As many families and friends gather around bountiful tables of festive food this winter, we should pause to reflect on the millions of New Yorkers who do not have regular access to food. In 2020, 10.5 percent of all Americans were food insecure, according to the U.S. Department of Agriculture. In New York State, about 2.6 million people, or one in eight, are facing hunger. Of those, about 803,560 are children.
At the beginning of the COVID-19 pandemic, sharp increases in unemployment heightened food insecurity. More recently, even as employment has begun to rebound, inflation has reduced purchasing power and further fueled the need for food assistance. Help from government agencies, community-based organizations, and health care providers has spurred increased investments in food pantries and food purchasing programs. This alleviated food insecurity for some, but much more is needed to create a long-term solution.
HEALTH AND FOOD INSECURITY
Research highlights the link between health and social needs, including access to affordable and healthy food. As a result, the health care sector increasingly recognizes the importance of investing in efforts to support patients’ access to healthy food.
Our team at UHF partnered with Boston Consulting Group (BCG) to investigate the role that the New York health care system can play in improving food security. Individuals facing food insecurity are more likely to develop, and less likely to be able to manage, chronic health conditions. This leads to more frequent emergency room visits, more prescription drug usage, and greater dependence on the health care system. We estimated that reducing the prevalence of food insecurity by 20 percent could lower the burden of chronic disease by $550 million in New York annually. Additionally, increased food security has been linked to higher high school graduation rates, lower rates of poverty, and increased life expectancy. Food security alone will not cure chronic conditions, but reliable access to healthy food can support communities’ ability to reduce the financial and social burden of chronic conditions and poverty.
THE INSIDIOUS ROLE OF SYSTEMIC RACISM
There are many contributing factors to an individual’s or family’s inability to afford or access food, including systemic racism, which has created and perpetuated inequities in many of the root causes of food insecurity. In 2020, the prevalence of food insecurity among Black, non-Hispanic households was 21.7 percent nationwide, up from 19.1 percent in 2019. Conversely, food insecurity declined for households with white, non-Hispanic persons during this same time period.
Persistent unemployment, low-paying jobs, lack of affordable housing, and other costly living expenses all contribute to food insecurity. Many New Yorkers have been forced to choose between their need for food, housing, transportation, medical care, and savings. Each of these is a fundamental need to ensure a person’s well-being.
HEALTH SYSTEMS’ UNIQUE OPPORTUNITY
As a community hub, cornerstone employer, and political force, health systems are uniquely situated to improve food security in their communities. Health systems, health insurance companies, and foundations are making conscientious investments to support food security. Many providers, such as Federally Qualified Health Centers, screen patients for food insecurity and refer them to resources within their organizations or to external community partners that can meet the patients’ food needs; they also connect them with a continuum of services to support long-term food security and to reduce poverty. There are numerous free meal and grocery programs across the state that serve immediate food needs, but these are short-term solutions.
Government-sponsored programs, such as the Supplemental Nutrition Assistance Program (SNAP), Women, Infants, and Children (WIC), and Healthy Bucks, provide cash assistance to food-insecure individuals who meet eligibility criteria. In her first months in office, New York Governor Kathy Hochul spearheaded several food security policies to simplify enrollment in SNAP for people with disabilities and older adults, and to use emergency federal funds to increase SNAP allocations for all eligible New Yorkers. New York City Mayor-elect Eric Adams championed initiatives to improve food access as Brooklyn Borough President and appointed a food advisory committee as part of his transition team. However, a policy or program that works well in New York City does not always benefit New Yorkers upstate. Policies that make structural changes to improve purchasing power to afford food, like increasing employment, raising wages, and decreasing the cost of fresh fruits and vegetables, could create long-term systemic change to improve communities’ food security.
Nationally, about half of individuals experiencing food insecurity are covered by public insurance (e.g., Medicaid and Medicare), but nearly 40 percent are privately insured. This means the population experiencing food insecurity is incredibly diverse and multifaceted and includes people who are low-income, middle-income, working poor, single adults, families, older adults, and people with disabilities. As a result, some of these people may not be eligible for public assistance programs, like SNAP and WIC. Government sponsors should continue adjusting eligibility requirements to increase access to food assistance. This gap between eligibility and need also creates ripe opportunities for collaboration between health plans and providers to help secure reliable access to food for their patients.
PARTNERSHIPS ARE CRITICAL
Food insecurity will not be solved by the health care system alone, and partnerships across sectors will be essential. Efforts to address this critical issue must consider the impact of systemic racism on policies and structures that affect New Yorkers’ access to services related to their health and well-being.
The potential rewards are invaluable: greater equity, reduced health care costs, a healthier population, and children not going to bed hungry at night. While UHF is not an expert on food insecurity, we are a trusted convener who helps bridge the gap between clinical and community leaders who are championing innovations in health policy. UHF hopes to build on the great work being done by highlighting awareness with this report, an upcoming webinar, and the development of sustainable solutions with partners in New York City and across the State. We hope you will join us on an upcoming date as we continue this conversation with Vicki Escarra, former CEO of Feeding America and BCG Senior Advisor, on the role that the New York health care system can play in reducing food insecurity.
Emily Arsen is a senior research analyst at UHF; Denise Arzola is UHF’s director of clinical-community partnerships; and Gabriela Groenke is an executive and program assistant at UHF. All three authors contributed to a recent report by UHF and Boston Consulting Group that analyzes food insecurity in New York State and explores how the health care sector can help address this urgent issue.
United Hospital Fund has a long history of bringing together diverse perspectives to address critical challenges in health care in New York. In the current crisis, it’s more important than ever to hear from all parts of the health care system. Today’s commentary from UHF’s Emily Arsen, Denise Arzola, and Gabriela Groenke highlights how the health care system can help address the critical issue of food insecurity. – UHF President Tony Shih