Millions of children are facing food insecurity, according to the U.S. Census Bureau. The bureau’s Household Pulse Survey, created to examine the social and economic effects of COVID-19, shows that in July more than 10 million respondents indicated that their households with children sometimes or often did not have enough to eat.
Unemployment and poverty – two long-standing reasons for food insecurity – have led to households having uncertain or limited access to nutritious food. The consequences can have lifelong effects on even the youngest family members, said Dr. Arshed Quyyumi, a cardiologist and director of the Emory Clinical Cardiovascular Research Institute at Emory University in Atlanta.
“Kids are stressed by food insecurity. It’s not just the parents,” he said. “Kids learn how and what to eat because of what their parents did. If you are stuck eating bad choices because you were food insecure as a child, then a lot needs to change fundamentally when you grow up.”
Children who are food insecure face higher risks of health conditions such as anemia and asthma, are more likely to have problems in school and other social situations, and often have more behavioral problems, according to the nonprofit hunger-relief organization Feeding America.
When families can’t afford enough nutritious food to feed everyone in a household, they may have to opt for less-healthy alternatives or skip meals, Quyyumi said. The burden of food insecurity often leads to other health problems, such as obesity, anxiety and sleep disorders. Families with children may also forgo essential expenses like medical care, he said.
“Food insecurity or limited access to good food makes a difference in one’s overall health and the long-term outcomes for people with heart conditions,” Quyyumi said. “Food insecurity is one of the issues facing our patients that deserves increased awareness from doctors and policymakers.”
For a healthy person, a temporary lack of food may cause some suffering, he said. But for those who have heart disease or other underlying health problems, the strain of poor nutrition could be fatal.
According to an American Heart Association report last year, food insecurity is often higher for those with hardening of the arteries and can affect 1 in 2 people who are in the most disadvantaged socioeconomic groups.
A 2019 study in the Journal of General Internal Medicine found that nearly twice as many people had diabetes in the food-insecure group as those who were food-secure. The study of nearly 15,000 U.S. adults ages 24-32 also found food insecurity resulted in higher rates of hypertension, obesity and obstructive airway disease.
People who were food insecure before the COVID-19 pandemic started in March 2020 continue to be disproportionately affected. Feeding America projects that 1 in 8 people and 1 in 6 children may experience food insecurity this year, with significant disparities seen in certain racial and ethnic groups. For instance, Feeding America estimates that 21% of Black people may experience food insecurity, compared to 11% of white people.
Other underlying factors often contributing to food insecurity include income level. structural racism and discrimination, and proximity to grocery stores with affordable and nutritious food. Exploring these problems and finding solutions deserve more attention, Quyyumi said.
“The awareness on social determinants of health has increased over the past year in large part due to Covid-19,” he said. “There is now more of a focus on how certain sections of the public are disproportionately affected and on how interlinked so many of these problems are.”
Tackling food insecurity will require a multifaceted approach, Quyyumi said. This includes funding future research, getting support from policy makers and improving access to local and federal nutrition programs. A study commissioned by the U.S. Department of Agriculture found the Supplemental Nutrition Assistance Program (SNAP) reduced the likelihood of being food insecure by about 30%.
“There are ways doctors can advocate for better care for patients, even though it’s not medicine,” Quyyumi said. “Often the last thing we do as cardiologists is evaluate the social determinants of health when we’re seeing a patient. But more and more we see how outcomes are so dependent on these determinants and on how much social support our patients are getting.”
Another way to create lasting change for the next generation is to focus on the basics, Quyyumi said.
“If you were going to attack one long-term solution to target food insecurity, it’s to improve education,” he said. “If you can get every child educated to a high standard, then you don’t have to worry. These kids will grow up educated, get good jobs and be able to afford nutritious food. If you want to socially change the trajectory, education is where the action needs to be.”