Food Insecurity and Health Outcomes

Abstract

Food insecurity is increasingly recognized as a major health crisis in the U.S. More than 42 million persons were food insecure in 2015, far higher than the levels preceding the 2007 Great Recession. Decades of research demonstrate that food insecurity diminishes individuals’ overall well-being. The recognition of food insecurity as a health crisis, however, stems from a more recent appreciation of the multiple negative health outcomes and, thus, higher health care costs, attributable to food insecurity. An extensive literature from multiple fields, including agricultural economics, economics, medicine, and nutrition, has emerged in recognition of food insecurity as a health crisis. Among other findings, food insecurity among children is associated with increased risks of some birth defects, anemia, lower nutrient intakes, cognitive problems, and aggression and anxiety. Food insecurity is also associated with higher risks of being hospitalized, poorer general health, worse oral health and with having asthma, behavioral problems, depression, and suicidal ideation. For adults, studies have shown that food insecurity is associated with decreased nutrient intakes; increased rates of mental health problems (including depression), diabetes, hypertension, and hyperlipidemia; being in poor or fair health; and poor sleep outcomes. Food insecurity and poor health are likely linked bi-directionally; that is, it is true both that living in a food insecure household predisposes an individual to poor health, and that poor health predisposes one to living in a food insecure household. After describing how food insecurity is measured, we turn to the multiple causes of food insecurity and potential pathways through which food insecurity leads to these negative health outcomes. Finally, we describe two recently articulated interventions designed to address both food insecurity and its health impact. The first is a targeted increase in benefit levels for supplemental nutrition assistance program (SNAP, formerly known as the Food Stamp Program) enrollees and near eligible households, and the second provides tailored support for food insecure individuals with diabetes.

Food Insecurity in Older Adults in an Integrated Health Care System

“…Many of the sociodemographic, clinical, and psychosocial predictors of food insecurity in KPCO members (Table , Supplemental Table S5) were consistent with findings of prior research in older adults. Food insecurity was more common in members of racial and ethnic minority groups, individuals with less education, and those who were unmarried or lived alone . Diabetes mellitus, depression, poorer self‐reported health, and limitations in activities of daily living were also more common in older KP members with food insecurity .…”

“…Food insecurity, defined as lack of access to adequate food because of limited money or other resources, is an important social resource need for older Americans. In 2015, 12.7% of all U.S. households experienced food insecurity, including 8.3% of households with a member age 65 and older and 9.2% of older individuals living alone .…”

“…In 2015, 12.7% of all U.S. households experienced food insecurity, including 8.3% of households with a member age 65 and older and 9.2% of older individuals living alone . Although primary care–based strategies for identifying and referring older adults with food insecurity have been proposed, information about the health effects of food insecurity in older adults is limited …”

Stretching Food and Being Creative: Caregiver Responses to Child Food Insecurity

“…The HFSSM is a standard measure of food security in the US and is valid, reliable and widely used. 1,2,11 …”

Food insecurity screening: A missing piece in cancer management

“…4 Households described as having "low" and "very low" levels of food security are considered food insecure, whereas those with high or marginal levels of food security are considered food secure. 9,10 Longitudinal studies have suggested that food insecurity likely contributes to the development of chronic disease in some cases (through both nutritional and behavioral pathways), whereas chronic disease likely contributes to the development of food insecurity in other cases (by increasing health care expenditures and decreasing employability). Conversely, individuals in food-insecure households may experience such anxiety, as well as reductions in both the quality and quantity of food available.…”