Strengthening US Food Policies and Programs to Promote Equity in Nutrition Security: A Policy Statement From the American Heart Association

Abstract

Nutritionally inadequate dietary intake is a leading contributor to chronic cardiometabolic diseases. Differences in dietary quality contribute to socioeconomic and racial and ethnic health disparities. Food insecurity, a household-level social or economic condition of limited access to sufficient food, is a common cause of inadequate dietary intake. Although US food assistance policies and programs are designed to improve food security, there is growing consensus that they should have a broader focus on nutrition security. In this policy statement, we define nutrition security as an individual or household condition of having equitable and stable availability, access, affordability, and utilization of foods and beverages that promote well-being and prevent and treat disease. Despite existing policies and programs, significant gaps remain for achieving equity in nutrition security across the life span. We provide recommendations for expanding and improving current food assistance policies and programs to achieve nutrition security. These recommendations are guided by several overarching principles: emphasizing nutritional quality, improving reach, ensuring optimal utilization, improving coordination across programs, ensuring stability of access to programs across the life course, and ensuring equity and dignity for access and utilization. We suggest a critical next step will be to develop and implement national measures of nutrition security that can be added to the current US food security measures. Achieving equity in nutrition security will require coordinated and sustained efforts at the federal, state, and local levels. Future advocacy, innovation, and research will be needed to expand existing food assistance policies and programs and to develop and implement new policies and programs that will improve cardiovascular health and reduce disparities in chronic disease.

Food Insecurity Among Individuals With Cardiovascular Disease and Cardiometabolic Risk Factors Across Race and Ethnicity in 1999-2018

“…As a potent SDOH that is associated with worse outcomes among individuals with CVD or cardiometabolic risk factors, food insecurity could be addressed by public policy, health care systems, and clinicians . As the largest public food benefit program, SNAP decreases food insecurity and is associated with higher prescription drug adherence and lower medical costs and hospitalizations .…”

State-based policies to promote early childhood health and improve equity

“…In 2020, 10.5% of US households reported being food-insecure (having limited access to sufficient food), with the rate of food insecurity higher (15.3%) for households with children under age six [5 ▪ ]. US policies and programs that aim to improve food security are increasingly focusing on ‘nutrition security’, which means having equitable and stable availability of, access to, affordability of, and use of foods and beverages that promote wellbeing and prevent and treat disease [6 ▪▪ ].…”

Importance of Nutrition Security to CVD Prevention Efforts in the USA

“…Poor diet quality and diet-related chronic diseases are associated with food insecurity [ 4 ], which is defined as an “economic and social condition of limited or uncertain access to adequate food” [ 5 ]. Effective policies and interventions can help address barriers to achieving both food security and nutritionally adequate dietary intake, or nutrition security [ 6 ••], and help promote equitable reductions in CVD. The purpose of this review is to describe the importance of addressing nutrition security in CVD prevention efforts in the United States of America.…”