is the Core Food Security Module, designed by the United States Department of Agriculture. The Food Security Module is an 18-item questionnaire that is based on a longer set of questions, the Food Security Supplement, used yearly since 1995 by the U.S. Census Bureau as part of the ongoing Current Population Survey (CPS) of 65,000 households. Both of these survey tools are the result of 10 years of extensive research and validation studies by government, research and university groups. The Food Security Module has been further adapted for use in national surveys such as the National Health and Nutrition Examination Survey (NHANES), and research conducted by Centers for Disease Control (CDC).

The questions used in the Core Food Security Module reflect the findings of previous research that households facing economic hardship go through a continuum of coping strategies as food insecurity due to lack of money becomes more severe, finally resulting in stark hunger. Initially, heads of households feel anxiety about the insufficiency of food to meet their basic needs, and begin to adjust to limited food budgets by changing the quality or variety of the food they eat or serve their children. As the situation becomes more severe or prolonged, adults in the household reduce their food intake and begin to experience hunger. In the most severe conditions, children, as well as adults, suffer from hunger due to reduced food intake.

Each of the 18 questions in the survey verifies that the reported behavior or condition occurred due to financial limitations placed on the household by phrasing the questions in this context.  For example, one question asks, "In the last 12 months, did you ever cut the size of your meals or skip meals because there wasn't enough money for food?"  Another question asks, "In the last 12 months, did you ever not eat for a whole day because there wasn't enough money for food?"  Participants respond by answering that this statement is "Always true", "Sometimes true", or "Never true".

Based on the statistically scaled responses to the 18 questions in the Food Security Module, a Food Security Measure was derived, which assigns a score of 0 - 4 to each household surveyed. The Measure uses the definitions adopted in 1990 by the Life Sciences Research Office (LSRO) of the Federation of American Societies for Experimental Biology (FASEB).

USDA's Food Security Measure: The Hunger Continuum

Charitable Social Service Organizations Survey

In the fall of 1997, California Food Policy Advocates approached Catholic Charities of California, a statewide organization representing the directors of Catholic Charities, non-profit charitable social service agencies operating in California’s twelve Catholic Dioceses. We invited these agencies to collaborate in using the USDA Food Security Measure to study the prevalence of hunger and food insecurity among their client population using emergency food and other charitable social services, such as free clinics or clothing donations.

Seven Catholic Charities agencies agreed to participate in the initial survey during the month of April 1998. The directors provided CFPA with a list of member agencies within their networks with the staffing and experience necessary to comply with the study protocol. Ten counties (El Dorado, Fresno, Imperial, Orange, Sacramento, San Diego, Santa Cruz, Solano, Monterey and Sonoma), 12 cities (Placerville, Fresno, El Centro, Watsonville, Salinas, Santa Cruz, Santa Ana, Sacramento, Vista, San Diego, Santa Rosa, and Vallejo) and 19 survey sites were represented in this group.

In addition, we solicited the participation of St. Anthony’s Foundation in San Francisco County and Camarillo Community Church in Ventura County to ensure that these areas were included in the sample population. These two organizations are similar in philosophy and services to Catholic Charities and were considered suitable replacements. Twelve counties (see map), with a mix of urban and rural sites, are represented in the survey. Demographic information about the site survey population can be found in the Appendices.

A standard sampling protocol was used by each of the participating sites. Sample size was derived using calculations that included the client population served in an average month, and the number of days per week that a site was able to conduct interviews. A minimal sample of 30 surveys was needed for aggregation of the data, but agencies could collect more surveys in order to achieve statistical representation of their agency population. Most agencies collected the larger number of surveys.

After a sample size was calculated for each participating site, a random number program was run to select clients to interview. For example, at the Fresno site, the staff reported that they serve approximately 2,500 clients during a typical month, and that they would be able to conduct interviews three days a week. To reach the desired sample of 100 completed surveys at the end of the survey period, and with a projected refusal rate of 33 %, 150 clients would be approached by an interviewer. A Random Number Selection Sheet, provided by CFPA, would indicate that 13 of 50 clients coming into the site during a survey day should be approached. The interviewer followed the Selection Sheet and ticked off a number each time a client entered the agency and approached only those clients which were marked on the sheet as "selected" for the sample. Each site recorded in a logbook how many clients entered their site on a survey day, how many were asked to participate in the survey, and how many agreed to be interviewed.

In all, 7,745 clients used the services of the providers participating during the study period. 1,015 clients (13%) were randomly selected to be in the sample population and were approached by an interviewer, and 834 clients (82%) agreed to complete a survey interview. Of these surveys, 823 (99%) were completed correctly and were used to compute a household’s food security score.

Agency employees or volunteers administered the survey questionnaire in face-to-face interviews with adult clients who voluntarily agreed to participate. Training in sampling and interviewing techniques were conducted in person or via telephone before the survey period began, and all participating agencies received extensive written instructions. Surveys were available in Spanish and English. Completed surveys and logbooks were forwarded to California Food Policy Advocates for data entry and analysis. In compliance with the procedure outlined in the USDA guidelines for implementing the Food Security Measure, all surveys having more than seven missing responses were not included in the final analysis.

In addition to the Food Security Measure, the survey questionnaire asked each client the following questions:

• Number of children under the age of 18 in the household
• Number of adults over the age of 18 in the household
• Age
• Current monthly income
• Current monthly rent plus utilities expense
• Country of origin and the number of years in the U.S., if not a citizen
• Number of household members who are U.S. citizens
• Number of household members who are legal immigrants to the U.S.
• Whether the household’s food stamp benefits have been cut in the past year
• Whether any member of the household participated in the Food Stamp Program in the past year

 

III. Findings

Profile of Respondents

Of those who answered questions concerning country of origin (71% of the sample), the majority of the respondents were U.S. citizens (67%) or immigrants from Mexico (25%). Another 5% reported that they came to the United States from Central or South America, 1% reported coming from East or Southeast Asia. The remaining 2% came from diverse countries including Europe and North Africa.

Most (64%) respondents were female with an average age of 42. The average household size was 3.6 members, with 1.8 children. Although there was a wide range of monthly income reported, the median income was very low at $650 per month. Fifteen percent of the respondents reported that they had no income and 15% reported that they were homeless. The median amount paid for rent-plus-utilities was $429. While only 5% of clients reported that they were using emergency food services for the first time, 33% reported using such programs on a daily or weekly basis.

Not surprisingly, this sample of emergency food recipients was extremely impoverished. Nearly all (97%) clients in this study were living at or below the poverty line (set in 1998 by the federal government at $1,739 a month for a four-person household). Over half (52%) were living in extreme poverty – less than 30% of the poverty threshold.

Survey Results

The results from the statewide sample of 823 complete and valid surveys indicate an extremely high prevalence of food insecurity and hunger among this group of very poor Californians.

• Approximately 60% of the households in the sample are experiencing hunger.

According to the USDA Food Security Measure used in this study the term "food insecure with moderate hunger" means that the adults in the household have reduced their food intake to the extent that they have repeatedly experienced the physical sensation of hunger. Children, however, are not directly experiencing hunger at this stage. The term "food insecurity with severe hunger" means that children are being directly affected by the lack of food and money in the household, and there is evidence that they are experiencing the physical sensation of hunger. In this most serious level of food insecurity, adults are already severely restricting their own intake, but now report having to skimp on portions or cut food variety for their children, skip serving meals or snacks, or send their children to bed hungry.

In this study, 27% of households randomly selected into the study sample were experiencing food insecurity with severe hunger, and 33% were food insecure with moderate hunger present – an overall hunger prevalence rate of 60%.

In comparison, among a very poor population (households with incomes below 50% of poverty) the 1995 Current Population Survey found an overall hunger prevalence of 17% -- with 12% food insecure with moderate hunger and 5% food insecure with severe hunger. Thus, these results show rates of hunger in this population that are over three times higher than those found in a similarly very low income population three years ago. However, the CPS population sample was comprised of households with telephones that were not seeking charitable food or other assistance.

Food Security Measure results by individual agency site can be found in the Appendices.

• Children in families using emergency food have not been protected from the negative consequences of hunger and malnutrition.

Nearly two thirds (63%) of households with children under the age of 18 are experiencing food insecurity with moderate to severe hunger evident. This high level hunger of persists despite the fact that virtually all poor children are eligible for federal or state nutrition programs such as Food Stamps, School Lunch, School Breakfast, and Summer Food and WIC Supplemental Food.

 

 

 

 

 

 

 

 

• Households reporting that their food stamp benefits had been cut in the past year had significantly higher hunger rates than households reporting that they did not have their food stamps cut.

For this analysis, only those households (330) who reported that they participated in the Food Stamp Program during the past year were included. Of these, 253 households reported losing their food stamps. Among those households who lost food stamps, 71% experienced food insecurity with moderate to severe hunger, compared to a 48% hunger rate among those who did not lose benefits. This large discrepancy was statistically significant and appears to occur predominantly in households with young children.

• Immigrant families who had their food stamps cut had the highest rates of food insecurity and hunger in the sample.

Immigrant families, who had some or all of their food stamps cut, had the highest percent of hungry households of any other group in this sample. Seventy-five percent of these immigrant households were suffering from hunger because they didn't have enough money for food.

 

• Single adults seeking emergency food were also faring badly.

One third of the sample were single adults without dependent children. Only 18% of these 246 adults were experiencing food security. Over half (59%) were food insecure with moderate to severe hunger. Over one-fifth (22%) of this sub-population reported that their food stamp benefits were cut during the past year. A comparison of those households who had cuts and those who did not shows a very high rate of food insecurity with hunger among the cut households which was significantly different from those whose benefits were not cut.

IV. Discussion

This study documents intolerable rates of food insecurity and hunger among California’s low-income population and provides clear evidence that the food stamp cuts contained in the federal welfare reform bill are actually generating hunger and harming children and adults alike. Since this study design included a validated and widely used survey instrument, a random sample of a distinct population, and careful quality control of all aspects of data collection, the findings are particularly powerful and compelling.

High rates of hunger among these households were detected despite concerted public and private efforts to mitigate the potential harm caused by the food stamp terminations and other welfare and immigration policy changes. Eight of twelve counties included in the survey had full or partial waivers that have postponed the strict three-month limit for single adults on food stamps. Some counties allocated additional financial resources to county food banks to purchase and distribute food to emergency food sites to meet the expected increased demand for food especially among legal immigrants. The California Legislature created the California Food Assistance Program to provide state-funded food stamps to legal immigrant children and the elderly who lost federal benefits, and established a $2 million grocery voucher program for migrant farmworkers who lost food stamps, as well.

These findings were consistent with a previous study reported by California Food Policy Advocates which detected an increase in hunger from 42% to 50% in the six month period following the enactment of the food stamp cuts in Los Angeles County. That study also reported a finding of 32% of households with moderate to severe hunger in San Francisco County. Recently, the Physicians for Human Rights reported that they found a similar prevalence of food insecurity with hunger evident among three distinct immigrant populations in three large metropolitan areas in the United States. Latino and Asian clients in community medical clinics were interviewed with the same USDA questionnaire used in this study. Investigators found similar but slightly lower rates of moderate and severe hunger.

Clearly, a partial legal immigrant food stamp restoration, such as that contained in the current California Food Assistance Program and the recently signed federal Agricultural Research Conference Report bill (S. 1150) will not go far enough. Full restoration of food stamps to all impacted immigrant households is needed to more adequately protect vulnerable populations from needless and unjust hunger. Furthermore, policymakers must address the implications of current policies that enforce time limits and harsh sanctions on single jobless adults who rely on food stamps during periods of seasonal unemployment.

The findings of this monitoring effort can be placed in the context of other recent medical studies that demonstrate that hunger and food insecurity can cause serious short and long-term health consequences, in both children and adults. These studies have found that children suffering from hunger are more likely to have psychosocial dysfunction, such as aggression and anxiety. Episodes of food insufficiency and hunger are also associated with poor academic performance. Young hungry children may exhibit long-term nutrition-related health problems such as delayed growth, iron-deficiency anemia and increased uptake of lead. A recently published study of an adult patients in a Minneapolis county hospital used the USDA Food Security Measure, and found that hunger was closely correlated with reduction in food stamps, and that inadequate food was severely compromising the health of low-income diabetic patients treated in the emergency room.

Other studies have demonstrated the protective effect of the Food Stamp Program against food insecurity and nutritional problems. Studies have indicated that food stamp use during pregnancy is associated with a decrease in the incidence of low birth weight infants. Poor children in households receiving food stamps are better nourished than poor children in non-food stamp households. Food stamp households receive more nutrients for every dollar's worth of food than those living in similar non-food stamp households.