What is the Hunger Vital Sign™?

In 2010, Drs. Erin Hager and Anna Quigg and the Children’s HealthWatch team developed the Hunger Vital Sign™, a validated 2-question food insecurity screening tool based on the U.S. Household Food Security Survey Module to identify households at risk of food insecurity.

The Hunger Vital Sign™ identifies households as being at risk for food insecurity if they answer that either or both of the following two statements is ‘often true’ or ‘sometimes true’ (vs. ‘never true’):

“ Within the past 12 months we worried whether our food would run out before we got money to buy more.”

“ Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.”

The peer-reviewed journal article on the Hunger Vital Sign™ has been cited in hundreds of publications since its release and the screening tool has been used widely in medical and community-based settings around the country. In 2015 the Hunger Vital Sign™ was validated for use among youth and adolescents, and in 2017 the Hunger Vital Sign™ was validated for use among adults as well.

In October 2015, the American Academy of Pediatrics released a policy statement, recommending that pediatricians screen all children for food insecurity. In May 2017, the Centers for Medicare & Medicaid Services incorporated the Hunger Vital Sign™ in the Accountable Health Communities Screening Tool.


There is no fee or license required to use the Hunger Vital Sign™. We only ask that parties properly cite the tool as follows:

Hager, E. R., Quigg, A. M., Black, M. M., Coleman, S. M., Heeren, T., Rose-Jacobs, R., Cook, J. T., Ettinger de Cuba, S. E., Casey, P. H., Chilton, M., Cutts, D. B., Meyers A. F., Frank, D. A. (2010). Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity. Pediatrics, 126(1), 26-32. doi:10.1542/peds.2009-3146.

Selected Hunger Vital Sign™ resources:

Peer-reviewed journal articles:

Children’s HealthWatch publications:

Recommended publications:

Other resources:

About the Hunger Vital Sign™ National Community of Practice (NCoP)
Co-convened by Children’s HealthWatch and the Food Research & Action Center (FRAC), the NCoP works to facilitate conversations and collective action among a wide-range of stakeholders interested in addressing food insecurity through a health care lens. The overarching goal and purpose of the NCoP is to rapidly share leading best practices and data on food insecurity screening/intervention activities and strategies to scale what works.

Quarterly virtual meetings facilitate a collaborative forum and a venue where multiple stakeholders gather to disseminate research and best practices, incubate innovative ideas, and most importantly, collaborate in sub-groups to inform and influence large-scale policy and practice change resulting in evidence-based innovations to alleviate food insecurity and improve population health outcomes.

  • To learn more about the Hunger Vital Sign™National Community of Practice, click here.
  • To join the Hunger Vital Sign™National Community of Practice, please contact Children’s HealthWatch Deputy Director of Innovative Partnerships, Richard Sheward richard.sheward(at)bmc.org.