Hardly a day went by in my pediatric practice that I did not care for a child who suffered from food insecurity.
The term food insecurity, “a limited or uncertain availability of adequate and safe foods,” has an unfortunate technical ring to it. It’s perhaps better simply to use the word “hunger.”
And when people are hungry, they’ll fill up on the most available and least expensive foods available — the ultra-processed, high-calorie, shelf-stable junk food sold everywhere, even in the “food deserts” affecting low-income inner-city areas of the United States. This is a major contributor to obesity, which affects 24 million parents and children, and 50 million Americans.
According to Linda Nageotte, CEO of Feeding America, a consortium of 200 food banks and 60,000 food pantries across the country, we are facing the highest incidence of hunger since the Great Recession.
Not having enough food at times (like the end of the month when government benefits run out) leads to “feast or famine” cycles, what researchers call “repeated glycemic excursions” when food is available. This results in strain on the pancreas, increased fat stores and often leads to metabolic syndrome (hyperglycemia, hypertriglyceridemia, hypertension), fatty liver, stroke, diabetes and heart disease.
Food insecurity raises the risk of all of these chronic diseases, plus much more: Micronutrient deficiencies and an altered gut microbiome cause immune system dysfunction and chronic inflammation. People who are food insecure suffer twice the risk of having a chronic illness and a full 40 to 80% risk of premature death.
Hunger results in chronic stress, on the body and mind, with an increased risk of anxiety, depression and insomnia. Among children, food insecurity is an often-overlooked cause of conduct problems and ADHD. Hunger leads to increased gestational diabetes in pregnant women and an increased risk of Alzheimer’s Disease in the elderly.
The Supplemental Nutrition Assistance Program (SNAP) has long been a safety net for low-income Americans, providing money to buy groceries. SNAP benefits had been budgeted for $101.2 billion annually, but the “Big Beautiful Bill” cuts the budget by a fifth over 10 years. This will shift more costs to the states. Five million Americans have already lost benefits. Over half of Americans ages 55 to 64 and almost half ages 45 to 54 are projected not to meet the new work requirements for Medicare (mostly because of poor health) and so will lose SNAP benefits.
Jim McGovern, co-chair of the bipartisan House Hunger Caucus and organizer of the second White House Conference on Hunger, told me in a recent phone conversation, “50 million Americans are living in hunger, in the richest nation in the history of the world… and the president just passed $200 billion in cuts to SNAP. SNAP benefits amount to $2 per meal per day. That’s like a small black coffee from Dunkin’ Donuts.”
WIC (Special Supplemental Nutrition Program for Women, Infants and Children) provides between $7.7 and $8 billion in benefits to low-income families, specifically for nutritious food. Congress has cut $141 million from the fresh fruits and vegetables in the program, trimming the dollar amount from $52/month for breastfeeding mothers to $13, and $26 for young children to $13.
In the meantime, our “War Department” gets $954 billion yearly (half of all discretionary spending), with $46 billion spent thus far on the war in Iran.
Each $1 spent in SNAP benefits leads to a $1.50 boost to the local economy (farms, grocery stores, etc.) and several thousand dollars in lowered medical costs for participating adults; each dollar cut in SNAP benefits leads to $14-$20 in lost income. WIC participation in pregnancy leads to a 14%-24% decrease in low birth weight and preterm births, and a lower risk of cognitive and developmental delays, saving the need for special care for those children.
Congressman McGovern mentioned being called a “flaming liberal” at one Town Hall meeting, when he talked about food insecurity. He responded that yes, he is a liberal, but “even if I was a hard-edged conservative, I would do the same because (supporting food benefits) saves money!”
McGovern has been an advocate for programs in which health professionals write prescriptions for specific meal plans. He is the co-sponsor of the Medically Tailored Home-Delivered Meals Program Pilot Act. It was approved out of committee with a unanimous vote. Based on a successful program established in Massachusetts, this initiative would enlist 40 hospitals nationwide to provide medically tailored meals (MTMs) to eligible Medicare recipients.
MTMs overcome not only food insecurity but the hardship many single chronically ill people face when trying to prepare nutritious meals for themselves. Mass General Brigham sponsors several food pantries, one of which is plant-based, for example, and three hospitals in Florida have “food pharmacies.”
Fortunately, Massachusetts is one of nine states with universal school lunch programs — not dependent on Medicaid access, so not subject to the whims of this administration. Many schools are offering innovative programs with school gardens. Congressman McGovern visited one in Arlington: “A little kid in third grade was giving me a tutorial on the benefits of kale. This little third grader is going to grow up to be smart and engaged and healthy.”
The congressman regularly walks all 40 miles of the annual Monte’s March, which supports The Food Bank of Western Massachusetts, a member of Feeding America. The Food Bank not only provides an average of 1,217,427 meals a month to hundreds of thousands of families in four western Mass. counties but also operates two local organic farms, partners with dozens of others, provides much-needed nutrition education and has an active community engagement team.
The problem of hunger in America may seem insurmountable, but McGovern is convinced that “this is a solvable problem… We need to make sure people can afford good food. We need to support our local farms. We need to educate our kids. And we need to get our health care institutions to take more advantage of the link between food and medicine.”
Dr. David Gottsegen is a local physician who is participating in Monte’s March for the seventh time. To join a team or support this worthy endeavor, go to the Food Bank of Western Massachusetts website (https://www.foodbankwma.org/) and click on “Get involved.”