Finding the facts on food insecurity

Believe it or not, increased costs of daily living can impact nutrition care. Increasing numbers of Americans are experiencing food insecurity – more than 38 million people, including 12 million children. Oftentimes, the patients and clients who dietitians serve experience food insecurity. Being educated on food insecurity and equipped with solutions can help to provide more tailored nutrition interventions.

What is food insecurity?

According to the United States Department of Agriculture (USDA), food insecurity refers to a lack of reliable access to healthy, nutritious food. Food insecurity can exist on a spectrum with different causes and levels of impact. Consider these scenarios that all illustrate food insecurity.

• A family living in a rural community is without access to a community grocery store. Depending on their financial resources and means of transportation, they may rely on local food stands for fresh produce in the summer months and go without most fruits and vegetables during the winter.
• An individual who is unhoused may lack appropriate refrigeration, food storage, and/or means to cook or heat food items. As a result, they choose ready-to-eat, single serving foods that can be eaten at room temperature.
• An elderly widow struggles to make ends meet while living on a fixed income. She lives alone in her home, and with the rising costs of utilities, gas, groceries, and medications, she relies more and more on food pantries and meal delivery services for older adults. As a result, she has little choice is what foods she eats.

How food insecurity impacts nutrition interventions

When our patients and clients lack reliable access to nutritious food, it may be difficult to implement nutrition recommendations they receive from a dietitian. Eating healthy foods may be too expensive or unavailable to them. When it comes to food, a patient’s priority may simply be to eat…period.

Part of a dietitian’s nutrition assessment should investigate what our clients need, where and how they obtain food, and how much they are able to spend on food. Doing so can help to ensure nutrition interventions are feasible and will help to empower the patient or client to implement some of the nutrition recommendations. Not sure where to start? Consider these tips.

• Ask about a patient’s living situation. Do they have access to a refrigerator, stove, hot plate, microwave, oven, etc.? What about kitchen utensils and cookware? How would they rate their cooking skills from novice to competent?
• Ask how and where a patient obtains food. Open-ended questions are better. Rather than asking, “Where do you do your grocery shopping?” ask instead, “Where do you get food to eat?”
• Modify nutrition recommendations to what is financially feasible. This may be more important for some patients than making comprehensive nutrition recommendations. Start small with goals that seem within reach.
• Educate yourself about resources in the community for individuals and families with food insecurity. Collaborate with a social worker or reach out to community-based organizations who serve this population to learn more about what services are offered and where.
• Know the grocery store chains in various areas of town. Also become familiar with convenience stores, “mom and pop” shops, food stands, ethnic grocery stores, food banks, USDA food distributions, and other establishments or programs that may be used to obtain food and what food choices are available in each location.

Dietitians can be advocates for their patients’ health by being realistic in their nutrition recommendations. Rather than making assumptions, ask questions of your clients to better tailor your nutrition intervention to their individual needs.

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References:

Understanding food insecurity. Feeding America Hunger + Health website. Accessed October 11, 2022. https://hungerandhealth.feedingamerica.org/understand-food-insecurity/