Ten million Americans, including almost 4 million children, don't get enough to eat, according to a new study from Cornell University and the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention.

Employment is no guarantee of being well fed: More than half of the 4 percent of Americans who say they are sometimes or often hungry live in households in which at least one person has a job.

"Food insufficiency is not limited to the unemployed or to single-mother families," says study lead author Katherine Alaimo, a doctoral candidate in nutritional sciences at Cornell University and a former nutritionist at NCHS. "Although families with single mothers are at higher risk for having inadequate food, more Americans who don't have enough to eat live in families of married couples with children than in other types of families."

Alaimo, together with Christine Olson, her advisor and Cornell professor of nutritional sciences; Cornell statistician Edward Frongillo; and Ronette Briefel of the NCHS, published their study in the March issue of the American Journal of Public Health (Vol. 88, No. 3).

Americans most at risk for not having enough to eat are children and the poor, say the study's authors. About 6 percent of children and 14 percent of America's low-income population reported that they don't have enough food to eat.

"Food insufficiency is still a considerable problem in this country and is not limited to very low-income persons, specific racial/ethnic groups, certain family types or the unemployed," Alaimo says.

Among those Americans who reported not having enough to eat in the survey were:

• 4.5 million non-Hispanic whites;
• 2.4 million non-Hispanic blacks;
• 2.4 million Mexican Americans, or one-quarter of the low-income Mexican American population;
• People without health insurance : Twice as many as Americans without insurance say they are going hungry as those with insurance.

"Many low-income, uninsured Americans may be making the choice between paying for health care and paying for food," Alaimo points out.

Most of those in the survey who reported food shortages said the primary reasons were lack of money, food stamps or WIC (the Special Supplemental Nutrition Program for Women, Infants and Children) vouchers; about 9 percent also blamed inadequate transportation.

In examining the reports of food shortages, the researchers considered a number of factors, including race, ethnicity, age, family size and income, education and whether the head of the family was employed.

The new findings come from the Third National Health and Nutrition Examination Survey (NHANES III), which was conducted by the NCHS. This survey is the most comprehensive health examination survey in the U.S., and was conducted from 1988 to 1994. More than 30,000 Americans were selected from civilian, non-institutionalized and non-homeless populations. The survey included standardized physical examinations, laboratory tests and dietary and health interviews. In addition to data on food insufficiency, the survey collected data on dietary patterns, food and nutrient intake as well as such nutrition-related information as serum cholesterol levels and obesity.