Food nourishes us, but it does so much more

Quick Summary

Robin Stanton, MA, RDN, LD, is a Nutrition Consultant with Oregon Health Authority’s Public Health Division in the Maternal & Child Health Section. “Food is connection and celebration, linking us to family and community. When we don’t have enough healthy food, we have poorer physical and mental health, and children have worse health and educational outcomes.”

Everyone needs nourishment to be healthy, productive and engaged. Food is fuel for our bodies and brains; food and water are very basic essential needs for everyone to not only survive but thrive. Healthy food during pregnancy sets the foundation for the developing child. Food is critical for children to support their growth and development – to nourish healthy bodies, and develop brains for learning, social and emotional health, and really, lifelong health.

Early in my nutrition career I was struck by the significant impact food insecurity has on children and their families, especially when families are not able to afford foods needed to manage their child’s disease. Parents face so many barriers like having to drive long distances to a grocery store once a month, not being able to store fresh food because they don’t have a refrigerator, or often skipping meals so their children can eat. The toll of food insecurity on struggling families goes far beyond the health impacts. For children, their educational outcomes are poorer as well.

What does food security mean?

The definition most often used to measure how people are faring with food security comes from the United States Department of Agriculture (USDA):

  • Food security means access by all members of a household at all times to enough food for an active, healthy life. At a minimum, food security includes:
    • The ready availability of nutritionally adequate and safe foods.
    • Assured ability to acquire acceptable foods in socially acceptable ways, meaning without resorting to emergency food supplies, scavenging, stealing or other coping strategies.
  • Food insecurity is the limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.

The definition has evolved over the last few decades. We are experiencing another shift that looks at nutrition quality more intentionally and this includes culturally appropriate foods. Because diet-related diseases continue to increase, it’s important to not just look at calories. Currently, there is not a standard federal definition for “nutrition insecurity.” Some experts have proposed “nutrition security,” to mean consistent access, availability and affordability of foods and beverages that promote well-being and prevent (and if needed, treat) disease.

Food insecurity is associated with poor diet and nutrient deficiencies, depression and anxiety – all of which lead to poorer overall health. Chronic food insecurity is linked with increased risk for diet-related chronic diseases like type 2 diabetes, obesity and cardiovascular disease. People with food insecurity also face stigma, which I have seen first-hand when shopping with a family member on SNAP (Supplemental Nutrition Assistance Program); I sometimes notice impatience or rudeness from others when shoppers use their electronic benefit card.

Food security may not be constant

Food security and insecurity are really a continuum – from having enough healthy food, to reduced quality and variety, worry about running out of food, reducing food intake, and then not having enough food. Further, not everyone in a household may experience food insecurity in the same way. Food insecurity is usually recurrent but not constant; it ebbs and flows for a household.

Steps of food insecurity
1. A family may run out of SNAP, or wages can spike up and down.
2. The family might buy cheaper foods or worry about having enough to eat.
3. A parent may skip meals to make sure their children have enough food.
4. The worst case is very low food security (or hunger) when no one in the family is getting enough to eat.

Food is a somewhat flexible expense compared to other basic needs – so when there are not enough household resources, people are forced to choose between other necessities like medication, energy bills, childcare, transportation and housing. Food insecurity is closely linked with housing instability, along with unemployment and underemployment.

The pandemic is highlighting disparities

Now, the pandemic is only adding complications to an already tough situation. When it started, there was an unprecedented spike in food insecurity – doubling overall and tripling for children. In response to the crisis, the federal government provided a substantial increase in many types of support for people, including nutrition assistance such as additional cash support, program flexibility and waivers.

It’s easy to see how eating habits have changed during the pandemic, with barriers to physical activity for many; for example, when children weren’t attending school in-person, they missed out on physical education and sports. This can result in weight gain, and indeed obesity rates have increased across the country. Having a chronic disease might make it more difficult for individuals to get healthy foods and be able to manage their disease and having higher health care costs strains household budgets.

Mom and kids in the produce aisle of the store

Food and nutrition security is not equitable across groups of people. The pandemic highlighted disparities already with us. I think many of us expected to see a greater impact on hunger overall; however, data show that the prevalence of food insecurity for the past year was relatively unchanged for the overall population. Truly, all the federal legislation helped avert a worse crisis. However, it appears that racial and ethnic disparities increased, with some groups facing a lot more hardship over the past year – particularly households with children, and Black and Hispanic households. Older adults and people with disabilities have increased risk for food insecurity as well.

Food insecurity is one of many disparities that stem from racial injustice

The USDA has described low access to food as food deserts, but that phrase is based only on geography and the prevalence of retail food outlets. Disinvestment in communities of color and residential segregation have resulted in unequal access to healthy food – this has been called “food apartheid.” Food apartheid looks at the whole food system beyond geographic access to include the racist policies and practices that are in place. For example, neighborhoods of color have fewer grocery stores and are exposed to more predatory marketing of unhealthy food and transportation corridors like freeways that disrupt Black neighborhoods. All of this destroys vibrant communities and changes the food landscape.

Look at the I-5 freeway through North and NE Portland as a good example of urban planning and housing policy that have helped create “food apartheid” in U.S. cities. The development of these areas of limited healthy food options has a long history tied to practices such as redlining – when the private sector and government conspired to restrict mortgage lending to Black and other homebuyers of color.

Oregon is doing better than other states

Oregon’s rate of food security has improved significantly over the past decade. This is likely due to many factors: Increased employment and wages after the 2008 recession; increased advocacy, outreach and access to nutrition assistance programs like SNAP; a coordinated food bank system and community-based organizations that provide support such as improving access to healthy and culturally appropriate food, such as community gardens. I am a member of the Nutrition Council of Oregon, which includes representation from many programs addressing food security. It has been a great benefit for the state to have this network to collaborate on food and nutrition policies and programs that affect Oregonians.

U.S. Households by Food Security Status in Oregon, 2018-2020
Food secure = 90.8%
Food insecure = 9.2%
within food insecure category is
Households with very low food insecurity = 3.9%
Households with low food insecurity=5.3%

Still, 9.2% of Oregon’s households experience food insecurity, roughly equivalent to the total populations of Albany, Eugene and Salem combined. But certainly, the cost of food varies across Oregon. To explore individual counties in Oregon or see how Oregon compares with the rest of the country, check out this interactive “Map the Meal Gap” online resource.

It really comes down to this: Every person deserves food that is healthy and affordable. Food and nutrition insecurity in our communities is closely linked with the social determinants of health like housing, employment and transportation. It’s up to all of us to make sure our food system ensures equity for all – from farmer to consumer.

Look for Part II of Robin Stanton’s blog on food security. Next time she will explore food sovereignty and how a focus on local control of the food system can benefit Black and tribal communities, as well as look at the many resources Oregon has to fight food insecurity.

Robin Stanton, MA, RDN, LD, is a Nutrition Consultant with Oregon Health Authority’s Public Health Division in the Maternal & Child Health Section

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