pain caused by a prolonged, involuntary lack of food). But unlike food insecurity, which is a household-level concept, hunger is an individual-level concept. For purposes of the HFSSM included in the Food Security Supplement to the CPS, the term “hunger” should refer to a potential consequence of food insecurity that, because of prolonged, involuntary lack of food, results in discomfort, illness, weakness, or pain that goes beyond the usual uneasy sensation. Two questions therefore arise. First, can the experience of severe food insecurity with hunger by households be measured and its prevalence estimated? Second, can the experience of hunger by individuals be measured and its prevalence estimated?
The HFSSM is measuring food insecurity at the level of the household; it is not measuring hunger at the individual level. The scale does not give special weight to the hunger questions. The HFSSM does include items that are related to being hungry among food-insecure households. The ethnographic and quantitative evidence discussed earlier has shown that the HFSSM items on hunger are probably appropriate in the food insecurity scale, but these items contribute to the measurement of household food insecurity and not specifically to the measurement of hunger at the individual level.
For the purposes of measuring and estimating the prevalence of hunger among individuals in the population, something that the HFSSM does not do, some of these same items might be used in a measure of hunger among individuals, but it would require a measurement process that is based on the conceptual definition of the condition, as well as a battery of items designed to measure it and a reoriented sampling design that includes the individual as the unit of analysis. This work could be based on the information from such sources as up-to-date ethnographic studies of low-income populations, results of experiments and analysis of surveys, analysis of public opinion and perspectives of user groups, expert assessment, and other relevant information.
The panel therefore concludes that hunger is a concept distinct from food insecurity, which is an indicator and possible consequence of food insecurity, that can be useful in characterizing severity of food insecurity. Hunger itself is an important concept, but it should be measured at the individual level distinct from, but in the context of, food insecurity.
To summarize, the panel’s conclusion is based on the fact that, although a strong theoretical and research base exists for the conceptualization and measurement of food insecurity, we do not have a correspondingly strong base for either the conceptualization of hunger or its measurement. That is, there is now ample theoretical, conceptual, ethnographic, and quantitative work done to justify the measurement of the experience of food insecurity using a questionnaire. For the measurement of the experience of hunger to be equally credible, there needs to be a stronger base than we currently have