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Build it back better: Deconstructing food security for improved

measurement and action


Jennifer Coates
n
Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, United States
a r t i c l e i n f o
Article history:
Received 13 August 2012
Accepted 2 May 2013
Keywords:
Food insecurity
Measurement
Indicators
Food security scales
a b s t r a c t
The challenge of measuring food security became increasingly thorny during the 1990s, when the
number of conceptual elements proliferated in widely accepted denitions. There have been commend-
able recent advances in the development of simple, valid measures of food access. Yet most users apply
single indicators interchangeably and capture only a portion of the full concept. Rather than tackling
food insecurity as a monolithic concept, food security assessment and action would be more effective
if deconstructed into well-dened dimensions beyond the availability, access, and utilization pillars.
Internationally recognized denitions and ethnographic literature support the isolation of ve dimen-
sions: (1) food sufciency (2) nutrient adequacy (3) cultural acceptability, (4) safety, (5) certainty and
stability. This paper traces the evolution of food security concepts and measures up through the rst
decade of the 21st century, proposes indicators to represent these ve dimensions, and highlights areas
where the development of new metrics is warranted.
& 2013 Elsevier B.V. All rights reserved.
1. Introduction
The concept of food security has evolved over approximately
40 years from a narrow focus on national and global food
availability, to one that incorporates multiple concerns. The most
widely accepted denition of food security derives from the 1996
World Food Summit Plan of Action, which describes food security
as a state in which all people, at all times, have physical and
economic access to sufcient, safe and nutritious food to meet
their dietary needs and food preferences for an active and healthy
life (FAO, 1996). The international community should be
applauded for having adopted such a holistic denition of a term
which, though not as compelling as the word hunger for
galvanizing public action, serves as a useful organizing construct
for advocacy from global to local levels.
And yet, measurement efforts and the policies that ow from
framing and quantication have advanced unevenly, stymied
in part by the conceptual and technical challenges inherent in
capturing a multi-dimensional problem. Such efforts to improve
the measurement of food insecurity have also confronted political
realities that prioritize dimensions such as calorie insufciency,
that are the most visible, objectively quantiable, and familiar due
to historical experience with food-biased policies.
There has been substantial progress over the past decade in the
development of valid, simple indicators of household food access.
However, marked incongruities persist between the internation-
ally recognized denition of food security and the way it is applied
through both measurement and policy. In practice, indicators of
different food security dimensions are often treated interchange-
ably, due to a lack of clarity about which aspects of the food
security denition a metric is measuring and confusion about the
ways in which a set of indicators complement each other (or not).
And yet, evidence suggests that not all indicators of food security
capture the same thing (National Research Council, 2005; Barrett,
2010; Becquey, Martin-Prevel et al., 2010; de Haen et al., 2011;
Maxwell and Coates et al., 2012).
When the results of different indicators do not converge, it may
be that the true extent of food insecurity and undernutrition is
unknown (de Haen et al., 2011), but it is not unknowable. As this
paper will suggest, the term food security is a concatenation of
related but not identical dimensions, potent as a whole for advocacy,
but perhaps more usefully deconstructed into its constituent parts
for the purposes of systematic assessment, action, and evaluation.
The rst section of this paper reviews the evolution of food
insecurity concepts and measures through the end of the 20th
century. The second section comments on advances of the past
decade and highlights areas where there is still a lack of conver-
gence in technical aspects and practical applications of the newer
metrics. A third section deconstructs the dimensions of food
insecurity according to the denition and proposes potential
terminology and indicators for measuring each dimension. A nal
section summarizes some of the gaps, challenges, and opportunities
in applying this framework for the holistic measurement of food
insecurity and its dimensions.
Contents lists available at ScienceDirect
journal homepage: www.elsevier.com/locate/gfs
Global Food Security
2211-9124/$ - see front matter & 2013 Elsevier B.V. All rights reserved.
http://dx.doi.org/10.1016/j.gfs.2013.05.002
n
Tel.: +1 617 636 3677; fax: +1 617 636 3794.
E-mail address: Jennifer.coates@tufts.edu
Global Food Security 2 (2013) 188194
2. 20th Century concepts of food insecurity and hunger
Denitions are far more than semantics. According to Dery,
denition implies a choice, a particular way of seeing a problem
among a range of alternatives. Policy is determined in part by that
choice (1984, p. xii). There was not always such broad convergence
around a single denition of food security as there has been since
the World Food Summit denition was ratied (Maxwell and Smith
had identied over 200 variants in their 1992 review of the
literature (1992)), nor was the concept always conceived of in such
a multi-dimensional way. The narrative of the historical evolution of
the food security construct from the 70's though the 80's and 90's is
a familiar refrain (see Barrett, 2002; Clay, 2002). This section briey
reviews this earlier chronology before extending the narrative to
include more recent developments in conceptual emphasis and
measurement through the rst decade of the 21st century.
The rst use of the term food security in developing countries
dates back to the 1970's (Maxwell and Smith, 1992), where a backdrop
of spiking commodity prices and the energy shock of 1973 redoubled
fears of a global food crisis. At that time, food availability was seen as
the limiting factor in achieving enough food for all. For reasons of
national security, foreign exchange conservation, and protectionism,
many countries also aimed to achieve food self-sufciencythe
ability to produce enough food to feed the populace through domestic
channels alone. Policy interventions at the time focused on increasing
food production, and measures of food security were taken at
aggregate, national levels emphasizing production gures and related
food balance data. At this stage in the evolution of the food security
construct, metrics closely mirrored denitions.
By the late 1970's the Green Revolution had ushered in the
promise of abundance, commodity prices dropped, and worries of
an impending global food shortage were gradually molliedor,
more accurately, matched by competing concerns. Shortly there-
after, the Nobel prize-winning work of Amartya Sen struck
a convincing theoretical and empirical blow to the primacy of
the problem of food availability. Sen famously argued that a lack of
entitlements, rather than a lack of food, was the most signicant
contributor to deaths from famine in Bengal, Ethiopia, the Sahel,
and Bangladesh (Sen, 1981). His work prompted a paradigm shift
that led to renewed attention to the problem of food access.
Denitions of food security began to incorporate the terminology
of access while micro-level policies sought to ensure the entitle-
ment base for households. Here, the aims of food security policies
began to overlap with the objectives of poverty alleviation, while
poverty in many places was already being dened according to
food consumption standards (see Streeten, 1998).
Despite recognition that food access was a necessary condition
for food security, inadequate access was conceived of primarily in
terms of dietary energy requirements. Dietary quality was not a
signicant concern in the discourse, as exemplied by the widely
used denition adopted by the World Bank, that described food
security as access by all people at all times to enough food to lead
an active and healthy life [author's emphasis] (World Bank, 1986).
Though healthy life outcomes cannot be achieved on kilocalories
alone, the importance of a balanced diet was only implied in the
denition. Nutrition and food security were still in separate
worlds, with nutrition more closely linked to the health sector and
food security to agriculture.
In turn, food insecurity metrics evolved from global and
national measures to household-level indicators that included
income and expenditure, energy adequacy, and proxies that were
simpler to administer and analyze. Data on food expenditures or
dietary intake were commonly reduced to indicators of caloric
sufciency, considered by many to be the gold standard indicator
of food insecurity (Chung, Haddad et al., 1997; Maxwell et al.,
1999; Swindale and Ohri-Vachaspati, 2000). Indeed, attempts
to identify simplied surrogate measures of food insecurity often
still rely on this benchmark for validation purposes, wherein the
sensitivity and specicity of proxy indicators are tested against
caloric adequacy cut-offs (Haddad et al. 1994; Chung et al., 1997;
Maxwell et al., 1999; Rose and Tschirley, 2000; Hoddinott and
Yohannes, 2002).
In 1992 the United States Agency for International Development
(USAID) issued a policy statement redening the concept of food
insecurity for organizational purposes to include issues of utiliza-
tion. Adequate utilization exists when food is properly used; proper
food processing and storage techniques are employed; adequate
knowledge of nutrition and child care techniques exists and is
applied; and adequate health and sanitation services exist (USAID,
1992, p. 4). This change effectively folded, into the food security
construct, concerns over individual-level distribution and consump-
tion of micronutrients and the physiological ability to use them.
Anthropometric measures of nutritional status were soon cham-
pioned as an expedient way of capturing what many perceive to be
not only a conceptual constituent of food security, but also the
outcome of greatest interest.
With this step in conceptual evolution, the task of measuring
food security and the responsibility for assuring it were signi-
cantly broadened across sectors. On the downside, outcomes had
been conated with causes, making the operationalization of
metrics more challenging and less intuitive. Yet, USAID's redeni-
tion has become quite inuential even outside of US-funded
programs. For instance, the Bangladesh Ministry of Food, in
creating its National Food Policy, developed a three-tiered set of
objectives attacking each of the pillars of the problem (insuf-
cient food availability, access, and utilization). (Bangladesh Food
Planning and Monitoring Unit, 2008).
By the dawn of the 1990's, Chambers (1989) and Maxwell
(Maxwell, 1989, 1990) began to argue that the security element of
food security, though comprising half of the term itself and
implied in denitions (i.e. at all times), was rarely operationa-
lized in practice. This element of the denition recognizes the
reality that food sufciency itself is dynamic and subject to the risk
of future downturnsnot all food sufcient households remain so
at all times (Christiaensen and Boisvert, 2000). This perceived
uncertainty affects a household's approach to resource manage-
ment and inuences production and consumption decisions that
in turn impact current and future food security (Barrett, 2002).
Maxwell proposed to elaborate the 1986 World Bank denition to
include an explicit mention of problems of vulnerability and the
risk of entitlement loss. Much later, inuenced by the recommen-
dations set forth by Webb and Rogers (Webb and Rogers, 2003),
among others, USAID's Food for Peace Ofce formally adopted
a fourth food security pillar in 2005, stability, recognizing its
cross-cutting inuence on food availability, access, and utilization
(Ofce of Food for Peace (FFP) Bureau for Democracy Conict and
Humanitarian Assistance, 2005).
At the same time as his writing about vulnerability and food
insecurity, Simon Maxwell also suggested that the 1986 World
Bank denition be extended to include the subjective perceptions
of food insecurity (Maxwell, 1989, 1990). At the time, he and
scholars like Chambers were leaders among a vocal group promoting
bottom-up, participatory, processes of development attentive to the
needs and perspectives articulated by individuals that are the target
of development policies and programs. Later, Maxwell argued in a
1996 paper that a conceptual shift to subjective indicators in the
1990's marked a transition to a post-modern era of food insecurity
thinking. He summed up the evolution of thinking on food insecurity
like this:
Perceptions matter. Importantlyfood security must be treated
as a multi-objective phenomenon, where the identication and
J. Coates / Global Food Security 2 (2013) 188194 189
weighting of objectives can only be decided by the food insecure
themselves (Maxwell and Smith, 1992, p.4).
US and developing country concepts of food insecurity have,
until recently, had a parallel but largely distinct evolution.
The United States in the last two decades has had its own struggle
with competing theoretical understandings of the concepts of
hunger, malnutrition, food sufciency, and food security
(Eisinger, 1998). Interestingly, Simon Maxwell was advocating for
more attention to perceived food insecurity in the developing
country literature (see Maxwell, 1996) at the same time that food
insecurity in the US was increasingly thought of as an unobser-
vable and largely subjective experience.
In 1984 the President's Task Force Report on Food Assistance
afrmed that the presence of hunger in US society could not be
substantiated without an acceptable indicator to measure it
(President's Task Force on Food Assistance, 1984). In response to
these conclusions, Radimer and colleagues at Cornell sought to
develop a denition and measure of hunger, not in the physio-
logical sense of the word, but in terms of its wider social, poverty-
related meaning. Radimer et al. proposed that understanding
people's own perceptions of what it meant to be hungry was the
most direct approach to dening and measuring an otherwise
unobservable experience (Radimer et al., 1990; Radimer et al.,
1992). The women she interviewed using naturalistic methods in
rural upstate New York expressed feelings of deprivation having to
do with having less food than they would like (perceived insuf-
cient quantity), less of the types of foods that they would like
(perceived insufcient quality), having to eat foods that they felt
were not culturally accepted, and having to acquire their food
through what they perceived to be culturally unacceptable chan-
nels. They also expressed worry and uncertainty that they would
not be able to get enough of the foods they wanted in the future.
Inuenced by these and other theoretical and empirical devel-
opments, an Expert Panel of the American Institute of Nutrition
(AIN) working with the Life Sciences Research Ofce (LSRO) of the
Federation of American Societies for Experimental Biology (FASEB)
formalized a denition of food insecurity, which states that it
exists whenever the availability of nutritionally adequate and safe
foods or the ability to acquire acceptable foods in socially accep-
table ways is limited or uncertain (Life Sciences Research Ofce:
Federation of American Societies of Experimental Biology, 1990).
Notably, the elements of this 1990 US denition were closely
mirrored by the FAO World Food Summit denition, ratied six
years later. Thus, by the mid 1990s, there was a coincidence of
developing and developed country denitions. There was also
a meeting in the middle of the top-down, etic, denition of the
food security construct as it had evolved in the developing country
literature, and the bottom-up, emic, detection and codication of
an experience, as it had evolved in the United States.
The tool of choice used by the USDA to monitor national food
security, building on the theoretical groundwork described above
and inserted since 1995 into the annual Current Population Survey,
is the US Household Food Security Survey Module (HFSSM),
a validated scale of 18 items about behaviors and attitudes that
collectively distinguish households experiencing different degrees
of food insecurity along a spectrum of severity.
3. Recent developments and continued incongruence
The rst decade of the 21st century has been characterized by
a stable denition and interpretation of the food security concept.
Most of the dynamism over the past ten years has revolved around
the development and institutionalization of simplied, valid
indicators of access, such as experiential scales and dietary
diversity indices. Still-nascent efforts have been made to extend
the assessment of food insecurity to the individual level, though,
as described in this section, debates continue over whether food
security is more usefully treated as a household or individual
phenomenon. Most positively, the decade has been marked by
institutional convergence around an increasingly smaller and
more select set of indicators that appear to be valid in many
contexts. And yet, even with these advancements, there are still
sizeable gaps between the food security denition and its
measurement in practice.
Sparked by the simplicity of the US HFSSM, during this past
decade household-level experiential food security scales have been
popularized in developing countries following rigorous validation
testing through collaborations between academic and international
institutions (Coates et al., 2003, 2006, 2007b; Frongillo and Nanama,
2006; Deitchler et al., 2010; ELCSA Scientic Committee, 2012).
These scales, such as the Household Food Insecurity Access Scale
(HFIAS) and the Latin American and Caribbean Food Insecurity Scale
(ELCSA) are now widely used by researchers, operational agencies,
and, increasingly, by national governments (Perez-Escamilla et al.,
2004; Segall-Correa and Marin, 2009; Food and Agriculture
Organization, 2010). A similar, and equally popular, approach is
the Coping Strategies Index which, though not intentionally con-
structed around multiple food security dimensions, captures the
frequency and severity of behaviors that are undertaken in the face
of food insecurity (Maxwell et al., 1999, 2008). The CSI and the
experiential scales described above, attempt to capture the behavior
of individuals faced with uncertainty, irreversibilities, and binding
constraints on choice (Barrett, 2002, p.4) thus introducing into such
measures the element of perceived vulnerability.
Throughout the development of these metrics there have been
trade-offs and constraints that have hindered the aim of the fully
realized, systematic measurement of each of the food security
dimensions. Food security scales like the US HFSSM, the HFIAS,
and the ELCSA were built with an intention to capture key aspects of
food insecurity, including food insufciency (in quality and quan-
tity), cultural unacceptability, and uncertainty. However, competing
measurement considerations have led to the need to sacrice the
full measurement of each of these dimensions. The scale develop-
ment approach used in the US and elsewhere was motivated by the
desire for a simple measurement tool, and was justied by the
observation that the behavioral responses to food insecurity often
occur in a sequential, predictable way. The selection of items for
these scales was based on the items statistical conformation to the
properties of a unidimensional scale representing a single spectrum
of severity. To t these properties, items related to cultural accept-
ability were dropped from the US HFSSM and its derivatives, and
remaining items in the quality and uncertainty dimensions were
only touched upon. In the case of the HFIAS, for example, the
impetus to create a scale with cross-cultural properties meant that
items that were not cross-culturally invariant were omitted.
The resultant set of three culturally invariant items, which is limited
in capturing only the dimension of food insufciency, was renamed
the Household Hunger Index (Deitchler et al., 2010). The Food and
Agriculture Organization (FAO) has launched an initiative to insert
an 8-question experiential food insecurity scale into the Gallup
World Poll as a complement to FAOs existing undernourishment
measure (UN Food and Agriculture Organization, 2013). To be
piloted initially in four countries, the FAO hopes to scale-up the
use of this measure to 150 countries over time. Though some of the
statistical criteria against which the HFIAS was judged will be
relaxed slightly, it remains to be seen whether the content of the
scale will need to be similarly sacriced in favor of achieving a
cross-culturally comparable indicator.
Another example that represents successful advancement in
food security measurement in this decade, as well as continued
J. Coates / Global Food Security 2 (2013) 188194 190
conceptual confusion, is the rise of dietary diversity indices. At the
household level, evidence of the relationship between dietary
diversity and increases in caloric intake (Hoddinott and Yohannes,
2002) made simple dietary diversity metrics appealing to agencies
interested in identifying simple proxies of household caloric suf-
ciency (International Food Policy Research Institute, 2006; Swindale
and Bilinsky, 2006; Coates et al., 2007a; Wiesmann et al., 2008).
Since then, there has been an increased recognition of the potential
of dietary diversity indices administered at the individual level to
serve as markers of the quality of the diet, supported by evidence of
the indices' abilities to predict women's nutrient adequacy and child
nutritional status (Arimond and Ruel, 2004; Torheim et al., 2004;
Steyn et al., 2006; Kennedy et al., 2007; Arimond et al., 2010) and by
their compelling simplicity of administration and analysis. As Ruel
(2003) noted, some question remains as to whether dietary diver-
sity indices are able to capture caloric adequacy, or dietary quality,
or both. This conundrum should be readily resolvable with further
research and development. Depending on the food items or food
groups included and the weighting strategy selected, dietary diver-
sity indices can be geared toward capturing various nutrients of
interest, be they macro or micronutrients. This approach is
evidenced by the use of simple food frequency questionnaires
(FFQs) in epidemiological research though, these, too, have their
methodological limitations (Kristal et al., 2005).
A third example of measurement developments that are still short
of their mark relates to the level at which food security is measured.
Despite the fact that the ultimate effects of food insecurity are
experienced by individuals and that households do not always pool
resources equitably, historically the construct has been measured
at global, national and, most recently, household levels. While the
cost and feasibility of individual-level surveys are important factors,
the US has adopted a conceptually grounded justication for its
approach. The Committee on National Statistics of the National
Academies, that was enlisted to review the USDA approach to
measuring food security and hunger, asserted that the concepts of
food uncertainty and food insufciency are really household-level
concepts (National Research Council, 2005) The Phase II report
further explained that, It means that we can measure and report
the number of people who are in food-insecure households (with not
all of them necessarily food insecure themselves). When a household
contains one or more food-insecure persons, the household is
considered food insecure. (National Research Council, 2006, p.45).
And yet, a growing body of developing country research using
individual-level measurement techniques has underscored the fact
that a single individual respondent cannot be relied on to
accurately represent the experience of others in their household
in an interview (Hadley et al., 2008; Wutich, 2009; Coates et al.,
2010; Kuku et al., 2011; Bernal et al., 2012; Quisumbing, 2013).
In the US, where the household food security module has long
included both adult and child-referenced questions, developers of
the separate Children's Food Security Scale concluded that, Chil-
dren's food security is correlated with that of adults in the same
household, but the relation depends on the ages of children, such
that separate measures of children's and adults' food security
appear to provide better assessment than a single measure that
attempts to represent both (Nord and Hopwood, 2007, p.533).
Though some additional nationally representative surveys, such as
the National Health and Nutrition Examination Survey (NHANES),
collect selective individual-level food security information from
adults and children (Nord and Hopwood, 2007), the food security
prevalence in the United States is still measured annually at the
household level through the Current Population Survey.
Those in the business of measuring food security have attempted
valiantly to maintain pace with the proliferation of elements that
were folded into the food security denition by the close of the 20th
century. Incongruities remain, related as much to the application
of indicators in practice as to any gaping deciency in the availability
of suitable metrics. While it has been argued that the objective
necessitating measurement commonly drives the choice of indicator
(Barrett, 2010), anecdotal and empirical realities suggest that users
select indicators piecemeal, often relying on a single indicator to
represent the concept of food security in its entirety despite the fact
that different food security indicators capture very different aspects
of the multi-faceted phenomenon (National Research Council, 2005;
Barrett, 2010; Becquey et al., 2010; de Haen et al., 2011; Maxwell
et al., 2012). Despite calls at both the rst and second FAO Inter-
national Scientic Symposium on Food Security Measurement for the
selection and promotion of a suite of indicators, little progress has
been made on this front.
Though a single metric may be less unwieldy to interpret than
multiple measures, the operational practice of cherry-picking
indicators is detrimental for several reasons: (1) The prevalence of
food security globally and its consequences are likely to be
underestimated by overlooking the quantication of dimensions,
such as the dimension of uncertainty, that can have both nutri-
tional and non-nutritional functional outcomes (Weaver and
Hadley, 2009; Cole and Tembo, 2011; Nanama and Frongillo,
2012; Tsai et al., 2012); (2) using single indicators interchangeably
or lumping them together indiscriminately makes diagnostics
difcult; this approach obscures potentially signicant relation-
ships between functionally important causes and consequences of
individual elements of food security; (3) errors in diagnostics risk
leading to the design of one-size-ts-all interventions for house-
holds or individuals facing different types of food insecurity; and
(4) a misalignment of impact metric for a given policy or program
design can bias the impact estimate and obfuscate which elements
of food security have been most improved, or not, by a given
intervention.
4. Toward a holistic approach to measurement
In order to advance toward a more holistic practice of food
security measurement, it may be necessary to deconstruct the
term before rebuilding it again. One constraint at the moment is
that the dimensions that comprise the food security concept have
not been individually dened and agreed to in the international
context, aside from the well-recognized pillars of availability,
access, and utilization. The conceptual notion of pillars is arguably
less useful than it used to be, following Sen's upending of the
supply-driven view of food security and the mental gymnastics
that are required in order to think of utilization as both an
element of food security as well as an outcome much more closely
linked to nutritional status.
An alternative is to consider the functionally relevant dimen-
sions of food security as those that form the basis of the US food
security denition, that are reected in the UN WFS denition,
that are captured at least in part by many existing indicators, and
that have been expressed through ethnographic work as priority
concerns across many different cultures (Coates et al., 2006).
An individual must have access to food that is: (1) sufcient in
quantity; (2) adequate in nutritional quality; (3) culturally accep-
table; (4) safe; and (5) certain and stable. This last dimension cuts
across the rst four. With an emphasis on these dimensions, the
experience of food insecurity can be isolated from potential causes
(i.e. lack of availability, lack of access) and potential consequences,
both nutritional and non-nutritional, and can be considered within
a framework of risk that could jeopardize the secure achievement
of the rst four elements. While each of these dimensions is
relevant at global/national, household, and individual levels, the
higher levels of aggregation ultimately matter only insofar as they
affect an individual's well being.
J. Coates / Global Food Security 2 (2013) 188194 191
Measures of food insecurity should be identied to assess each of
these ve dimensions. There are, of course, already widely accepted
measures that represent some of these dimensions, including both
gold standard and proxy indicators. Table 1 presents a set of potential
indicators that could be considered as candidates. The table distin-
guishes indicators that are validated and in widespread use from
measures that do not yet exist in practice but would be desirable to
develop. It also highlights areas where there appear to be gaps. Note
that anthropometric outcomes are not included here as proposed
indicators of food security, since food insecurity is but one of several
contributors to poor nutritional status. Anthropometric measure-
ments yield important indicators that should be examined in relation
to these dimensions of food insecurity, but nutritional status should
not be measured as an indicator of food security itself. Additionally, it
bears reiterating that there are at least two approaches to the
operationalization of any of these dimensions; one approach relies
on survey recall of potentially observable behaviors and practices,
while the other inquires about people's perceptions (experiential
food security scales contain a mix of both). Neither of these options
provides the right answer, only a different perspective on reality,
and both perspectives should be taken into account.
A goal should be for this or a similar suite of indicators to be
implemented through nationally representative household surveys
for global food security monitoring, as well as for targeting, program
design, and evaluation. The food security dimensions should
be reported on, where possible, in their disaggregated form.
For advocacy purposes, an aggregate measure of all 5 dimensions
should be explored. Global and national measurement efforts should
shift away from food balance sheets and toward reliance on a food
security module incorporated into more regularly collected nationally
representative household consumption and expenditure surveys.
In parallel, or until that happens, food balance data should be
plumbed to estimate the global and national adequacy of protein
and micronutrients in order to measure diet quality concerns.
As is apparent from Table 1, more work needs to be done to
identify indicators reecting certain dimensions and to conrm
the dimensionality of existing metrics. Experiential food security
scales continue to hold great promise for capturing elements like
cultural acceptability, that are otherwise difcult to detect.
Experiential food security subscales, could be developed for each
of the ve dimensions referred to above, with items that range in
severity within each dimension. With more specic measures, it
will be possible to understand the how the various dimensions
interact and to link functional outcomes with single or overlapping
aspects of food insecurity.
In order to achieve this level of progress, the UN and other
international agencies in collaboration with academics must
commit to a process for identifying indicators that should belong
to the suite that has been demanded for over ten years. Decisions
about such a collection of metrics should take into account what is
feasible given currently available measures; but the availability of
measures should not be allowed to wag the dog of the dimen-
sions that need further attention. Thus, a long-range as well as
short-term plan will be necessary.
The conceptual and measurement developments described in
this paper have presented opportunities for more holistic, cross-
sectoral programs and policies to address food insecurity. They
also have also created new challenges in coordination, ownership,
and focus; recognizing the proliferation of elements in the food
security paradigm, Maxwell commented, rhetorically, Some might
feel that growth on these terms is unacceptable, that when a term
is used in many different ways, or provides many different
perspectives on reality, then its usefulness is limited. Would it be
better to abandon food security altogether and retreat to some
more narrow and quantiable indicator of wellbeing, like anthro-
pometric status or household income? (Maxwell, 1996, p.155).
The answer to this question is a resounding NO, but. As this
paper has argued, the preferred alternative is not to cower from
the challenge of measuring this man-made construct. Rather, the
international community should redouble efforts to ensure that
each of the dimensions of the multi-faceted construct is well-
dened and can be captured individually, for assessment and
action, and as a whole for advocacy.
References
Arimond, M., Ruel, M.T., 2004. Dietary diversity is associated with child nutritional
status: evidence from 11 demographic and health surveys. Journal of Nutrition
134 (10), 25792585.
Table 1
The Five Dimensions of Food Security and a Proposed Suite of Indicators.
Level of
measurement
Food security dimension
Food sufciency (Quantity) Nutrient adequacy (Quality) Cultural acceptability Safety Certainty and stability
Proposed metric
a
National and
global
Undernourishment
indicator
To be developed by imputing micro/
macro nutrient value of food balance
sheet data
National aggregation of HH-
level cultural acceptability
sub-scale
TBD Coefcient of variation (CV) of
calorie adequacy and of other
priority nutrients
CV of food prices
Household Household calorie
adequacy per adult
equivalent; or
Household Hunger
Index Score
Mean probability of adequacy per
adult equivalent; or
Household Dietary Diversity
Index Score
Experiential HH-level cultural
acceptability sub-scale
TBD Household Food Insecurity Access
Scale; or
Latin American and Caribbean
Household Food Security Scale
(ELCSA); or
Coping Strategies Index; or
Months of Adequate Food
Provisioning
Individual Caloric adequacy of
individual intake; or
Individual Hunger
Index Score
Mean probability of adequacy; or
Individual Dietary Diversity
Index Score
Experiential Individual level
cultural acceptability sub-
scale
TBD Individual Food Insecurity Access
Scale; or
Individual Coping Strategies Index
a
Italics indicate a metric that has not yet been developed.
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