“Is always that sense of wanting … never really being satisfied”: Women’s Quotidian Struggles With Food Insecurity in a Hispanic Community in New Mexico

Abstract

In this article, we explore women’s everyday experiences with food insecurity. Women’s narratives from a Hispanic community in New Mexico depict the poignant struggles women confront as they actively engage with buffering the experience of hunger to hide scarcity and mask and cope with emotional distress. These data give us a lens for understanding women’s lives in the context of disparity as it relates to food insecurity as a public health issue and provide a way to conceptualize how social determinants operate and integrate with quotidian life activities and processes.

INTRODUCTION

In this article we explore women’s everyday experiences with and response to food insecurity from research we conducted with support from the National Institutes of Health (NIH)/National Institute of Minority Health and Health Disparities (NIMHD) in a community where residents have identified food insecurity as a particular concern. Our study investigates local meanings, experiences, and relationships related to food and how they find expression in individual lives in in Santa Barbara/Martineztown (SB/MT), one of the oldest and most historic communities in Albuquerque, New Mexico. SB/MT is an area experiencing persistent poverty¹ and marked health disparities² and is an urban food desert with no full-service grocery store and little access to healthy, affordable food.³ Here we discuss our community-engaged research involving (1) a household survey; (2) structured observation of community meetings; and (3) ethnographic interviews. The narratives we gathered illuminate a world of individual experience hidden in homes and kitchens, providing a nuanced way of thinking about the food environment and health. Our analysis demonstrates the multidimensional nature of food insecurity and the importance of linking individual experience with root causes. This approach offers a lens for viewing the food system that incorporates what we have called a “critical food literacy” perspective and conceptualizes the everyday nature of the struggle for food justice.^4,5

Food Insecurity and Alternative Approaches

Food insecurity is the term that has replaced what most of us used to think of as hunger.⁶ This shift was promulgated by the global community in the 1970s in an attempt to address and understand food supply issues in relation to a series of large-scale regional famines that horrified the world. By the 1990s, the concept of food insecurity had become the basis for global and national policy but it was expanded to include nutritional, cultural, and social factors. In the United States, the shift from hunger to food insecurity was adopted in concert with the emerging neoliberal paradigm. In this context, the expanded consumption-orientation weakened the analytical capacity to use food insecurity as a concept to explore structural relationships and refocused attention on individual households. Moreover, as discourse, the emotionally evocative power of the word hunger is absent in formulations of the US Department of Agriculture’s distinction of low food security and very low food security.

In social science literature and in community-based movements concerned with food equity or the disparate and systematically unequal ability of people or groups to have access to food, a number of conceptual alternatives have been developed to improve upon or to replace the problematic food insecurity paradigm. Emerging from labor struggles in the 19th century,⁷ 20th century liberation theology prioritizing the well-being of the poor,⁸ concerns about disproportionate toxic exposure based on race and class in the environmental justice movement,⁹ and formulation of frameworks of health equity and health disparities,¹⁰ the concept of social justice has been applied to understanding the food environment and issues of food access. The food justice approach⁴ provides a more direct connection between food and human rights and links food equity with discussions of race and poverty in a way that food insecurity seems explicitly designed not to do. More recently, the idea of food sovereignty,¹¹ which was constructed through the work of the international peasant movement,^12,13 has been embraced by communities and producers interested in challenging the dominance of industrial, corporate food production. Food sovereignty has been embraced vigorously by small producers in different parts of the world, with specific interest among indigenous groups in the United States and Latin America. However, the concept of food sovereignty does not seem to fit quite as well for people who, despite being food consumers, do not farm or garden and who may not be able to engage in or be interested in being involved in actual food production work. As such, Phillips¹⁴ has suggested the idea of food citizenship as a way to connect consumers and producers within a framework of rights and responsibilities that bridges these divides, creating a blueprint for advocacy and collective action. In this article, we introduce the concept of critical food literacy as a way to further link the everyday reality and understanding of women from food insecure households to these broader concepts and struggles in a way that gives meaning to their own experience and creates the potential for empowerment and action.

FOOD INSECURITY AND HEALTH DISPARITY

In 2011, more than 50 million people in over 17 million US households were food insecure (the highest number ever recorded),¹⁵ with prevalence among food insecure households headed by Hispanics (30%) twice that of households headed by whites (14%).¹⁶ In addition to the troubling incidence of people (especially children) going without enough to eat and being hungry, food insecurity is associated with a wide range of serious health and developmental problems.¹⁷ Rose-Jacobs and colleagues¹⁸ found that even mild nutritional deficits during critical periods of brain growth cause harm to children’s physical, mental, social, and emotional health. The result is a cascade of permanent, lifelong negative consequences.¹⁹ Babies and toddlers from food insecure families are 76% more likely to be at developmental risk.²⁰ Children in food insecure homes are 2 times as likely to suffer poor health and 30% more likely to be hospitalized.²¹ In addition, the effects of food insecurity can be invisible or counterintuitive, often masquerading as obesity and diabetes.^22–24 Though the health consequences of hunger and food insecurity are most obvious and severe among children, adults and families are also negatively affected.²⁵

Although it seems fairly obvious that food insecurity has a dramatic impact on health and it receives a great deal of attention in the medical literature, food insecurity is not commonly considered to be a health issue in the same way that we might think about something like diabetes or even the incidence of teen pregnancy.²⁶ (A notable exception is the work of researchers at Children’s Health Watch, who have spearheaded extensive work on child health, food insecurity, and policy.) Perhaps this is because diabetes and teen pregnancy have an individual behavioral component that can be targeted by interventions for prevention or change. Food insecurity, on the other hand, is generally understood as reflecting individual shortcomings (for a critique of this perspective in New Mexico, see Page-Reeves²⁷) and structural relations of poverty that cannot easily be addressed through a specific health promotion intervention. However, the fact that this study has funding from the NIH for research on health disparities demonstrates the shifting paradigm in public health. Increasingly, a social determinants of health perspective^2,28 is seen as more adequate than a focus on individual behavior for addressing chronic community health issues, especially those that demonstrate significant disparities between populations. The social determinants of health focus recognizes that individuals exist within contexts that are structured by relations and forces external to individual authority. In our work, we locate food insecurity as a social determinant of health within this emerging paradigm while expanding the boundaries of how we think about environments and health determinants in order to better understand disparities.

FOOD INSECURITY AS SOCIAL PROCESS

A recent study of food access and affordability²⁹ focusing on revealing the perspectives and experiences of people who are food insecure through an extensive survey of more than one million people nationwide demonstrates “how the struggle by households to obtain affordable healthy food presents itself.” Data from the survey shed light on differences based on race, income, and health status, outlining a troubling contemporary landscape of food insecurity in the United States. Yet, despite the scale of the study, we remain unable to connect that outline with an accurate, fine-grained social and experiential topography. Insufficient attention has been paid in the literature to understanding and characterizing women’s experiences with food insecurity, the social and cultural meanings that they attach to food and food practices when food supplies are insufficient and food budgets are stretched, or the supportive social relationships that women rely upon in the context of scarcity and hunger. We need a deeper understanding to allow us to explore the nature of these meanings and relationships, how they intersect with personal experience, or how they are transformed by and connected with family and community social dynamics engendered by food insecurity.³⁰

Food insecurity has been a subtheme in ethnographic studies,³¹ a subsidiary focus in research on safety net programs,³² and an issue for understanding global processes of economic development.³³ In their participatory action research with women in Nova Scotia, Williams and colleagues^34–36 have demonstrated innovative approaches to conducting research with women experiencing food insecurity (structured dialogue and food costing) and identified unique gendered dimensions of food insecurity that are exacerbated by public policy in what they call “milk insecurity.”^37,38 Hamelin and colleagues^39,40 found multiple domains related to the social implications of food insecurity that influence both individual and family well-being. Rock and colleagues^41,42 investigated the “discomforting” physical and psychological emotions associated with having to eat in a manner outside of the experience of food secure households. Carney’s⁴³ analyses from work with Mexican immigrant women in California provide provocative insights regarding the gendered and political (immigration-related) dimensions of food as a human right. Mares⁴⁴ takes the analysis further, connecting women’s food access strategies in a Latino immigrant community in the Seattle area with concepts of marginality and cultural citizenship that she sees as related to constraints on women’s agency and their ability to feed their families.

These important studies highlight the need to develop a more detailed portrait of how food insecurity intersects with women’s daily lives and how cultural frameworks and social relationships influence food provisioning and food access, a process that affects entire households.³⁰ We believe that women have a unique experience with food insecurity that has been underappreciated in the broader literature. Exploring this theme with women from SB/MT provides insights into how women grapple with food insecurity on an everyday basis. The data we gathered allow us to not only think about food insecurity as a domain for women’s identity creation and enacting women’s agency as we have done elsewhere⁴⁵ but also to integrate women’s quotidian struggles with emerging perspectives on health disparity and food justice as we do here. We hypothesized that although an environment characterized by poverty and lack of access to food contextualize food insecure households in SB/MT, women’s household strategies and the social and cultural dynamics in which they are embedded influence the experience of food insecurity in ways that are not captured in population-level surveys or measures.

METHODS

Project Design

Investigators from the University of New Mexico (UNM) are partnering with the SB/MT Community Learning Center in Albuquerque, New Mexico, on “Fiestas: Improving Food Security in an Urban Hispanic Community.” Fiestas is a community-engaged, mixed-method research study sponsored through the NM Cares Health Disparities Research Center with funding from NIH/NIMHD. In this 2-year (September 2011 to September 2013), multiple-component study, we investigated women’s perspectives, experiences, and relationships related to food and how they find expression in individual lives. The Fiestas project was based on an innovative social network strategy to promote the development of positive social relationships among women in an urban Hispanic neighborhood in Albuquerque, New Mexico, as a way to reduce the incidence of food insecurity. A community board of 5 women who are residents of SB/MT provided input and guidance for the design and direction of the study:

1. Jeannie Romero, who has 3 adult children, moved to the neighborhood 30 years ago with her husband, who is from SB/MT. She runs a very popular daycare center in her home and the community board meets at her home once or twice a month.

2. Carol Carrillo Pimental has lived in SB/MT all her life. She has a back-ground in holistic medicine and is currently looking for work. Her husband is a well-known local musician and Carol is the president of the SB/MT neighborhood association.

3. Brenda Garcia moved to SB/MT when she was in grade school and her first language is Spanish. She attended the learning center afterschool and summer programs until she was done with high school and then worked as a counselor at the learning center until Spring 2013. She is currently a junior at UNM and is thinking about studying nursing.

4. Veronica Apodaca is a lifelong resident of SB/MT and is well known for her community activism. She works as the director of the learning center and serves as the study community coordinator for the research presented here.

5. Vanessa Apodaca was also born in the neighborhood. She worked for many years as a counselor at the learning center and served as the graduate research assistant for the study. She received her master’s in health education at UNM in Spring 2013 and has plans to continue on to graduate school.

Approval to conduct the research was obtained in November 2011 through a full committee review (as required by the NIMHD award) by the UNM Human Research Protections Office. All study participants provided signed informed consent and, when possible, chose pseudonyms to use in referring to their input in print and presentations.

Research Site: New Mexico, Albuquerque, and Santa Barbara/Martineztown (SB/MT)

New Mexico is statistically tied for the highest poverty rate in the nation⁴⁶ and was recently identified as having the highest level of income inequality, with the wealthiest fifth having 10 times the income as the poorest fifth.⁴⁷ New Mexico was ranked 49th in job creation, with the unemployment rate reaching more than 8%,⁴⁸ and in 2012, New Mexico was the only state economy with no projected growth.⁴⁹ The state economy has been described as “stuck” in recession relative to other parts of the country that are seen to be bouncing back.⁵⁰ If New Mexico is stuck, Albuquerque, where a third of the state’s population lives and where this study was conducted, has been described as suffering from recession “hangover.”⁵¹ Out of 100 metropolitan areas surveyed, Albuquerque was last place in job growth, and one of only 15 to continue to have decreasing home prices.⁵² Thirty-eight months of consecutive job losses have made state and local economic recovery steeper, with 6.7% of state jobs and 6.9% of Albuquerque jobs gone—compared to 6.3% job loss nationally.⁵⁰

SB/MT is a neighborhood in central Albuquerque where we conducted this research. SB/MT is one of the oldest and most historic neighborhoods in the city. It was established in the mid-19th century as an agricultural hub on the outskirts of the original city center at “Old Town.” In the late 19th and early 20th centuries, the railroad was located along the border of SB/MT. Concomitant zoning changes and a cascade of land speculation resulted in semi-industrial development (eg., warehouses to service the railroad) that transformed the landscape and dynamics of the community. However, many of the people who live in SB/MT retain a deep “old New Mexican” (Hispanic) cultural identity and have social relationships rooted the neighborhood’s past as a coherent geographic community (J. Page-Reeves, M. Moffett, A. Anixter Scott, and M. Bleecker, unpublished data). Today, nearly 70% of the neighborhood’s 2 287 residents identify as Hispanic or Latino, with only 17% immigrants.⁵³ Despite long-standing cultural assets that help to create a cohesive neighborhood environment, food insecurity, hunger, and food system challenges have been identified by residents of SB/MT as priority concerns. Official local food insecurity data do not currently exist because federal surveillance is conducted at the level of states and large urban areas or municipal districts. Census tract and neighborhood data are not necessarily captured or disaggregated. However, SB/MT has high risk for food insecurity given that median annual income is US$16 161, with 31% of households with children below the federal poverty level and extensive use of emergency food services.⁵³

In Community Food Environment, a UNM service-learning course sponsored in the spring of 2012 through our broader research, students conducted a household food security survey of residents of SB/MT. The survey combined validated questions from the US Department of Agriculture’s Food Security Survey with additional questions about specific dynamics in SB/MT. From a convenience sample of 49 households, representing 140 individuals, the prevalence of low food security was 32.7% and very low food security at 12.2%. These rates are approximately twice the rate for the New Mexico state-level food insecurity rate of 16.5% and 6.3%.¹⁶ Just over 71% of households reported that they had to leave the neighborhood to purchase the foods that they wanted to serve their family. Given that US Department of Agriculture reports indicate that nationally one in 6 families have been identified as food insecure,¹⁵ the implication of the results of our survey is that in the SB/MT urban food desert, the number of families who struggle with hunger is significantly higher at one in 3 (M. Moffett, J. Page-Reeves, A. A. Scott, Vanessa Apodaca, and Veronica Apodaca, unpublished data).

Data Collection and Analysis

Information collected in 16 initial ethnographic interviews with women from SB/MT and structured dialogue at community board meetings conducted in 2012 is used to frame the discussion presented in this article. Interviewee selection was purposive and dynamic,⁵⁴ with participants chosen from households that were identified by the study community coordinator as experiencing or being knowledgeable about food insecurity. Participants were mothers of children who currently attend or formerly attended the SB/MT community learning center or individuals involved with the SB/MT neighborhood association. In contrast to the well-established caricature of poor women, the majority of the women interviewed in this study work full or part time, and some hold multiple jobs. Seven of the women interviewed are single mothers of young children or were single mothers when their children were growing up. Five of the interviewees were born in the neighborhood, and 8 have lived in SB/MT for more than 10 years. Fifteen of the 16 women we interviewed identify in some way as Hispanic or Latina and 10 are from families that would be considered “old New Mexican” families. None of the women interviewed are themselves immigrants, but 6 have at least one parent who is an immigrant from Mexico.

A conscious decision was made to privilege voices of people from the community who had not been well represented in the mainstream literature or taken into account by policy makers. Interviews were conducted at a variety of locations of convenience for participants. All interviews were all conducted by the same investigator, lasted 1–2 hours, and followed a semistructured format that allowed for interviewees to drive the flow of conversation. Questions were developed with input from the study community board and were broadly framed and open-ended to allow participants to develop answers in relation to issues and ideas that they consider to be the most relevant and important (eg, Do you think there are feelings associated with food? How do you think it affects people/families when they don’t have enough food to serve their families or themselves? Why do you think that people have trouble affording food?). Questioning was designed to obtain perspectives on social and cultural dimensions of food and the experience of food insecurity. Responses were captured manually on a laptop computer. Participants received a $20 merchandise card (VISA card) to thank them for their time and effort.

The design of this research reflects insights from recent literature regarding studies of poverty. Goode and Maskovsky^55(p10) argued that academic depictions must resist current political dynamics and discourse that create a “regime of disappearance,” marginalizing or erasing the poor from popular and political consciousness. This is accomplished by ideologically driven constructions of poverty as a natural state separate from rather than generated by structural relations that actively promote the concentration of wealth, social benefits, privilege, and power. They proposed countering this discourse by studies that demonstrate how the lives of the poor are inextricably connected to—not separate from—economic restructuring and power arrangements. A similar point is made for research on women and poverty in the works of Krumer-Nevo and Benjamin,⁵⁶ Krumer-Nevo and Sidi,⁵⁷ Erler,⁵⁸ Ortega-Alcazar and Dyck,⁵⁹ and Harrison.⁶⁰ They highlighted the importance of methods and approaches that situate individual experience and the voices of individual participants within both material and cultural contexts as a mechanism for resisting othering in the social and discursive construction of poverty knowledge in writing and research. This counter can be made especially powerful through combining narrative, dialogue including participants’ interpretations, and a participatory research design. This study was designed to include participation of members of the community. The analysis presented here combines narratives gathered through interviews with interpretations that reflect insights from community board members that emerged through structured dialogue at regular community board meetings. The community board and 2 to 3 members of the research team met twice a month at the home of community board member, Jeannie Romero, between December 2011 and May 2013 and once a month from May 2013 to February 2014. At the meetings, we prepared and shared a meal; identified and discussed community issues related to food and health; discussed and decided upon interview questions; discussed and interpreted findings; planned and implemented a series of “fiesta” events (including many of the interviewees); and conceptualized and developed community-level strategies to improve food access, food security, and nutrition in SB/MT. We locate our interpretations here within an understanding of the broader political economic context in which the women from SB/MT develop their household food-related strategies. We believe that this approach provides a window into normally ignored, quotidian aspects of women’s daily lives, uncovers women’s “food voices,”^61(p354) and gives expression to women’s concerns and perspectives.

At the same time, contrary to current trends in social science research and writing, in our presentation of the data below we identify individual women by name (a pseudonym) but we do not provide further information about individual participants’ histories, characteristics, or family circumstances to contextualize individual quotes. Although it would be reasonable to assume that a community-engaged study would provide more detailed information about individual participants, this was a conscious decision that counterintuitively reflects the nature of community engagement in this project. Unlike the vast majority of academic studies that would never have occasion to be seen by people who participate in the research, we shared our findings and this manuscript with members of the community board, interviewees, and other community members. Providing further detail about any particular participant would make our narrative more individualized, tangible, personal, and authentic to readers—less otherizing, yet even seemingly inconsequential information about an individual woman’s life would easily make her identifiable to other community members. Many people in SB/MT know who participated in the interviews for this project because many interviewees were very public about their participation. However, because interviewees generously shared information about their lives related to private struggles and strategies (information that could potentially be seen as or was experienced as shameful), we are not in a position to follow en vogue approaches in academic research and writing that encourage detailed disclosure of information about individuals to add authenticity to the narrative.

Our rigorous, disciplined, empirical analysis of the data, using Hammersley’s⁶² criteria based on plausibility, credibility, and relevance, focused on understanding meanings and perceptions expressed by interviewees. The data were analyzed inductively using modified grounded theory^63,64 and insights from critical ethnography^65,66 to identify conceptual categories and patterns. Text from interviews was read consecutive times and themes were identified and coded. Coded data were analyzed for coherence and interpreted for patterns within each theme. Interconnections between theme categories were explored through constant comparison⁶⁷ in order to provide holistic interpretation of the data. Analysis of the interviews was presented to the 5-member study community board for discussion and their input informed development of this article, as well as further iterative interview questions for the Fiestas study. A preliminary framework for understanding the data that included relevant quotations was discussed at community board meetings. Our ultimate understanding of findings was influenced by these discussions and community board input captured by notes taken at the meeting (both handwritten and using a laptop computer). As part of this process, the community board was also involved in designing the questions to be asked in phase II of the interviews, which occurred subsequently in 2013. Of interest here, community board input was generally not focused on disclaiming the experience of women who participated in the interviews or in finding new ways to interpret the preliminary framework—which they found to be sound. Instead, in keeping with our argument below about the development of critical food literacy, the community board tended to view the information presented as a new way to think about the women in their community and the community itself. Discussions mostly involved trying to understand why the things that were emerging from the data might be so. In September 2012 and January 2014, we invited all interviewees to evening events at the SB/MT community learning center, where we presented findings from the interviews and gave interviewees and other community members an opportunity for further input or interpretation. Again, in line with our arguments below about critical food literacy, the primary response from community members was that this research provided people with a different lens for viewing their community and the everyday experience of their neighbors. The problematization of quotidian reality was novel and made them wish for even more information. In addition, because a number of the attendees were members of the SB/MT neighborhood association, there was discussion of how to use the information presented for advocacy purposes, in particular in relation to the siting of a grocery store that had been an ongoing point of discussion in city zoning and community stakeholder meetings.

EXPERIENCING FOOD INSECURITY: WOMEN’S QUOTIDIAN STRUGGLES

In SB/MT, women we spoke with enthusiastically discussed their perspectives on and experience with food. They shared thoughts and insights regarding positive associations with the smell of food: “Green chile roasting. … Oh my god, for me it is like comfort … food for the gods or kings. … The particular kind of chile that can only be found here.” “Oh gosh, the smell of garlic … you can smell that.” “When you cook beans, they have a special odor.” and “Oh my god, tortillas … flour tortillas … you just know mom was making tortillas.” These comments highlight the centrality of culturally specific regional cuisine and tradition in how women conceptualize food as part of a social landscape. Interestingly, although women often initially hesitated when we then asked them about the sounds that they associate with food, cooking, and eating, it was sound that elicited more specific, detailed description than smell. All of us know that the smell of food is evocative, but sound was something that neither we nor the women we spoke with had ever thought about in relation to food. After considering the issue, women told us that food sounds like: “Chopping and sautéing the garlic and the onion”; “crunching tacos”; “water boiling, the blender going, getting the chile pots ready”; “When I am testing the griddle, I want to make sure it is hot, so I drop some water on it and it sizzles. That way I know the griddle is hot enough”; and “The sound of the tea kettle, the sound of the pressure cooker, the giggling of the little knob … cooking timers.” These comments clearly demonstrate the power of the mundane to evoke a universe of experience. Micaela, one of our study participants, expressed the deep emotional connection she feels in her sensual relationship with food, reflecting that, “I think it would be a sad life without those sounds or smells. We always play that game of ‘which sense would you rather lose?’ It would feel really strange to sit among people if you couldn’t hear or smell. I wouldn’t have any memories linked to my family.”

Attesting to this emotional dimension of food, women in our study associated food with comfort, anticipation, pleasure, security, home, gathering, and a sense of family. Women told us how eating “food is … that moment of being together. It is subconsciously in there. That is our time to talk. When we have our deep conversations.” They recounted their belief that women have a very particular relationship with food, saying women “pour [their] heart into the food”; “It makes women sad when people don’t want their food”; and that women “personalize it because they have put love and care into what they are cooking.” These perspectives endorse the extensive emerging body of work demonstrating the extent to which “cultural meanings are established and reinforced”^68(p280) in the realm of food and food practices, especially for women.^69,70 Importantly, women in our study also shared perspectives that led us to consider dimensions of experience with food that are not as well represented in the literature. Ruth told us about how the smell of rice cooking is not something that brings her comfort or a pleasant sense of anticipation. Instead, she said that rice reminds her “of growing up poor … your mom trying to put rice every which way. You had rice in the soup … it reminds me of food for pigs … of trying to stretch food out.” Janelle recounted that when there is not enough food,

You are thinking about how you will provide for your kids and what you will not be able to make and create a healthy meal for them because you are limited. A lot of people around here have that experience. … I think that they are barely getting by. I’m watching the news, considering the situation that I am in. … You feel angry, sad and upset. When you follow all the rules … you feel upset, like “what now?”

In response to a question about who she associates with food, Janelle continued her story, telling us, “Me, because I prepare it and I am supposed to provide it. I provide it as minimal as it is or as big as it is. I can’t get everything that they want or give them everything that they want.” Marisol described how when you don’t have food to put on the table there “is always that sense of wanting … never really being satisfied.”

These perspectives made us wonder, not about the social and cultural dimensions of food and cooking per se but about how women negotiate and strategize in the context of food scarcity and what is entailed in that experience. Women did not talk about food insecurity or even hunger. No one used those words. Instead, they described their struggles to feed their families. From our perspective this was significant. If food and food practices are powerful, organizing social constructs as suggested by a cross-cultural literature,^68–70 we hypothesized that not having food and the inability to provide food must have similar social and emotional significance. If meals are sites of social construction, what happens when you struggle to put food on the table? Dearth must be equivalently meaningful, particularly for women, when as Ruth and Janelle suggest above, women are generally seen as responsible for providing and preparing food for their families.

We learned of the concern about food insecurity in SB/MT through our work with the SB/MT community learning center, at neighborhood association meetings, and in individual conversations over the past few several years. Women we spoke with for this study were not only concerned about the problem but felt that things are getting worse and that families are really struggling. Marie said,

The price of food has gone up significantly. You can’t even buy enough groceries with $100. Salaries are staying the same and food is going up. I will spend a good $150 at the store and I will come home and see that there is still stuff that we need to get. … It is getting worse just because more and more you hear more and more about people not having enough food in their homes … just talking to neighbors, kind of they aren’t real open about it but they make small hints.

Soo agrees, saying, “I am appalled by the cost of things. I went last week and it was $99 for four bags. That is a really inflated amount of money, and I buy very little meat. I can’t believe how much the cost of food has gone up just in the last year. That is disturbing.” Women we spoke with made it clear that in the context of economic downturn and inflation, standard conceptualizations of food insecurity do not necessarily capture the level of insecurity and anxiety that exists in SB/MT in relation to food. Luna told us, “I might know where my meal is coming from tonight or tomorrow, but seeing next month—the next six months type of thing, that may be another level of food insecurity.”

Women’s perceptions of the economic reality are on pitch. New Mexico is the state with the highest rate of child food insecurity,⁷¹ is ranked second worst for senior hunger,^72,73 and has the eighth overall highest state rate of food insecurity.⁷¹ One in 4 children and one in 8 seniors do not know where they will get their next meal.^73,74 In the Albuquerque metropolitan area (Bernalillo County), low-income residents missed an estimated 43 million meals in 2009.⁷⁴ Statewide, the use of federal food assistance rose to unprecedented levels with more than 400 000 people, or 20% of the state’s population, using Food Stamps/Supplemental Nutrition Assistance Program (SNAP)—up 66% since 2006.⁷⁵ Grocery stores report surges in food sales at midnight on the 1st and the 15th of the month—meaning that many families wait until the moment their Food Stamp/SNAP electronic benefit transfer cards are loaded so that they can shop for food.⁷⁶ In Albuquerque, emergency food providers have experienced increases in demand that often outstrip available supplies of food. The largest emergency food provider in Albuquerque and the state reports that 1350 households including 1542 children were served in 2011 by 2 mobile pantry food distribution sites in SB/MT (A. Wolfe, RoadRunner Food Bank, personal phone communication, January 2012). With SNAP/Food Stamp benefits at risk of severe cuts⁷⁷ as a result of the federal sequester enacted in Spring 2013 and budget conflict over funding for the Farm Bill, the situation is unlikely to improve in the immediate future.

Hidden Hunger

In the interviews we conducted in SB/MT it was immediately clear that women struggle with food insecurity in deeply personal ways. There was a good deal of discussion about the importance of socializing in relation to food and eating. The social, cultural, and emotional dimensions of food that were suggested in women’s descriptions of food smells and sounds discussed above were reiterated in the way that they see their own role in that domain. Interviewees see food as important to social interaction, and the women who prepare the food feel a sense of joy derived from being able to prepare food for others. They contrasted this with times in their lives or the lives of their parents when there has not been enough food and how that made them feel. Valerie said, “For the person responsible it is kind of like, if you aren’t able to provide food at any given moment, you feel kind of like you failed as the head of the household, like you failed in protecting your children and providing everything they need. That is failure.” At the same time, because women see their role as the food preparer and nurturer, they often make sacrifices that have a personal cost in order that others can eat. Describing what happens when she does not have quite enough food to go around, Dahlia told us, “It happens with me. If the kids will eat, then I am happy about it. I can always make do. If there isn’t enough food for everyone, I will figure out for myself. The kids don’t realize.” Similarly, when asked to describe a memory of a sad occasion with food, Janelle gave the startling response that, “I think that is pretty often,” elaborating that,

When I get off work and I get home for dinner … I feel sad that I can’t prepare everything for everyone. Sometimes I will eat something else like a boiled egg so that the others can have [the dinner] … it is kind of funny that [the kids] don’t realize what I am doing, neither does my husband. I just keep that to myself … I don’t share that with them. They say, “Oh, yeah you are a pretty picky mom!”

(In response to this question, most interviewees discussed how food is traditionally served at funerals. The interviewer was taken aback when Janelle made this statement as it was unexpected and the idea that she experiences this sadness “often” is disturbing.)

In studies of food insecurity, it has been demonstrated that in provisioning and preparing food for others, women often forgo meals and sacrifice their own nutrition to buffer others in the household from hunger.^78–80 Carney^43(p1) believes that this is a dimension of the food insecurity paradigm that is a commonly overlooked food justice issue because women are absent from calculations of food cost. She suggests that “a gendered cost of food framework should account for compromises to women’s physical and psychological health that result from food insecurity.” McIntyre and colleagues⁸¹ proposed that women manage the external appearance of poverty so that they do not “feel poor.” In their study of single, low-income mothers, women spoke candidly about the need to shield children from the experience of deprivation by hiding the fact that they go to the food bank or giving the appearance of being able to afford children’s clothing items by forgoing other necessary expenses. Women in our study hid their own hunger.

Like women’s hidden labor within the household, women’s hidden hunger subsidizes low wages, inadequate safety net resources, and the expensive price of food. Ironically, because they are hidden, the selfsacrificing strategies women develop to prevent their families from going without act to reinforce what Goode and Maskovsky^55(p10) see as “a mode of governance, economy and politics in which the poor are not so much vilified as they are marginalized or erased by the institutional and ideological aspects of work, social welfare and politics that are dominant under neoliberalism.” Recent media commentary^82,83 criticizing efforts to expand access to SNAP/Food Stamps and negative Internet posts following an announcement that Sesame Street is unveiling a new Muppet character to teach kids about hunger^84,85 do vilify the poor in a reflection of the tenor of current political discourse, but they are also indicative of the extent to which the massive problem of hunger in the United States is a hidden reality. Most people just have no idea that so many in the United States struggle to put food on the table. Roadrunner Foodbank, New Mexico’s largest emergency food provider, has the apropos tagline “Hunger is closer than you think,” a play on words reflecting the fact that most people do not really know whether their friends and neighbors are food insecure or whether children in their neighborhood go to bed hungry (or whether they will suddenly find themselves hungry). Because hunger is hidden in the shadows and in the kitchen, creating a national dialogue about the structural relations that produce poverty and create food insecurity in households across the county remains difficult. Because hunger is hidden, it is easy to think that hunger is rare and that those few people who struggle to buy food must be somehow deficient or lazy.⁸⁶ This theme has a deep history in US discourse. In SB/MT, women’s strategies to hide their own hunger inadvertently dovetail with constructions of hunger as based in individual shortcomings.

Emotional Consequences of Food Insecurity

Although women attempt to hide their hunger to buffer their families from the knowledge and experience of food shortage, the everyday experience of food insecurity creates palpable emotional consequences that undermine personal health for women and relationships within the family. The very nature of food as something that people need in order to be satisfied means that when there is not enough food, people feel shame, stress, anxiety, and even fear. Reutter and colleagues⁸⁷ discussed how individuals living in poverty develop personal and social identities that reflect the stigma they experience. Interviewees expressed the depth of the feeling of shame associated with the experience of food insecurity. Anna said, “You are supposed to be living the American dream. You are not supposed to be not making it even though you are trying so hard. I’m working three jobs and 60 hours a week and still can’t make it. You don’t want people to realize.” A number of interviewees suggested that even though extended family members can be strong social supports in times of crisis, they do not want their families to know that they are struggling to buy food. Marisol said, “People keep that to themselves … they don’t want to show that they need assistance—they are ashamed.”

Similar to findings by Williams and colleagues in their study with women in Nova Scotia,^34,36 inability to provide for children was a key component of this shame and was seen to be related to women’s feelings of stress, frustration, sadness, and anger. Ruth said, “It affects you emotionally. If you have little ones, you didn’t bring them in to suffer. You start beating yourself up because you can’t put food on the table, or maybe it isn’t as quality.” Similarly, Janelle told us, “I think it puts a big strain. You are so worried and sad that you get frustrated and angry within yourself that you can’t be the parent that you want to be. It is hard enough to be a parent any way, but then you can’t give them something to eat.” Most of those interviewed believed that women experience the emotional consequences of food insecurity more often and more concretely than men, especially in relation to providing for children’s food needs. Carney’s^43(p6) data support this idea, with men in her study perceiving and reporting less food insecurity than women. Through a survey conducted with 150 low-income household heads, Carney found that women were “gatekeepers of food procurement and preparation” and that men demonstrated incomplete knowledge about how these activities were accomplished. A rationale for this gender disparity was explained by Marie as being related to the intimate relationship that women often have with food procurement and preparation. She told us that

Women do more of the cooking and men don’t and well, not every man, but most of the time. A lot of the time men don’t know how to cook. I think women appreciate food more. Women stress about it a lot more, I think, because we see how much food we make. We see how much food the kids eat. We know how much food we need to [have] in a week. Typically guys don’t unless they are really involved and know exactly.

Also in keeping with findings by Williams and colleagues^34–36 and Hamelin and colleagues,^39,40 women we interviewed discussed how food insecurity can strain interpersonal relationships within the family. Valerie talked about how the inability to buy foods that children want can make them

just assume that you don’t want to get it and they start comparing to other kids and they feel embarrassed or scared. They demand things because they don’t know what is behind it. It creates conflict and tension. The child might tell the parent, “Why haven’t you got the food? It is your job,” and they get resentful and then the parent feels like a failure … and you are stressed and you get angry that they aren’t grateful … it creates conflict because the parent feels the child is being ungrateful and it just creates conflicts.

Sandra described how this dynamic is played out between husband and wife:

They improvise. They just eat the beans and rice and … they just do with what they have. Just the poverty in general. What do most couples fight over? Money. It affects everything, not just the meal but it affects your whole life. If you can’t afford to feed yourself what can you afford to do? That is a basic necessity of life. If you can’t do that, then everything else will fall apart.

Others took these ideas further, discussing how emotional strain can lead to escapism, make people vulnerable to criminal behavior and crime, disrupt lives, and impact personal physical and mental health. Soo explained this as follows:

If we don’t have enough it produces anxiety which puts us into fear. People may turn to addictions to escape. We all have ways of managing our fears, but food is a basic need and having enough is a basic need and when we don’t have that it puts us into survival mode and we do all sorts of things we might not otherwise do.

Athena said,

Stress, it makes them more vulnerable to crime. If I had a hungry baby and couldn’t feed him, I would be out there stealing … neglect, abuse. If you have a screaming baby because they are hungry and the mother is stressed out, thinking if I didn’t have this baby, it wouldn’t be screaming, it wouldn’t be hungry.

During our interview with Anna, she explained the emotional upheaval and disruption of basic everyday life associated with food insecurity, saying that people “start selling their stuff, their cars, getting rid of family pets … sell their home or rent out their home and move into an apartment. You can’t make your mortgage even when you have someone renting your home. … How am I going to survive? How will I make this work? What am I going to do? What do I do? Oh, gosh … ” Valerie has a large family and she described how even something seemingly innocuous like the sound of the music played by the “ice cream man” can take on a nightmarish quality in the context of food insecurity and poverty, saying that when she hears the approach of the ice cream truck,

I just try to distract [the kids]. … I distract them and I panic and put the volume on the TV a little higher. … It gives me kind of like short breath. I know what is coming. Even if I get them something it will keep happening and they will compare themselves to other children and think we aren’t loving them enough. … I have to explain to them and I have to go through it many times but they keep asking. It is the feeling like I have to go through that again. … I have to explain it again … they will ask me for something and they won’t stop asking and I say OK but not because I truly give permission but because saying yes stops them. That’s how I feel … suffocation, frustration, short of breath.

Women we spoke with connect shame, fear, stress, family conflict, the potential for child abuse, feelings of failure, having to sell beloved family pets, the risk of becoming homeless, not knowing where to turn for help, and actual physical distress described by Valerie caused by hearing the approach of (of all things) the ice cream truck with food insecurity. Their disturbing commentary highlights the extent to which despite the magnitude of the problem of food insecurity in the United States, women experience food insecurity in an extremely personalized way as individuals. Rather than questioning the larger structural dynamics and power relationships that generate poverty and make it impossible for the women in this study and 17 million other American families to buy food, women in SB/MT focused on their own inadequacies as a rationale. Their narratives reflect mainstream discourse that identifies individual shortcomings of the poor as the cause of poverty and hunger.⁶ It would seem that 17 million of anything should legitimately be considered to be a pattern, with the expectation of identifying a structured cause. Yet, because of mainstream failure or inability to critically analyze the dynamics involved, poverty is conceptualized as a discrete problem of individuals who fail to pull themselves up by their bootstraps⁸⁶ rather than as a dynamic process reflecting structural relations. Power⁸⁸ sees the phenomenon of othering that occurs among women who use social services as a type of disciplining that occurs within the neoliberal paradigm. What she calls the practice of “unfreedom” that acts to control the life of the poor is generated and maintained through the social construction of groups deemed unable to govern and take care of themselves.

This mainstream discourse influences the way that women in SB/MT experience and think about food insecurity. A number of the women interviewed discussed how problems with the economy have made it hard to get work and influence levels of food insecurity in SB/MT. But of 16 women interviewed, only Marisol really made a connection between what is happening in homes in SB/MT and broader forces that goes beyond recognizing that the economy impacts people’s lives. She said, “I think it has gotten worse. I’m not sure why. That is something I would like to look into. Why is this happening?” Though Marisol does not have answers to these questions, she is not buying in to the status quo narrative that locates blame within individual food insecure households and is still looking for an explanation that makes sense to her.

CONCLUSION: FOOD INSECURITY AND HEALTH DISPARITY

Women’s narratives from SB/MT depict the poignant struggles that women confront in their experience of food insecurity. A key finding that has implications for understanding food insecurity as a health disparity is about how women internalize and individualize their relationship to the broader structural forces that produce the social and economic contexts that generate food insecurity in households in SB/MT and throughout America. Women actively engage with buffering the experience of hunger for family, friends, and themselves to hide scarcity and mask and cope with emotional distress, and they develop food procurement and preparation strategies that recontour the food landscape.⁴⁵ However, the experience of individual women remains unconnected to what is happening in neighbors’ kitchens and to broader food system dynamics.

As Nash⁸⁹ found in her seminal work on women and resistance in the Bolivian tin mines, the direct experience of exploitation provides powerful instruction in the politics of injustice and can be a catalyst for change. Women’s confrontation with rationing and shortage in the pulperia (company store) became a rallying point for mine workers’ political mobilization. However, in SB/MT, lack of critical literacy regarding structural processes external to SB/MT households means that individuals are unable to locate their experience as part of a system dynamic. A broader understanding of exploitation within a system was what led Bolivian miners and their families to be able to connect what was happening in the pulperia with a bigger picture of inequality and domination in the mines. We believe that operationalizing the concept of critical health literacy^90,91 through community-engaged research such as that which we are conducting with the Fiestas project has the potential to establish a context for nurturing what we call women’s critical food literacy. Williams and colleagues^34–36 found that through structured dialogue and participatory food costing work, women developed empowering skills and knowledge. Through our research, women are learning about, exploring, discussing, and analyzing food system issues that they find to be of interest and developing an understanding of the broader forces that influence the food choices and practices that structure and define what their families eat on an everyday basis. Locating their own experience within a context helps them to make sense of the disparities. Without this critical literacy of the food system, women’s strategies in SB/MT have little opportunity to become a point of mobilization around which women might rally for collective action. Food insecurity, then, remains an individual problem.

The data presented here also give us a lens for understanding women’s lives in the context of disparity as it relates to food insecurity as a public health issue. Though clearly seen as an individual health issue, particularly in terms of children’s nutrition, food insecurity is harder to “sell” as a public health problem. Despite recognition of the need to understand and address the social determinants of health, conceptualization of the issues involved in generating health disparity continues to be undertheorized and shallow.^92–96 A tendency in public health to focus narrowly on barriers and promoters acts to silo health as somehow separate from the political, economic, social, and cultural realm. As a result, issues like food insecurity are routinely positioned as outside the purview of public health or, more appropriately, too political. This stance reflects a tendency the public health paradigm to lack focus on broader, non-health-related factors and dynamics that generate disparity.^97,98 We believe that although the shift toward a social determinants of health approach is an advance, acknowledging that life is embedded and multidimensional^99,100 is insuffucient. The experience of women from SB/MT testifies to the level of complexity that must be incorporated into our analyses. The stories and perspectives we gathered from women in SB/MT provide a way to conceptualize how social determinants operate and integrate with quotidian life activities and processes to produce food insecurity. Just as Passidomo¹⁰¹ suggested in her article entitled “Beyond Food,” food-related disparity is much less about the food itself than a manifestation of inequitable relationships that define food production and food access. As such, dealing with and measuring food insecurity requires a broad conceptualization of households and of the food system. The growing food justice^3,4 literature allows us to embrace this approach by exploring food as a human right in the context of extreme disparities, questioning increasing inequality and insecurity in the ability of people to eat, and advocating for social dynamics associated with creating a more just and healthy food system. The way that our analysis activates the social determinants expands our definition of what food justice means for women in their kitchens and in their community. As McIntyre^102(p51) so eloquently framed it, food security is

more than a social determinant … food security is perhaps the most precious of all determinants of health. If we make the necessary investments, we can reap a food security dividend that enriches all of society with payoffs in health, social captial, sustainability of our physical and social environments, justice and cost savings and wealth creation.

Women’s quotidian struggles to procure and prepare healthy meals for their families demonstrate that despite the inequities of the system and power relations that militate against them, women are invested denizens of the food system. We believe that critical food literacy has the capacity to allow women to deploy their own food citizenship in order to re-enfranchize themselves and their families.

LIMITATIONS

This research was limited by nature of the issue under consideration. The women we interviewed were candid about their experience and struggles to an extent that actually surprised us, given that many of the interviewees were not acquainted with the interviewer before the interview and because of the power dynamics inherent in having a white PhD conduct interviews with women of color from low-income households. However, we believe that it is likely that many of the women we interviewed may still have been “managing” their poverty by consciously or unconsciously glossing over dimensions of their own struggles with poverty and hunger in order to limit their experience of and social enactment of stigma.