American College of Physicians calls US food insecurity a threat to public health

Inadequate access to nutrition has become a threat to public health in the U.S., amplifying existing food insecurity and social issues, the American College of Physicians declared on Monday.

With about 10 percent of the U.S. population suffering from food insecurity, more needs to be done to address the source of the problem and strengthen public health, the organization said in a new position paper.

Achieving these goals means empowering physicians and other medical professionals to better account for social drivers of health that are happening beyond their office doors, according to the paper, published in the Annals of Internal Medicine.

“Strengthening access to good nutrition is a public health imperative,” Ryan Mire, president of the American College of Physicians, said in a video statement accompanying the paper.

“We know that food insecurity is associated with worse mental and physical health, worse health outcomes, and an increased risk of diet-related illnesses and health conditions,” added Mire, whose organization, which represents U.S. internists, is the largest medical specialty group in the country.

Food insecurity in the U.S. is linked to a variety of health issues, such as greater risks of birth defects, anemia, lower nutrient intakes, cognitive issues, asthma, poor oral health, and a heightened risk of mental and behavioral health issues in children, according to the position paper.

For nonsenior adults who are food insecure, the paper identified a connection to lower nutrient intakes, higher rates of mental health problems, diabetes, high blood pressure and high cholesterol, and poorer reported sleep and health exam outcomes.

As far as seniors are concerned, the authors likewise observed lower nutrient intakes, as well as poorer reported health, higher rates of depression and increased limitations on daily activity.

“Physicians and other clinicians should learn about the prevalence of food insecurity and its health consequences,” Mire said.

The American College of Physicians therefore suggests that physicians and health care professionals incorporate “screening tools for food nutrition and other social drivers of health as an integral part of medical practice,” Mire added.

The position paper provided several specific recommendations, calling upon officials to make food insecurity a policy and funding priority as part of a broader effort to encourage safe and healthful diets.

The authors urged lawmakers to improve the Supplemental Nutrition Assistance Program to better serve the needs and health of food-insecure individuals. Meanwhile, they suggested that the Centers for Medicare and Medicaid Services develop, test and support innovative models that incorporate benefits related to food-insecurity issues.

“Strict qualification requirements and inadequate benefit calculation formulas have created a case scenario where it is still inadequate for patients to be able to afford healthy and nutritious foods,” Mire said.

“Nearly 2 out of 3 food assistance recipients have had to choose between paying for food versus paying for their medical bills or medications within the past year,” he added.

Medical professionals should take initiative on activities that might help them understand and mitigate food insecurity issues experienced by their patients, according to the paper.

In addition to screening patients for food insecurity, some such efforts could include the incorporation of food insecurity into medical education curricula as well as establishing tools for referring patients in need to community and government resources, the authors explained. 

“Physicians cannot do this alone. These efforts need to be supported by governments, payers and other stakeholders,” Mire said.

“Looking more big picture, we need to undertake efforts to reform our food nutrition systems and to research and implement innovative and sustainable systems in addressing food insecurity,” he added.