The White House hopes to end hunger by the end of the decade and reduce the burden of disease-related health issues, President Biden said during a Conference on Hunger, Nutrition, and Health—the first of its kind in more than 50 years.
The announcement comes in the wake of historic high prices that are making it challenging for Americans to access the nutritious foods needed to stay healthy—in August, food prices were 11.4% higher than they were in August 2021, the U.S. Department of Agriculture reported.
“The national strategy recognizes the critical role that nutrition plays in our health and our healthcare system, and it acknowledges that…we have to give families the tools to keep them healthy,” Biden said at the conference.
In 2021, about 13.5 million U.S. households faced food insecurity, meaning they weren’t able to get enough food or were unsure if they would be able to have access to the food they needed. Not only do these Americans face hunger as a health issue, but research has shown that lower food security is associated with a higher likelihood of some chronic diseases, including cancer, asthma, and diabetes.
Here’s what experts have to say about hunger and its connections to health, as well as who may be facing poor health as a result of limited access to nutritious foods, and in the face of inflated prices, whether Biden’s plan is enough to tackle the issue.
Hunger and food insecurity are dangerous to our overall health, but the consequences of not eating a nutritious diet are much further reaching than an empty stomach. People who struggle to afford the food they need often end up purchasing food that’s less nutritious, either because it’s cheaper or because it’s generally more filling.
“Filling your cart up with healthy foods, it typically does cost more than a cart full of highly processed foods,” Erica Kenney, ScD, MPH, assistant professor of public health nutrition at the Harvard T.H. Chan School of Public Health, told Health.
Not only are healthier foods more expensive in general, but fruits and vegetables are also more expensive per calorie, Kenney explained—meaning you have to buy and consume more of them to feel full.
“If your goal is really to make sure that you're keeping yourself and your kids from feeling hungry, you might be opting for stuff that is cheaper per calorie,” she said. “You'd have to buy a lot more fruits and vegetables to get the same kind of caloric load.”
Because more nutritious foods are often unaffordable for many people—especially with heightened food prices due to inflation—it’s not unusual for consumers to make swaps for foods that are less nutritious in order to stretch their dollar a bit further. The result is poor nutrition that can lead to health risks, including high blood pressure or obesity.
If a person is hungry or unsure whether they can feed themselves or their family, they may also experience high levels of stress which can create further health issues.
“Psychologically, those stresses might lead us to binge on certain things when we're able to, or to stock up on things that are storable that might be more energy dense,” Sean Cash, PhD, Bergstrom Foundation professor of global nutrition at the Tufts University Friedman School of Nutrition Science and Policy, told Health. “Physiologically, there's evidence to suggest that our bodies also react to these stresses and changes in ways that may be bad for our long term health.”
Because having access to healthy foods is much more difficult for people who experience food insecurity, large health disparities often pop up. One example of this may be in death rates of those with diabetes based on location, Sagar Dugani, MD, PhD, MPH, physician and assistant professor of medicine at the Mayo Clinic, explained.
Dr. Dugani published a study in September, which found that between 1999 and 2018, the mortality rate for diabetes was much higher for people in rural areas than for people in urban areas. Furthermore, over the course of the last two decades, the rate of people dying from diabetes in rural areas has remained relatively unchanged, even though it has declined in urban areas.
The study didn’t look at the causes behind this exactly, but Dr. Dugani said that nutrition and food insecurity likely plays a major role.
“There are a lot of [rural] counties that have food deserts or are food deserts, they have lower access to fresh vegetables, fresh fruits, they have lower access to quality food,” Dr. Dugani told Health.
A lack of access to healthy foods—whether it be because of price or physical distance—can make it harder for people to ward off obesity, which is a risk factor for type 2 diabetes.
“There's been a focus on the phrase here—[to] talk about nutrition security, not just food security. To think beyond calories,” Cash said.
Unlike other things that people can cut back on during times of economic hardship, food is not one of them, Cash explained. When wages don’t keep pace with the cost of food prices, it puts families in a situation where they have to buy cheaper, more filling food, in addition to possibly visiting charitable food organizations. But these organizations don’t always offer the most nutritious food either, Kenney said.
With limited options for individuals, Biden announced a partnership with philanthropic organizations and private companies to address the issue of food insecurity and the chronic disease that often follows. Over 100 different organizations pledged a combined over $8 billion to fighting hunger with donations to charities or their own nutrition programs.
There are other efforts that the White House has implemented in latest years that could address food insecurity too, Biden added. His child tax credit—included in the 2021 American Rescue Plan—somewhat eased the burden of buying groceries for families, and should be expanded, Biden argued. This could be doubly helpful, as many parents often skip out on meals themselves in order to provide for their kids, Cash explained.
Biden also pointed to updated allowances for SNAP benefits (food stamps) which were meant to better reflect the cost of living in 2022. Those changes went into effect on Saturday.
Additionally, the Food and Drug Administration (FDA) has proposed a change to which foods can be labeled as healthy, in line with Biden’s conference and the larger goal of “helping consumers Boost nutrition and dietary patterns to help reduce the burden of chronic disease and advance health equity.”
Though Cash and Kenney say Biden’s plan is certainly a step in the right direction, the notion that we can end food insecurity and the chronic health disparities it causes by the end of the decade seems out of reach.
“Every little bit is going to help. I do think that in the long term, food insecurity and hunger are sort of just one symptom of what happens when folks are in poverty,” Kenney said. “It’s not going to go away if folks can’t earn living wages.”
Even with the increase in SNAP benefits and the possibility of a child tax credit extension, inflation is still an immense burden on people’s budgets that may not be subsiding soon.
“If we are to promote a healthy lifestyle, which includes nutrition, high quality food, less processed foods, then inflation can be a major barrier for people being able to access all of these,” Dr. Dugani said.
Yet another way inflation creates obstacles to accessing healthy food is by making gas prices higher—which means people may not be able to travel long distances to visit grocery stores, Dr. Dugani added. It may also make the cost of medicines more steep and both of these challenges could make chronic disease worse, especially if inflation continues to be an issue for months or years to come.
Another important aspect of food insecurity and nutrition is changing public opinion, Cash explained. Federal programs will certainly help, but not if people can’t get into the habit of eating healthy.
“Some of this [is] changes in norms, and what has been considered good food and how we've been talking about communicating what good food is—marketing drives a lot of that conversation,” Cash said. “That often sets norms in ways that make it harder for people to maybe make the best choices nutritionally.”
While many factors tied to eating healthy are beyond the individual’s control—because of issues surrounding price, physical access, marketing campaigns, or other factors—there are some things people can do in the meantime to try to eat as healthy as possible while on a tight budget.
Canned or frozen fruits and vegetables are good options because they’re frequently less expensive than fresh options, Kenney explained, and beans can be a good substitute for meat, as they’re a good source of protein. But even these things may not be feasibly worked into people’s diets when they’re facing food insecurity, and that’s okay.
“At the end of the day, folks who are experiencing food insecurity need to feed themselves and they need to feed their families,” Kenney said. “So these are all things that people can do, but it's still quite challenging to do in practice.”
The government’s attempt at solving the problem—or at the very least, making concerted efforts to address it for the first time in decades—should bring a larger spotlight to the issue of food insecurity, and the millions of people that are affected by it. Framing the issue of hunger as a medical issue could take the conversation in a more productive direction, especially as officials reinforce the fact that food insecurity is more than just hunger, it’s also a matter of health and mortality.
“I did really like the food as medicine focus of the conference as well,” Kenney said. “Getting people to think about it more directly in terms of how it can influence health and health care costs, and relating it back to what happens in the doctor's office, might be a solution to sort of get folks a little bit more invested in changing it.”