Summary Food insecurity functions as a social driver of health, having a direct negative impact on health status and outcomes, which can further impact employment and income and increase medical expenditures, all of which exacerbate food insecurity. Progress in significantly reducing the rate of food insecurity has stalled in recent years. Although rates have declined since their peak during the Great Recession, these gains have been reversed by the economic implications of the COVID-19 pandemic. Since the federal government is the largest provider of food assistance, there is great potential to better leverage nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) and Child Nutrition Programs to increase access to healthy foods and improve public health. However, these programs face many funding challenges and internal deficiencies that create uncertainties and prevent maximum effect. Physicians and other medical professionals also play a role in improving nutritional health by screening for food insecurity and serving as connectors between patients, community organizations, and government services. Governments and payers should support these efforts by providing sufficient resources to practices to fulfill this role. In this position paper, the American College of Physicians (ACP) offers several policy recommendations to strengthen the federal response to food insecurity and train physicians and other medical professionals to better address the social drivers of health that occur beyond the office doors. |
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In a new position paper, the American College of Physicians (ACP) says inadequate access to nutritious foods negatively affects the health of many Americans, which in turn can significantly exacerbate food and nutrition insecurity and other social factors that affect health.
The document says more needs to be done to comprehensively address food and nutrition insecurity and strengthen public health. Strengthening Food and Nutrition Security to Promote U.S. Public Health: A Position Paper from the American College of Physicians is published in Annals of Internal Medicine .
In the United States, about 10% of the population experiences food insecurity, which is associated with a wide range of health problems, including increased risks of birth defects, anemia, lower nutrient intake, cognitive problems, asthma, and poorer health. oral, as well as an increased risk of mental and behavioral health problems among children.
For nonelderly adults, food insecurity has been associated with lower nutrient intake; higher rates of mental health problems, diabetes, high blood pressure, high cholesterol and other chronic diseases; and worse reported health, sleep, and health screening outcomes.
Food insecure older adults are at risk for lower nutrient intake, poorer reported health, higher rates of depression, and more limitations in an activity of daily living. These health impacts can be seen in the higher rates of healthcare utilization and costs experienced by people with food insecurity.
ACP says the United States needs to strengthen its response to food insecurity and train doctors and other medical professionals to better address social health factors that occur beyond the office doors. Specifically, the ACP recommends that:
- All people should have adequate access to healthy foods and policymakers should make addressing food insecurity and nutritional drivers of health a policy and financial priority.
- Policymakers must sufficiently fund and support efforts that aim to reduce food and nutrition insecurity and promote safe and healthy diets.
- Policymakers should improve the Supplemental Nutrition Assistance Program (SNAP) to better address the needs and health of food-insecure individuals and households.
- The Centers for Medicare and Medicaid Services (CMS) should develop, test, and support innovative models and waivers that incorporate benefits and activities that address social drivers of health, including food insecurity.
- Physicians and other medical professionals should undertake activities to better understand and mitigate the food insecurity their patients experience. This should include screening patients for food insecurity, incorporating teaching about food insecurity into medical education, and establishing mechanisms to refer patients in need to community and government resources.
- Research efforts should strive to better understand the prevalence, severity, and cost of food and nutrition insecurity; its impact on health and health care; and ways to improve them effectively and efficiently. The federal government should support nutrition research and coordinate research and other activities among federal departments and agencies.
