August 2, 1991 | Backgrounder on Religion and Civil Society, Civil Society

Hunger and Malnutrition Among American Children

(Archived document, may contain errors)

August 2,1991 HUNGEX AND -ON AMONG AMERICAN CHILDREN INTRODUCI'ION Ast-numberofA&anchildrenmin- ofstarving one out of e

tAmer iCrar children isgoinghungrytonight So began a CBS Evening News broadcast last Mar& 27th Its headline-grabbing conclusion came from a swey conducted by the "Food Research Action Center" (FRAC a liberal advocacy group, and sponsored by Kraft General Foods, Inc one of America's largest food processing companies As it turns out, FRAC claimed that one of eight children in America had been hungry" at some time during the prior year, not each night, as CBS reported. Yet the mistake made by CBS has passed into pr ess and political folklore as conven tional wisdom.The FRAC study received saturation coverage in.the press, includ ing stories in the Boston Globe, the Chicqgo Tdune, the Christian Science Monito the NmYotkTi, US4 TW, and the Washington Post.

Subjective Q uestions. What is worse, CBS not only exaggerated the study's con clusion, the study itself is flawed and completely contradicted by serious, scientific surveys. Unlike other studies, the FRAC suivey did not measure actual food con sumption or physiologic a l indices of nutritional status among poor persons. In stead, FRAC asked American families highly subjective questions about whether they would like to have more or a wider variety of foods 1 Media Rd Center, Media Eat Up Hungcr Study: Media Wad, April 19 91 p. 1.

Disproving FRAcs conclusions (and the press distortions of them) are exten sive, scientific surveys conducted by the Food and Nutrition Service of the U.S.

Department of Agriculture and the U.S. Department of Health and Human Ser vices. These stu dies actually measure the levels of food consumption and malnutri tion in America. Among their findings There is little evidence of hunger or insufficient caloric intake among poor children. The Atlanta-based Centers for Disease Control, the federal agenc y that monitors disease, reports that poor children are no more likely to experience clinical thinness (very low body weight relative to height) than are children in the general population.

There is no evidence of protein deficiency among American adults or children, rich or poor, according to the Centers for Disease Control 1976-1980 Health and Nutritional Examination Survey, which measures protein levels in the blood.

Protein, vitamin, and mineral consumption by poor children under age six are in almost all cases well above recommended norms, accord ing to a 1985 United States Department of Agriculture survey of the ac tual food consumption of these children. Little difference was found between the level of nutriments consumed by poor and affluent childr en.

Wvenveight not underweight is a major problem in the U.S. accord ing to Nutrition Monitoring in the United States, a joint report of the U.S. Department of palth and Human Services and the U.S. Depart ment of Agriculture. Being overweight is far more p revalent among the poor than among the affluent. Some 40 percent of poor adult women are overweight. Being overweight, as it is widely recognized contributes to such serious medical problems as heart disease, high blood pressure, diabetes, and some types of cancer. The major nutri tion-related health problems among poor Americans are not due to hunger or undernutrition.

Other FRAC findings and statements are as unreliable as its statements on nutrition. FRAC, for example, claims that the recent ostensible increases in hunger result from spending cuts on food assistance during the Reagan presiden cy. In fact, federal, state, and local spending levels, measured in inflation-adjusted 2 U.S. Department of Health and Human Services and US. Department of Agrkult ure, Nufntion Monitoring in the United States A Repnlfrom the Joint Nutdion Monitoring Evaluation Committee. DHHS Publication No PHS) 8612

55. Public Health Service (Washington, D.C U.S. Government Printing Office, July 1986 p. 52 2 dollars, increased in the 1980s. Last year, government spending on food Sissistance was 68 percent higher in constant dollars than in 1975.

Overall, there isno evidence of protein or calorie deficiency among poor children or adults? Some poor children may experience shortfalls in specific minerals or vitamins but similar shortfalls will occur among higher-income children as well. FRACs claim t hat poor families suffer from chronic empty stomachs and physical food shortages is belied by the high rate of obesity among poor adults as well as the high level of protein and meat consumption among poor persons.This pattern of food consumption is relat ively expensive and is unlikely to occur among households that consistently run out of food to eat.

Abundant Reliable Data. The findings of the FRAC study survey are already being used by Representative Leon Panetta, the California Democrat, to justiij in creased spending on food assistance. In fact, FRAC is promoting state policies to address problems which do not really exist. Instead of relying upon answers to leading questions, such as those posed by FRAC, federal policy makers and citizen groups conce r ned about Americas poor should base policy on the scien tific data abundantly available from government agencies like the departments of Agriculture and Health and Human Services. Such reliable data enable policy makers to determine what nutritional defic i encies actually exist and to address genuine health problems arising from obesity and overconsumption of unhealthy foods such as fat rather than allegedly widespread hunger As serious, the unsubstantiated and then distorted FFWC claims distract from the r e al problems facing poor families and children: escalating crime, growing il legitimate birth rates and family disintegration; prolonged welfare dependence and the virtual collapse of the work ethic throughout low-income communities and government schools t hat can no longer even protect the physical safety of poor children, let alone educate them HOW FRAC DISCOVERED WIDESPREAD HUNGER In contrast to the surveys conducted by the U.S. Department of Agriculture USDA) and the Centers for Disease Control (CDC the FRAC study did not ac tually measure food consumption, physiological status, or obesity. FRAC merely asked parents vague and subjective questions Example: Thinking about the past 12 months, did you ever rely on a limited number of foods to feed your child ren because you were running out of money to buy food for a meal?

I SUndemutrition likely will occur among pr children who are victims of chronic child abuse. Under-nutrition also may appear among adults who abuse alcohol or drugs or who are mentally ill. However, these problems are not due to failure of government food programs and are unlikely to be resolved by changes in food assistance Policy 3 Example: Thinking about the past 12 months, did you or adult members of your household ever cut the size of m eals or skip meals because there was not enough money for food?

Clear and concrete questions, such as the number of times children were forced to skips meals entirely due to a lack of food, were not asked. Instead, the FRAC questions focus mainly on whethe r a family would like extra money to buy more different, or better quality food. Predictably, such leading questions led FRAC to discover that many low-income households were hungry.The same method led FRAC to conclude that more than 5 percent of families With incomes over 25,000 per year were hungry as well! Complained Mickey Kaus in the New Uepublc: The whole project oozes ph~niness proposes, for example While FRACs survey questions were vague, its policy proposals are not. FFUC An aggressive publicity p r ogram to promote use of the Food Stamp program to combat putative hunger Increasing funding of the Women, Infants, and Children (WIC) food program until all eligible families receive aid Expanding the School Breakfast program, noting that while nearly all schools offer free lunches to poor children, many do not offer free breakfasts.

FRACs claim that one-third of families eligible for Food Stamps do not receive them is correct. But this does not necessarily mean that there is a real need for these families to begin receiving them. USDA studies conducted during the Carter Administration, when there was also concern that Food Stamps were not reaching many eligible families, found that families eligible for Food Stamps, but not participating, generally had hi g her incomes than families which did receive ood stamps. On average these non-participating families would have been eligible to receive only a small amount of Food Stamp aid. Moreover, the USDA study did not find these families to be malnourished; in fact , the study found few significant nutritional differences between eli ble but non-participating families and families actually receiving Food Stamps. 7 4 Food Research and Action Center, A Survey o/ Childhood Hunger in the United States, Community Childhoo d 5 Mickey Kaus, Facts for Haw The New Republic, May 20,1991, p. 23 6WIC is not an open-ended entitlement program. Its funding is limited by annual appropriations and is not Hunger IdentiGcation Project, 1991, p. 62 sufficient to provide benefits to all th e oretically eligible persons. FRAC seeks to expand WIC funding to cover all eligible persons 7 US. Department of Agriculture, Human Nutrition Information Service, Food Consumption and Dietory Levels of Low-Income HousehdrLF November 1979 Match 1980 (Washin g ton, D.C U.S. Department of Agriculture 1987 pp. 23-25 4 Misguided Proposal. Likewise, FRACs proposed expansion of WIC ismis guided. Most poor families eligible for WIC already receive assistance, but other families earning up to $24,0oO per year are also eligible for WIC aid. FRAC seeks to expand WIC assistance provided to these higher income families. But the needy families to which FRAC wishes to extend WIC services and many now receiving WIC have money taken out of their paychecks to pay federal taxes. A family of four earning $16,000 per year now pays about $2,000 to the federal government in taxes. A family earning $24,000 per year pays $5,1

27. Thus, in ef fect, FRAC proposes taking money out ,of. a familys paycheck through taxes on Friday and then g iving them free orange juice through WIC on Monday. To the ex tent that these families find it hard to afford food, the obvious alternative is simply to reduce their taxes.

FRAC urges expansion of the School Breakfast Program, arguing that poor children w ho eat breakfast will be less fatigued and will learn more during the school day. But research has shown that the availability of the School Breakfast program at a school does not increase the probability that poor students at that school will eat breakfa s t, nor does active partici ation in the breakfast program in crease a poor childs overall nutritional intake. 8 THE MYTH OF AMERICAN MALNUTRITION The FRAC report defines hunger as a physical condition that comes from not eating enough food due to insuffic i ent economic reso~rces According to FRAC, hunger is a state of chronic mild undernutrition.lo Malnutrition is caused by the significant over- or under-consumption of nutri ments. The human body requires three basic types of nutriment: calories (fuel for t he body proteins (the amino acids that are the building blocks of bone and tis sue and minerals and vitamins (the catalysts for vital body functions).

Americans at different income levels. The federal government establishes a pover ty income threshold each year and families with incomes below this threshold are defined as poor. In 1989 the poverty income threshold for a family of four was 12,6

75. Children living in these families, according to the data, consume high levels of calories, protein, vitamins, and minerals.

The federal government compiles its nutrition data through detailed and precise surveys that, of course, are far more elaborate and exact than FRACs vague ques tions. Since the 1930s, in fact, the U.S. Department of Agriculture has conducted food consump tion surveys, extensively interviewing representative house holds Detailed scientific data exist on the consumption of these nutrients by I 8 Barbara Devaney and Thomas Fraker, The Dietary Impacts of the School Breakfast Program,American Agn cultuml Economics Association, 1989, pp. 932-948 9 Survey of QIildhood Hunger in the United States, op. cit p. 2 10 Ibid 5 to determine how much food is consumed on various days throughout the year.

These surveys permit comparisons of average food consumption in households from different socio-economic strata.

In 1985, the USDA thoroughly surveyed the food consumption and nutritional status of pre-school children and young mothers. It found little evidence of under nutrition among the poor.To the contrary, it found that children in low-income families consume food with just about the same nutritional content as do children in affluent American families Example Example Example Children in families with incomes below 75 percent of the poverty level (roughly $ 8,242 for a family of four in 1985) consume 54.4 grams of protein per day, compared with 53.6 grams for children in families with incomes above 300 percent of poverty (roughly $33,000 for a family of four in 1985).n Black pre-school children consume 56.9 g rams of protein per day compared with 52.4 grams for white children.'3 Children in the central cities consume sli tly more protein and calories than do children in the suburbs P llThe USDA food consumption data not only show that the average consumption o f nutriments between poor and higher-income children is similar, but also that the variances from the average intakes in both income groups are similar. This reinforces the argument that poor children are not significantly undernourished relative to higher income children. 12 Human Nutrition Information Service, U.S. Department of Agriculture, Low Income Women 19-50 Yem curd Their Chilhn 1-5 Years, 4 Days: 1985, CSF I1 Report 85-5 (Washington, D.C U.S. Department of Agriculture 1988 p 50. Human Nutrition In f ormation Service, U.S. Department of Agriculture, Women 19-50 Years und Their children 1-5 Years, 4 Days: 1985, CSF I1 Report No. 85-4 (Washington, D.C U.S. Department of Agriculture, 1987 p. 42 l3 Women IPSO Yeam, op. cit p. 42 14 hid 6 AsTable 1 indicat e s, average consumption of nutrients is very high for pre school children in families of all income classes. Indeed, for children living in families with incomes below 75 percent of the poverty level, average daily protein consumption is 21 1 percent of re commended USDA Recommended Daily Al iow~~s (RDA Table 1 Average Per Caplta Consumption of Nutriments as a Percentage of Recommended Daily Allowances Children under age 6 in 1985 Sources: Low Income Women 19-50.Yea~ and Their Children 1-5 years, 4 Da .72-

7 3. Women 19-50 Years and Their Children 1-5 years, 4 Days, 1985, op. cp pp. 64-6 op. cit p lsLow Income Women 19-30 Years and neir Chilhn 1-5 Years, 4 Days: 1985, op. cit., p. 72 7 Essential minerals and vitamins, meanwhile, are consumed by children in bo t h high and low income families at levels often as much as 50 percent above USDA standards. In only a few instances does nutriment consumption fall below recom mended levels. This is true of calcium consumption, which for both poor and high income families is slightly below the USDA level. Average zinc consumption also falls below recommended levels, but this shortfall is unrelated to income class.16 Since the recommended USDA standards for consumption of minerals and vitamins, are set above the levels need ed for good health for most persons, an average deficiency does not necessarily indicate significant nutritional pr~blems Table 2 Average Per Ca ita Food Consumption By c! ram Weight Children under age 6 in 1985 PAII fipures in prams I 14

36. Women 79-50 Years and Their Children 1-5 years, 4 Days, 1985, op. cit. pp. 14d 16 Low Income Women 19-50 Years, op. cit p 73. Women 19-50 Yem, op. cit p. 65.The 1985 food consumption survey also shows iron deficiency in all income classes. However, th e USDA determined that the recommended daily allowance for iron per young children had been set too high. A new recommended daily iron intake for young children was established in 19

89. According to this standard, the average intake of iron of both poor a nd non-poor children was sufficient 17NuDirion Monitor, 1986, p. 29.The federal government has a complex process of evaluating the nutritional status of the American population.The USDA food consumption surveys provide prehnhary data on the nutrient intak e s of various groups. If a group's average intake of a nutriment falls below the Recommended Dietary Allowance (RDA this is not a definite indication of a nutritional deficiency. States nte Nubirion Monitoc mean intakes of population groups falling well be l ow the RDA can be taken as a rough indicators that further examination of the status of the population is needed Monitor, 1989, op. cit p 16. Additional information on a group's nutritional status can be provided by hematological and biochemical tests, cl i nical examinations and body structure data.Tbese will show clearer evidence on nutritional deficiency 8 Table 2 shows the types of food consumed by poor and affluent children. As it turns out, poor children actually eat more fish, meat and poultry than do children in higher-income families. In other foods, the general consumption pattern is similar for both economic groups. Though higher-income family children do con sume much higher levels of fruit and fruit juice, lower consumption by poor children does n ot result in Vitamin C deficiency THE SCIENTIFIC SEARCH FOR SIGNS OF MALNUTRITION The federal government supplements its extensive food consumption surveys with periodic physiological surveys of Americans. Between 1976 and 1980, for in stance, the Centers for Disease Control conducted the National Health and Nutri tion Examination Survey II (ANES II) analyzing blood, urine, and physical characteristics in the U.S. population. Based on a representative sample of tens of thousands of Americans, the NHANES II data were used to gauge levels of vitamin, mineral and protein intake.

Protein. As part of the 1976-80 ANES II survey, CDC offices analyzed the bloods most common protein, serum albumin. Low levels of serum albumin are the strongest indicator of protein-c aloric malnutrition. Protein deficiency is dangerous; it retards growth, impairs mental functions and causes fatigue. Starva tion, in fact, results from massive and prolonged protein-caloric deficiency.

The NES II survey found protein deficiency in only 1 9 individuals out of the 15,457 persons in the representative sample surveyed. This is less than one tenth of 1 percent.There were no differences, moreover, between races or be tween poor and non-poor persomu Thus concluded the Nutrition Monitoring Up e, a joint report prepared by the Department of Health and Human Services HHS) and the USDA in 1989: Protein is not considered to be a current public health issue there is no evidence of health problems associated with deficiency or excess.1g The report added that protein deficiency in America is essentially non-existent. Those few instances when it does occur are not linked to poverty.

Indeed, poor as well as affluent Americans have protein-rich diets in comparison with the rest of the world.20 18 Nuttition M onitotingin the United States:1986, op. cit., p. 65 19 Life Sciences Research Office, Federation of American Societies for Experimental Biology, Nubition Monitoring in The United States: An Update on Nubition Monitoring, Report prepared for the U.S. Depar t ment of Agriculture and the U.S. Department of Health and Human Services (Washington D.C.:U.S. Government Printing Ofice, September 1989 p. 51 20 Robert Rector, Kate Walsh OBeirne, and Michael McLaughlin, How Poor are Americas Poor? Heritage Foundation, B a ckgmunder No. 791, September 21,1990 9 Minerals and Vitamins. NHANES II analyzed children's blood for a variety of mineral and vitamin deficiencies. Such deficiencies were found to be rare and lar gely unrelated to economic status. Example: NHANES II foun d no evidence of low levels of serum Vitamin C among children under eleven. While from 1 percent to 2 percent of American teenagers have low serum Vitamin C levels, this actually is more common among non-poor than poor teenagers?l A deficiency slightly mor e prevalent among children from poor families is low serum zinc levels; yet even this is found in only among 2 percent to 3 percent of all children Iron Deficiency. Iron is the nutrient most commonly deficient in America, as it is in most other developed n a tions. As a key component of hemoglobin, iron is es sential to blood's ability to absorb and deliver oxygen to the body. Iron deficiency most frequently occurs in periods of rapid body growth, like infancy, adolescence and pregnancy, and can reduce work p erformance, cause fatigue, impair mental ac tivity, and increase susceptibility to infection.

During the early 1970s there was concern that iron deficiency was causing high rates of anemia (low blood cell levels per volume of blood fluid) among poor young children.This concern prompted the Centers for Disease Control in 1974 to begin monitoring anemia among those low-income pre-school children deemed at high nutritional risk. In 1975, the CDC found a 7.8 percent incidence of anemia in this group. By 1985 a n emia among low-income children had been more than halved down to 2.9 percent.= The anemia rates for poor children are now quite low, though still slightly higher than the anemia rates for middle-class children.24 Part of the decline in anemia is a result o f the expanded Women, Infants and Children program. Yet the most dramatic reductions in anemia from 1975 to 1985 occurred among poor children before their enrollment in WIC. Similar reductions in anemia occurred among middle class children not eligible fo r WICZ These dramatic improvements resulted from increases in iron levels in the general food supply and from changes what young children were eating.These improvements in high- and low-income families included: greater frequency and duration of breast fee d ing, increased substitution of iron-fortified infant formula for non-fortified milk, and increased use of iron-fortified cereals 21 Nubition Monitohg in the United States: 1986, op. cit p. 148 22 aid, p. 186 23RayYip et d Declining Prevalence of Anemia Am o ng Low-Income Children in the United States," JM UInterView with Dr. Ray Yip of the Centers for Disease Control, July 17,1991 25 Ray Yip et ul Declining Prevalence of Anemia in Childhood in a Middle-Class Set- A Pediatric Success 26 "Declining Prevalence o f Anemia Among Low-Income Children op. cit p. 1622 September 25,1982258 pp. 1619-1623 Stow Pediam'cs, September 1987:80 No. 3 pp330-334 10 While CDC data from the mid 1970s show significant declines in anemia among children from poor families after hose c h ildren began participation in WIC, CDC data from the 1980s show WIC playing a diminishing role. The dif ference in anemia rates among poor children prior to enrollment in WIC and the anemia rates of such children after participation in WIC shrank between 1 975 and 198Xn This suggests that the increased level of iron nutrients consumed by children in general has meant that WIC has played a less significant, though still important, role reducing iron deficiency among the poor in recent years MALNUTRITION AND B ODY STRUCTURE The effects of malnutrition are evident not only in blood chemistry but also in a childs body structure. Body weight relative to height, for instance, is the best in dicator of adequate caloric intake.28 A child who consumes far too few calo ries will have low body weight relative to height, a condition known as thinness or wasting.29 In detecting malnutrition, therefore, surveys of body structure are im portant supplements to food intake studies.

The CDC in 1973 began monitoring thinness or w asting among poor children. The CDC datashow that thinness is no more common among im poverished children than among the general population. Concludes the Nutrition Monitor report produced by the USDA and HHS in 1986: Wasting does not con stitute a signif icant health problem among Americas impoverished children.

Poor girls have roughly the same level of general body fat as non-poor girls of the same age up to their early teenage years. After that, poor girls begin adding markedly more body fat and are more likely to become obese than are non-poor girls. By contrast, poor boys have slightly less body fat than more affluent boys up to the teen years, but after that have roughly the same body fat?1 30 27 &id 28 Nutition Monitoring in the United States: 1986, o p. cit p. 51 29 Nutition Monitor, 1986, op. cit p. 198 30 Bid, p. 199 31 Stanley M. Garnet ul Differential Fatness Gain of Low Income Boys and Girls, The American Journal of Clinical Nutition, August 1981: 34 pp. 1465-1468 11 While the N"ES II survey did find that poor children were rou y'l per cent, or a half inch, shorter than non-poor children of the same age: the suryy found no consistent evidence linking lower height to lower levels of nutrition.

The Munitor Update report cautions that many factors may contribute to the rela tive shortness of poor children.

Parents' height, genetically transmitted to offspring, is the strongest deter minant of a child's height. Poor children, on average, have shorter parents than non-poor. children.

A child's height and growth may also be reduced by: emotional disturbances triggered by unstable family structure smoking by a mother during pregnancy exposure to parental smoking in the home during ~hi1dhood:~and low birth weight. Unstable families, smoking during pregna n cy and in the household, and low birth weight all are more common among children from poor families than those from non-poor families P 34 35 HUNGER AND OBESITY IN AMERICAN FAMILIES FRAC and others-citing hunger as one of America's most pressing problems t ypically paint a dismal picture of millions of malnourished poor families with bare cupboards and empty refrigerators, of parents who skip meals so that children may eat, and of children going to bed on empty stomachs 32 Based on children aged 6 to 11 33 D . Yvonne Jones et al Influences in Child Growth Associated With Poverty in the 1970s; an Examination of Es I and HANES 11, Cross-Sectional U.S. National Survey 1-3 The American Journal of Clinical Nubition, October 1985.42 pp. 714-724 34 Bid p. 721 35 Geo r ge R. Kerr et al Height Distributions of US. Children: Associations with Race, Poverty Status and 36 Nubition Monitoring in the United States: 1989 op. cit p. 86 37 Peter C. Elwood et al Growth of Children From 0-5 years: With Special Reference to Mother' s Smoking in 38 Nancy J. Binkin et ul Birth Weight and Childhood Growth Pediubics, 1988:82 No 6, pp. 828-834 Parental Size Growth, 1982% pp. 135-149 Pregnancy,"Ann& of Human Biology 1987:14 No. 6, pp. 543-557 12 This picture, however, is contradicted by al l available facts, particularly the high prevalence of obesity among poor adults. Persons who consistently lack enough food to eat become underweight, but being underweight is not a problem among the poor. By contrast, clinical obesity is a genuine, seriou s health problem among poor adults? Nearly 40 percent of all poor adult women are overweight; a poor adult woman, moreover, is 40 percent more likely to be overweight than a non poor woman.40 Overweight is particularly severe among black women!l States 77z e .Nutritwn Monitor, Obesity is more prevalent among the poor in dicating an imbalance of energy intake to ener expenditure. Many of the health problems of the poor are related to obesity.%cessive weight or obesity con tributes to high blood pressure, diabe tes, cardio-vascular disease, and some types of cancer. By contrast, there is no indication among the poor of any prevalence of the medical problems caused by consistent caloric insufficiency.

It is possible, of course, to be overweight and malnourished. T his could occur through the over-consumption of calories and the under-consumption of minerals protein, and vitamins, but government surveys indicate that this probably is not what is happening.They reveal that when the poor suffer vitamin and mineral sho r tages, they do so in ways similar to upper-income ad~lts.4 Efficient Purchasers. There is also no evidence that poor families are forced by financial pressures to eat cheap and unhealthy foods. To the contrary. Surveys find that poor households purchase f o ods quite efficiently. In fact, the poor generally buy more protein and other nutriments per dollar of food expenditure than do 39 Nubidon Monito*gin the United States: 1989 op. cit p. I1 32 40 Nubition Monitoring in the United States: 1986 op. cit p. 302 41 Each individual has an energy balance: the relation between food energy (calorie) intake and energy expenditure. Energy expenditure is determined by the bodys base metabolic rate plus the level of physical activity. Consistent doridenergy intake in exc e ss of energy expenditure causes 0verweight.This does not mean that overweight persons ndy eat more than other individuals but simply that their caloric consumption is greater than their specific energy expenditure. However, an overweight person cannot be c onsistently hungry in the conventional sense of having insufticient bulk food and calories to consume. Ibid, pp. 51-63 42 Ibid, p. 2 43 Human Nutrition Information Service, U.S. Department of Agriculture, Nationwide Food Consumption Survey Continuing Swey of Food Intakes by Individuals Men IPSO Yem, Z Day:Z985, NFCS, CFSll Report No. 85-3 Washington D.C.:U.S. Department of Agriculture, 1986 Low Income Women IPSO Yem and Women IPSO Yem, op. cit. See also Shiriki Kamanyika, Obesity in Black Women, Epidemiolo g ical Review, Vol. 9,1987, pp 39-45. typical affluent households.u Poor households, moreover, generally do not eat more fat as a share of total diet than do non-poor~households~s And poor households actually eat less unhealthycheap simple sugars and slight ly more corn plex carbohydrates a healthy food item than do affluent households.46 Poor persons actually have lower levels of serum cholesterol relative to higher income persons of the same gender, age, and race.

That children in poor families do not suffe r from food shortages and recurring caloricdeficiency is,confirmed further-by surveys of the types of food eaten by poor families. As shown inTable 2, poor children on average eat more meat products than do higher-income children, while the average protei n intake of poor children and adults is well above recommended standards. Much of this protein comes from meat, which today is eaten by poor households to about the same ex tent that it is by higher-income households.a Meat is relatively expensive. The hig h consumption of meat by the poor reflect's the poor's preference for meat over the much less exgensive grain products, which provide a healthful source of bulk food and calories 47 CUTSINFOODAID America's putative hunger problem is blamed by FRAC and othe r s on the Reagan Presidency's putative cuts in food and welfare programs. In fact, total spending on federal and state welfare programs in constant dollars during the Reagan Presidency jumped by 18 percent from 1980 to 1988, reaching a grand total of $184 b illion per annum.5o Aggregate spending on food assistance programs, measured in constant dollars by both federal and state governments also increased during the 1980s. After peaking during the recession of the mid 44 Nutrition Monitmhg in the United State s : 1986 op. cit p. 56,68 45 hid, p. 75 46 hid, P. 87 47 Nubition Monitoring in the United States: 1989 op. cit pp. I1 72-74 48 Rector, O'Behe, and McLaughlin, op. cit 49 Calories are a cheap nutriment. According to USDA, grains caa supply one-fourth of a f i ve-year-old child's calorie needs for roughly 17.cents a day. This is not to suggest that poor children should increase grah consumption, but it is simply intended to indicate that once a child's protein, mineral, and vitamin requirements have been met, a s is the case with the average poor child, the marginal cost of providing extra calories is very low. Therefore it is unlikely for pr children to have very high intakes of protein, minerals and vitamins while suffering from calorie insufficiency. It is ver y unlikely for poor children to have the same level of meat consumption as an afnuent child while still beiig calorically deprived or going to bed on an empty stomach 50 Rector, O'Beirne, and McLaughlin, op. cit 14 1980s food assistance remained at $24.4 b illion in 19

90. Adjusted forinflation this was 15 percent higher than spending in 1980 and 68 percent higher than spending in 1975.'l Graph 1 Total State and Federal Expenditures on Food Assistance Programs Bllllona Of O OnllMI lSS0 ws 27 70 72 74 78 78 '80 '82 '84 '88 '88 '90 Herllagr DrtrChrrt Spending ro rams include: Food Stamps, WIC, School Lunch Program, Food Donation Programs ildlNutriiion Programs, among others.

Source: USDA, Food and Nutrition Service Graph 2 Tot al Food Assistance Spending Per Poor Person Conatant l989 (US 800 70 71 72 73 74 76 76 77 78 79 '80 '81 '82'83'84'86'88'87 '88 '89 Herltwe DataChart Source: U.S. Bureau of the Census; USDA, Food and Nutrition Service 51 Expenditure figures provided by the Food and Nutrition Service of USDA. Fwes have been adjusted for inflation according to the Bureau of Labor Statistics Consumer Price Index for food consumed in the home 15 An analysis of per capita spending yields similar results. Graph 2 shows total spen d ing on food assistance per poor person between 1970 and 1989 (the last year for which data on the number of poor persons are a~ai1able.f~ In inflation-ad justed dollars, spending on food aid per poor person changed little during the 1980s; the value of go vernment food assistance per poor person in 1989 remained roughly the same as in 19

80. However, food aid per poor person today is far higher than in the 1970s. In inflation-adjusted terms, government food aid per poor person equalled $687 in 1989 compared to $529 in 1975?3 POLICIES TO MEET NUTRITIONAL NEEDS In general, poor Americans, young and old are relatively well nourished. Some poor Americans appear to have deficiencies in specific minerals or vitamins but higher-income persons have deficiencies in t hese same nutriments. Example: the 1985 Food Consumption Survey indicates that some low-income and high-income mothers consume insufficient levels of calcium, iron and zinc. Some poor and non poor children may be deficient in zinc. But there is little rea s on to believe these specific nutriment shortfalls, will be addressed by the broad expansion of food programs recommended by FRAC. There are two reasons for this 1) Giving a family food aid does not necessarily increase how much a family spends on food. Re s earch by the Congressional Budget Of fice finds that the average family receiving 100 in Food Stamps decreases its cash spending on food by 43. Thus $100 in food aid results in only $57 in increased food expenditures 2) Even if poor families spend more on food, they will not necessarily buy more foods which are rich in the specific nutriments that they lack. This is particularly true of those nutriments that tend to be un derconsumed by both high and low income families I The way to correct potential speci f ic vitamin or mineral deficiencies among poor persons is to increase the levels of these nutriments provided through exist ing food programs. Example: potential calcium, iron, or zinc deficiencies among poor mothers could be addressed by providing mineral supplements to these women as part of the WIC and Food Stamp programs. Poor children could be given increased zinc through foods provided through the WIC and School Lunch programs 52 The figures in graph 2 are intended to show trends in expenditures relat i ve to the poverty population, not absolute benefit levels. Because some food assistance goes to persons with incomes above the poverty level, the figures should not be construed to represent the average value of food assistance received by poor persons 53 Expenditure totals provided by Food and Nutrition Service, USDA. All figures are in 1989 dollars 54 Congressional Budget Ofice. "The Food Stamp Program: Income or Food Supplementation Washington D.C US. Government Printing Ofice, January 1977 16 CONCLUSIO N At the turn of this century, as many as 10,000 Americans died annually from pel lagra, a disease caused by vitamin B deficiency. Such diseases caused by under nutrition have all but disappeared in America. U.S. Department of Agriculture and Centers for D isease Control surveys meanwhile find no evidence of sig nificant widespread undernutrition and few significant differences in food con sumption and nutritional intake between poor children and upper-income children.

Major nutrition-related health problems in America are caused by excessive food consumption, not by food shortages. And being overweight is far more com mon among poor families than among non-poor: 40 percent of poor adult women are overweight.

Among poor children there are few nutritional def iciencies: some may suffer shortfalls in nutriments such as iron and zinc. Similar deficiencies, however, occur among the non-poor.The most effective way to deal with specific mineral and vitamin deficiencies among poor children is to increase the levels of these minerals and vitamins in foods already provided under the WIC and School Lunch programs.

American poor children and their families face overwhelming problems: escalat ing crime, disintegrating families, prolonged welfare dependance, and collapsing public schools. Chronic widespread undernutrition, however, is not a problem among poor children. FRACs policy proposals are defined to combat a problem that does not exist. The FRAC research only distracts attention from the serious problems that face p oor families today.

Robert E. Rector Policy Analyst 55 Nuairion Monitor 1986, op. cit p. 120 17

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