Academic journal article Bulletin of the World Health Organization

Measuring Hunger in the Russian Federation Using the Radimer/Cornell Hunger Scale

Academic journal article Bulletin of the World Health Organization

Measuring Hunger in the Russian Federation Using the Radimer/Cornell Hunger Scale

Article excerpt

Introduction

From February 1992 to May 1994, the U.S. humanitarian relief organization CARE responded to the health and food security crisis in the former Soviet Union. With financial support from the U.S. Agency for International Development (USAID), CARE established a survey unit whose task was to identify nutritionally vulnerable groups and to assess their needs. One round of surveys assessed food security and nutrition among children under 2 years of age. For this purpose, CARE conducted nutritional surveys in the cities of Moscow, St Petersburg and Ekaterinburg and their surrounding oblasts, which are more rural. The surveys were carried out by personnel hired and supervised by CARE technical staff.

The results of the study showed that children under 2 years of age were at risk of food insecurity, although there was no evidence of frank protein-energy malnutrition. A high proportion, approximately 25%, had anaemia. The majority of households reported spending over 50% of their monthly income on food. The risk was exacerbated by low levels of childhood immunization.

Details of the under-2-year-old survey itself have been published (1). This article analyses hunger in the Russian Federation and compares the results with those on hunger in a U.S. population. Both the U.S. and Russian studies used the Radimer/Cornell hunger scale to measure the prevalence of hunger in the respective populations. This scale was first used in New York State in 1988 and 1993 to identify households experiencing hunger, defined as "the inability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so" (2). The entire Radimer/Cornell questionnaire from the New York surveys, except for one item used only in the 1993 survey, was translated into Russian and used in the present study, together with a range of socioeconomic, demographic and nutritional data.

The present article compares the findings of hunger assessment among the Russian population with those of the 1993 New York study, since both their designs were similar. Both included random samples of women, not just low-income women. In addition, an evaluation is presented of the criterion-related validity of the Radimer/Cornell hunger scale.

Methods

The Russian study design was based on a cross-sectional representative sample of 4860 children under 2 years of age. Six areas -- Moscow, St Petersburg, Ekaterinburg and their surrounding oblasts were sampled. Two-stage cluster sampling was used in the cities, and three-stage sampling in the oblasts. Approximately 800 mothers were questioned in each of the six study sites. The survey in the cities was conducted from July to September 1993 and the oblast survey from October to December 1993. Details of the sampling methodology have been published previously (1).

In the 1993 New York survey, the study design consisted of a stratified random sample of women and their children living in a rural county in New York State. Radimer et al. sampled a much smaller number of women than were sampled in the Russian study (3).

The Russian questionnaire included questions on the socioeconomic status of the household (household food and non-food expenditures), dietary assessment, anthropometry, and the Radimer/ Cornell hunger scale. The questionnaire for under-2-year-olds used the same 12 Radimer/Cornell hunger items as in the 1988 New York survey, which did not include an additional household qualitative item used in the 1993 survey. These items measured hunger at three levels: household, women, and children. Radimer and a team from Cornell University developed the questionnaire by first conducting in-depth interviews with mothers who had experienced hunger. The Cornell team then carried out a second phase, using survey methodology and factor analysis to determine the 12 items that were most valid and reliable (3). …

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