A Measure for Ending Hunger in the United States

Hunger is a persistent problem in the United States. In 1999, three percent of U.S. households (more than 7.5 million people) were food insecure with hunger.2(p7) An additional seven percent of households (more than 23 million people) were food insecure without hunger. In all, 31 million Americans, including 12 million children, did not have enough food to meet their basic needs.In response, PARTNERS IN ENDING HUNGER (a grass-roots organization with over 17 years of experience) has declared itself an organization accountable for providing communities with the tools and training necessary to create and implement effective action plans for ending hunger (see Appendix A). Two essential tools for this work are: (1) a direct and accurate way to measure hunger in a community and (2) criteria that define when hunger has ended.The hunger measure PARTNERS has chosen is the U.S. Household Food Security Measure. It is a survey instrument and severity scale developed under the joint leadership of the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS). It has been used to measure the extent of hunger at national and state levels since 1995 and was specifically designed to be used at the local level as well.Building on distinctions and definitions presented in the U.S. Household Food Security Measure, PARTNERS has established criteria that define when hunger in a community has ended. According to PARTNERS' criteria, a community has ended hunger when, for two consecutive years, the results of the U.S. Household Food Security Measure show that none of the community's households have members who experience hunger and four percent or fewer of the community's households experience food insecurity. PARTNERS asserts that when communities meet these criteria and sustain these results over time, they have ended the persistence of hunger. These communities will then serve as models and catalysts for other communities to do the same

Home birth in the United States and the Netherlands: understanding women's experiences of stigma, nature, and trauma

University of Ph.D. dissertation. December 2013. Major: Sociology. Advisor: Kathleen E. Hull. 1 computer file (PDF); vii, 298 pages.This is an ethnographic study of contemporary home birth in the United States and the Netherlands. Data include (1) fieldnotes collected at prenatal appointments, births, postpartum visits, and professional meetings, (2) transcripts from pre- and post-birth interviews with pregnant women as well as interviews with midwives, and (3) textual materials including statements by medical and midwifery associations and books by leaders of the natural birth movement. Analysis reveals three key components of women's experience: stigma, natural birth, and trauma. Home birth in the U.S. is seen as risky behavior and women who plan such births are labeled risk mothers. Women cope with this stigma by employing isolation and secrecy, attempting an education campaign, or seeking comfort in a family tradition of alternative approaches to health. In the Netherlands, home birth is part of the mainstream health care system. In the absence of stigma, structures for collaboration between midwives and physicians facilitate relatively smooth interactions. An international discourse of natural birth informs a script for how to accomplish home birth in the U.S. This script emphasizes a warm, dark, and quiet environment, continuous labor support, and the achievement of an altered state of consciousness. A different script operates in the Netherlands - one that focuses on home birth as ordinary (as opposed to extraordinary) and is based on a tradition of independent midwifery, insurance industry support, and professional postpartum home care. Home-to-hospital transport is a traumatic experience in the U.S. - not so much because of the obstetric complications that necessitate the transfer as because of the disruption of beliefs and values that occurs when women move from the midwifery to the biomedical model of care. In the Netherlands, non-Dutch women with a medicalized view of birth experience a similar rupture between their worldview and a system that promotes unmedicated, low-intervention birth