Food Insecurity Questionnaire
A survey regarding people's access to enough and nutritious food
Demographics
What is your age?
Where do you live?
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
What is your level of education?
Please Select
No school diploma
High school diploma
Bachelor's degree
Master's degree
Other
What is your employment status?
Please Select
Full time
Part time
Unemployed looking for a job
Unemployed not looking for a job
Other
Food Insecurity Questions
1. My last meal didn't finish and I didn't have enough money to buy new food.
Often true
Somestimes true
Never true
Prefer not to answer
2. I don't have enough money to eat a healthy and balanced diet.
Often true
Sometimes true
Never true
Prefer not to answer
3. Have you ever lower the portion of meals you eat because you didn't have enough money to afford?
Yes
No
Don't remember
Prefer not to answer
4. I eat less than I should because I don't have enough money.
Often true
Sometimes true
Never true
Prefer not to answer
5. I feel hungry but I didn't eat because I don't have money for food.
Often true
Sometimes true
Never true
Prefer not to answer
6. Please indicate your level of agreement with the following statements.
Rows
Totally Agree
Agree
Not Sure
Disagree
Totally Disagree
I am worried about not eating enough food.
1
2
3
4
5
I am not able to eat healthy and nutritious food.
6
7
8
9
10
I eat very few kinds of food.
11
12
13
14
15
I sometimes have to skip meals.
16
17
18
19
20
I sometimes ran out of food.
21
22
23
24
25
I sometimes spend a day without eating.
26
27
28
29
30
Please verify that you are human
*
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