Food Insecurity and Health: How Lack of Access to Nutritious Food Affects Chronic Disease
Food insecurity, a condition of limited or uncertain access to adequate food, is associated with a wide range of poor health outcomes, extending beyond hunger and malnutrition. The relationship between food insecurity and the development and progression of chronic disease is important and complex, and understanding it may help to address gaps in health equity.
Food insecurity is often associated with inadequate intakes of key vitamins and minerals that are critical to health. For example, people facing food insecurity are more likely to experience deficiencies in key vitamins and minerals such as iron, calcium and vitamin D, all of which can predispose to chronic disease such as cardiovascular disease, diabetes and osteoporosis. Food insecurity may have one of its most profound effects on health through its tendency to promote chronic conditions such as obesity and type 2 diabetes. Restriction of food budgets often creates incentives for purchasing foods that are calorie-dense but nutrient-poor and often highly processed (eg, French fries instead of fruit). In turn, such a diet results in weight gain and obesity.
Food insecurity can also make the effects of chronic disease worse. For example, patients with hypertension or diabetes can struggle to control their disease if they don’t have access to the right foods, especially fresh vegetables and protein. For patients with diabetes, for example, their recommended diet stresses foods with a low glycemic index, which are natural and unprocessed, but these can be hard for patients with food insecurity to manage if they lack the means to find or afford such foods. More broadly, patients who are food insecure can develop anxiety and depression due to the chronic stress of not knowing where they will get their next meal. These psychological burdens can in turn interfere with their ability to manage their chronic diseases.
To tackle food insecurity, a range of approaches are needed that allow for access to all forms of food. Expanding government resources to increase funding levels and broaden eligibility criteria for such food-assistance programs aids in addressing food insecurity and access to the foods that people need. Local food banks, community gardens and farmers’ markets also provide critical access to nutritious food for those suffering from food insecurity. Supporting and expanding these forms of access would also be of great benefit. A focus on improving education and outreach about how to eat well and how to make the most of the food that currently is available to people can also empower them to engage in a healthier diet and reduce food insecurity. It includes public health campaigns and community-based workshops about nutrition about how to prepare more nutritious meals on a budget. Beyond simply improving access to nutritious foods, addressing the broader drivers of food insecurity, such as poverty and unemployment, is critical. Policies that either stimulate employment and fair wages, or promote the provision of affordable housing, can help mitigate these economic factors that contribute to food insecurity. Lastly, it is important that food systems become more resilient to economic and environmental shocks in order to maintain consistent access to nutritious food. The expansion and promotion of local agriculture and investing in sustainable food production practices are essential to achieving this goal.
Food insecurity is a major public health concern and a contributor to the burden of chronic disease. It is high time to consider food security as a chronic disease prevention strategy. Emergent strategies to improve food security would then become important targets for chronic disease prevention. Access to healthy food is not simply a nutrition issue or a chronic disease issue. Rather, it is a critical threat to the health of individuals.
Food insecurity is a public health crisis that poses an important, remediable risk for the development and progression of chronic diseases. Knowing how food insecurity affects health and taking steps to reduce food insecurity and promote access to healthy food help us promote better health for all people. Access to healthy food is not only about nutrition, it is about health and chronic disease prevention.
