Food insecurity and nutritional insecurity

While food insecurity has long been the focus of local and national policymakers and researchers, nutrition insecurity has been largely overlooked. A new study from the Institute for Food System Equity (IFSE) at USC Dornsife College of Letters, Arts and Sciences aims to change that.

The work is published in The magazine for nutrition.

This is the first study in Los Angeles County to identify the populations most affected by nutrition insecurity, separate from food insecurity. Nutrition insecurity refers to a lack of access to healthy foods that meet personal preferences, including cultural, religious, and dietary needs, while food insecurity simply focuses on a lack of access to sufficient food.

The study also looked at specific health outcomes associated with a lack of nutritious diet, compared to a lack of diet in general.

The vast majority of Americans do not eat nutritious food because many factors, such as cost, access, and time, make it very difficult to do so.

• Food insecurity has not been analyzed as extensively as food insecurity. This leaves gaps in information on how to address this problem, and on the specific health problems that are directly related to food insecurity.
• Poor diets are a leading cause of death nationwide. Understanding which demographics are most affected by food insecurity is essential to addressing the problem.

“To address the leading causes of chronic diseases like diabetes and mental health issues, we need to map both food insecurity and food insecurity in LA County,” said Kayla de la Haye, founding director of IFSE at USC Dornsife’s Center for Economic and Social Research. “Addressing food insecurity is essential to ensuring people have enough food, but we also need to understand who faces barriers to eating a healthy diet.”

Researchers surveyed more than 1,000 adults in LA County from December 5, 2022, to January 4, 2023, to determine the level of food and nutrition insecurity among county residents.

In 2022, nearly one in four residents experienced food insecurity. A similar percentage reported experiencing food insecurity. Interestingly, nearly half of those who experienced food insecurity did not report food insecurity, and vice versa.

• 24% of Los Angeles residents were food insecure, and 25% were nutrition insecure, while 14% were food and nutrition insecure. That means 1.4 million residents don’t have enough money to buy enough food and don’t have access to food that is both healthy and meets their personal preferences.
• Six million Asian residents—16% of the county’s population—were more than twice as likely as white residents to be food insecure, despite not being at higher risk for food insecurity. This disparity may be due to a lack of access to foods that are both healthy and culturally appropriate, rather than an inability to afford adequate food.
• Conversely, Hispanics, who make up nearly half of the county’s population, were twice as likely as non-Hispanic whites to experience food insecurity, but were not at higher risk for nutrition insecurity. This suggests a challenge in being able to afford adequate food in general, but not a challenge in accessing healthy foods that meet their personal preferences.
• Adults aged 18 to 40 and 41 to 64 are about five times more likely to experience food and nutrition insecurity than those aged 65 and older.

Nutrition insecurity is widely followed in low- and middle-income countries that face food shortages and malnutrition. However, in high-income countries such as the United States, access to healthy options is often unequal despite an abundance of food.

The White House emphasized the importance of access to nutritious food by announcing in February that it will commit nearly $1.7 billion to end hunger and promote healthier eating by 2030.

According to the researchers, both food and nutrition insecurity are valuable predictors of diet-related health problems in LA County, including diabetes and poor mental health, but not cardiovascular disease.

• People who were either malnourished or food insecure were twice as likely to report diabetes than people who were both malnourished and food secure.
• The study found that nutritional insecurity was more closely associated with diabetes than food insecurity.

Both food and nutrition insecurity are equally linked to poor mental health. The study’s findings add to an emerging line of research on “food and mood,” which documents how poor nutrition, a consequence of food insecurity, increases the risk of depression, anxiety, and stress.

• People who are food insecure are almost 4.5 times more likely to have poor mental health than people who have access to adequate food.
• People who are not well nourished are 3.5 times more likely to have poor mental health than people who are well nourished.
• People who experience both food and nutrition insecurity are three times more likely to have poor mental health than people who experience neither.

The researchers advise governments and public health officials to monitor food and nutrition insecurity and that nutrition programs aim to address both issues to improve food access and remove barriers to healthy diets.

Los Angeles County has long monitored food insecurity and added food insecurity measures to its public health monitoring for the first time in 2023.