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:
- Original Children’s HealthWatch validation study of the Hunger Vital Sign™ for use among families with young children (2010)
- Validation study of the the Hunger Vital Sign™ for use among youth and adolescents (2015)
- Validation study of the the Hunger Vital Sign™ for use among adults (2017)
- Screening for Food Insecurity: Short-Term Alleviation and Long-Term Prevention (2017)
- Successes, Challenges, and Considerations for Integrating Referral into Food Insecurity Screening in Pediatric Settings (2018)
- The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care (2019)
Children’s HealthWatch publications:
- The Hunger Vital Sign™ policy action brief (2014)
- Cultivating Healthy Communities policy action brief (2016)
- The Hunger Vital Sign™: Best practices for screening and intervening to alleviate food insecurity white paper (2016)
- Case Study #1 — Hennepin County Medical Center
- Case Study #2 — Boston Medical Center
- Professional Brief: Four Opportunities for Medical and Health Organizations to Address Food Insecurity
- Food Is Medicine Massachusetts State Plan Case Study
- Food Insecurity and Health: Overcoming Food Insecurity Through Healthcare-Based Interventions
- An Overview of Food Insecurity Coding in Health Care Settings: Existing and Emerging Opportunities
- Addressing Food Insecurity: A Toolkit for Pediatricians
- Addressing Food Insecurity in Health Care Settings: Key Actions & Tools for Success
- Identifying Food Insecurity in Health Care Settings: A Review of the Evidence, The Social Interventions Research and Evaluation Network (SIREN)
- Bi-State Primary Care Association’s Hunger Vital Sign Explainer Series: Nine sections offer short audio conversations, transcripts, and reference materials to walk through different aspects of Hunger Vital Sign and answer common questions.
- SIREN Tools and Resources: These resources include the SIREN Evidence Library as well as reports, issue briefs, and commentaries on relevant topics, social and economic determinants screening tools, webinars and presentations that have been conducted in this field
- SIREN Community Resource Referral Platforms: This guide outlines new technologies available for health care organizations to document patients’ social and economic needs and facilitate relevant referrals to social service organizations
- Free, online course: Screen & Intervene: Addressing Food Insecurity Among Older Adults
- Moving Health Care Upstream’s (MHCU) Policy Learning Lab Compendium of Research & Technical Assistance Memos
- NCoP: Food Insecurity Screening, Workflow Design, Multi-Site Expansion, and County-Wide Examples
- NCoP: Food Insecurity Screening, Workflow, Compliance, and Measuring Success
- Children’s HealthWatch: Identification Requirements at Food Banks
- Children’s HealthWatch: Implementing Food Rx Partnerships in Rural Settings
- MHCU’s Policy Learning Lab Webinar slide deck and audio/slide recording
- English/Spanish translation of the Hunger Vital Sign™
- English/Portuguese translation of the Hunger Vital Sign™
- Additional translations of the Hunger Vital Sign™ (multiple languages)
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 Charlotte.Bruce(at)bmc.org.