HFSSMHousehold Food Security Survey Module
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The HFSSM yields a 4-level categorical variable, classifying households as either having high food security (households that had no problems or anxiety about access to adequate food), marginal food security (households that had problems at times or anxiety about accessing adequate food, but the quality, variety, and quantity of the food intake were not affected), low food security (households that reduced the quality and desirability of their diets, but the quantity was not substantially disrupted), or very low food security (households that had some disruption in eating patterns, including reduced intake) (Coleman-Jensen et al.
This was assessed from an item from the HFSSM, where households were asked whether they "could not afford balanced meals" in the past 12 months (Table 1, item 3) (Spanish translation: "No tenia/No teniamos recursos suficientes para comer comida variada y nutritiva").
They apply to the households that responded to the HFSSM survey, which were those below the poverty line or reporting issues accessing food.
We did not collect data using the 18-item HFSSM or the US Department of Agriculture 18-item food security survey, which are the standard measures of food security.
Here, I focus on the details of the food security portion of the questionnaire, which was based on the six-item subset of the widely used USDA Household Food Security Survey Module (HFSSM).
Because the questions were embedded within a longer questionnaire that included several sensitive topics, the standard six-item subset of the HFSSM, rather than the full 18-item core module (Bickel et al., 2000), was chosen to minimize respondent burden.
The modifications I implemented were based on (1) re-phrasing of HFSSM questions used by Lawn and Harvey (2004) and in other studies conducted by Indian and Northern Affairs Canada, (2) food security survey instruments used in subsistence studies by the Alaska Department of Fish and Game (ADF&G), and (3) suggestions made by Kangiqsujuarmiut respondents who pretested the survey.
In order to assess the current prevalence of food insecurity in Kangiqsujuaq, a subset of the questions in the food security module used in this study (Ql, Q3, and Q6-8, which represent the questions in the original six-item HFSSM) was coded according to the criteria described in USDA (2012).
Instruments such as the HFSSM are designed to assess a one-dimensional scale of food insecurity and were developed in contexts where food access is entirely or almost entirely determined by purchasing power (Bickel et al., 2000).
For this study, households whose respondents provided no affirmative responses to the HFSSM were classified as food secure, while those with one or more affirmative responses were considered to be food insecure.
Although the HFSSM was included as optional content on the CCHS in 2005, Newfoundland and Labrador, New Brunswick, Manitoba and Saskatchewan opted out of the module, so the data were excluded from this study.