American College of Physicians says food insecurity is a threat to public health in the United States

Inadequate access to nutritious food negatively impacts the health of many Americans, which in turn can significantly exacerbate food and nutritional insecurity and other social factors impacting health, says the American College of Physicians (ACP) in a new position paper published today in the Annals of Internal Medicine. The paper says that more needs to be done comprehensively to address food and nutrition insecurity and bolster public health.

"In the United States it's estimated that about 10 percent of the population experiences food insecurity," said Ryan D. Mire, MD, FACP, president, ACP. "That means that 10 percent of Americans have inadequate quality, variety, and quantity of the food available them. Persistent food insecurity and hunger can negatively impact employment, income, and medical expenditures."

Food insecurity is associated with a wide range of health issues, including higher risks of birth defects, anemia, lower nutrient intakes, cognitive problems, asthma, and worse oral health, as well as increased risk of mental and behavioral health problems among children. For non-senior adults, food insecurity has been associated with lower nutrient intakes; higher rates of mental health problems, diabetes, high blood pressure, high cholesterol, and other chronic diseases; and poorer reported health, sleep, and health exam outcomes. Food insecure seniors are at risk for lower nutrient intakes, poorer reported health, higher rates of depression, and more limitations in an activity of daily living. These health impacts can be observed in the heightened health care utilization rates and costs experienced by food insecure individuals.

ACP says that the United States needs to strengthen its food insecurity response and empower physicians and other medical professionals to better address those social drivers of health occurring beyond the office doors. Specifically, ACP recommends that:

• All persons need to have adequate access to healthful foods and policymakers must make addressing food insecurity and nutritional drivers of health a policy and funding priority.
• Policymakers need to sufficiently fund and support efforts that aim to reduce food and nutrition insecurity and promote safe and healthful diets.
• Policymakers should improve the Supplemental Nutritional Assistance Program (SNAP) to better serve 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 food insecurity experienced by their patients. This should include screening patients for food insecurity, incorporating teaching about food insecurity into medical education, and establishing mechanisms for referring 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; their impact on health and health care; and ways to effectively and efficiently improve them. The federal government should support nutrition research and coordinate research and other activities across federal departments and agencies.

"Ending food insecurity needs to be a priority for policymakers, the health care community, and other stakeholders," concluded Dr. Mire. "Ensuring all individuals have access to feed themselves a nutritious and healthful diet is an important component of a just society. We have a moral and public health imperative to comprehensively address food insecurity in the United States."