Understand Food Insecurity

What are the Connections Between Food Insecurity and Health?

The Hunger in America 2014 study found that many households served by the Feeding America® network of food banks include people coping with a diet-related chronic disease.[1] Fifty-eight percent of households reported having at least one member with high blood pressure and 33 percent had at least one member with diabetes.

The cycle of food insecurity and chronic disease begins when an individual or family cannot afford enough nutritious food, illustrated by the image below. The combination of stress and poor nutrition can make disease management even more challenging.[2] Further, the time and money needed to respond to these health conditions strains the household budget, leaving little money for essential nutrition and medical care. This causes the cycle to continue, increasing the risk of worsening existing conditions. Many families experiencing food insecurity often have several, if not all, compounding factors which makes maintaining good health extremely difficult.

The video below describes how food insecurity complicates chronic disease management.

 Illuminating Intersections: Hunger and Health

How do households cope with food insecurity?

Food insecurity is highly stressful.[3] When people do not know when or where they will eat their next meal, finding food may become their central focus.[4] It can take priority over health-related behaviors, such as refilling medications and making doctor appointments.[5]

According to Hunger in America 2014, many households who use charitable food programs must make difficult choices to meet their basic needs. Specifically, households served by the Feeding America network reported choosing between:

  • Food and medical care (66%)
  • Food and utilities (69%)
  • Food and transportation (67%)
  • Food and housing (57%)

Oftentimes, households must use coping strategies to meet their food needs, including:

  • Receiving help from friends (53%)
  • Watering down food or drinks (40%),
  • Purchasing inexpensive, unhealthy food (79%)
  • Selling or pawning personal property (35%)
  • Growing food in a garden (23%)

More than half (55%) of households served by the Feeding America network reported having to use three or more coping strategies to deal with tough financial choices. Some of these coping strategies may support one’s health, but others that make sense in the short term can be detrimental to health in the long term. This is particularly true in households with children and among people who are already coping with a diet-related, chronic disease.

How is the charitable food sector addressing food insecurity?

The charitable food sector, including institutions like food banks, food pantries, soup kitchens, and feeding programs, is working together to address food insecurity while promoting health.

Hunger-relief efforts are increasingly contributing to health-focused initiatives through healthcare partnerships, targeted programming, and nutrition education. Spotlights of initiatives led by Feeding America and peers in the sector can be found on the Hunger + Health Blog.

Food Insecurity Research

Research is integral to better understanding the causes and effects of food insecurity. While additional research continues to emerge, visit this blog post for a non-exhaustive list of notable articles that provide a gentle introduction to food insecurity research. These have been recommended by the Technical Advisory Group at Feeding America®.

Further research which has been submitted to this site and related resources can be found here.

How is Feeding America working to understand food insecurity?

Below are a sample of studies conducted by or for Feeding America that help us further understand the connection between food insecurity and health. For Feeding America’s complete research portfolio, visit feedingamerica.org.

Project and Studies:

The State and Local Healthcare Costs of Food Insecurity

Research using data from Map the Meal Gap and other national datasets indicate that food-insecure households face additional healthcare costs in every county in the U.S., totaling $52.9 billion in healthcare costs in 2016 – but this varies substantially around the country. To illustrate the healthcare costs associated with food insecurity at the local level, Feeding America created an interactive data visualization on Tableau using a study published in Preventing Chronic Disease, a publication of the US Centers for Disease Control.

The State of Senior Hunger in America

The State of Senior Hunger in America report series documents the prevalence of food insecurity among the senior population age 60 and older in the United States. It examines the demographics and characteristics of seniors who lack access to enough nutritious food and identifies geographic variation in food insecurity among seniors, providing rates for all 50 states and the District of Columbia. New as part of the 2019 release, a parallel report explores the same issues as faced by older adults age 50-59. A separate report, produced periodically, explores health implications for seniors who are food insecure.

Comprehensive Diabetes Self-Management Support from Food Banks: A Randomized Controlled Trial

This study, published in 2018 by Feeding America in partnership with subject matter experts from University of California San Francisco and the Urban Institute, evaluated the effectiveness of food bank interventions on outcomes for adults living with uncontrolled type 2 diabetes.

Bringing Teens to the Table: Teens and Food Insecurity in America

This study, published in 2016 by Feeding America and the Urban Institute, explores the experiences, coping strategies and viewpoints of teenagers dealing with food insecurity in 10 communities across the U.S.

Hunger in America 2014

Hunger in America was a series of quadrennial studies that provided comprehensive demographic profiles of people seeking food assistance through the charitable sector and an in-depth analysis of the partner agencies in the Feeding America network that provide this assistance.

In Short Supply: American Families Struggle to Secure Everyday Essentials

Published in 2013, In Short Supply is a study demonstrating the struggle of many low-income families in the U.S. to afford basic, non-food household items. Families report using a variety of coping strategies when they are unable to afford personal and household care items. Some of these strategies, such as altering eating habits and delaying other healthy habits to afford non-food items, raise concerns about potential risks to the health and well-being of many families with children.


  1. Feeding America, 2014. Hunger in America 2014 – National Report. Available online at: https://www.feedingamerica.org/research/hunger-in-america

  2. Seligman, H. K. and Shillinger, D. 2010. Hunger and Socioeconomic Disparities in Chronic Disease. The New England Journal of Medicine, 363:6-9. doi:10.1056/NEJMp1000072

  3. Laraia, B.A., Leak, T.M., Tester, J.M. and Leung, C.W., 2017. Biobehavioral factors that shape nutrition in low-income populations: a narrative review. American Journal of Preventive Medicine. Vol 52(2:2), pp. S118-S126. https://doi.org/10.1016/j.amepre.2016.08.003

  4. Hadley, C., & Crooks, D. L. (2012). Coping and the biosocial consequences of food insecurity in the 21st century. American Journal of Physical Anthropology, 149(S55), 72-94. https://doi.org/10.1002/ajpa.22161

  5. Berkowitz, S. A., Seligman, H. K., & Choudhry, N. K. (2014). Treat or eat: food insecurity, cost-related medication underuse, and unmet needs. The American journal of medicine, 127(4), 303-310.