Trends in Food Insecurity Detailed in America’s Health Rankings® Health Disparities Report

by Rhonda Randall EVP & Chief Medical Officer, UnitedHealthcare Employer and Individual

Food insecurity is a critical public health threat in the United States today and can affect our neighbors, friends and family members. The prevalence of food insecurity varies across the country and can impact Americans’ health and overall well-being differently. Today, there are still far too many barriers to good health, and those barriers are disproportionately experienced by people of color, other historically marginalized groups, and those with lower incomes. Race and ethnicity, gender, geography, educational attainment and income level should not decide one’s access to health care, or the determinants and outcomes that contribute to our overall well-being. But we know they do, and that we all must get involved to solve this. 

UnitedHealth Group’s mission is to help people live healthier lives and help make the health system work better for everyone. Health equity is achieved when every person, regardless of race, place, or circumstance, has the opportunity to live their healthiest life. In our commitment to health equity, this year our foundation produced the first-ever America’s Health Rankings® Health Disparities ReportBuilding on more than three decades of data and reporting from America’s Health Rankings, the report provides a comprehensive portrait of the breadth, depth and persistence of health disparities over time-based on the latest data collected in the years leading up to the pandemic. It highlights staggering disparities in food insecurity.   

The definition of food insecurity that we use in America’s Health Rankings reports is the percentage of households unable to provide adequate food for one or more household members due to a lack of resources. But to provide even more specificity, food insecurity is a social and economic condition where access to food is limited or uncertain. It differs from hunger in that hunger is a physiological feeling. Food insecurity has broad effects on health due to the mental and physical stress that it places on the body. Among women, food insecurity is associated with obesity, anxiety and depressive symptoms, and negative pregnancy outcomes such as low birth weight and gestational diabetes. America’s Health Rankings uses the most recently available data from the U.S. Census Bureau, Current Population Survey Food Security Supplement, 2015-2019.  

Notable Disparities in Food Insecurity Rates 
Even before the COVID-19 pandemic’s impact was felt, large disparities existed in food insecurity.  

  • For example, in 2015-2019, American Indian/Alaska Native households had a rate of food insecurity (26.7%) that is three times higher than that of white households (8.8%).   
  • A person’s level of educational attainment also correlates with food insecurity rates. In 2015-2019, households headed by an adult without a high school education had nearly a six times higher rate of food insecurity (24.8%) than households headed by college graduates (4.4%). 

Many of these gaps widened over the past decade as challenges in food insecurity faced by certain populations worsened over time. For example, American Indian/Alaska Natives experienced a 39% rate increase in food insecurity between 2003-2007 and 2015-2019. In addition, since the 2003-2007 time period, the Health Disparities Report found that food insecurity rates have increased for Americans of every education level – including a 15% increase in households headed by those with less than a high school education and a 19% increase in households headed by college graduates.  

Food Insecurity Impacted by Disparities in Poverty Rates 
Differences in household income contribute to disparities in food insecurity. Prior to the COVID-19 pandemic, notable disparities persisted in poverty rates by education level, race and ethnicity and geography. For example: 

  • In 2015-2019, households headed by those with less than a high school education had almost a six times higher rate of poverty (30.7%) than those headed by college graduates (5.2%).  

Although we’ve seen an improvement in recent years regarding this measure, the nation’s children face particularly concerning rates of poverty. Nationally, 18.6% of children lived in households below the federal poverty level in 2015-2019. 

Addressing Disparities in Food Security to Achieve Healthier Communities 
Overcoming poverty is important to ensuring food security and improving overall health and quality of life for all Americans. The United Health Foundation is working hard to combat many public health challenges, including food insecurity, through partnerships with organizations like Feeding America, providing $1.5 million to help address food insecurity in 2020.  

The data for the Health Disparities Report is available on the America’s Health Rankings website. We encourage you to visit the site and use the data in your work. We hope that the data and insights highlighted in our report help the Feeding America network and others to help their communities take action to reduce hunger. 

Rhonda L. Randall, D.O. is an Executive Vice President and Chief Medical Officer of UnitedHealthcare Employer & Individual. Dr. Randall serves as a senior medical advisor to the United Health Foundation and spokesperson on behalf of America’s Health Rankings. She is a fellowship-trained geriatrician and is board certified in family practice.