Lethal combination: Unhealthy diet paired with food insecurity a recipe for disaster

By Kate Marx

Food insecurity is defined by the U.S. Department of Agriculture (USDA) as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.” Feeding America and Louisville’s Dare to Care Food Bank state it more simply – food insecurity is the lack of access to enough food for a healthy, active life.

Brian Riendeau, executive director of Dare to Care, explained, “Food insecurity can be a temporary situation. It could last for several months. It could last for a year.” He continued, “Today in Kentuckiana, there are 181,000 food insecure individuals. That’s a lot of people who are making real choices every day, like do I buy food for the family or do I pay rent?”

Today in Kentuckiana, there are 181,000 food insecure individuals. That’s a lot of people who are making real choices every day, like do I buy food for the family or do I pay rent?


Humana, a health and well-being company based in Louisville, partnered with Feeding America, the largest domestic hunger-relief charity in the United States, to develop a toolkit for addressing food insecurity.

One of the points the toolkit makes is that food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps); the Women, Infant, and Children’s Program (WIC); and the National School Lunch and School Breakfast programs, help feed many low-income families across the country.

That means that many households under the Federal Poverty Line are food secure, while those with slightly higher incomes, but without access to other support, may be food insecure.

It goes on to cite USDA Economic Research Service findings that unhealthy diets amplify the negative outcomes experienced by food insecure individuals. The combination of an unhealthy diet and food insecurity leads to impaired growth in children, more chronic disease for adults, higher healthcare costs and missed work days.

Dare to Care is working to combat food insecurity by delivering more than 19 million meals through a network of 270 emergency kitchens, shelters and food pantries. Dare to Care also operates several programs targeting the most vulnerable in our community, including:

  • Kids Cafes: Hot nutritious meals, prepared by the Dare to Care team, to after school sites.
  • Backpack Buddy: Nutritious, kid-friendly foods for children from low-income families to take home on the weekends.
  • Summer Meals for Kids: Breakfast, lunch and dinner for children during the summer months.
  • Cooking Matters: Empowers families to prepare healthy and affordable meals.
  • Mobile Pantry: Brings a pantry directly to a neighborhood, and provides fresh produce and other nutritious food items.
  • Senior Outreach: Provides nutritionally-balanced food boxes to seniors through a unique partnership with the Louisville Metro Police Department, mobile pantries for seniors and the Commodities Supplemental Food Program.

Healthcare professionals can support their patients’ nutritional needs and keep them food secure by using a validated, two-item screener known as Hunger Vital Sign. This screener is a subset of the USDA’s 18-item screener. The screener is available as part of the standard base build in EPIC (EMR).

The screener identifies individuals and families as being at risk for food insecurity if they answer that either or both of the following two statements is ‘often true’ or ‘sometimes true’ (vs. ‘never true’):

  1. Within the past 12 months we worried whether our food would run out before we got money to buy more.
  2. Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.

A response of ‘sometimes true’ or ‘often true’ to either or both questions should trigger a referral for food security support. In Louisville and the surrounding communities, Dare to Care offers a Prescriptive Pantry Program. These pantries are located inside healthcare providers’ facilities.

“The physician’s office is a natural place to address food insecurity, due to the strong correlation between food and health,” said Emily McGrath, who leads Humana’s strategy to address food insecurity. “Food insecurity negatively impacts disease risk, condition self-management and healthcare costs, so it is important for physicians to have the information they need to accurately screen patients and refer to food assistance programs and community resources. The food insecurity discussion needs to be one about health.”

Once a clinician is aware of a patient’s food insecurity status, they might consider other aspects of care that should be addressed, such as medications, health and nutrition education and mental health.

Food Insecurity and Health: A Tool Kit for Physicians and Healthcare Organizations can be found online at https://goo.gl/nfkWyF.

-Kate Marx is with Humana.


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