FOOD INSECURITY WHOS AFFECTED? WHY DOES IT MATTER? Audrey C. - - PowerPoint PPT Presentation

FOOD INSECURITY

WHO’S AFFECTED? WHY DOES IT MATTER?

Audrey C. McCool, EdD, RDN, LD

Learning Objectives

 Session Participants will:  Have increased understanding of the extent of food insecurity throughout the U.S. and in their local area (Vermont).  Recognize that there are multiple causes of food insecurity, not all of which are related to persons’ income level.  Understand that food insecurity impacts not just individuals, but has an impact on the total community, including the health care system.  Appreciate that they have a role in addressing food insecurity in their community. 2

Food Insecurity – What Is It?

 Food insecurity and hunger are NOT the same.

 Hunger: The uneasy or painful sensation caused by a lack of food, or the recurrent and involuntary lack of access to food1

 Hunger is an individual-level physiological condition that may result from food insecurity2; hunger describes the physical pain & discomfort an individual experiences9

 Food Insecurity: The limited or uncertain availability of nutritionally adequate and safe foods or the ability to acquire acceptable foods in socially acceptable ways1

 Food insecurity is a social, cultural, or economic state9  Low food security is indicated by reduced quality, variety, or desirability of diet. Little or no indication of reduced food intake2  Very low food security is characterized by multiple indications of disrupted eating patterns and reduced food intake2

3

What we think of as hunger What is often the hunger reality we don’t see

Indicators of Food Insecurity

20 40 60 80 100 120 Did not Eat Whole Day, 3+ Months Did Not Eat Whole Day Lost Weight Hungry But Did Not Eat Ate Less Than Felt Should Cut of Skipped Meal in 3+ Months Cut Size of Meal or Skipped Meal Could Not Afford Balanced Meal Food Bought Did Not Last Worried Food Would Run Out Percentage of Households Reporting Indicators of Adult Food Insecurity, by Food Security Status, 2014

4

Source: Calculated by ERS using data from the December 2014 Current Population Survey Food Security Supplement2

All households without children that were classified as having very low food security reported at least six

• f these conditions,

and 69% reported seven or more. Food-insecure conditions in households with children followed a similar pattern2

Who Are The Food Insecure?

In 20143,4:

• Approximately 1 in 7 households (14%) were food insecure
• 6% of households had very low food insecurity
• Children were food insecure in 9.4% of households with children
• On average, a food secure household spent 26% more on food than did a

typical food-insecure household of the same size and composition (including food purchased with SNAP program benefits)

• Rates of food insecurity were substantially higher than the national average for

households with:

• Incomes near or below the Federal poverty line
• Children headed by single women or single men
• Black or Hispanic families
• 10% of seniors over age 65 were food insecure

5

Food insecurity exists in every county in the U.S.

Rural Hunger and Food Insecurity

 Rates of rural household insecurity are generally higher than for urban households

 Ironically, many food insecure rural households are in the farm communities whose productivity feeds not only American consumers, but much of the world

 Rural counties account for 43% of all the counties in the U.S.  17% of rural households are food insecure (estimated 3.3 million)  54% of the U.S. counties with the highest rates of food insecurity are in rural areas  62% of the U.S. counties with the highest rates of CHILD food insecurity are in rural areas  17% of rural Americans live below the federal poverty line  46% of people in families with a single female head of household living in rural areas were poor, compared to 37% in the suburban metropolitan areas7

6

Hunger & Food Insecurity in Vermont

 In 2014, 1 in 4 (25%) of the population accessed programs such as the Food Bank or other meal service programs (such as the senior meal programs) for food for themselves or for their family.

 This number included:

 33,900 children  26,010 seniors

 76% of households reported being food insecure

 Vermont Food Bank ethnic demographics:

 88% were White (Caucasian)  1% were Black (African American)  2% Hispanic (Latino)

 18% of households accessing the Vermont Food Bank included a military veteran  24% were children under age 18  17% were seniors (age 60 and older)5 

7

Hunger & Food Insecurity in Vermont

 Health problems and food insecurity go hand-in-hand  Among food insecure households:

 23% had at least one member with diabetes  46% had at least one member with hypertension  56 % reported having to choose between paying for food or for medicine or medical care at least once in the past 12 months  72% reported purchasing inexpensive, unhealthy food because they could not afford healthier food

 Many households had to choose between paying for food or meeting the cost of other needs:

 63% between food or utilities  58% between food or transportation  52% between food or housing  20% between food or education expenses

 As many as 17 – 23% of households reported making these choices every month5 

8

Hunger and Food Insecurity Among Seniors

 Seniors are facing increasing challenges trying to meet their food needs  In 2012, 15.3% of all seniors were food insecure (9.3 million seniors)  From 2001 to 2012, the % of all seniors who were food insecure increased by 44%  From 2001 – 2012, the number of seniors who were food insecure increased by 98% - reflecting the growing population of seniors  In 2012, seniors most at risk for food insecurity had incomes below the poverty line, were Black or Hispanic, and lived alone; 41% were disabled  However, within the food insecure population, in 2012 the majority had incomes above the poverty line, were white, were married, and 60% were between the ages of 60 – 698,9

9

Hunger and Food Insecurity Among Seniors

 Challenges that Increase the risk of food insecurity among seniors include:

 Increasing – sometimes unique – medical needs

 Leading to increased medical costs  Medical conditions possibly requiring modified diet meals

 High incidence of diabetes, cardiovascular disease, and increasing incidence of renal disease  High incidence of dental problems  Increasing mobility challenges – disabilities – arthritis limiting hand movement

 Leading to difficulties in preparing and/or eating food

 Lack of motivation for food preparation or eating – often living alone  Isolation, especially in rural areas – transportation challenges; lack of grocery stores  Living on fixed incomes (social security, retirement programs) as food costs increase

10

Reasons for Hunger & Food Insecurity

 Food Distribution  U.S. Economic System  Political-Agricultural Practices  Substitution of commodity crops for food crops  Heavy exportation of food crops  Demand for bio-fuels  Environmental Factors  Lack of Knowledge4,6 11

POVERTY

Poverty is the principal factor leading to household hunger and food insecurity. However, socioeconomic and political factors often underlie poverty – thus contribute to persons hunger & food insecurity

Reasons for Hunger & Food Insecurity

 Miscellaneous Factors

 Increased Food Costs – Changes in Supply and Demand  Housing  Food deserts  Transportation  Physical Ability  Life Style Choices4,6 12

Strategies Persons Use to “Stretch” Their Food Supply

 Eat food past the expiration date  Purchase food in dented or damaged packages  Purchase inexpensive food, unhealthy food,

• r highly filling foods

 Shop in bulk – select generic brands – use coupons  Water down food or drinks  Adults skip meals – give available food to their children  Eat less at each meal  Avoid food waste  Grow food in a garden  Eat with relatives or friends or a church  Go to food pantries or soup kitchens  Commit petty crime – get a meal in jail  Participate in Federal nutrition programs (SNAP, WIC, Older Americans Meals)1,5

13

Factors Impacting “Food Availability”

 Equipment for Storage and Preparation  Time for Preparation  Time and Cost for Travel to Full-Service Store  Poor Food Quality  Food Variety  Fear of Food Waste1 14

Psychological Impact of Food Insecurity: Disordered Eating Practices

 Cyclical Food Availability – such as from SNAP or WIC program supplements or monthly social security or welfare checks – can lead to disordered eating practices among food insecure persons

 Binge Eating  Hoarding  Food Obsessions  Strong Preferences for Highly Filling Foods  Extreme Avoidance of Food Waste1

15

Food Insecurity, Hunger, and Obesity

A conundrum raising many questions is the relationship between high rates of food insecurity and obesity Why does this relationship matter????

 In the U.S., persons living in the most poverty-dense counties and who have the least education are the persons most prone to

• besity11

 Food insecurity without hunger appears to be associated with

• verweight among women – but not among men12

16

Food Insecurity, Hunger, and Obesity

Several factors may contribute to the food insecurity – obesity relationship  Poor access to fresh food  High rate of sedentariness in low income counties

 Afraid to be active outdoors – high crime and violence rates  Lower availability of parks and recreational facilities  Costs associated with sports and recreational activities

 Increased consumption of energy-dense foods

 Consumption of a constant volume of food – energy density determines amount

• f calories consumed

 Consumption of low cost foods – usually energy dense  Periodic food insecurity leads to over eating when food is available11,12

17

Food Insecurity, Hunger, and Obesity

Contributing Factors, Continued

 Portion distortion  Preferences for sensory satisfying foods (fats/sugars)  Family food preferences and eating/meal practices  Glycemic index – recurring feelings of hunger  Inadequate nutrition knowledge  Excessive vulnerability to external environment  Consuming food in search of comfort  Television11,12

18

Impact of Food Insecurity

 On Children:

 Increased incidence of obesity

 Increased incidence of type II diabetes  Increased incidence of high blood pressure  Increased incidence of asthma  Food insecurity childhood obesity leads to adult obesity

 Higher incidence of hospitalizations and generally poor health  Reduced brain/cognitive development  Lower learning, academic performance, and educational attainment  Increased irritability and anxiety  Increased incidence of fights and school suspensions13

19

Impact of Food Insecurity

 On Seniors

 Lower nutrient intake  Increased risk for chronic health conditions

 Compared to food secure seniors, food insecure seniors are:

 60% more likely to experience depression  53% more likely to report a heart attack  52% more likely to develop asthma  40% more likely to have an experience of congestive heart failure10

 Reduced ability to remain in their own home  Low protein intake can contribute to age-related sarcopenia and contribute to

 Increased potential for falls  Diminished physical strength  Increased frailty  Decreased ability to perform activities of daily living21

 More likely to be seen as senile or losing mental capabilities  Increased likelihood of unplanned weight loss  Increased susceptibility to disease (flu, pneumonia, etc.)

20

Impact of Food Insecurity

 On the Community  Loss of future resource/economic potential

 Children unable to reach full potential – physically, mentally  Adults unable to work throughout their life – diabetes, other physical disabilities

 Food insecurity contributes significantly to the cost of health care within a community14,15

 66% of food bank clients in US had to choose between food and medical care

 Lack of medical care contributes to illness and disability, loss of income, inability to attend school, loss of productivity within the community  Excessive use of community funded hospital emergency rooms as primary care facilities

 10.2% incidence of diabetes in food insecure households, 16.1% in very insecure households – compared to 7.4% in food secure households (1999 – 2004)16  In Canada, health care costs 49% higher for food insecure persons than for food secure persons; 121% higher for very low food security persons14  Excessive hospital readmissions  Increased need for institutional care of seniors

21

What Can We Do? – Diabetes Programs

DIABETES is one of the most critical and rapidly growing health programs associated with food insecurity16,17,18

 Encourage local food banks to learn about Feeding America’s successful diabetes intervention program and to initiate a similar program16,17,18  If no food bank is in your community, talk with local food pantries or other

• rganizations with meal programs – Salvation Army, churches, etc. – to see

what you might do with them to initiative a diabetes intervention program.

22

Source: Feeding America17

What Can We Do? – Food Waste

20

 Food waste is a component of food loss.

 Food Loss: “The edible amount of food, postharvest, that is available for human consumption but is not consumed for any reason. It includes cooking loss and natural shrinkage, and loss from mold, pests, or inadequate climate control.”

 USDA’s definition of food waste:

 “Food waste is a component of food loss and occurs when an edible item goes unconsumed as in food discarded by retailers due to color or appearance and plate waste by consumers.”

 Approximately 40% of all food produced in the U.S. goes to waste (2012 report)  Average American throws away 50% more food today than in 1970

 Average American throws away about 300 pounds of food each year – or about 1200 calories per person wasted every day.  Dairy products account for 19.1% of waste; vegetables for 19.0%; fruit for 13.9%; and grain products for 13.9%  Total waste for all Americans: 133 billion pounds of food with net worth >$130 billion

23

What Can We Do? – Food Waste THINK HOW MUCH FOOD INSECURITY AMONG U.S. FAMILIES COULD BE REDUCED IF WASTED FOOD COULD BE SAVED AND THE SAVED EDIBLE FOOD COULD BE DISTRIBUTED TO PERSONS IN NEED OF FOOD!!

24

What Can We Do? – Food Waste

20

 Hidden costs of food waste

 Excessive land fill requirements  Excessive use of water  Contribution to greenhouse gas production  Disposal fees for waste removal

 44% from residential food waste disposal  33% from restaurants  11% from grocery stores

 Portion distortion

 Contributes to obesity and related economic costs – health care, etc.  Contributes to restaurant waste, as well as residential food waste

25

Berries recovered from supermarket dumpster

What Can We Do? – Food Waste

20

26

Food Recovery Hierarchy developed by the USDA and the EPA

What Can We Do? – Food Waste

20

 Ways to reduce food waste – businesses and organizations

 Buy less food – better calculations of what’s actually needed  Buy local  Rescue/Recover food from farms – use “ugly” foods  Donate extra food to local organizations  Establish or participate in composting programs  Created employee awareness of amount of wasted food

27

What Can We Do? – Food Waste

20

 Ways to reduce food waste – Consumers

 Consumer education

 How to shop for food  Understanding “use by”, “sell by”, “best by”, etc. labels and applicability to varied types of food products

 “Shop” the refrigerator before going to the store

 Designate one or more meals weekly as “use it up” meals

 Rotate foods in the refrigerator and in the cabinets – use oldest products first  Take restaurant leftovers home

 Combat portion distortion – divide the food into “eat here” and “take home” portions before starting to eat at the restaurant  Refrigerate “take-home” food within 2 hours  Eat the “take-home” food within 3 -4 days or freeze it for later use

 Track what’s being tossed into the trash or put down the garbage disposal

 If see same foods consistently tossed – eat them sooner, buy less of them, incorporate them into more recipes, or freeze them

28

What Can YOU Do?

 Advocacy – Every voice counts

 Help keep Congress reminded of the need to protect anti-hunger and sustainable agriculture programs  Academy of Nutrition and Dietetics Grassroots Manager. http://www.eatrightpro.org/resource/advocacy/action-center/local- advocacy/grassroots-manager.

 Programs of value to aid with food insecurity19

 Supplemental Nutrition Assistance Program (SNAP)

 Supplemental income for 47 million low income persons

 Women, Infants, and Children (WIC)

 Provides supplemental foods for pregnant women and children

 The Emergency Food Assistance Program (TEFAP)

 Supplemental food for emergency situations – provided through food banks

 Commodity Supplement Food Program (CSFP)

 Provides USDA foods to 575,000 low income seniors

 Fresh Fruit and Vegetable Program (FFVP)

 Provides funds for free F&V snacks for school children in low-income districts

 Conservation Stewardship Program (CSP)

 Provides funding for farmers & ranchers who help conserve natural resources

 Environmental Quality Incentives Program (EQIP)

 Provides incentives for farmers & ranchers to implement conservation practices

29

What Can YOU Do?

 Get to know your community  Educate

 Teach nutrition education classes  Do grocery store tours – teach how to shop  Develop or share educational materials

 Get involved with community organizations, committees with a focus on food – ask how you can help  Volunteer

 Donate time, skills, resources

 Participate in or host a food drive  Donate – your employer as well as yourself

30

Kids Eat Right

http://www.kidseatright.org.  The Academy of Nutrition and Dietetics

 Academy of Nutrition and Dietetics Foundation

 Future of Food Initiative  Kids Eat Right Program

have developed many resources, including tool kits for education regarding: Hunger in Our Community What We Can Do Toolkit http://www.kidseatrightvolunteer.org/programs/kidseatright/activities/con tent.aspx?id=6442474975. Tossed Treasures. How We All Can Waste Less Food. http://www.kidseatrightvolunteer.org/programs/kidseatright/activities/con tent.aspx?id=6442486837. See the conference website for handout samples from these two tool kits.

31

References



1Academy of Nutrition and Dietetics. Contributors and Effects of Food Insecurity:

Nutrition and Beyond. Kids Eat Right Webinar Series http://www.eatrightfoundation.org/Foundation/content.aspx?id=6442484076. Accessed 1/26/2016. 

2USDA Economic Research Service. Definitions of Food Insecurity.

http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the- us/definitions-of-food-security.aspx. Accessed 3/20/2016. 

3World Hunger Education Service. Hunger in America: 2015 United States Hunger and

Poverty Facts. http://www.worldhunger.org/articles/Learn/us_hunger_facts.htm. Accessed 1/23/2016. 

4Feeding America. Hunger and Poverty Facts and Statistics.

http://www.feedingamerica.org/hunger-in-america/impact-of-hunger/hunger-and- poverty/hunger-and-poverty-fact-sheet.html. Accessed 1/23/2016. 

5Hunger in America. Vermont Foodbank.

http://www.vtfoodbank.org/About/AboutHunger/HungerinAmerica.aspx. Accessed 1/23/2016.

32

References



6Grace Communications Foundation. Food Security & Food Access.

http://www.sustainabletable.org/280/food-security-food-access. Accessed 1/23/2016. 

7Feeding America. Rural Hunger Facts.

http://www.feedingamerica.org/hunger-in-america/impact-of- hunger/rural-hunger/rural-hunger-fact-sheet.html. Accessed 1/23/2016. 

8Ziliak, J.P. & Gundersen, C. The State of Senior Hunger in America 2012: An

Annual Report. National Foundation to End Senior Hunger, 2014. 

9Strickhouser, S., Wright, J.D., & Donley, A.M. Food Insecurity Among Older

• Adults. AARP Foundation. Original publication 2014, 2015 Update.

http://www.aarp.org/content/dam/aarp/aarp_foundation/2015-PDFs/AF- Food-Insecurity-2015Update-Final-Report.pdf. Accessed 1/23/2016. 

10Spotlight on Senior Health. Feeding America.

http://www.feedingamerica.org/hunger-in-america/our-research/senior- hunger-research/spotlight-on-senior-health.html. Accessed 3/21/2016.

33

References



11Levine, J.A. Poverty and Obesity in the U.S. Diabetes. Nov 2011;60:2667-8.



12Drewnowski, A & Specter, S.E. Poverty and Obesity: The Role of Energy

Density and energy Costs. Am J Clin Nutr. 2004;79:6-16. 

13Academy of Nutrition and Dietetics. Hungry & Overweight. How Is It

Possible?. Kids Eat Right Webinar Series. http://www.eatrightfoundation.org/Foundation/content.aspx?id=644248407

• 5. Accessed 1/26/2016.



14Feeding America. How Food Insecurity is adding to Our Health Care

• Costs. http://www.feedingamerica.org/hunger-in-america/news-and-

updates/hunger-blog/how-food-insecurity-is-adding.html. Accessed 3/21/2016. 

15Feeding America. Community Health and Nutrition in America.

http://www.feedingamerica.org/about-us/helping-families-in- need/nutrition-initiative/. Accessed 3/21/2016. 

16Gucciardi, E, Vahabi, M, Norris N, Del Monte, J. P., Farnum, C. The

Intersection between Food Insecurity and Diabetes. Curr Nutr Rep, (2014 3:324-332.

34

References



17Feeding America. Intervention Trial for Health: Diabetes.

http://www.feedingamerica.org/hunger-in-america/our- research/intervention-for-health-diabetes/. Accessed 1/23/2016. 

18Leligman, H.K., Lles, C., Marshall, M.B., et al. A Pilot Food Bank Intervention

Featuring Diabetes-Appropriate Food Improved Glycemic Control Among Clients in Three States. Health Affairs, 2015;34(11):1956-1962. doi:10.1377/hlthaff.2015.0641. 

19Copenhaver, A. & Miller, A.M. Changing the Way We Look at Agriculture:

Opportunities for RDNs. Webinar presented by the Academy of Nutrition and Dietetics, 1/26/2016. http://www.eatrightfoundation.org/Foundation/content.aspx?id=644248680

• 3. Accessed 1/26/2016.



20Vogliano, C. & Brown, K. The State of America’s Wasted Food &

Opportunities to Make a Difference. Academy of Nutrition and Dietetics

• Foundation. http://www.eatrightfoundation.org/foundation/futureoffood/.

Accessed 3/18/2016. 

21Golan, K. Dietary Protein and Sarcopenia Prevention. The Spectrum.

Healthy Aging DPG Newsletter. Academy of Nutrition and Dietetics, 2016 Winter: 6-7.

35

Additional Resources

 Bhattacharya, J, Currie, J, & Haider, S. Poverty, Food Insecurity, and Nutritional Outcomes in Children and Adults. J Health Econ. 2004 Jul;23(4):839-62.  Academy of Nutrition and Dietetics Foundation. Future of Food Initiative. http://www.eatrightfoundation.org/foundation/futureoffood/.  Academy of Nutrition and Dietetics Foundation. Future of Food Initiative; Future of Food Webinar Recorded Webinars. http://www.eatrightfoundation.org/foundation/futureoffood/. Accessed 1/23/2016.  Academy of Nutrition and Dietetics Foundation. Hunger in Our community. What We Can Do About It Toolkit. http://www.kidseatrightvolunteer.org/programs/kidseatright/activities/content.aspx? id=6442474975.  Vogliano, Chris & Brown, Katie. The State of America’s Wasted Food. Academy of Nutrition and Dietetics Foundation, 2016.

36

Additional Resources

 Community Health and Nutrition in America. Feeding America. http://www.feedingamerica.org/about-us/helping-families-in- need/nutrition-initiative/. Accessed 3/21/2016.  Child Hunger. Feeding America. http://www.feedingamerica.org/hunger- in-america/impact-of-hunger/child- hunger/?_ga=1.172750507.943782917.1408220980. Accessed 3/21/2016.  True Cost of Hunger Panel Illuminates Health Risks of Poor Nutrition. Feeding

• America. http://www.feedingamerica.org/hunger-in-america/news-and-

updates/hunger-blog/true-cost-of-hunger-panel.html. Accessed 3/21/2016.  Senior Hunger Research. Feeding America. http://www.feedingamerica.org/hunger-in-america/our-research/senior- hunger-research/. Accessed 3/21/2016.  Academy of Nutrition and Dietetics. Nourish to Flourish Infographic. http://www.eatright.org/resource/food/resources/eatright- infographics/nourish-to-flourish-infographic.

37

Additional Resources

 USDA Food and Nutrition Service. Supplemental Nutrition Assistance Program (SNAP) rules and regulations. http://www.fns.usda.gov/snap/federal-register-documents.  Crawford, P.B. & Webb, K.L. Unrageling the Paradox of Concurrent Food Insecurity and Obesity. Am J Prev Med. 2011;40(2):274-275.  Dammann, K.W. & Smith, C. Factors Affecting Low Income Women’s Food Choices and the Perceived Impact of Dietary Intake and Socioeconomic Status on their Health and Weight. J Nutr Educ Behav. 2009; 41(4):242-253.  Lohman, J.J., Stewart, S., Gundersen,C., et al. Adolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family

• Stressors. J of Adolescent Health. 2009;45(3):230-237.

 University of Nebraska-Lincoln Extension Service Website. Https://food.unl.edu/fnh  Lovefoodhatewaste web site. http://www.lovefoodhatewaste.com/.

38

Organizations Concerned with Hunger

 The Root Cause Coalition: Looks at hunger as a public health issue rather than a social/economic issue.  Sees hunger as a national health issue that is more than a lack of food –

 Sees hunger as encompassing insufficient access to health nutritious food which leads to higher instances of obesity, diabetes, heart disease, and many chronic illnesses

 Founded by the AARP Foundation. Root Cause Coalition. http://www.rootcausecoalition.org/.

 Feeding America. http://www.feedingamerica.org/.  Bristol-Myers Squibb Foundation. Together on Diabetes. http://www.bms.com/togetherondiabetes/partners/Pages/default.aspx.  Share Our Strength. No Kid Hungry. http://www.nokidhungry.org.  Academy of Nutrition and Dietetics. Kids Eat Right Program. http://www.eatright.org/resources/for-kids/. (http://www.kidseatright.org.)  Feeding America’s Healthy Food Bank Hub. http://healthyfoodbankhub.feedingamerica.org/.

39

THANK YOU ANY QUESTIONS??

Audrey C. McCool, EdD, RDN, LD, FAND 806-698-6956 bmccool@earthlink.net

FOOD INSECURITY

WHO’S AFFECTED? WHY DOES IT MATTER?