RUNNING HEAD: FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 1

Food Insecurity and Health Disparity in America

Jake Wostoupal

Arizona State University

FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 2

Abstract

Currently, there is a growing number of health disparities in America. Some health

disparities on the rise are diseases such obesity, cardiovascular issues and cancer. With a healthy

lifestyle, research has suggested that these diseases can be prevented. To guide the population to

a healthy lifestyle, dietary guidelines have been established, however, many households cannot

meet these dietary guidelines due to food insecurity. Furthermore, limitations in transportation

and access to grocery stores and supermarkets are contributing to food insecurity. Due to these

limitations, food deserts are being created. Food deserts are urban or rural areas vapid of fresh

fruits, vegetables, and other healthy whole foods. Therefore, individuals living in these food

deserts are settling for energy dense and less nutritional foods such as highly processed and fast

food. The impact of limited access to nutritional foods results in higher incidences of the afore-

mentioned diseases. However, there is hope that we can begin to eliminate food insecurity and

thus food deserts in America. Several government programs are at our disposal to help with food

insecurity. Eventually, as we solve the problem of food insecurity, we will begin to see less

health disparities amongst communities nationwide.

Keywords: United States Department of Agriculture, Supplemental Nutrition Assistance

Program, Women Infants and Children, Electronic Benefit Transfer System

FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 3

Introduction

In the United States, researchers are starting to realize there are health disparities within

the population. Health disparities occur when the prevalence of diseases is different between

groups (U.S. National, 2016). These groups can be categorized based on culture, social

economic standing, gender and age. Regardless, a healthy lifestyle can prevent health disparities

such as cardiovascular disease, Type 2 diabetes and cancer (Office of Disease, 2015). To obtain

a healthy lifestyle, a healthy diet is imperative. Diets rich in essential macronutrients (proteins,

carbohydrates, fruits, vegetables, fats and water) as well as micronutrients (potassium, fiber,

zinc, etc.) are characterized as being healthy. (Office of Disease, 2015). However, Americans are

afflicted to implement a healthy diet due to food insecurity. One can define food insecurity as

limited access to food and capability to obtain nutritionally safe food (Burke, 2016). Due to food

insecurity, there is a growing epidemic of health disparities in the United States.

Before one can start solving the problem of food insecurity in America, one must find out

how many Americans are suffering from food insecurity. To measure food insecurity in America,

the United States Department of Agriculture (USDA) surveys over 39,000 households yearly

(Coleman-Jensen, Rabbitt, Gregory, Singh, 2016). In the survey, respondents are asked to

answer questions about food conditions in the household. The USDA then categorize households

as having food insecurity based on respondents demonstrating insufficient financial or other

resources to obtain nutritional food (Coleman et al., 2016). In 2015 the results of the survey

were troublesome. Although 87.3 percent of households in the United States were food secure in

2015, of the remaining 12.7 percent who were food insecure, five percent of households suffered

from very low food insecurity (Coleman et al., 2016). There is a critical difference between food

insecurity and very low food insecurity. Households who suffer from food insecurity reported on
FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 4

the USDAs survey that food acquisition and diet quality was a challenge (Coleman et al., 2016).

In contrast, households with very low food insecurity not only had challenges in food acquisition

and reduced diet quality but reported multiple indications of reduced food intake (Coleman et al.,

2016). From these results, we can postulate there is great affliction among five percent of the

population having to ration ones food intake.

Food Insecurity and Health Disparity

After identifying the number of households suffering from food insecurity, one must find

the cause of food insecurity. There are two significant reasons for food insecurity in the United

States. These reasons are lower income and accessibility. Lower income is a fundamental issue

for those suffering from food insecurity. Being able to afford healthy food on a regular basis is a

burden for those suffering from low income (Schroeder, 2015). Ineluctably, households are

having to opt for low cost food which are typically unhealthy, processed foods. (Schroeder,

2015). Moreover, these diets are usually high-calorie and energy dense which can contribute to

weight gain and increase the possibility of Type 2 diabetes (Gucciardi, Vahabi, Norris, 2014). If

the United States can make healthy food more affordable than unhealthy food, there will be a

decline in food insecurity from those suffering from low income.

If America can make healthy food affordable, there is still another hurdle to overcome.

Accessibility of healthy food is the other component to food insecurity. Relative to ones home,

nine percent of the population in America does not have access to a grocery store or supermarket

that offers healthy food (Bell, Mora, Hagan, Rubin, Karpyn, 2013). Another alarming statistic

was revealed when researchers studied Native American reservations in Washington State. The

study found that 15 out of 22 reservations did not have a supermarket or grocery store on the

reservation itself (Bell et al., 2013). Therefore, these and other households that are not close to a
FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 5

supermarket or grocery store are left with an oversaturation of fast-food restaurants, liquor

stores, and other inexpensive, unhealthy food options (Bell et al., 2013). Health disparities will

rise in areas where healthy food is inaccessible. A solution to the inaccessibility of healthy food

is expanding local farmers markets, supermarkets and grocery stores into rural and urban areas.

Food Deserts

Due to the limited inaccessibility of healthy foods, there have been developments of food

deserts throughout the United States. The USDA has defined food deserts as areas vapid of fresh

fruits, vegetables, and other healthy whole foods. (American Nutrition, 2015). Though food

deserts can arise in rural and urban populations, low income urban areas tend to have more food

deserts. In a study of the number supermarkets in Philadelphia, Pennsylvania, higher income

neighborhoods had 156 percent more supermarkets compared to the lowest income

neighborhoods (Walker, Keane, Burke, 2010). Furthermore, food deserts are heavily populated

with local quickie marts and fast food restaurants whose selection primarily consists of

processed and other unhealthy food options (American Nutrition, 2015). However, abolishing

these unhealthy food options has not shown positive results on eliminating health disparities. A

study has shown that the removal of fast food restaurants in South Los Angeles found no effect

on obesity rates (Block, 2015). There are other alternatives to eradicating fast food restaurants to

battle food deserts. If healthy food is more accessible and information relating to the

consequences of consuming unhealthy food is available at the point of sale, one could predict a

decline in food deserts (Block, 2015).

In addition to the inaccessibility of healthy foods in food deserts, other contributing

factors exist. Transportation is one of these factors. Many low-income populations cannot

afford to travel beyond ones neighborhood to healthy food markets due to transportation costs
FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 6

(Walker et al., 2010). Furthermore, about 2.1 million households do not own a vehicle and live

more than one mile from the nearest supermarket. (Bell et al., 2013). Although one mile may not

seem a long trek to some, those suffering from mental illness, handicaps or disease find this

distance challenging. Along with transportation, a lack of time due to work schedule, single

parent families, time commitment to prepare meals and unsafe neighborhoods for walking all

contribute to the inaccessibility of healthy foods and thus the development of food deserts

(Walker et al., 2010).

Researchers have found a correlation between health disparities and food deserts.

Common health disparities found in food deserts are obesity and cardiovascular disease. An

example of this is the city of Baltimore, Maryland. In areas where food deserts are prominent in

Baltimore, there is a higher rate of stroke, diabetes and heart disease (John, 2015). An increased

risk of cardiovascular disease can also be found in food deserts. Individuals are at risk for

cardiovascular disease from having a poor diet that is rich in unhealthy fats and low-density

lipoprotein cholesterol (Food, 2016). Since food deserts are more likely to offer these kinds of

unhealthy diets, researchers have found that cardiovascular disease is more prominent in food

deserts (Food, 2016).

In Outagamie County, Wisconsin, the existence of food deserts is prominent. In

Outagamie County, 17,914 residents or 10 percent of the population were food insecure in 2014

(Gunderson, Dewey, Crumbaugh, Kato, Engelhard, 2016). In Appleton alone, the largest city in

Outagamie County, there are three neighborhoods that are classified as food deserts (United

States, 2016). Primarily in the downtowns of the larger cities in Outagamie County, there is a

depletion of grocery stores. The City of Appleton along with Economic Development of

Appleton have been working hard to develop a grocery store in downtown Appleton to eliminate
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food deserts (Reilly, 2016). The growth of farmers markets in downtown Appleton is evident.

With the growth of farmers markets and the development of grocery stores in Outagamie

County, the elimination of food deserts is an attainable goal.

Nutrition and Health

Households who are suffering from food insecurity are supplied with unhealthy food.

Regularly these households are consuming foods that are energy dense and nutrient poor which

can lead to adverse health conditions including a higher body mass index (BMI) (Pereira, Hodge,

2015). To help Americans live a healthy life, dietary guidelines created by the USDA have been

set. In the Dietary Guidelines for 2015-2020, a heathy eating pattern includes a diet consisting of

vegetables, fruits, grains, dairy, protein foods and oils (Office of Disease, 2015). The Dietary

Guidelines has also suggested that positive health effects are attainable from foods that are

nutrient dense since essential vitamins, minerals, and dietary fiber are provided (Office of

Disease, 2015). However, low income adults are not meeting these Dietary Guidelines. A study

on 3,835 low income adults showed that a vast majority did not meet food and nutrient

guidelines (Farrell, 2014). Furthermore, individuals who were food insecure consumed less

vegetables, fruits and salads compared to those who were food secure (Farrell, 2014). Thus,

people suffering from food insecurity settle for more processed, packaged foods that are less

expensive but have more calories and sugars and lack key nutrients (Farrell, 2014). These kinds

of unsafe foods put individuals at a greater risk for diseases such as diabetes, cardiovascular and

cancer (Farrell, 2014).

FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 8

Government Programs

There are several government programs that can offer help to households suffering from

food insecurity. An example of a government program that can help households is the

Supplemental Nutrition Assistance Program (SNAP). The SNAP program is administered by the

USDA with a goal to alleviate hunger and malnutrition by increasing food purchasing power

(Food Research 2015). Eligible low-income families are provided with an electronic benefit

transfer system (EBT) that can be used to purchase food (Food Research 2015). The SNAP

program is valuable as it allows people to purchase food but cannot use it at fast food restaurants.

This gives households the opportunity to purchase healthy food rather than having to settle for

less nutritious food. Thus, one could predict a decline in obesity rates amongst households that

take advantage of the SNAP program

The School Breakfast Program is another government program to help eliminate food

disparity. The School Breakfast Program is administered by the USDA and state agencies and

provides reimbursements to public and nonprofit schools that provided free and reduced-priced

breakfasts to eligible children (Food Research 2015). When the program became a permanent

entitlement program in 1975, the probability of school children to receive a nutritious breakfast

every school day became a certainty (Food Research 2015). Studies have shown that eating

breakfast at school increase students math and reading scores as well as improving their scores

on standardized tests (Food Research 2015). The School Breakfast Program implementation has

also seen benefits such as a reduction in health disparities such as obesity and malnutrition (Food

Research 2015).

The government program to help with food insecurity for women and young children is

the Women, Infants and Children (WIC) program. This program is designed to support low-
FOOD INSECURITY AND HEALTH DISPARITY IN AMERICA 9

income women, new mothers, infants and children (Food Research 2015). The WIC program

aids eligible participants in obtaining nutritious foods, nutritional education, and improved

access to health care to prevent nutrition-related health problems in pregnancy, infancy and early

childhood (Food Research 2015). When WIC food packages were revised in 2007, there was

evidence that the food packages had favorable impacts on health disparities including dietary

intake, breastfeeding outcomes, and obesity rates (Food Research 2015). Households who are

eligible for WIC will see benefits to end health disparities.

Conclusion

In conclusion, health disparities are on the rise in communities across the United States.

Food insecurity is playing a major role in health disparities. Nutritional guidelines have been set

to live a healthy life, however, many households are struggling to meet these guidelines. Due to

affordability and availability of healthy and nutrient dense foods, many communities are

suffering from food deserts. Numerous studies have shown that a diet rich in nutrient dense

foods can help reduce the risk of diseases such as obesity, cardiovascular and cancer. If

Americans cannot have adequate access to grocery stores and supermarkets there will continue to

be a food disparities. Along with accessibility, affordability is another critical issue. Gratefully,

government programs exist to help households that are having a difficult time affording healthy

food. Continuous improvement and studies on these programs will make them more effective

and beneficial. With these government programs and overall education about nutrition benefits

and the harmful effects of unhealthy and processed foods, one can predict a decline of food

disparities. With this impact on food disparity, health disparities amongst communities across

the United States will begin to deteriorate.

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