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Why Should We Think About Food Insecurity and Health?

Social determinants of health, such as access to healthy foods, play an important role in disease prevention, health status and health outcomes. An estimated 20 percent of a person’s health status is predicted by health care services such as visiting a doctor. Socioeconomic factors such as location (zip code), food insecurity and health behaviors (e.g., smoking status, BMI) are estimated to play a much larger role [i].

Food insecurity is known to impact health status, including putting individuals at greater risk for chronic diseases, such as diabetes, hypertension, and kidney disease.  Individuals with diet-sensitive chronic disease and food insecurity experience more difficulties managing their health, leading to more health complications, more emergency room usage, hospital stays and readmissions and ultimately higher health care costs. New research shows that food insecure patients cost the health care system an average of $1,863 per year, or $77.5 billion in additional health care expenditure annually.

In an effort to improve the health of patients and to reduce health care costs, many health care providers and payers are considering ways to effectively address food insecurity and other social determinants of health as “upstream” interventions. With their connections to the community and infrastructure to connect individuals and families to healthy food, food banks and other community based organizations can serve as good partners in these efforts toward health promotion.


Getting Started

There are many different partnerships that health care partners and food distribution organizations can forge to address specific health issues that affect your community. Start understanding the main health issues in your community by exploring these questions:

  • Who are the key health care organizations in your community?
  • What are the priority health issues in your community? How does food insecurity fit with the identified priorities of the hospital, as determined by Community Health Needs Assessment and Community Health Improvement Plans?
  • What other problems are the health care providers trying to solve? How can improving food access play a role?

For more about the Community Health Needs Assessment Process, see the Public Health Institute Report: Making Food Systems Part of Your CHNA and the Health Care Without Harm Healthy Food Playbook.

Resources from Feeding America’s “Food Banks as Partners in Health Promotion” Series

Types of Partnership Activities

Around the country, community based organizations such as food banks are finding success with partnerships to address the food insecurity and health needs of their common patients and clients. Early food bank-health care partnership activities address food insecurity as a social determinant of health, or link health care partners with food insecure people to support the health and health care access priorities of the community. Those food bank-health care partnership activities fall into three main categories:

Addressing Food Insecurity in Health Care Settings

Addressing Health at Food Distribution Sites

Addressing Health Care Coverage Needs


Evaluating Food Bank and Health Care Partnership Activities

Evaluation of partnership activities will have two components:

  • Evaluation of the impact of interventions on food insecurity status, diet quality, and the health status of the patient.
  • Evaluation the success of the process, including food insecurity screening activities, the referral processes, and other elements of the partnership to support the replication and scaling of these efforts.

One framework to consider utilizing is the RE-AIM framework, which was designed to incorporate research and evaluation into public health programs and initiatives.

Sources

  1. Berkowitz, S. e. (2017). Food Insecurity and Health Care Expenditure in the United States, 2011-2013. Health Services Research, 10.1111/1475-6773.12730.

  2. Institute for Clinical Systems Improvement. Going Beyond Clinical Walls: Solving Complex Problems (October 2014

  3. Kangovi, S. (2011). Hospital readmissions - not just a measure of quality. JAMA, 306(16):1796-7.

  4. Seligman, H. e. (Jan 2014). Exhaustion of Food Budgets at Month's End and Hospital Admissions for Hypoglycemia . Health Affairs, 33(1): 116-123.