The U.S. Department of Agriculture (USDA) defines food insecurity as "a household-level economic and social condition of limited or uncertain access to adequate food."1 Approximately 12% of Americans-more than 38 million people-live in food-insecure households, with Black and Hispanic households disproportionally affected.2 In addition, households with children, those in rural areas, and those in the South are more likely to experience food insecurity.2
An underrecognized social determinant of health, food insecurity may increase the risk of type 2 diabetes, obesity, cardiovascular disease, and depression and anxiety.3 Furthermore, children living in food-insecure households have poorer academic performance and higher rates of lifetime asthma diagnosis, forgone medical care, and ED use compared with children in food-secure households.4, 5 Individuals with limited financial resources may purchase inexpensive, nutritionally poor foods or consume less food, which may result in malnutrition that, in turn, can lead to longer hospital stays, decreased responsiveness to treatment, and increased risk of developing postsurgical infections.6 Some people may also underuse medication or delay medical care in order to afford food.6
Nurses play an essential role in identifying, caring for, and advocating for patients and families experiencing food insecurity, in addition to supporting community programs like food banks, soup kitchens, and food drives. The following resources are provided to help nurses advance their knowledge about food insecurity and share information with patients and the public.
RESOURCES FOR NURSES
AARP Foundation and IMPAQ International: Implementing Food Security Screening and Referral for Older Patients in Primary Care: A Resource Guide and Toolkit
http://www.aarp.org/content/dam/aarp/aarp_foundation/2016-pdfs/FoodSecurityScree
Strategies for addressing food security with older adults.
American Heart Association Policy Position Statement: Expanding Access to Healthy Food for Medicaid Beneficiaries
http://www.heart.org/-/media/files/about-us/policy-research/policy-positions/acc
This statement discusses intervention models and policy recommendations.
Delivering Community Benefit: Healthy Food Playbook
https://foodcommunitybenefit.noharm.org
Resources, case studies, and research reports on promoting access to healthy food in the community. Clinician resources for food insecurity screening are also included (see https://foodcommunitybenefit.noharm.org/resources/implementation-strategy/food-i).
Food Research and Action Center
https://frac.org
This nonprofit, which works to reduce U.S. poverty-related hunger and undernutrition, offers research and data, screening tools, advocacy updates, an overview of federal nutrition programs, and information on hunger in specific populations. A free continuing education course, "Screen and Intervene: Addressing Food Insecurity Among Older Adults," is available at https://frac.learnercommunity.com/account/login/secure.
Healthy People 2030: Nutrition and Healthy Eating
https://health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition
Evidence-based resources and exemplars related to the Healthy People 2030 goal: Improve health by promoting healthy eating and making nutritious foods available.
Hunger and Health
https://hungerandhealth.feedingamerica.org
Food insecurity information, educational materials, toolkits, and links to trainings for health care professionals.
Hunger Free America
http://www.hungerfreeamerica.org
Visit this advocacy group's site to learn more about hunger in the United States-and actions individuals can take to help combat it.
Indian Health Service: Food Insecurity Assessment Tool and Resource List
http://www.ihs.gov/MedicalPrograms/Diabetes/HomeDocs/Resources/InstantDownloads/
Steps to take to address food insecurity, plus a shareable document to help patients find food assistance.
MAZON: A Jewish Response to Hunger
https://mazon.org
This national organization aims to address hunger among often overlooked populations, including military families; veterans; Native Americans; single mothers; and lesbian, gay, bisexual, transgender, and queer older adults.
The Hunger Vital Sign
https://childrenshealthwatch.org/public-policy/hunger-vital-sign
A validated two-item screening tool to identify households at risk for food insecurity.
USDA Economic Research Service: Food and Nutrition Assistance
http://www.ers.usda.gov/topics/food-nutrition-assistance
This federal agency publishes research reports and data on child nutrition and food assistance programs, food insecurity in the United States, and more.
RESOURCES FOR PATIENTS, FAMILIES, AND THE PUBLIC
211: Food Programs and Food Benefits
http://www.211.org/get-help/food-programs-food-benefits
Call 211 or visit this site to learn about local food resources, including nutrition assistance programs for children and older adults.
Feeding America
http://www.feedingamerica.org
This national hunger relief network offers a food bank locator, food assistance information, and local volunteer opportunities.
Meals on Wheels America
http://www.mealsonwheelsamerica.org
Older adults can receive home-delivered meals through this community-based organization.
USDA
* Child Nutrition Programshttp://www.fns.usda.gov/cnInformation on the National School Lunch Program, the School Breakfast Program, the Special Milk Program, the Child and Adult Care Food Program, and the Summer Food Service Program.
* Commodity Supplemental Food Programhttp://www.fns.usda.gov/csfp/commodity-supplemental-food-programThis program provides food packages to low-income adults ages 60 and older.
* Find Meals for Kids When Schools Are Closedhttp://www.fns.usda.gov/meals4kidsUse this interactive map to locate nearby sites that supply meals to children when school is not in session.
* Food and Nutritionhttp://www.usda.gov/topics/food-and-nutritionA summary of the USDA's nutrition assistance programs, plus links to additional information.
* National Hunger Hotlinehttp://www.fns.usda.gov/partnerships/national-hunger-clearinghouseFor assistance finding local food resources, call 1-866-3-HUNGRY (Spanish speakers can call 1-877-8-HAMBRE) between 7 AM and 10 PM EST or text 914-342-7744.
* Seniors Farmers' Market Nutrition Programhttp://www.fns.usda.gov/sfmnp/senior-farmers-market-nutrition-programThis initiative helps low-income seniors access fresh, local produce.
* Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)http://www.fns.usda.gov/wicWIC enables low-income pregnant and postpartum women, infants, and children up to age five to receive vouchers to buy food.
* Supplemental Nutrition Assistance Program (SNAP)http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-programFormerly known as the Food Stamp Program, SNAP provides eligible individuals monthly benefits to purchase groceries.
REFERENCES