Codes and Frequencies
For sample children and sample adults (and prior to 2019, for all persons), FSRAWSCORE reports their family's raw score on the 30-day food security scale.
It ranges from 0-10 and reflects the number of affirmative responses to each of the ten food security questions. For more information about the Food Security supplement or about how the 30-day food security score was calculated, please refer to the Family Food Security Supplement section below.
The Family Food Security Supplement was introduced to the NHIS interview beginning in 2011, and is sponsored by the United States Department of Agriculture (USDA). The 2019 National Health Interview Survey Description states that family food security is defined as "access at all times to enough food for active, healthy lives" (p. 84). The Family Food Security Supplement consists of ten items measuring food security in the past 30 days, initially added to the NHIS Family questionnaire. Beginning in 2019, the Family Food Security Supplement was asked using the "family-level replicate" approach. In cases where the sample adult and sample child belong to the same family, responses to the Family Food Security Supplement were copied from the first interview to the record of the second person interviewed to avoid duplication of survey content. In cases where the sample adult and sample child belong to different families, the Family Food Security Supplement was asked in each interview.
Scoring on the Family Food Security Supplement takes place in two stages. First, if any of the responses to FSRUNOUT, FSNOTLAST, or FSBALANC is "refused," "not ascertained," or "don't know," then FSRAWSCORE is set to "missing" (99). Second, for cases with valid responses to FSRUNOUT, FSNOTLAST, and FSBALANC, the number of affirmative responses are summed, creating a score ranging from 0 to 10. Responses of "yes," "often true," or "sometimes true" were counted as affirmative responses. For the two items asking about the number of days a meal was skipped (FSSKIPNO) and the number of days where no food was eaten (FSNOTEATNO), responses of 3 or more days were considered affirmative. For more information about the USDA's efforts to measure food security, please refer to their Guide to Measuring Household Food Security.
FSRAWSCORE is recoded into three-category (FSSTAT) and four-category (FSSTATDET) summary categorical variables. Below is a list of all of the Food Security Supplement variables that are components of the 30-day family food security scale:
- FSRUNOUT: Family worried food would run out before got money to buy more, last 30 days
- FSNOTLAST: Food did not last until family had money to get more, last 30 days
- FSBALANC: Family could not afford to eat balanced meals, last 30 days
- FSSKIP: Family members cut size or skipped meals because not enough money, last 30 days
- FSSKIPNO: Number of days any family members cut size or skipped meals for financial reasons, last 30 days
- FSATELESS: Ever ate less than felt should because not enough money, last 30 days
- FSHUNGRY: Ever hungry but did not eat because not enough money, last 30 days
- FSWEIGHT: Ever lost weight because not enough money for food, last 30 days
- FSNOTEAT: Any family members not eat for a whole day because not enough money for food, last 30 days
- FSNOTEAT: Number of days any family member did not eat due to lack of money, last 30 days
There have been some changes in question wording that may affect comparability over time. Please refer to the "Comparability" tab for more information.
The comparability of FSRAWSCORE over time is affected by changes in the question wording in three of the component items and a change in the universe beginning in 2019.
Changes in Question Wording
The wording of the questions used to collect information for the variables FSATELESS, FSHUNGRY, and FSWEIGHT changed twice during the 2011-2019 period. For all three variables, the wording of the question changed back and forth between a version that asked whether the family respondent had experienced the specific type of food insecurity and whether the family respondent or other adults in the family had experienced the specific type of food insecurity. For example, for FSATELESS in 2011-2012, quarters 1-2 of 2013, and 2014-2018, the family respondent was asked:
In the last 30 days, did you ever eat less than you felt you should because there wasn't enough money for food?
In quarters 3-4 of 2013 and in 2019 and later years, the respondent was asked:
In the last 30 days, did you or other adults in your family ever eat less than you felt you should because there wasn't enough money for food?
Users who wish to exclude responses to FSATELESS, FSHUNGRY, and FSWEIGHT in quarters 3 and 4 of 2013 from their calculation of the FSRAWSCORE can use QUARTER to identify responses that were recorded in quarters 3 and 4 of 2013.
Changes in Universe
When the Family Food Security Supplement was introduced in 2011, it was added to the Family Questionnaire, asked about all surveyed families in all responding households. Between 2011 and 2018, the universe for the Family Food Security Supplement was all members of surveyed families ("all persons"). Beginning in 2019, the NHIS changed to eliminate data collection about all members of responding households and families, and instead randomly sampled one adult ("sample adult") and one child ("sample child") per household. The Family Food Security Supplement questions were asked of the sample adult or the respondent for the sample child about their respective families. As a consequence of the change in NHIS data collection design, the universe for the Family Food Security Supplement is now "sample children age 0-17 and sample adults age 18+."
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
- 2011-2018: All persons.
- 2019-2022: All sample children age 0-17 and all sample adults age 18+.