7, 27 February 2020 | Community Mental Health Journal, Vol. In this article we focus on recent research that examined the association of food insecurity and health. This suggests that setting a higher gross-income test for eligibility could reduce food insecurity of the so-called near-poor and, in turn, improve their health outcomes. Severe food insecurity is more strongly related to insufficient quantity of food (energy) and therefore strongly related to undernourishment or hunger. Socioeconomic status, food security, and dental carries in US children: Mediation analyses of data from the National Health and Nutrition Examination Survey, 2007–2008. Women’s changing food insufficiency status was positively associated with a change in major depression status (. 21, No. Second, reducing the barriers to applying for SNAP and recertifying eligibility for the program—including the barriers related to stigma and transactions costs—would further reduce food insecurity. Cook JT , Frank DA , Levenson SM , Neault NB , Heeren TC , Black MM , Child food insecurity increases risks posed by household food insecurity to young children’s health, Does food insecurity at home affect non-cognitive performance at school? [Free full text] Tarasuk V, Cheng J, Gundersen C, de Oliveira C, Kurdyak P. The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario. A number of studies have demonstrated SNAP’s success in achieving its central goal of alleviating food insecurity. 2018, 21 March 2018 | Public Health Nutrition, Vol. 41, No. 17, No. Testing mediation effects. 3, No. Examining Reciprocal Effects of Cigarette Smoking, Food Insecurity, and Psychological Distress in the U.S. Do Work Requirements Benefit Medicaid, SNAP, and TANF Recipients? 45, No. 7, 7 January 2019 | Maternal and Child Health Journal, Vol. 15, No. 3, 18 August 2017 | Nutrition and Health, Vol. 4, 2 July 2020 | Public Health Nutrition, Vol. SOURCE Authors’ analysis of data from Coleman-Jensen A, et al. The health impacts of other means of stabilizing housing, including rental and foreclosure assistance, have also been rigorously studied in relation to mental health outcomes. 12, 5 December 2020 | Translational Behavioral Medicine, Vol. 13, No. 7315 Wisconsin Avenue, Suite 1200W Bethesda, MD 20814 240.223.9200 9, 15 May 2019 | Global Public Health, Vol. 2 Similarly, the effect of being marginally food insecure on having a limitation in an activity of daily living (ADL) is roughly equivalent to being fourteen years older. 50. 23, No. 1, 12 January 2020 | Applied Psychology: Health and Well-Being, Vol. We show that the literature has consistently found food insecurity to be negatively associated with health. 1 About one-third of these were at a more serious level known as “very low food security.” The fact that so many people are food insecure is important in and of itself, but potentially more concerning are the possible negative health consequences of food insecurity. Hunger + Health explores the impact of food insecurity as a social determinant of health and its effect on individual and population health outcomes. Food insecurity can contribute to or exacerbate nutrition deficits that are linked to chronic conditions and diseases. After the introduction of the CPS-FSS, dozens of papers have examined whether food insecurity is associated with poor health outcomes. S2, 3 September 2020 | Health Services Research, Vol. 31, No. 4, 28 October 2020 | Sociology of Health & Illness, Vol. Casey P , Goolsby S , Berkowitz C , Frank D , Cook J , Cutts D , Maternal depression, changing public assistance, food security, and child health status, Hromi-Fiedler A , Bermúdez-Millán A , Segura-Pérez S , Pérez-Escamilla R, Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas, Seligman HK , Bindman AB , Vittinghoff E , Kanaya AM , Kushel MB, Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutritional Examination Survey (NHANES) 1999–2002, Seligman HK , Laraia BA , Kushel MB, Food insecurity is associated with chronic disease among low-income NHANES participants. In recent years some states have opted to use a cutoff that is above 130 percent of poverty. 17, No. 4, American Journal of Public Health, Vol. 1, 29 December 2020 | International Journal of Environmental Research and Public Health, Vol. 20, No. We then provide a selected review of the literature that has examined the impacts of food insecurity on health outcomes for children, nonsenior adults, and seniors. Many people do not have the resources to meet their basic needs, challenges which increase a family’s risk of food insecurity. 4, Annual Review of Public Health, Vol. Along with this geographical concentration, our review concentrates on research that with few exceptions has appeared in peer-reviewed journals since 2001. 15, No. 7, Journal of the Academy of Nutrition and Dietetics, Vol. The need for a new menu, The Impact of Food Insecurity on Child Health, Food Insecurity, Maternal Mental Health, and Domestic Violence: A Call for a Syndemic Approach to Research and Interventions, Measuring Food Insecurity Using the Food Abundance Index: Implications for Economic, Health and Social Well-Being. 121, No. In what follows, we review some of the major findings from the literature examining food insecurity and health that takes into account both self-reports of health and clinical outcomes. defines food insecurity as a lack of consistent access to enough food for an active, healthy life. 1998–2000 Fragile Families and Child Wellbeing Study. 3, 22 January 2020 | Nutrition Reviews, Vol. Why Should We Think About Food Insecurity and Health? 9, No. 4, 9 August 2016 | Maternal & Child Nutrition, Vol. 23, No. Improving the Nutritional Impact of the Supplemental Nutrition Assistance Program: When Does it Count? 41, No. 52, No. 17, 27 August 2020 | International Journal of Environmental Research and Public Health, Vol. 4, No. 12, 27 January 2020 | Canadian Journal on Aging / La Revue canadienne du vieillissement, Vol. 23, No. Other nutrition-related health determinants, such as obesity, have received quite a bit of attention within the context of the doctor-patient relationship, but food insecurity has not received nearly as much. 17, No. 1, American Journal of Public Health, Vol. Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999–2010, Heflin CM , Siefert K , Williams DR, Food insufficiency and women’s mental health: findings from a 3-year panel of welfare recipients, Food insufficiency, food stamp participation, and mental health, Household food insecurity with hunger is associated with women’s food intakes, health, and household circumstances. A recent example of researchers who considered this issue in a convincing manner is Kelly Noonan and coauthors. As a consequence, the results found in these papers are subject to some level of bias. 10, 19 December 2018 | Child Maltreatment, Vol. The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults. 11, 20 July 2017 | Public Health Nutrition, Vol. While most of the papers use the USDA’s measure of food insecurity (defined above) as the key variable of interest, in some cases we include papers that used variants on this measure of food insecurity. 1, 18 December 2020 | PLOS ONE, Vol. 5, 5 October 2018 | JAMA Network Open, Vol. 109, No. 18, No. 1, Journal of the Academy of Nutrition and Dietetics, Vol. 6, 13 October 2016 | Preventing Chronic Disease, Vol. Food Insecurity across the Rural-Urban Divide: Are Counties in Need Being Reached by Charitable Food Assistance? 23, No. Does food insecurity at home affect non-cognitive performance at school? 1, 19 June 2020 | Gerontology and Geriatric Medicine, Vol. 34, No. 45, No. 5, Family & Community Health, Vol. SSM -Population Health. 17, 8 September 2020 | Public Health Nutrition, Vol. 40, No. We therefore concentrate on papers that reflect the most recent work in this area, especially in the fields of economics, internal medicine, nutrition, public health, and social work. 14, 18 March 2020 | Health Services Research, Vol. 2, 13 January 2021 | International Journal of Environmental Research and Public Health, Vol. 1, 1 December 2019 | Tourism Recreation Research, Vol. In the United States, SNAP has been used successfully for over fifty years to reduce food insecurity. The Department of Agriculture (USDA) measures food insecurity through responses to a series of eighteen survey questions and statements fielded to roughly 45,000 households in the Food Security Supplement of the Census Bureau’s Current Population Survey (CPS-FSS). Controlling for other confounding factors, such as income, is especially important because many of the determinants of food insecurity are also determinants of health. 22, No. That said, many SNAP recipients remain food insecure even after receiving benefits. 3, 29 August 2019 | Nutrition and Health, Vol. NHANES is National Health and Nutrition Examination Survey. This approach does not allow, in general, for point estimates of the impact. In some cases, there may be variables that influence food insecurity but not health outcomes, and in those cases, standard instrumental variable techniques could be used to derive point estimates of the impact of food insecurity on health outcomes. 52, No. 40, No. One in nine Americans is food insecure. 34, 23 May 2018 | Journal of Urban Affairs, Vol. 5, 10 November 2020 | Health & Social Care in the Community, Vol. 2007 nationally representative stratified random sample of working poor Canadians ages 18–64, Odds of oral health problems among the working poor with food insecurity were 3.31 times higher (. The work that has been done has found, for example, that compared food-insecure seniors report lower nutrient intakes, 2,36,37 are more likely to be in poor or fair health 2,36,37 and to be depressed, 2,38 and are more likely to have limitations in activities of daily living, 2 compared to their food-secure peers ( Exhibit 4 ). For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. 25 Gundersen C, Kreider B. Bounding the effects of food insecurity on children’s health outcomes. Ideal Cardiovascular Health Among American Adults After the Economic Recession of 2008-2009: Insights from NHANES. 10, 30 March 2020 | VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, Vol. Transition to adulthood: Dynamics of disability, food security, and SNAP participation, Changes in Food Insecurity and Smoking Status over Time: Analysis of the 2003 and 2015 Panel Study of Income Dynamics, The Association of Socioeconomic Conditions and Readiness to Learn New Ways of Performing Daily Activities in Older Adults With Functional Difficulties, Development and testing of the FRESH Foods Survey to assess food pantry clients’ dietary behaviours and correlates, University student food insecurity and academic performance, Food Security and 10-Year Cardiovascular Disease Risk Among U.S. 1, 4 August 2018 | Population Research and Policy Review, Vol. Older Adults, The impact of changes in social policies on household food insecurity in British Columbia, 2005–2012, A Call to Oppose the Child Nutrition and Education Act of 2016 (H.R. 187, American Journal of Preventive Medicine, Vol. 17,18Exhibit 2 gives details about the data sets and methods used in a subset of these papers and, in some cases, the magnitude of the effects reported. 78, No. 119, No. 18, Exhibit 3 Summary Of Research On Food Insecurity And Health Among Nonsenior Adults In The United States And Canada Published During 2004–14. 55, No. 5, 2 October 2019 | Children, Vol. SNAP benefits must be redeemed on food to be prepared in the home, and hot prepared food is the only ineligible food item. Household food insecurity (HFI) is the result of poverty, poor health of the household member or members, and suboptimal livelihood and household management strategies . 21, No. Project HOPE—The People-to-People Health Foundation, Inc. 2, 8 October 2019 | Health & Social Care in the Community, Vol. 12, No. 5, 7 May 2020 | Policy, Politics, & Nursing Practice, Vol. 58, No. NHANES is the National Health and Nutrition Examination Survey. 15, No. 3, 23 June 2017 | The ANNALS of the American Academy of Political and Social Science, Vol. 8, Annals of Emergency Medicine, Vol. S2, 20 October 2020 | JAMA Network Open, Vol. 45, No. 15, No. 13, No. 8, 19 June 2020 | The Journal of Nutrition, Vol. 2, 22 January 2021 | The American Journal of Bioethics, Vol. 57, No. 12, No. 26 Metallinos-Katsaras E, Must A, Gorman K. A longitudinal study of food insecurity on obesity in preschool children. 3, 10 April 2019 | Journal of General Internal Medicine, Vol. 16, No. 2, 12 July 2017 | American Journal of Health Promotion, Vol. 34, 13 November 2020 | Public Health Nutrition, Vol. Available online at: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. 58, No. 2, 6 January 2021 | American Journal of Law & Medicine, Vol. Food insecurity among nursing students: A mixed methods study, Feeding inequality: food insecurity, social status and college student health, Food Insecurity Is Associated With Cardiovascular and All‐Cause Mortality Among Adults in the United States, Foods for Health: An Integrated Social Medical Approach to Food Insecurity Among Patients With Diabetes, South West Food Community: understanding systemic change, and its associated challenges and successes, among food security projects, Validation of a 2-Item Food Insecurity Screen Among Adult General Medicine Outpatients, Food Hardship during the Covid‐19 Pandemic and Great Recession, Food Insecurity and Influenza and Pneumonia Vaccines Uptake Among Community-Dwelling Older Adults in the United States, Food insecurity and psychological distress in Inuit adolescents of Nunavik, Socio-demographic characteristics, diet and health among food insecure UK adults: cross-sectional analysis of the International Food Policy Study, Food insecurity, health care utilization, and health care expenditures, Unmet social needs among low‐income adults in the United States: Associations with health care access and quality, Criminal offending trajectories from adolescence through young adulthood and the risk of food insecurity: evidence from the Add Health study, Patient-Reported Social and Behavioral Determinants of Health and Estimated Risk of Hospitalization in High-Risk Veterans Affairs Patients, Food Banking and Food Insecurity in High-Income Countries, Food insecurity: A key determinant of health, The complexities of family mealtimes in the 21st century: A latent profile analysis, Are We Underestimating Food Insecurity? 9, Journal of the Academy of Nutrition and Dietetics, 11 November 2019 | Advances in Nutrition, Vol. Obviously, the most direct way to ameliorate the health consequences associated with food insecurity is to reduce food insecurity. Food insecurity and its health consequences present a serious challenge to policy makers, program administrators, and health care providers in the United States. Understanding the existence of certain negative health outcomes that stem from food insecurity is of direct importance to health care professionals and to the policy makers and program administrators charged with improving health and well-being. 120, No. Food insecurity, a condition in which households lack access to adequate food because of limited money or other resources, is a leading health and nutrition issue in the United States. 48 The scope of SNAP is reflected in both its reach and the size of its benefits. Exhibit 1 Trends In Food Insecurity In The United States, 2001–13 SOURCE Authors’ analysis of data from Coleman-Jensen A, et al. 37, No. 18, No. Depression and suicide ideation in late adolescence and early adulthood are an outcome of child hunger. We begin with an overview of how food insecurity is measured in the United States, followed by a presentation of recent trends in the prevalence of food insecurity. Obesity, a k ey consequence of food insecurity as desc ribed above, has been found to . 55. ECLS-K is Early Child Longitudinal Study–Kindergarten Class. 3, 1 July 2020 | Delaware Journal of Public Health, Vol. 13, No. 5, 17 July 2017 | Journal of Applied Gerontology, Vol. It allows users to easily access food insecurity rates for different states and different racial and ethnic groups. There is no single face of food insecurity, as it impacts every community in the United States. Food Insecurity, Health, and Well-Being In 2016, approximately 28.3 million adults (11.5 percent of all adults) and 12.9 million children (17.5 percent of all children) lived in food-insecure households.69 Food insecurity — even marginal food security (a less severe level of food insecurity)70 71,, 72 — is associated with some of the The researchers found that when mothers are moderately to severely depressed, the risk of child and household food insecurity rises by 50–80 percent, depending on the measure of food insecurity. 17, 5 December 2019 | Journal of General Internal Medicine, Vol. Are food insecurity’s health impacts underestimated in the US population? 7, 23 May 2016 | Public Health Nutrition, Vol. First, their gross monthly income must be less than 130 percent of the federal poverty level. ... but for an end to the structural inequities that lead to unequal health outcomes. NLSCY is National Longitudinal Survey of Children and Youth. 57 This would then give health care professionals one more tool to use in identifying food-insecure patients and offering care options. 46, No. 14, No. 41, No. Adults, The Culture Of Health In Early Care And Education: Workers’ Wages, Health, And Job Characteristics, Loss Of SNAP Is Associated With Food Insecurity And Poor Health In Working Families With Young Children, The Environmental Impact and Formation of Meals from the Pilot Year of a Las Vegas Convention Food Rescue Program, Disability and food access and insecurity: A scoping review of the literature, Household Food Insecurity and Parent-to-Child Aggression, The Plenary Power Meets the Police Power: Federalism at the Intersection of Health & Immigration, Beyond Housing for Homeless People, It Is Crucial to Remediate Food Insecurity, Aligning Programs and Policies to Support Food Security and Public Health Goals in the United States, Trends in Food Insecurity and SNAP Participation among Immigrant Families U.S.-Born Young Children, Exploring the Challenges and Coping Strategies in Households Relying on SNAP and Food Pantries, The Occupational Therapy Approach to Addressing Food Insecurity among Older Adults with Chronic Disease, Food insecurity, psychosocial health and academic performance among college and university students in Georgia, USA, Associations between food insecurity and prediabetes in a representative sample of U.S. The USDA, in consultation with other federal agencies, academics, and members of the policy community, developed the food insecurity measure used in the United States in part because of the myriad negative health outcomes that were thought to be associated with food insecurity. Other members of Congress and the public health community have argued for imposing further restrictions on the types of items that SNAP benefits can be used to purchase. 110, No. 4, 24 May 2017 | Paediatrics & Child Health, Vol. They Don’t Know Where to Go or They’re Not Sure of What to Do”: Frontline Service Provider Perspectives of the Nature of Household Food Insecurity in Scotland, Association of food security status with overweight and dietary intake: exploration of White British and Pakistani-origin families in the Born in Bradford cohort, SNAP Benefits and Pregnancy-Related Emergency Room Visits, Voices for food: methodologies for implementing a multi-state community-based intervention in rural, high poverty communities, Using Household Fit Indices to Examine the Psychometric Quality of Food Insecurity Measures, Advancing Health Disparities Research in Population Health, Food insecurity and food preparation equipment in US households: exploratory results from a cross-sectional questionnaire. 1, 8 January 2021 | Journal of Women's Health, 7 January 2021 | Preventing Chronic Disease, Vol. 117, No. Supplemental Nutrition Assistance Program size and timing and hypertension-related emergency department claims among Medicaid enrollees, Food insecurity is associated with prediabetes and dietary differences in U.S. adults aged 20–39, Functional Status and Quality of Life Determinants of a Group of Elderly People With Food Insecurity, Factors Associated With Cancer Disparities Among Low-, Medium-, and High-Income US Counties, Inpatient Medicaid Usage and Expenditure Patterns After Changes in Supplemental Nutrition Assistance Program Benefit Levels, Clinical–Community Partnerships to Reduce Food Insecurity Among High-Need, High-Cost Medicaid Patients, Food insecurity and cognitive function in older adults: Brief report, Frequency of Food Insecurity and Associated Health Outcomes in Pediatric Patients at a Federally Qualified Health Center, When does it count? 1, 6 January 2021 | International Journal of Environmental Research and Public Health, Vol. 3, 14 December 2016 | Public Health Nutrition, Vol. They argued that diabetes is more affected than hypertension by limitations in diet, while hypertension is more affected than diabetes by medication adherence. 17, 28 August 2020 | International Journal of Environmental Research and Public Health, Vol. 2, 30 June 2017 | Gerontology and Geriatric Medicine, Vol. 27, No. In contrast, others have used depression as a predictor of food insecurity, treating food insecurity as the dependent variable and depression as one of the independent variables. 2, 8 November 2019 | Public Health Nutrition, Vol. 1.2 million children under 18 live in … 1, 14 December 2018 | Journal of Hunger & Environmental Nutrition, Vol. 4, 26 March 2020 | Journal of Hunger & Environmental Nutrition, Vol. 3, 16 November 2017 | Journal of Consumer Affairs, Vol. 3, 10 October 2018 | Applied Economic Perspectives and Policy, Vol. 2, American Journal of Preventive Medicine, Vol. This assumption is unlikely to hold, since we expect that multiple factors are not included as covariates in any given model. 38, No. Trends in food insecurity for adults with cardiometabolic disease in the United States: 2005-2012, Brief assessment of food insecurity accurately identifies high-risk US adults, Food assistance programs and food insecurity: implications for Canada in light of the mixing problem, Supplemental Nutrition Assistance Progam benefits and emergency room visits for hypoglycaemia, The association of food insecurity with health outcomes for adults with disabilities, Stretching Food and Being Creative: Caregiver Responses to Child Food Insecurity, Scalable principles of community-based high-value care for seriously ill individuals: Diamonds in the rough, High vulnerability to household food insecurity in a sample of Canadian renter households in government-subsidized housing. 3, 23 January 2020 | Nutrients, Vol. Food insufficiency and women’s mental health: findings from a 3-year panel of welfare recipients. This is especially true among seniors, a population in which over 60 percent of those eligible do not receive assistance. 16, No. 110, No. U.S. Department of Agriculture Economic Research Service. Stuff JE , Casey PH , Szeto KL , Gossett JM , Robbins JM , Simpson PM , Household food insecurity is associated with adult health status, Household food insufficiency is associated with poorer health, Ding M , Keiley MK , Garza KB , Duffy PA , Zizza CA, Food insecurity is associated with poor sleep outcomes among US adults, Factors associated with food insecurity among U.S. elderly persons: importance of functional impairments, Nutritional and health consequences are associated with food insecurity among U.S. elderly persons, Laraia BA , Borja JB , Bentley ME, Grandmothers, fathers, and depressive symptoms are associated with food insecurity among low-income first-time African-American mothers in North Carolina, Hypothesis: muscle insulin resistance is the (“not-so”) thrifty genotype, Seligman HK , Jacobs EA , López A , Tschann J , Fernandez A, Food insecurity and glycemic control among low-income patients with type 2 diabetes, Food insecurity and weight status among U.S. children and families: a review of the literature, Hanson KL , Sobal J , Frongillo EA, Gender and marital status clarify associations between food insecurity and body weight, Food insecurity and subsequent weight gain in women, Change in food security status and change in weight are not associated in urban women with preschool children, The modifying effects of Food Stamp Program participation on the relation between food insecurity and weight change in women, Noonan K , Corman H , Reichman NE, Garg A , Toy S , Tripodis Y , Cook J , Cordella N, Influence of maternal depression on household food insecurity for low-income families, Bartfeld JGundersen CSmeeding TMZiliak JP, Gregory C , Rabbitt M , Ribar D, The Supplemental Nutrition Assistance Program and food insecurity, Kreider B , Pepper JV , Gundersen C , Jolliffe D, Identifying the effects of SNAP (food stamps) on child health outcomes when participation is endogenous and misreported. 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