The Food Insecurity Experience Scale – a new

tool for valid and comparable measurement of

food insecurity

Terri Ballard, Sara Viviani and Anne KeppleVoices of the Hungry Project, FAO

5th LCIRAH Conference

Agri-health research: what have we learned and where to next?

Food and Agriculture Organization of the United NationsJune 3-4, 2015

Voices of the Hungry project for

measuring food insecurity

FAO has developed an approach for measuring food insecurity at

different levels of severity, which consists of

the Food Insecurity Experience Scale (FIES)

a global standard for cross country comparisons.

• The FIES is an experience-based food insecurity scale that builds on

other similar scales that have evolved over the past 20 years in the US,

Canada and many Latin American countries.

• Using the FAO methods, prevalence estimates of food insecurity at

different levels of severity are valid and comparable across countries

and regions

Food insecurity measurement

• The aspect of food insecurity measured by the FIES is

a condition by which people are unable to access food

• The severity of the food insecurity condition is not

directly observable but is manifested by certain food-

related experiences and behaviors

• Food insecurity is measurable on a one-dimensional

scale using information from a set of questions

analyzed together

The Food Insecurity Experience Scale

(FIES) Survey ModuleDuring the last 12 MONTHS, was there a time when:

1.You were worried you would run out of food because of a lack of money or other resources?

2.You were unable to eat healthy and nutritious food because of a lack of money or other

resources?

3.You ate only a few kinds of foods because of a lack of money or other resources?

4.You had to skip a meal because there was not enough money or other resources to get food?

5.You ate less than you thought you should because of a lack of money or other resources?

6.Your household ran out of food because of a lack of money or other resources?

7.You were hungry but did not eat because there was not enough money or other resources for food?

8.You went without eating for a whole day because of a lack of money or other resources?

The Food Insecurity Experience Scale

(FIES)

Mild food insecurity Severe food insecurity

Anxiety about ability

to procure adequate

food

Compromising

quality and variety

of food

Reducing quantities,

skipping meals

Experiencing hunger

Global implementation of the FIES

FIES included within the Gallup® World Poll (GWP) since 2014 -

nationally-representative annual survey of individual adults conducted

in over 140 countries since 2005.

Item Response Theory (psychometric analysis) providing

comparable rates of food insecurity across countries. Software package

on R.

Annual results for global monitoring

Research into association between FIES and other aspects of people’s

lives to better understand the experience of being food insecure in

different settings.

Application of the FIES in the GWP

Eight questions asked to individual adults

– Adapted from the similar questions in use for 20+ years (US measure, ELCSA)

– Y/N responses with frequency-of-occurrence follow up questions for the last 2 items

A reference period of 12 months to ensure comparability of surveys conducted in different months

Country sample sizes of 1000 individuals, representative of the male and female resident population aged 15 and over (except in very large countries such as India and China, with sample sizes up to 5000.)

Application of the FIES

in other settings

The FIES survey module used in the GWP can be customized to

other applications (e.g. national household surveys or nutrition

surveys)

Items can be added to increase precision

Questions can be framed at the household level

The reference period can be changed (ex. 1, 3, 6 months)

Innovations of the FIES measurement

approach for cross-cultural comparability

Each application (i.e., in a certain country, in a certain year) produces an estimate of the relative position of raw scores (no. of affirmative responses ranging 0-8) on the severity scale

Mild FI Severe FI

Raw score-based classifications are not directly and fully comparable across settings, requiring methods to equate measures obtained in different applications by referencing them to a global standard

This produces probability estimates for being food insecure at different levels of severity, taking into account measurement error.

Uses of the

FIES measurement approach

Through the GWP, national estimates of the prevalence of moderate and severe food insecurity are produced for each country

Provides estimates of food insecurity of individuals, allowing for analysis by gender and other individual traits

Inclusion of the FIES in nationally representative surveys carried out by countries can produce sub-national prevalence levels.

The FIES may be appropriate for capturing changes in food insecurity severity due to programmes and policies

The FIES has been recommended by Rome-based UN agencies as monitoring indicator for the post 2015 SDG agenda

Agri-health research: what can we learn from

measuring food insecurity and where to next?

Exploratory research using the 2014 GWP data to

understand associations between food insecurity

and other aspects relevant to health, nutrition

and well-being

How agriculture may improve diet,

health and nutrition

Modified from Herforth & Ballard, forthcoming

Possible causes and consequences of

experiencing food insecurity

• Smallholder agriculture is the foundation of food security in

many countries.

• Food insecurity has been found in a number of studies to be

associated with a wide range of health issues, including

psychological distress

• Gender inequality contributes to food insecurity

• There is likely to be an association between food insecurity and

low self-esteem, which may lead to feelings of shame and can

affect a person’s standing in the community.

Exploratory analyses on food insecurity,

residence, gender, health and respect. GWP 2014

Analyzed 61 GWP datasets from low or lower middle income countries (World

Bank 2014 classification).

• Modeled food insecurity status separately for each country against

– gender

– urban-rural residence

– health (Do you have any health problems that prevent you from doing any of the

things people your age normally can do? )

– respect (Were you treated with respect all day yesterday?)

• Tested for interaction between gender and other independent variables (none

found).

Factors associated with food insecurity

GWP FIES data 2014

Logistic Regression Models (dependent variable: moderate- severe food insecurity status)

Independent Variables

Odds Ratios * 95% Confidence intervals *

% Countries with significant

associations N=61

Female gender 1.15 0.84-1.59 26%

Rural residence 1.47 1.00-2.19 60%

Health problems 1.93 1.35-2.77 83%

Not respected 1.82 1.16-2.86 72%

* Average across the countries

FEMALE GENDER and

RURAL RESIDENCE

Female (26%)

Rural (60%)

HEALTH PROBLEMS

Self-reported health problems (83%)

LACK OF RESPECT

Lack of respect (72%)

Agri-health research: what can we learn from

measuring food insecurity and where to next?

• Food insecurity is principally, but not exclusively, a rural problem.

• Food insecurity is an obstacle to good health, nutrition and well being

• Valid and comparable measurement of food insecurity should be part of agri-

health research to understand the dynamics of food insecurity along the causal

pathways

• Important to capture gender differences in food insecurity

• FAO has developed a measurement approach that provides comparable

estimates of food insecurity of individuals and households and can be applied

in different settings

Thank you from the Voices of the Hungry team

http://www.fao.org/economic/ess/ess-

fs/voices/en/

terri.ballard@fao.org

The Analytics: the Rasch model