Vulnerable populations disproportionately affected by food security, despite public programs

Under Section 743 of the Consolidated Appropriations Act, 2014 (P.L. 113-76), Congress directed the U.S. Department of Agriculture's Food and Nutrition Service (FNS) to contract with a nonprofit research organization to prepare a report on the current and prospective scope of hunger and food security in America.

The report developed by RTI International will serve as a jumping off point for the National Commission on Hunger, and provide the president, Congress, and the public with a deeper understanding of the myriad risk factors that influence the food security of Americans. In addition, the Act provides support for a 10-member National Commission on Hunger to develop policy and program recommendations that reduce and prevent hunger and food insecurity.

"Our review of this body of research strongly suggests that food insecurity remains a substantial and intractable problem in the United States," said Stephen Beaulieu, director of RTI's Center for Health and Environmental Modeling and the project's principal investigator. "We found that food insecurity increased significantly at the start of the Great Recession and remains at historically high levels. Despite public, private, and community responses to food insecurity, these disturbing trends suggest that we lack a fundamental understanding of the landscape of factors that influence the rates of food insecurity. These rates ultimately have serious health and economic consequences on millions of Americans."

The USDA refers to food insecurity as the limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to obtain food in socially acceptable ways. Risk factors for food insecurity include socioeconomic status, rising energy and food prices, high housing costs and unemployment rates.

To produce the report, RTI conducted a comprehensive literature review and environmental scan of research on food insecurity from 2008 to the present time. The report examines key determinants, consequences and responses to food insecurity, while establishing a framework to guide the development of policy and programming recommendations.

Twenty percent of U.S. households with children (7.8 million households) experienced food insecurity in 2012; in half of those households, only adults were considered food insecure because adults often shield children from food insecurity. In the other half (3.9 million households), both children and adults were food insecure.

According to the report, food insecurity has broad social consequences for children, adults, and senior adults. For children, experiencing food insecurity can result in near-term developmental delays and poor health outcomes, longer-term educational setbacks, and negative impacts on the U.S. economy when educationally unprepared children become unprepared members of the labor force.

For adults, experiencing food insecurity can result in poor health status, leading to illness and development of chronic diseases, and can contribute to mental health issues such as depression. Adults experiencing food insecurity may also be less prepared for a competitive workforce because of diminished development of human capital, lowered productivity and more sick days.

Seniors experiencing food insecurity may have accelerated declines in health and cognitive function and increases in chronic disease development. Poor health status can increase health care usage (and thus, potentially increase costs to Medicare and Medicaid) and can further stress an already burdened health care system.

"Food insecurity imposes both direct costs such as food assistance programs and health care, and indirect costs such as worker absenteeism, on society. Thus, food insecurity impacts not only those who are at-risk, but the nation as a whole," Beaulieu said. "Hunger impacts productivity, public education and health care costs."

The report also includes potential strategies to reduce and prevent food insecurity, including maintaining and strengthening federal food and nutrition assistance programs, improving economic security through lower-middle income employment, and improving the affordability of housing and health insurance.

Throughout the next year and a half, RTI will support the bipartisan National Commission on Hunger in their deliberations that, ultimately, will lead to policy/program recommendations and innovative strategies that will reduce or prevent hunger and food insecurity.

The full report is available online at: http://www.rti.org/pubs/full_hunger_report_final_07-24-14.pdf