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Dietetic approaches to hunger, food insecurity: Concerns
LETTERS TO THE EDITORS
Dietetic approaches to hunger, food insecurity: Concerns To the Editors: As academics who have conducted research on the topic of food insecurity for many years, we are writing to express our concerns about the Commentary by Jeffrey S. Hampl, PhD, RD, and Rick Hall, MS, RD, “Dietetic approaches to US hunger and food insecurity,” published in the July 2002 issue of the Journal (1). While we consider Hampl and Hall’s literature review to be incomplete, and are mystified by the inferences that they draw from some studies, eg, Tarasuk and Beaton (2), our deepest concern lies with the specific actions they recommend for dietitians in their “Call for Action.” They provide no evidence to support these actions. While households with children headed by a single mother do have a high rate of food insecurity, Hampl and Hall fail to consider the much higher poverty rate among this group. Further, they imply that households headed by a single mother begin with an unplanned pregnancy in adolescence; however, there are many routes to single motherhood. Rather than tackling the fundamental issue of poverty, they promote “family planning as a public health measure to decrease food insecurity” (1). There is little in our education as dietitians that would qualify us as family planners, even if family planning were relevant to food insecurity. Hampl and Hall present no evidence to support their contention that “at-risk” families need education in meal planning or budgeting, nor that such education would decrease food insecurity and hunger. Nor do they provide any evidence that money spent on tobacco affects household food security status. They provide no evidence that changes to the WIC food package could have a significant impact on the food security of those
who participate. They repeat their call for dietitians to educate those who participate in government food programs, again without evidence of the impact of such initiatives. Indeed, it could be argued that dietitians have been providing nutrition education for “at-risk” families for many years without evidence of significant impact on levels of hunger and food insecurity. We agree that since “the primary determinants of hunger and food insecurity are economic and social, our approaches to remedying this situation should also be economic and social” (1). Hampl and Hall have proposed no such solutions. Their Call for Action is intensely individualistic, completely ignoring the important social processes by which women and racialized minorities come to live in poverty, and with food insecurity, in much greater proportions than men and white people. Since they do not provide evidence for the effectiveness of the actions they propose, ignore evidence of systemic sexism and racism which lead to poverty and food insecurity in the United States, and disregard the welldocumented relationship between poverty and risk of food insecurity, we can only conclude that the motivations for their Call for Action are moralistic. This is inappropriate for a scientific review and unacceptable as a basis for dietetic practice. ELAINE POWER, PhD, RD VALERIE TARASUK, PhD Department of Nutritional Sciences University of Toronto Toronto, Ontrario, Canada References 1. Hampl J, Hall R. Dietetic approaches to US hunger and food insecurity. J Am Diet Assoc. 2002;102:919-923. 2. Tarasuk V, Beaton G. Household food insecurity and hunger among families using food banks. Can J Public Health. 1999;90:109-113. doi: 10.1053/jada.2003.50099
Journal of THE AMERICAN DIETETIC ASSOCIATION / 435
Dietetic approaches to hunger, food insecurity: Concerns To the Editors: As academics who have conducted research on the topic of food insecurity for many years, we are writing to express our concerns about the Commentary by Jeffrey S. Hampl, PhD, RD, and Rick Hall, MS, RD, “Dietetic approaches to US hunger and food insecurity,” published in the July 2002 issue of the Journal (1). While we consider Hampl and Hall’s literature review to be incomplete, and are mystified by the inferences that they draw from some studies, eg, Tarasuk and Beaton (2), our deepest concern lies with the specific actions they recommend for dietitians in their “Call for Action.” They provide no evidence to support these actions. While households with children headed by a single mother do have a high rate of food insecurity, Hampl and Hall fail to consider the much higher poverty rate among this group. Further, they imply that households headed by a single mother begin with an unplanned pregnancy in adolescence; however, there are many routes to single motherhood. Rather than tackling the fundamental issue of poverty, they promote “family planning as a public health measure to decrease food insecurity” (1). There is little in our education as dietitians that would qualify us as family planners, even if family planning were relevant to food insecurity. Hampl and Hall present no evidence to support their contention that “at-risk” families need education in meal planning or budgeting, nor that such education would decrease food insecurity and hunger. Nor do they provide any evidence that money spent on tobacco affects household food security status. They provide no evidence that changes to the WIC food package could have a significant impact on the food security of those
who participate. They repeat their call for dietitians to educate those who participate in government food programs, again without evidence of the impact of such initiatives. Indeed, it could be argued that dietitians have been providing nutrition education for “at-risk” families for many years without evidence of significant impact on levels of hunger and food insecurity. We agree that since “the primary determinants of hunger and food insecurity are economic and social, our approaches to remedying this situation should also be economic and social” (1). Hampl and Hall have proposed no such solutions. Their Call for Action is intensely individualistic, completely ignoring the important social processes by which women and racialized minorities come to live in poverty, and with food insecurity, in much greater proportions than men and white people. Since they do not provide evidence for the effectiveness of the actions they propose, ignore evidence of systemic sexism and racism which lead to poverty and food insecurity in the United States, and disregard the welldocumented relationship between poverty and risk of food insecurity, we can only conclude that the motivations for their Call for Action are moralistic. This is inappropriate for a scientific review and unacceptable as a basis for dietetic practice. ELAINE POWER, PhD, RD VALERIE TARASUK, PhD Department of Nutritional Sciences University of Toronto Toronto, Ontrario, Canada References 1. Hampl J, Hall R. Dietetic approaches to US hunger and food insecurity. J Am Diet Assoc. 2002;102:919-923. 2. Tarasuk V, Beaton G. Household food insecurity and hunger among families using food banks. Can J Public Health. 1999;90:109-113. doi: 10.1053/jada.2003.50099
Journal of THE AMERICAN DIETETIC ASSOCIATION / 435