1. Assuring Access to Health Promoting Foods for Everybody What are the consequences if we don't? How can we reduce disparities?

2. Nutrition Security The provision of an environment that encourages and motivates society to make food choices consistent with short and long term good health.

3. Food Security Assess by all people at all times to sufficient food for an active and healthy life. Food security includes at a minimum: the ready availability of nutritionally adequate and safe foods, and an assured ability to acquire acceptable foods in socially acceptable ways.

4. Food Insecurity a household had limited or uncertain availability of food, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways (i.e., without resorting to emergency food supplies, scavenging, stealing, or other unusual coping strategies).

5. Hunger The uneasy or painful sensation caused by a lack of food. Involuntary hunger that results from not being able to afford enough food The recurrent and involuntary lack of access to food May produce malnutrition over time.

6. History of the Food Security Measurement Project 1990 NMRR Act recommends a standardized mechanism for defining and obtaining data on the prevalence of food insecurity 1992 USDA staff review existing research 1994 USDA and DHHS sponsor conference on Food Security Measurement and Research 1995 Current Population Survey of US Census Bureau includes Food Security Measurement scale 1996- present Annual Surveys, ERS assumes leadership, others encouraged to use FSMS

8. Washington State Data

9. Washington State, 1999-2001 Food Insecure without hunger – 12.5%

10. Food Insecurity with Hunger

19. Gradient exists at all levels of the SEP hierarchy Adapted from Smith and Shipley. Soc Sci Med, 32; 1991 Mortality Rate

20. Washington Mortality and Education WA Death Certificate 1997 – 1999, SPS