Applying a Health Access Framework to Understand and Address Food Insecurity.

Nasser Sharareh,Andrea S Wallace

doi:10.3390/healthcare10020380

Abstract

The prevalence of food insecurity (FI) in United States households has fluctuated between 10% and 15% for the past two decades, well above the Healthy People 2030 goal. FI is associated with increased use of healthcare services and the prevalence of multiple health conditions. Our current efforts to address FI may be limited by measures that lack granularity, timeliness, and consideration of larger food access barriers (e.g., availability of food providers and lack of knowledge regarding where to obtain food). If the Healthy People 2030 goal of reducing FI to 6% is to be met, we need better and faster methods for monitoring and tracking FI in order to produce timely interventions. In this paper, we review key contributors of FI from an access barrier perspective, investigate the limitations of current FI measures, and explore how data from one nonprofit organization may enhance our understanding of FI and facilitate access to resources at the local level. We also propose a conceptual framework illustrating how nonprofit organizations may play an important role in understanding and addressing FI and its intertwined social needs, such as housing and healthcare problems.

Highlights

Food Insecurity (FI) is the reduction of food intake, disruption of eating patterns, and downgrading the quality and variability of a diet necessary for a healthy life [1]
We developed a Causal Loop Diagram (CLD) to illustrate the causalities among access barriers and the FI system, incorporating nonprofit organizations as actors addressing access barriers, and identifying important feedback loops that could potentially explain the dynamic changes in FI rates
We propose that studying FI through the lens of access barriers could provide more actionable, real-time insights for policymakers and stakeholders seeking to address FI

Summary

Introduction

Food Insecurity (FI) is the reduction of food intake, disruption of eating patterns, and downgrading the quality and variability of a diet necessary for a healthy life [1]. People living with FI are at higher risk of depression, violence, obesity, hypertension, diabetes, substance use, suicide, and lower medication/treatment adherence [3,4,5,6,7,8,9]. FI is associated with higher healthcare costs and increased use of healthcare services [10,11]. Primary attempts to address FI in the U.S are the U.S Department of Agriculture (USDA) nutrition assistance programs, which aim to increase access to healthy food for low-income residents [14]. The largest nutrition assistance program in the U.S is the USDA’s Supplemental Nutrition Assistance Program (SNAP) [15], covering 42.2 million individuals and costing $68 billion in 2017 [16].

Objectives

Methods

Results

Discussion

Conclusion