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Social Determinants of Health Literature Summaries (/healthypeople/priority-areas/social-determinants-
health/literature-summaries)
Food Insecurity
Economic Stability
About This Literature Summary
This summary of the literature on Food Insecurity as a social determinant of health is a narrowly
defined examination that is not intended to be exhaustive and may not address all dimensions of
the issue. Please note: The terminology used in each summary is consistent with the respective
references. For additional information on cross-cutting topics, please see the Access to Foods
that Support Healthy Dietary Patterns (/healthypeople/priority-areas/social-determinants-
health/literature-summaries/access-foods-support-healthy-eating-patterns) literature summary.
Related Objectives (4)
Here's a snapshot of the objectives related to topics covered in this literature summary.
Browse all objectives (/healthypeople/objectives-and-data/browse-objectives).
Reduce household food insecurity and hunger — NWS‑01 (/healthypeople/objectives-
and-data/browse-objectives/nutrition-and-healthy-eating/reduce-household-food-
insecurity-and-hunger-nws-01)
Eliminate very low food security in children — NWS‑02 (/healthypeople/objectives-and-
data/browse-objectives/nutrition-and-healthy-eating/eliminate-very-low-food-security-
children-nws-02)
Increase fruit consumption by people aged 2 years and over — NWS‑06
(/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-
eating/increase-fruit-consumption-people-aged-2-years-and-over-nws-06)
Increase vegetable consumption by people aged 2 years and older — NWS‑07
(/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-
eating/increase-vegetable-consumption-people-aged-2-years-and-older-nws-07)
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Related Evidence-Based Resources (1)
Healthy People 2030 organizes the social determinants of health into 5 domains:
1. Economic Stability (/healthypeople/topic/economic-stability)
2. Education Access and Quality (/healthypeople/topic/education-access-and-quality)
3. Health Care Access and Quality (/healthypeople/topic/health-care-access-and-quality)
4. Neighborhood and Built Environment (/healthypeople/topic/neighborhood-and-built-environment)
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5. Social and Community Context (/healthypeople/topic/social-and-community-context)
Literature Summary
Food insecurity is defined as a household-level economic and social condition of limited or
uncertain access to adequate food.1 In 2020, 13.8 million households were food insecure at
some time during the year.2 Food insecurity does not necessarily cause hunger,i but hunger is a
possible outcome of food insecurity.3
The United States Department of Agriculture (USDA) divides food insecurity into the following 2
categories:1
Low food security: “Reports of reduced quality, variety, or desirability of diet. Little or no
indication of reduced food intake.”
Very low food security: “Reports of multiple indications of disrupted eating patterns and
reduced food intake.”
Food insecurity may be long term or temporary.4,5,6 It may be influenced by a number of factors,
including income, employment, race/ethnicity, and disability. The risk for food insecurity increases
when money to buy food is limited or not available.7,8,9,10,11 In 2020, 28.6 percent of low-income
households were food insecure, compared to the national average of 10.5
percent.2 Unemployment can also negatively affect a household’s food security status.10 High
unemployment rates among low-income populations make it more difficult to meet basic
household food needs.10 In addition, children with unemployed parents have higher rates of food
insecurity than children with employed parents.12 Disabled adults may be at a higher risk for food
insecurity due to limited employment opportunities and health care-related expenses that reduce
the income available to buy food.13,14 Racial and ethnic disparities exist related to food insecurity.
In 2020, Black non-Hispanic households were over 2 times more likely to be food insecure than
the national average (21.7 percent versus 10.5 percent, respectively). Among Hispanic
households, the prevalence of food insecurity was 17.2 percent compared to the national average
of 10.5 percent.2 Potential factors influencing these disparities may include neighborhood
conditions, physical access to food, and lack of transportation.
Neighborhood conditions may affect physical access to food.15 For example, people living in some
urban areas, rural areas, and low-income neighborhoods may have limited access to full-service
supermarkets or grocery stores.16 Predominantly Black and Hispanic neighborhoods may have
fewer full-service supermarkets than predominantly White and non-Hispanic
neighborhoods.17 Convenience stores may have higher food prices, lower-quality foods, and less
variety of foods than supermarkets or grocery stores.16,18 Access to healthy foods is also
affected by lack of transportation and long distances between residences and supermarkets or
grocery stores.16
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Residents are at risk for food insecurity in neighborhoods where transportation options are
limited, the travel distance to stores is greater, and there are fewer supermarkets.16 Lack of
access to public transportation or a personal vehicle limits access to food.16 Groups who may
lack transportation to healthy food sources include those with chronic diseases or disabilities,
residents of rural areas, and some racial/ethnicity groups.15, 16,19 A study in Detroit found that
people living in low-income, predominantly Black neighborhoods travel an average of 1.1 miles
farther to the closest supermarket than people living in low-income predominantly White
neighborhoods.20
Adults who are food insecure may be at an increased risk for a variety of negative health
outcomes and health disparities. For example, a study found that food-insecure adults may be at
an increased risk for obesity.21 Another study found higher rates of chronic disease in low-
income, food-insecure adults between the ages of 18 years and 65 years.22 Food-insecure
children may also be at an increased risk for a variety of negative health outcomes, including
obesity.23,24,25 They also face a higher risk of developmental problems compared with food-
secure children.12,25,26 In addition, reduced frequency, quality, variety, and quantity of consumed
foods may have a negative effect on children’s mental health.27
Food assistance programs, such as the National School Lunch Program (NSLP); the Women,
Infants, and Children (WIC) program; and the Supplemental Nutrition Assistance Program (SNAP),
address barriers to accessing healthy food.28,29,30,31 Studies show these programs may reduce
food insecurity.29,30,31 More research is needed to understand food insecurity and its influence
on health outcomes and disparities. Future studies should consider characteristics of
communities and households that influence food insecurity.32 This additional evidence will
facilitate public health efforts to address food insecurity as a social determinant of health.
Endnotes
i
The term hunger refers to a potential consequence of food insecurity. Hunger is discomfort,
illness, weakness, or pain caused by prolonged, involuntary lack of food.
Citations
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