Amber Thomas HCA 450 April 29, 2014 Food Insecurity Many people do not understand the hunger crisis in the United States. Food insecurity is defined as “the limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” (Jung, 2013), which therefore means many families have to go without food or have nutritionally undesirable food available to them. America is one of the richest countries in the world, yet according to the World Hunger Education Service food insecurity affects over 17.2 million households (49 million people), which is 14.5% of the overall population (2011) (see Appendix A). Food insecurity is related to many issues, such as developmental problems in children and malnourishment, and is also caused by many social and political factors. Food insecurity is a complex problem that cannot be linked to one direct cause or solution, and drastically affects a large portion of the United States
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Amber Thomas
HCA 450
April 29, 2014
Food Insecurity
Many people do not understand the hunger crisis in the United States. Food
insecurity is defined as “the limited or uncertain availability of nutritionally adequate
and safe foods or limited or uncertain ability to acquire acceptable foods in socially
acceptable ways” (Jung, 2013), which therefore means many families have to go without
food or have nutritionally undesirable food available to them. America is one of the
richest countries in the world, yet according to the World Hunger Education Service
food insecurity affects over 17.2 million households (49 million people), which is 14.5%
of the overall population (2011) (see Appendix A). Food insecurity is related to many
issues, such as developmental problems in children and malnourishment, and is also
caused by many social and political factors. Food insecurity is a complex problem that
cannot be linked to one direct cause or solution, and drastically affects a large portion of
the United States population. It is a serious problem that needs to be addressed by many
different outlets, politically, environmentally, and socially.
Based on a household’s severity of food insecurity the USDA has made different
ranges to describe different levels of food insecure households. High food security is
households with no reported indications of food-access problems or limitations.
Marginal food security is when there has been one or two reported indications of
anxiety over food sufficiency or shortage of food in the house, but overall there is little
or no indication of changes in diet or food intake of those household members. Food
insecurity is defined as households that during the year are uncertain of having, or is
unable to acquire, enough food to meet the needs of the household because they have
insufficient money or other resources for food, this affects 14.5% of the population (17.6
million households). Within food insecurity is low food security and very low food
security. Low food security reports show that these households obtained enough food to
avoid “substantially disrupting their eating patterns or reducing food intake by using a
variety of coping strategies, such as eating less varied diets, participating in Federal food
assistance programs, or getting emergency food from community food pantries” (Jensen,
2012). Low food security affects about 8.8% of the food insecure population, or about
10.7million households in the U.S. And lastly, there is very low food security, which
reports multiple indications of disrupted eating patterns and reduced food intake by
household members. Very low food security affects 5.7% of the food insecure
population, or in other words about seven million United States households (see
Appendix B). Among the households who fall under food insecure, 80% of them had
children under 18 living within that household, and in 10% of those households with
children, only the adults were food insecure, in the other 90% all members were
reported as food insecure, with 1.2% of households reporting one or more child
experiencing reduced food intake and disrupted eating patterns at some point. Those
suffering from food security have to deal with a variety of concerns. They are generally
worried about if they will run out of the food that they have bought, the food they
bought actually did not last as long as it was intended to, they cannot afford balanced
meals, they have cut meal sizes or skipped meals, they have cut or skipped meals for 3+
months, they are hungry but do not eat, they have lost weight due to their food
insecurity, they do not eat for whole day(s) at a time, and have not eaten for whole days
at a time for 3+ continuous months (Jensen, 2012). Like stated before, 17.2 million
households are food insecure. That breaks down to 49 million people living in food
insecure households and 977,000 being children who experienced very low food
security.
The next question is who exactly is food insecure in the United States? The
prevalence of food insecurity varies considerably among household types. However,
rates of food insecurity are shown to be higher than the national (14.5 percent) average
for certain groups. These groups include all households with children (20%),
households with children under the age of six (20.5%), households with children headed
by a single woman (35.4%), households with children headed by single men (23.6%),
African American households (24.6%), Hispanic households (23.3%), and low-income
households with incomes below 185% of the poverty threshold (34.3%) (see Appendix
C). There is also a similar, but slightly different pattern for very low food security. These
include households with a higher average than that of the national average for very low
food security (which is 5.7%) and are households with children headed by a single
woman (12.7%), women living alone (7.5%), men living alone (7.3%), African American
households (10.4%), Hispanic households (7.4%), households with incomes below 185
percent of the poverty line (14.5%), and households located in principle cities of
metropolitan areas (6.7%) (“USDA ERS- FOOD,” 2013) (see Appendix D). The biggest
prevalence of food insecurity are for those living in poverty, minority populations have a
higher rate of poverty, which makes those suffering from any level of food insecurity
mostly minorities within with the United States.
There are many negative health implications for children and adults experiencing
food insecurity. The first being malnourishment. Micronutrient deficiencies are very
common in individuals lacking proper nutrition; micronutrients are chemicals or
substances (vitamins and minerals) that are required in trace amounts for proper
development and growth. These deficiencies are most commonly deficiencies of vitamin
A, B, C, and D, calcium, foliate, iodine, iron, and zinc. According to the Agriculture and
Consumer Protection Department vitamin and mineral deficiencies have a “significant
impact on human welfare and on the economic development of communities and
nations. These deficiencies can lead to serious health problems, including reduced
resistance to infectious disease, blindness, lethargy, reduced learning capacity, and in
some cases, to death” (“Household Food Security,” 2010). Vitamin A deficiencies are
most common in young children, and if left untreated, it can lead to blindness and death.
Iron deficiency is the most common dietary deficiency worldwide, and even more
common for those with food insecurities. Iron deficiency leads to anemia, which
“significantly contributes to maternal and neonatal deaths” (“Household Food Security,”
2010). Severe iodine deficiencies can lead to lower IQs, stillbirth, and birth defects.
Micronutrients are huge contributors to our health that are very commonly overlooked,
and deficiencies in micronutrients are extremely detrimental to ones overall health.
Malnutrition leads to many other physical impairments as well. Fatigue and
illness are also a major concern for food insecure children. Food insecure children are
more vulnerable to infections, and end up being hospitalized with illnesses that their
food secure peers fight off successfully with their stronger immune systems, or with
help of the primary care available to them (“Child Nutrition and,” 2012). They are also at
a higher risk for chronic health conditions such as anemia and asthma, and just in
general a higher frequency of illness and developmental and growth problems than their
peers. Other physical symptoms of hunger from food insecurity are gastrointestinal
distress, dizziness, frequent headaches, hypersensitivity to noise, light, and cold,
reduced strength, and poor motor control. Another area of malnutrition is consuming
foods that are not nutritionally valuable. Fast food and unhealthy processed foods are
usually what struggling families can afford, but do not provide the nutrients people
need. Toddlers that live in households suffering from food-insecurity are 3.4 times more
likely to be obese at age 4 than others their age because of the lack of nutritional value
from the food that they are provided with and consume (“Child Nutrition and,” 2012).
While physical impairments lead to poor health outcomes, there are also emotional and
cognitive problems associated with being food insecure and hungry.
Children growing up in food-insecure families are also at a higher risk for
emotional, cognitive, and behavioral challenges. They have a higher risk of truancy and
tardiness to school, and if they are in class they may experience an increase in
behavioral problems such as fighting, hyperactivity, aggression, anxiety, mood swings,
and bullying. Data also suggests that, by third grade, children who have been “food
insecure in kindergarten saw a 13% drop in their reading and math test scores
compared to their food-secure peers” (“Child Nutrition and,” 2012). One astonishing
statistic from The National Health and Nutrition Examination Survey suggests that food
insecure teens are more likely to have repeated a grade and missed more school days
compared to their food secure peers. More than “40% of teens living in food-insecure
households had repeated a grade, as compared with 20.7% of food-secure teens” (“Child
Nutrition and,” 2012). As children grow older their behavioral problems associated with
being food-insecure are likely to increase, with teenagers being twice as likely to have
been suspended than their peers, they have a harder time getting along and making
friends with their peers, and overall are four times as likely to have no friends, all
stemming from living in a food-insecure family (“Child Nutrition and,” 2012). All of this
leads to them being four times more likely than their peers to require mental health
counseling. School can be very challenging for children growing up in food-insecure
households because impaired concentration, lack of friendships, reduced alertness and
comprehension, and overall poor judgment, which is highly likely to carry over into their
adult lives as well (“Hunger and Food,” 2011). Families as a whole suffering from hunger
and food insecurity are more likely to suffer from emotional distress, depression, and
feelings of alienation from society. Feelings of alienation stem from the lack of control
over how they feed themselves and their family, and their constant reliance upon the
charity of others and state programs such as SNAP and WIC. This is considered a forced
giver-receiver relationship, and it alienates the hungry from the rest of society, which
makes individuals feel shame and distress about their food insecurity. Many are working
as hard as they can to provide for their family, but simply cannot. The “working-poor” is
a term being used for a large part of society because of low wages paid to those working
part and full-time positions. Even those working 40+ hours per week cannot provide the
necessities for their family on minimum wage incomes.
We have looked at the effects of food insecurity on the individual, but what
impact does it have on the rest of the country? Recent reports suggest that rising rates of
hunger and food insecurity in the United States is costing the American economy billions
of dollars every year, because of a “widespread financial ripple effect” (Eichler, 2011).
The healthcare bills, missed days of work due to the effects of hunger, and the expense of
state food programs really adds up. Food insecurity contributes to various nutrition and
non-nutrition problems such as nutrient intake, physical and mental health problems,
poor chronic disease management, medication non-adherence, and increased healthcare
service use, which increases healthcare spending. If people cannot afford the basic
necessity of food, they cannot afford to pay their healthcare bills either. The healthcare
cost burden of food insecurity can be estimated by calculating the costs of managing
adverse health outcomes associated with food insecurity. When determining the cost we
must look at both direct and indirect costs. Direct costs are medical expenditures for
diagnosis, treatment, continuing care, rehabilitation, “as well as non-medical
expenditures caused by diseases directly related to food insecurity” (Jung, 2013). Major
categories of medical expenditures include hospitalizations, outpatient clinical care,
healthcare professionals, medications, and rehabilitation. Indirect costs could include
the loss of “resources and/or productivity incurred as a result of food insecurity-related
morbidity and mortality” (Jung, 2013). According to the Center for American Progress,
the annual cost of hunger and food insecurity is about 167.5 billion dollars in the United
States. $130.5 billion illness costs are linked to hunger and food insecurity, $19.2 billion
is liked to poor educational outcomes and lower lifetime earnings from food insecure
individuals, and $17.8 billion is linked to charitable contributions to address hunger and
food insecurity in America (“Economic Impact,” 2013). That is a huge, unnecessary,
annual bill that shows food insecurity not only affects those struggling with it on a daily
basis, but also the country, and economy, as a whole.
Now that we know what food insecurity is, who is food insecure, and the negative
health implications of food insecurity, it is important to look at the reasons for food
insecurity within the United States. We are a nation of wealth and overabundance, but
yet millions are hungry and living in food insecure households. To get a good
understanding of why this is we need to look at food distribution, political practices,
agricultural practices, environmental factors, economic factors, and lack of access to
food. Many of these issues are associated and connected to one another as well.
Food distribution is a huge problem in the United States. Current production of
food exceeds our population requirements, but millions are still food-insecure and
hungry. This clearly shows that the distribution of food and access to food is a problem.
Many people who are food-insecure are living in poverty and/or are unemployed or
underemployed. Recent studies have found that people with nonstandard work
arrangements are more likely to be food insecure than those who have full-time jobs
(Jensen, 2012). Nonstandard workers can be those who hold multiple jobs, work only
part-time, have varied/inconsistent work hours, or are unemployed. This leads to lower
incomes and is also correlated to those individuals living at or below the poverty line.
Lower incomes also affect the type of food a household can purchase, because of where
they live. Many grocery stores located in low-income areas do not have the fresh and
nutritious food available that stores in more affluent areas have. The distribution of food
to grocery stores is correlated with the price of food, making low-income families less
likely to even have healthy options available for them to purchase. Unemployment,
therefore, is associated with decreased access to food, which leads to food insecurity and
poor nutritional choices when food is available to them.
Access to food, although it relates to food distribution, has more to it. Assistance
to those suffering from food-insecurity is in need. A major problem with SNAP benefits
is that it does not reach everyone who is suffering. Three out of ten people eligible for
SNAP are not enrolled in the program. And in some states the income requirements are
set so low that hundreds of thousands of working poor households do not even qualify,
even though it is desperately needed (Spencer, 2009). This further limits their access to
food. Many of those who are participating in SNAP or another program such as WIC do
not receive enough to support their family members throughout the whole month, and
are scared of running out of food before the benefits for the next month kick in. This
leads to unhealthy diets and families purchasing and relying more heavily on cheaper
stable foods to try and make ends meet for the month. These people have access to food,
but it is not sufficient access, which leads to food insecurity.
Access to food brings up other concerns as well. Food deserts are a major
problem, and many people do not even know what this problem is or that it exists. Food
deserts are areas where inhabitants cannot access affordable and good-quality food.
Many low socioeconomic households live in areas, where they have plenty of food but
none of it is healthy. They can be in urban neighborhoods or rural towns, and instead of
supermarkets and grocery stores they are surrounded by fast food restaurants and
convenience stores, or no food options at all. This lack of access contributes to a poor
diet “and can lead to higher levels of obesity and other diet-related diseases, such as
diabetes and heart disease” (“Food Deserts,” n.d.). There are about 6500 food deserts in
the United States currently, and about 75% of them are urban and 25% are rural (see
Appendix E). About 2.3 million households live more than one mile from a supermarket,
and an additional 3.4 million live between one-half to one mile from a supermarket but
do not have access to a vehicle to go to those supermarkets and transport their
purchases (“Hunger and Food,” 2011). This leaves many people forced to shop at smaller
stores such as 7-Eleven, or to travel long distances, usually on public transportation, to
obtain food for themselves and their families.
Political, agricultural, and environmental factors are closely connected. Political
agendas supporting industrial agriculture are related to soil degradation and erosion,
which negatively affects not only the United States’ food security, but the global food
security as well (“Food Security & Food,” 2014). There is also an increase in commodity
crops instead of food crops (particularly corn, wheat, and soy), which yields more junk
food, fast food, and cheaper options that do not have high nutritional value. The United
States overproduces commodity crops in part because of government subsidization, and
a lack of promotion of healthful foods by the government. These subsidized cheap foods
are what many low-income families have access to. Small farmers who do produce
vegetables and healthful options cannot compete with less expensive, subsidized,
industrial farming. There is also an increased demand for biofuels right now, which is
primarily produced from corn and soy, which has further decreased the amount of
viable land used for food production. Development in general has led to the loss of
farmland and pastureland, which affects our availability of healthy food options at a
reasonable price. Politically, the United States does not have policies that support food
crops. This has led to environmental concerns and agricultural changes in how food is
produced. All this contributes to food insecurity, and if the food people are able to obtain
at reasonable prices is not healthy, it leads to more health concerns having to do with
micronutrient deficiencies, and chronic conditions associated with high fat, unhealthy
foods.
Other economic and political contributors are the rise in food prices over the last
several years. Increases in food costs “generally mean increases in the food insecure”
(“Food Security & Food,” 2014) for a few reasons. Those who are already food insecure
and then see an increase in food prices really struggle. If they are receiving state
assistance such as SNAP, their benefits do not go up just because food prices went up,
and neither do their already low incomes, making increased food prices a huge burden.
It can also push those who were barely making it over the brink, and cause a family to
become food insecure when they weren’t before, because their budgets just do not
stretch far enough to cover the excess cost. Food insecurity is obviously a very complex
issue with many contributing factors, and it cannot be narrowed down to one direct
cause, but no matter the reason it has devastating effects.
Since there is not a sole cause of food insecurity, there is also not just one
solution. It’s a complex issue that is going to have to be solved through a variety of
measures. The solution to end food insecurity would be to eliminate poverty and the
income gap in the United States; however, other aspects of food insecurity may be more
immediately solvable. One is sustainable agriculture. The use of genetically modified
organisms (GMOs) has become a central way for big companies to produce food, and
these large companies also own patents to food seeds, making it hard for small farmers
to stay in business. With high amounts of fertilizers, pesticides, fossil fuels, and intensive
irrigation required for industrial agriculture, it is very expensive, degrades the
environment in numerous ways, and in the long run will increase global food insecurity
when the environment cannot handle it anymore. Focusing more on small farms with
sustainable agricultural practices can actually increase yield and lower food costs. With
sustainable agriculture we can also focus on improving agricultural biodiversity.
Industrial agriculture relies on monocropping, “in which one genetic type of crop is
planted on large tracts of land, while sustainable farms frequently plant a genetically
diverse array of both crop type and species” (“Food Security & Food,” 2014).
Monocropping increases crop susceptibility to both pests and diseases, which has led to
several historical famines and crop decimations. Enhancing biodiversity through
sustainable agricultural practices can protect communities from food insecurity
associated with both crop loss and decreased yield.
If we had more sustainable agricultural practices we could focus on policy
changes as well. Right now government policy encourages industrial farming by
subsidizing those foods, making them cheaper, more available options. If we have more
sustainable farming and locally produced food, we could increase incentives for local
farmers and markets where fresh, healthful food is available, and increase community
food security. By expanding healthful food options, policy could be changed to increase
the acceptance of “food stamp (SNAP) benefits at local food outlets such as farmers’
markets, and improve access to healthful food and increase consumption of fruits and
vegetables” (“Food Security & Food,” 2014). Community gardening, home gardening,
and urban farming are other ways in which sustainably grown, local food can be used to
improve food security and increase the consumption of healthy food. SNAP benefits have
already been expanded to allow participants to buy seeds and edible plants, which just
further increases the potential “for urban agriculture and home gardening to help
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