Food insecurity is defined as the disruption of food intake or eating patterns because of lack of money and other resources.
Any level of food and nutrition insecurity can affect health as food plays important roles in supporting growth and development, preventing disease and enhancing well-being.
Food insecurity and poor nutrition are closely linked, with individuals with the most food insecure are at higher risk of developing obesity, diabetes, hypertension coronary disease, stroke, cancer, and associated conditions.
It was estimated that 2.33 billion people worldwide had moderate to severe food insecurity in 2023, and 864 million had severe food insecurity.
In 2023 864 million people reported having reduced dietary intake for a day or going for at least an entire day without food within the past 12 months because of lack of money or resources.
In 2023 13.5% of US households experienced food insecurity.
In the US persistent effects of structural racism, minority groups, including the American Indian/Alaskan native, Black and Hispanic individuals are more than twice as likely to have food insecurity than white populations.
World Bank-64.5% of the population experience, moderate to severe food insecurity between 2021 and 2023:in the same period the prevalence to moderate to severe food insecurity in low middle income, upper to middle income, and high income countries was 43%, 13%, and 8%, respectively.
While the prevalence of food insecurity decreases with increasing economic development of a country, such economic prosperity does not guarantee food and nutrition security.
Food and nutrition insecurity, contributes to malnutrition and is associated with communicable disease, non-communicable diseases, and poor mental and physical health.
While severe food and nutrition insecurity, which manifest is hunger, is associated with the most serious health consequences, evidence suggests is a dose response association between the level of food and security and poor health outcomes, including sub optimal child development.
Food and nutrition and security can lead to poor physical and mental health through nutritional, psychological, and behavioral pathways by contributing to increased chronic stress and the physiological load on the human body with the potential to alter epigenic information such as telomere length and DNA methylation that appears to be transferable across generations.
Preconceptual and prenatal maternal food and nutrition insecurity characterized by diets that provide insufficient energy may lead to intrauterine growth restriction manifested as low birth weight.
Babies with low birth weight or an increased risk for suboptimal, growth and development, illness and death.
Nutrition insecurity can result from factors beyond food insecurity, and therefore affects a much larger portion of the population, whereas focusing on food insecurity may be on agriculture and food markets rather than on health.
Inadequate diets are linked to epigenetic programming which may lead to increase risk of non-communicable disorders, including cardiovascular disease, obesity, metabolic syndrome, diabetes, depression, and accelerated age in adulthood, termed perinatal programming or the developmental origins of health and disease.
Preconceptual and prenatal, micro, nutrient deficiencies involving iron, folate, iodine, vitamin A, and zinc can affect child development, growth, and immunity in our associated with the development of disease later in life.
A lack of these nutrients combined with the lack of clean water, sanitation, and hygiene, leads to diarrheal diseases which further affects the utilization of food and nutrition, causing malabsorption affect affecting childhood survival, physical and cognitive development and overall potential.
The failure to consume a nutritious diet is increasingly recognized as the largest contributor to the international burden of disease.
The predominant risk factors for international food and nutrition insecurity are: political conflict, climate change, adverse weather events, adverse consequences of international trade, economic instability, social and income inequalities.
Countries affected by one or more of these risk factors have the highest prevalence of food and nutritional insecurity.
Even in the absence of an emergency and with food generally available, a low level of education or no education, poverty, unemployment, or underemployment, or employment in underpaid or precarious work, increases the risk of financial inability to meet household food needs.
Women of childbearing ages age, pregnant women, children, and older adult adults who have a higher requirement for nutrient dense foods than the general population are at increased risk.
Households headed by women and households with children, have a great prevalence of food and nutrition insecurity, and the health status of family individuals affect expenditures, income generation, and the ability to procure food.
Marginalization, domestic and family violence, and discrimination related to racism, sexism, or homophobia can increase the risk of food and nutrition insecurity.
Food insecurity is increased among people who experience discrimination and violence due to race, skin, color, sex, gender identity, migrants, refugees, and indigenous people.
The prevalence of food and nutrition insecurity among indigenous people is six times the size that of the non-indigenous population.
In 2018, an estimated 1 in 9 Americans were food insecure, equating to over 37 million Americans, including more than 11 million children.
In 2019-2020 it was estimated nutritional insecurity affected 10.8% of the US households.
Estimated 13.8 million food insecure US households in 2020.
In 2022, approximately 9% of the international population experienced hunger, an end result of food insecurity, and nearly 30% experienced moderate to severe food insecurity.
Children and adults were food insecure in 7.6 percent of U.S. households (2.9 million households) in 2020.
Estimated that in 2020 the prevalence of food insecurity among African-American/Black households was estimated at 21.7% and among Latin/Hispanic households it was estimated at 17.2%, both substantially higher than the overall estimated prevalence of 13.5%.
About one in 10 children lived in a food insecure household 2019 to 2020 (CDC).
In 2014, 17.4 million U.S. households were food insecure at some time during the year.
Income inequality has increased, with self reported food insecurity disproportionately affecting individuals with lower incomes.
Hunger is a possible outcome of food insecurity.
The U.S. Department of Agriculture (USDA) defines food insecurity as a lack of consistent access to enough food for an active, healthy life.
Hunger and food insecurity are closely related, but distinct concepts.
Hunger refers to a personal, physical sensation of discomfort.
Food insecurity refers to a lack of available financial resources for food at the household level.
Food insecurity is closely related to poverty, but not all people living below the poverty line experience food insecurity.
People living above the poverty line can experience food insecurity, as well.
Food insecurity does not exist in isolation.
Food insecurity is associated with low-income, lack of affordable housing, social isolation, chronic or acute health problems, high medical costs, and low wages.
Food insecurity is associated with social determinants of health and conditions in the environment in which people are born, live, learn, work, play, worship and age.
Food insecurity impacts every community in the United States.
There are four levels of household food security.
Households with high food security and marginal food security make up the food secure category.
Households with low food security and very low food security make up the food insecure category.
Low food security: reduced quality, variety, or desirability of diet, but no indication of reduced food intake.
Very low food security: disrupted eating patterns and reduced food intake.
Food insecurity may be long term or temporary problem.
Food insecurity is influenced by income, employment, race/ethnicity, and disability.
The risk for food insecurity increases when money to buy food is limited or not available: 31.6% of low-income households are food insecure, compared to the national average of 12.3%.
High unemployment rates among low-income populations is associated with high food insecurity.
Similarly, children of unemployed parents have higher rates of food insecurity than children with employed parents.
Black households nearly 2 times more likely to be food insecure than the national average, 22.5% versus 12.3%, respectively: among Hispanic households, the prevalence of food insecurity is 18.5% compared to the national average (12.3%).
Disabled adults may be at a higher risk for food insecurity due to limited employment opportunities and health care-related expenses.
Neighborhood conditions affect physical access to food: redominantly black and Hispanic neighborhoods have fewer full-service supermarkets than predominantly white neighborhoods.
Convenience stores and are more common in such neighborhoods than full-service supermarkets or grocery stores, with foods at higher prices, lower quality, and less variety.
In such neighborhoods transportation options are limited, and the travel distance to stores is greater, with fewer supermarkets.
People living in low-income predominantly black neighborhoods of Detroit travel an average of 1.1 miles farther to the closest supermarket than people living in low-income predominantly white neighborhoods.
Food-insecure adults may be at an increased risk for obesity, and higher rates of chronic diseases.
Food-insecure children may be at an increased risk for negative health outcomes, including: obesity, developmental problems and mental health.
Children who experience hunger and food and security a less likely to perform well in school and to attain a higher education.
Unemployment and underemployment contribute to food insecurity, and adults who lack access to quality food are less likely to achieve and maintain employment.
The levels of hunger in the US are high and increasing with serious health consequences and multi generational effects.
- Food assistance programs, may reduce food insecurity.
Caloric insufficiency has largely been eliminated in the US and greatly reduced globally, but disparities remain in access to healthy and affordable food, at the same time the prevalence obesity in the US has increased significantly.
Food insecurity and lack of access to affordable nutritious food are strongly associated with chronic multiple health conditions including: diabetes, heart disease, fatty liver disease, mental disorders, lower HIV medication adherence, drug and alcohol use, and other chronic conditions.
The COVID-19 pandemic worsened the US food insecurity level, limiting economic opportunity and mobility.
Aside from inadequate quantities of food, there can be compromised dietary quality where there is an overreliance on starchy staple foods, such as rice, bread, potatoes with low intake of high quality protein, sources, and food supplying essential micronutrients.
In societies experiencing food and nutritional insecurity, there is increased consumption of energy dense, hyperpalatable, predominantly ultra processed foods and decreased consumption of fruits and vegetables, resulting in a low diversity diet with poor quality.
Psychological, toxic stress associated with food insecurity, may cause secretion of corticotropin releasing hormone from the hypothalamus and downstream release of corticotropin and cortisol, and can have potential systemic effects, including: growth restriction in children, weight gain in adolescence and adults, insulin resistance, immunosuppression, mental health dysregulation, increasing appetite for hyperpalatable, but often nutritionally sub optimal foods, and the development of eating disorders in high income countries.
Food insecurity may lead to behavioral changes such as forcing trade-offs between food and heating or cooling and between medical care or medications.
With more severe food and nutrition insecurity there are increasingly poor health outcomes.