Validating the Hunger Vital SignTM and USDA Food Insufficiency Tools Against the HFSS-10 Measure in a New York City Population Survey

Introduction. Hunger Vital SignTM (HVS) and Food Insufficiency Tool (FIT) are two screeners of food insecurity that have not been extensively researched against the wellknown 10-item Household Food Security Survey (HFSS-10) Module in large population settings such as New York City (NYC). Methods. We calculated sensitivity and specificity of the HVS compared with the HFSS-10-based food- insecurity measure and of the FIT compared with the very low food security category of the HFSS-10 using data from the June 2022 New York City Health Panel food access survey. Results. Overall, the HVS had a sensitivity of 98.1% and a specificity of 72.1%. The FIT had a sensitivity of 53.8% and a specificity of 94.5%. Specificity varied for the HVS while sensitivity varied for the FIT when stratified by sociodemographic subgroups. Conclusion. The HVS captured people experiencing or at risk of experiencing food insecurity. The FIT underestimated the prevalence of people experiencing very low food security. These screeners may be measuring different constructs of food insecurity.