To most Americans, the epitome of hunger is the Third World child with bloated belly and spindly limbs, too weak to brush away the flies that land on drooping eyelids. The notion of that happening here--a body cannibalizing itself for want of food in a country so rich--is hard to imagine. But that extreme image is beyond hunger. It is hunger's end result: malnutrition. Hunger came long before. And that chronic inability to get adequate food does plague millions of Americans, according to researchers who gathered here last week to examine hunger in America.
The three-day workshop, designed as a precursor to the first national conference on hunger, was held at the University of California at Berkeley and sponsored by the School of Public Health. It brought together about 25 social scientists, nutritionists and physicians from across the country to discuss ways of better measuring hunger and defining a problem that has no universal definition.
The absence of a single definition of hunger and arguments over methods used to measure its extent have fueled highly partisan debates: Liberals claim hunger is widespread and rising under the Reagan Administration. Conservatives charge that such claims are exaggerated at best and without valid scientific data to support it.
Workshop planners and participants--most of whom were self-described liberals--had hoped for an open, friendly exchange of ideas between colleagues in an academic setting, they said. They eventually got that after a day of political pot shots aimed at liberals by a personable and vocal conservative from the Reagan Administration, Anna Kondratas. However, the politics of hunger were apparent from both sides.
Debbie Allen, project director for the Physician Task Force on Hunger based at Harvard University's School of Public Health, set the scene when she repeated its 1985 findings: "a minimum of 20 million Americans experience hunger each month." Allen concedes that the figure is an imprecise one, but sometimes "you have to stick your neck out" when the problem is so serious and no one has precise data on the extent of it.
The Physician Task Force's figure is based on the 20 million food stamp recipients in 1983, subtracted from the number of people in poverty that year, 35 million. That amounted to 15 million people below the poverty line not receiving food stamps. Added to that was another 5 million, an estimate based on data from sources such as the Salvation Army and local emergency food networks which often provide food to families when their food stamp allotment is insufficient.
The Task Force found that "hunger is widespread, affects varied population groups in all regions and thus far is not decreasing."
The U.S. Conference of Mayors and the National Council of Churches reached similar conclusions in recent studies.
But Kondratas, the Reagan Administration official, disputed those findings.
"A lot of the samples in the (studies) are not scientific . . . ," said Kondratas, director of analysis and evaluation for food and nutrition programs at the Department of Agriculture. She is also a former senior fellow at the Heritage Foundation, a conservative think tank.
Poverty in 1960s
"Our idea about what hunger and poverty is changes over time. In the 1960s, poverty was much higher, we had almost no federal nutrition programs at all, hunger was probably far more prevalent than it is today. And yet, if you go back to the magazines . . . TV, radio and news reports, you'd have to go a year before you may see a mention of the problem. There are different things that people focus on at different times. It doesn't mean that things have changed, it means that things have changed in the public policy debate and in terms of the attention we pay a problem. But unless we have comparable data over time, we can't really know if this is something new, or just a new perception."
Said Kondratas: "In the 1950s nobody cared about poverty, in the 1960s we had a huge war on poverty, in the 1970s, with the country's economic problems so bad, it got downplayed again, with the perceived threat of the Reagan Administration, these things became an issue again."
Very little has changed for the very poor since the 1950s, she said. "We had poverty and hunger then . . . and looking at objective data, I don't see this great retrenchment."
The workshop participants readily admitted that methods that have been used to measure hunger are imperfect. Improving them, by sharing the experiences of other researchers, was the purpose of the meeting. "Increasingly, studies will become more statistical and epidemiological and less anecdotal," said Linda Neuhauser, a professor in the School of Public Health at UC Berkeley and a coordinator of the workshop.
Human Face on Statistics
But anecdotal information is vital; it puts a human face on the statistics, the researchers said. Eventually, said Neuhauser, the trend will be toward studies that try to bring all these elements together.
Kondratas has been critical of studies based primarily on anecdotal information about hunger, as well as assumptions gleaned from emergency food centers. Just because these centers may report an increase in the number of people seeking food assistance, that doesn't automatically mean, she argued, that hunger is rising. The fact that more people are seeking assistance "is equally consistent with the interpretation that there is less hunger, if one assumes that previously hungry people now have access to food they did not formerly have," she told a U.S. Senate hearing on hunger last year and repeated the point at the Berkeley workshop.
But there will never be a perfect study, said Rod Leonard of the Washington-based Community Nutrition Institute. In the most partisan liberal response to Kondratas he said, "She is truly a romantic. . . ." A person looking for "a way to make the world perfect. But we can't wait for the perfect solution," he said. And even if it were possible, there would always be politically motivated people looking for a reason to undermine the effort, he said.
"Having a specific number sometimes is not so important as the fact that hunger exists" and something has to be done about it, said Charles DiSogra, project consultant for the California Nutrition Monitoring Project. "It comes down to the fact that if you want to find the extent of hunger, you've got to define it. Even if you come up with a definition, conducting a survey is very expensive and not easy to do."
It's difficult, said DiSogra, to extrapolate from one study to another. "Most of the studies are pretty good within the area they've looked at, but what can they tell us about a state or region?
"Even in California, I'm not so sure, given the expense, how useful it would be to find out the extent of hunger in the state as it might be to find out the extent of hunger in those urban and rural areas where at least we know we can deliver services." Some hungry people may be excluded, but it becomes a matter of "pragmatics," he said. DiSogra thought for a second then added: "I don't think the state of California even has a definition of hunger."
Hunger as Social Problem
Finding a single definition of hunger was not the goal of the workshop. Different kinds of research require "different degrees of precision in the kind of definition," said Allen of the Physician Task Force. Doctors at the workshop who were investigating the extreme effects of hunger in children, for example, look at clinical symptoms--weight loss, underdevelopment, disease. But the Physician Task Force, said Allen, looks at hunger "as a social problem that has a medical impact. We need a much broader definition."
Attempting to define hunger in great part means describing behavior and conditions that lead to it or are caused by it. Researchers call these correlates of hunger. Directly asking a person if he or she is hungry may not illicit a direct, truthful response. Pride, researchers explained, often prevents people from answering honestly.
One hunger survey conducted in Alameda County found that when a family's food supply was low, they diluted their child's baby formula or gave children Kool-Aid instead of milk. Among that population being surveyed, those changes in food practices were indicators of hunger.
Neuhauser said the survey also showed the importance of the "social consequences of hunger": family violence, family breakup, crime, depression, work and school disruption linked specifically with the occurrence of hunger in households.
One of the indisputable correlates of hunger is low income. Poverty is at the root of hunger, and because of that, said Kondratas, welfare reform is the key to eliminating it. As part of that reform, Kondratas would have food benefits based on the cost of living in each state and a "national consumption standard. There should be a market basket of goods that the government says 'without this you can't live,' and it should be costed out in state and local communities so that you'd have a higher level in New York City and a lower one in some rural town."
But Allen, and others at the workshop, said that meaningful welfare reform would have to guarantee an income above the poverty level for every American, and added, "I suspect the welfare reform the Administration will talk about will not have anything to do with increased benefits."
She said that short of welfare reform, she would "like to see expansion of the programs that are specifically targeted for food. . . . While that may not answer the problems of poverty, at least we can cut the link that says to be poor is to be hungry."