How Food Insecurity Impacts Public Health
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Food is a basic human need, and in food-insecure households, the need for food competes with the need for other basic human necessities such as medication, housing, utilities, and transportation. As food budgets are stretched, they may become barriers to adopting nutritious diets. Food security is a top public health priority for any nation. Food insecurity is defined as when people do not have adequate physical and economic access to sufficient, safe, and nutritious foods that meet their dietary needs and preferences for an active and healthy life.[1]
Food insecurity and malnutrition are related; major global concerns are embedded in many UN sustainable development goals. Food insecurity predicts all forms of malnutrition including stunting, wasting, micronutrient deficiencies, and overweight and obesity. It places a substantial burden on any society through health care and social costs. People experiencing food insecurity often consume a nutrient-poor diet, and fail to purchase more healthful food items, such as vegetables, lean proteins, and whole grains. In addition, low-income families might postpone needed medical care to buy food or might underuse medicine because of budget constraints, which can result in expensive and avoidable hospitalizations.[1]
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Food security is essential to people’s health and well-being. The World Health Organization (WHO) argues that “health is wealth and poor health is an integral part of poverty; governments should actively seek to preserve their people’s lives and reduce the incidence of unnecessary mortality and avoidable illnesses”. However, lack of food is one of the factors which affect health outcomes. The social determinants of health, such as poverty and food insecurity, are associated with some of the most severe and costly health problems in a country. It is generally believed that food security and nutrition are crucial to improving human health and development. The global food crisis is affecting millions of people around the world. In 2023, record levels of acute food insecurity persisted due to protracted food crises and new shocks. In 58 countries, 257.8 million people were found facing high levels of acute food insecurity – 10% more than in 2022.[2]
Food insecurity is highest in Sub-Saharan African Countries (SSA) countries, where nearly one-third are defined as severely insecure. It will be a huge challenge to achieve the SDGs of zero hunger by 2030. Hidden hunger is also one of the most severe types of malnutrition (micronutrient deficiencies). One in three persons suffers from inadequacies related to hidden hunger, which impacts two billion people worldwide.[2]
An important consequence of food insecurity is that around 9 million people die yearly worldwide due to hunger and hunger-related diseases. Even though the hunger crisis affects many people of all genders and ages, children are particularly affected in Africa. There are too many malnourished children in Africa, and malnutrition is a major factor in the high infant mortality rates and causes physical and mental development delays and disorders in SSA. Malnutrition is responsible for almost one child under the age of five dying every two minutes worldwide. The child mortality rate in the SSA is among the highest in the world, about one in nine children pass away before the age of five.[2]
In addition to the direct impact of food insecurity on health outcomes, it also indirectly contributes to disordered eating patterns, higher or lower blood cholesterol levels, lower serum albumin, lower hemoglobin, vitamin A levels, and poor physical and mental health. Iodine, iron, and zinc deficiency are the most often identified micronutrient deficiencies across all age groups. Even though it is frequently noted that hidden hunger mostly affects pregnant women, children, and teenagers, it further affects people’s health at all stages of life.[3]
People’s health condition is impacted by food insecurity through nutritional, mental health, and behavioral channels. Under the nutritional channel, food insecurity has an impact on total caloric intake, diet quality, and nutritional status. Food insecurity is related to poor mental health conditions (stress, sadness, and anxiety), which have also been linked to obesity and cardiovascular risk. There is a connection between food insecurity and health practices that impact disease management, prevention, and treatment. For example, lack of access to household food might force people to make bad decisions that may raise their risk of sickness, such as relying too heavily on cheap, calorically and dense, nutrient-poor meals. Moderate to severe food insecurity is a significant risk factor for the physical and mental health of the general population. Moreover, age over 40 years, gender (female), a large family size, workplace dissatisfaction, and health risks at work all negatively impact physical health status. Besides dissatisfaction with the workplace and the prevalence of one or more major diseases, impact mental health status negatively.[3]
Food insecurity leaves an indelible mark on children’s well-being. Experiencing food insecurity at an early age is associated with childhood mental health problems, such as hyperactivity and inattention. The health consequences of food insecurity put a large burden on the health care system and are costly for any government’s public health care budget. Adults in food-insecure households are more likely to be admitted into acute care for a wide array of reasons. They also stay in the hospital for longer and are more likely to be readmitted. Reducing food insecurity could offset considerable public healthcare expenditures and reduce the burden on healthcare resources.[4]
Governments at all levels should focus on the issue of food insecurity and health status. Structural factors, such as climate, socio-economic, social, and local food availability, affect people’s food security. The UN agencies are now calling for new ways of thinking to integrate food security concerns into malnutrition eradication, addressing hunger, food insecurity, and their consequences for nutrition. Achieving this goal necessitates emphasizing nutrition in all food security targeting policies, designs, and interventions fostering nutrition-sensitive agriculture, driving economic prosperity, and promoting food systems that prioritize access to safe, nutritious, sufficient, and high-quality food for all. People with disabilities appear to be disproportionately affected by food insecurity. Food-insecure individuals may struggle to adhere to therapeutic diets and forgo necessary medications because of the expense. Nearly half of adults living in severely food-insecure households reported delaying, reducing, or skipping prescription medications because they couldn’t afford them.[5]
Providing income and food support to unemployed individuals and their families should be the immediate policy response of any government. The outcome will also contribute to Sustainable Development Goal 2 (SDG 2), where countries are committed to ending hunger and achieving food security by the year 2030 through the fulfillment of SDG target 2.1 (ensuring access to sufficient, safe, and nutritious food for all people, especially for the poor and people in vulnerable states all year round).[6]
Food insecurity issues among poor communities should be addressed carefully by the social community, local authorities, and enterprises. They should provide sufficient income and operate under a care system linking nutrition assistance and food support. Enterprise-based food banks may aid in improving food insecurity among workers, particularly the elderly. Consumption support can also be helpful. It can be in cash if food markets are working and in kind if they are not. The existing stigma of receiving food assistance might have increased mental stress and despair for those who were not food insecure before. This can be an argument for why food insecurity is associated with mental health. Therefore, measures should be taken to introduce food assistance as a social support system that may reduce the stigma and shame associated with accepting food support, either in cash or in kind. Enterprise owners should come forward and address the physical and mental health status of people carefully, as it is linked to productivity.[7]
Household food insecurity is a significant problem worldwide particularly in underdeveloped countries and in children. Shockingly, food insecurity continues, especially given the plethora of wide-ranging effects – reduced learning and productivity, mental health, and chronic diseases. Health professionals are an important point of contact to educate parents about making healthy food choices for their families and to link patients who are experiencing recurrent hunger to the appropriate services.
References
1. US Department of Agriculture, Economic Research Service. Definitions of food security. http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx
2. 12 July 2023 Joint News Release Rome/New York/Geneva, WHO/UN
3. Men F, Gundersen C, Urquia ML, et al. Association between household food insecurity and mortality in Canada: a population-based retrospective cohort study. CMAJ. 2020;192(3):E53-E60. https://doi.org/10.1503/cmaj.190385
4. Berkowitz SA, Seligman HK, Choudhry NK. Treat or eat: food insecurity, cost-related medication underuse, and unmet needs. Am J Med. 2014;127:303–310
5. Tarasuk V, Mitchell A, McLaren L, et al. Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. J Nutr. 2013;143(11):1785-93. https://doi.org/10.3945/jn.113.178483
6. Tarasuk V, Cheng J, de Oliveira C, et al. Association between household food insecurity and annual health care costs. CMAJ. 2015;187(14):E429-E36. https://doi.org/10.1503/cmaj.150234
7. Riches G. Food banks and food security: welfare reform, human rights and social policy. Lessons from Canada? Soc Policy Adm. 2002;36:648–63. https://doi.org/10.1111/1467-9515.00309.