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More than 44 million people in the United States — roughly 14% of the population — experience food insecurity. People in households experiencing food insecurity have much higher rates of diet-related chronic diseases and poor nutrient intake, along with increased mental health concerns, healthcare spending and hospitalizations. Improving food security at home is one of many steps that can directly improve overall health of families.

What is Food Insecurity?

Food insecurity occurs when people don’t have consistent access to enough food to live an active and healthy lifestyle. It’s often caused by financial hardship, scarcity of grocery stores, or transportation barriers. When money gets tight, families may compromise on the nutritional value of food or may have to forego buying food to pay other expenses.

What is Nutrition Insecurity?

Nutrition insecurity occurs when people do not have equitable or consistent access to nutritious food that promotes optimal well-being. The term is often used to hyperfocus on the nutritious quality of foods available.  Improving access to nutritious foods can, in many cases, prevent, manage, and treat health conditions that are better managed with nutritious food. 

Improve Health Outcomes by Reducing Food and Nutrition Insecurity

When people have consistent access to affordable and nutritious food, they experience food security. Recently, however, the term ‘nutrition insecurity’ has been used to bring more attention to disease prevention, management, and treatment. Using the term ‘nutrition insecurity’ also puts a focus on health equity and the quality of food available. To effectively address the rapidly increasing rates of diet-related disease, a strategic approach to addressing the concepts of food insecurity and nutrition insecurity is required.

We’re not choosing or prioritizing one over the other. To improve health outcomes, we need to reduce both food insecurity and nutrition insecurity.”

Dr. Kofi Essel

Elevance Health’s food as medicine director

Poor nutrition is one of the leading causes of early death in the United States. About 600,000 people die each year from conditions linked closely to diet like diabetes, heart disease, and obesity. These and other diet-related conditions also contribute to 85% of healthcare spending.

“Food insecurity has traditionally incorporated a component of nutrition insecurity — the lack of nutritious food available or eaten — in its definition. Both food and nutrition insecurity are really challenging areas. We’re not leaving one behind or ranking one over the other,” said Dr. Kofi Essel, food as medicine program director at Elevance Health. “Right now, finding solutions to the accelerating trend in the development of diet-related conditions among all ages and populations requires a laser focus on the quality of food in addition to its availability.”

Contributors to Nutrition Insecurity

People who regularly experience food insecurity are often forced to focus not on the nutritional quality of food but rather on ensuring they get enough food to feed themselves and their families. While more whole foods like fruits, vegetables, whole grains, and legumes may be desired, people need to make tough decisions when finances are limited. Concerns arise over access, waste, and the limited shelf-life – and sometimes even the taste profile of some nutritious foods. In addition, people may lean toward more ultra-processed foods that are less nutritious because they are readily available, convenient, designed to be tasty, and often more affordable. 

Another leading contributor to nutrition insecurity is the limited time families mention they have to plan and prepare nutrient-rich whole foods. In addition to having concerns about access, they also express difficulty in identifying and selecting nutritious foods along with not knowing the best ways to prepare and cook these foods. Employing food as medicine strategies that support families with nutritious foods while providing access to culturally grounded nutrition counseling and education are needed to improve health outcomes. 

Approximately 87% of the U.S. population lives in food-secure homes which means they have enough food for an active, healthy life for all household members. However, that does not guarantee they are nutritionally secure. For example, among food-secure households in a small pilot study, about 36 percent reported nutrition insecurity. The rate of diet-related chronic disease is increasing in adults. In order to use the powerful tool of food to make a larger impact, both food and nutrition insecurity have to be addressed to optimize health.

Reducing the trend in the development of diet-related diseases takes improving access and availability and outreach, support, and education. “We’re working with community partners to reduce food and nutrition insecurity by improving access and availability of nutrient-rich foods,” Essel said. “Increasing consistent access to nutritious foods and helping people create and maintain nutritious diets are foundational steps to improve health outcomes.” 

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