Food insecurity is widespread throughout the world but differs over time and place with variabilities in food prices and incomes. The World Health Organization reported in September 2017 that global food insecurity and hunger were again on the rise due to conflict and climate change. The ERS International Food Security Assessment for 2017 estimated that there were 646 million food-insecure people in 76 low- and middle-income countries, with the most food-insecure populations in sub-Saharan Africa, followed by populations in Latin America, the Caribbean, and Asia. The Famine Early Warning Systems Network predicted that 70 million people worldwide would require food assistance, by far the highest level in several decades. Armed conflict, drought, and economic collapse put parts of Yemen, South Sudan, northeastern Nigeria, and Somalia at high risk of famine. Other countries facing crisis-level food insecurity or worse included Syria, along with Syrian refugees in neighboring countries; Burundi; the Central African Republic; Iraq; Malawi; and Zimbabwe.
Note: Food insecurity includes low food security and very low food security.
Some 96% of households in ten Mozambique provinces experienced minimum or phase 1 food insecurity as defined by the Integrated Food Security Phase Classification (IPC), with another 3% in phase 2 “stress” and 0.3% in phase 3 “crisis.” In the Democratic Republic of the Congo (DRC), 11% of the total rural population of almost 72 million were in IPC phases 3 and 4 (“emergency”), an increase of almost 30% in acute food insecurity over the previous year. Food insecurity is by no means restricted to countries experiencing violent conflicts or climate crises. A 2015 study reported that over a 12-month period, 6% of rural Chinese elementary school children were food insecure, including more than 16% suffering from malnutrition. Nevertheless, global food security has improved since the turn of the twenty-first century. The assessment projected that food insecurity would decrease 42%—from 17.7% of the global population to 8.9%—by 2027 due to falling food prices and rising incomes, with Asia experiencing the largest improvement.
Food insecurity is the limited or uncertain availability of sufficient, safe, nutritionally adequate food for all household members or the inability to acquire such food in socially acceptable ways, without resorting to emergency food supplies, borrowing, scavenging, stealing, or other such strategies. Food insecurity and hunger are closely related but distinct: food insecurity is the lack of financial resources for obtaining food at the household level, whereas hunger is an individual experience of physical discomfort from lack of food. Likewise, food insecurity is distinct from malnutrition, although they often coexist. Food insecurity is associated with undernutrition and overweight/obesity in children, adult obesity, and anemia in women. These associations appear to be due primarily to increased consumption of less-expensive, higher-calorie, less-nutritious foods, especially among children in food-insecure households.
The USD Ameasures food insecurity on a continuum:
Every December the USDA surveys 45,000 representative US households to assess food insecurity over the past 12 months. Households are classified as food insecure if they report at least three conditions that indicate at least occasional inability to obtain adequate food for one or more household members because of insufficient money or other resources. There are additional indicators for households with children, because parents often prevent their children's food insecurity by going without food themselves. Food insecurity is assessed according to the frequency and severity of the following indicators, with the percentages of very low food security households that experience these indicators in parentheses:
In developing countries, climate variability and violent conflict are major risk factors for food insecurity. Worldwide, the other most important risk factors are:
Although food insecurity and poverty are closely linked in the United States and around the world, many households with above poverty level incomes are food insecure, and below poverty level households may be food secure.
Increased global food insecurity in 2017 was caused primarily by violent conflicts and climate-related events such as droughts or floods.
Other significant causes of global food insecurity are:
Even marginal food insecurity in children is associated with poorer developmental and health outcomes. A 2016 study of public school children in Georgia reported a strong association between food insecurity, as determined by participation in the National School Lunch Program (NSLP), and reduced academic achievement. Childhood food insecurity and inadequate food intake has been associated with:
Food insecurity is associated with poor nutrition, including limited fruits and vegetables, skipping breakfast, and higher consumption of sugar-sweetened beverages and fast food. These factors, along with less diet variety and unpredictable food availability, can contribute to overweight/obesity. Other concerns associated with food insecurity are vitamin and mineral deficiencies, which can lead to anemia, rickets, scurvy, and other health problems. Food insecurity is also associated with consumption cycling—eating more food when it is available—which can contribute to obesity. Food insecurity is associated with maternal depressive symptoms and fewer positive interactions between parents and their infants, which also contribute to overweight/obesity. One study found that women in food-insecure households gained more weight during pregnancy and had a higher risk of diabetes, which increased their infants' risk for health conditions related to excess weight.
Severe food insecurity is strongly associated with poor diet, higher stress levels, and compromises surrounding many basic needs, which can reduce the ability to manage health problems and increase healthcare needs. Although some studies have found no association between U.S. household food insecurity and child body mass index (BMΙ) percentiles, other studies have reported that the altered food choices and inconsistent dietary patterns that accompany food insecurity put children at risk for obesity, particularly children aged 6–11. A 2015 review reported that food-insecure children were at least twice as likely to be in fair or poor health and at least 1.4 times more likely to have asthma than food-secure children. Food-insecure seniors have limitations in their activities of daily living comparable to food-secure seniors who are 14 years older.
Food insecurity is also associated with:
Food aid alone cannot prevent food insecurity. Combined with population growth and climate change, global food insecurity often appears a near intractable problem. The United States has been a leader in fighting global food insecurity and has provided about half of all global food aid. As of 2018, the Trump administration had threatened to cut international aid.
The U.S. Supplemental Nutrition Assistance Program (SNAP) helps prevent food insecurity with a monthly food allowance for low-income households, thereby helping to feed one in seven Americans, including one in four children and millions of people with disabilities. The Trump administration's 2018 budget called for almost 30% (more than $213 billion) in SNAP cuts over the next ten years, including replacing a portion of food vouchers with boxes of processed foods. As of 2018, some states were restricting access to SNAP. Critics have warned that such measures would increase food insecurity. Studies have shown that SNAP:
The NSLP and school breakfast programs, where available, have been shown to reduce food insecurity in young children. A 2016 study reported that similar school food programs could reduce food insecurity for children and their families in developed countries, such as Greece, that are experiencing economic hardship and high levels of food insecurity.
Medical guidelines call for pediatricians to always ask families—and children—whether they have enough to eat. The American Diabetes Association standards recommend that doctors assess patients for food insecurity. Some experts recommend that such assessments be extended to patients undergoing chemotherapy or with conditions such as high blood pressure and heart disease. Many food-insecure patients must choose between paying for food or their medications. Food pharmacy programs enable physicians to prescribe healthy, affordable food for patients who live in food deserts or cannot afford to buy food. Patients can be screened and referred to resources such as food banks or pantries or given help in applying for SNAP. Meals on Wheels delivers food to homebound seniors nationwide. Other organizations deliver medically tailored meals to food-insecure patients with diabetes, who have been shown to be at higher risk for hypoglycemia (low blood sugar), especially near the month's end.
See also Adult nutrition ; Childhood nutrition ; Infant nutrition ; Senior nutrition .
Ashley, John M. Food Security in the Developing World. Boston: Academic, 2016.
Bartfeld, Judi, Craig Gundersen, Timothy M. Smeeding, et al., eds. SNAP Matters: How Food Stamps Affect Health and Well-Being. Stanford, CA: Stanford University Press, 2016.
Bosso, Christopher J., ed. Feeding Cities: Improving Local Food Access, Security, and Resilience. New York: Routledge, Taylor & Francis, 2017.
Carney, Megan A. The Unending Hunger: Tracing Women and Food Insecurity Across Borders. Oakland: University of California Press, 2015.
Christoplos, Ian, and Adam Pain, eds. New Challenges to Food Security: From Climate Change to Fragile States. New York: Routledge, 2015.
Eise, Jessica, and Kenneth A. Foster, eds. How to Feed the World. Washington, DC: Island, 2018.
Ivers, Louise C., ed. Food Insecurity and Public Health. Boca Raton, FL: CRC, 2015.
McKeon, Nora. Food Security Governance: Empowering Communities, Regulating Corporations. New York: Routledge, 2015.
Thomas-Hope, Elizabeth M., ed. Climate Change and Food Security: Africa and the Caribbean. New York: Routledge, 2017.
Timmer, C. Peter. Food Security and Scarcity: Why Ending Hunger Is So Hard. Philadelphia: University of Pennsylvania Press, 2015.
Alterman, Eric. “Hungry and Invisible.” Nation 305, no. 13 (November 13, 2017): 6–8.
Chin, Paula. “Why Are Working Families Still Hungry in America?” Working Mother 39, no. 3 (August–September 2016): 38–43.
Fox, Claudia K., Nicole Cairns, Muna Sunni, et al. “Addressing Food Insecurity in a Pediatric Weight Management Clinic: A Pilot Intervention.” Journal of Pediatric Health Care 30, no. 5 (September–October 2016): e11–15.
Fram, Maryah Stella, Lorrene D Ritchie, Nila Rosen, et al. “Child Experience of Food Insecurity Is Associated with Child Diet and Physical Activity.” Journal of Nutrition 145, no. 3 (March 2015): 499–504.
Gundersen, Craig, and James P. Ziliak. “Food Insecurity and Health Outcomes.” Health Affairs 34, no. 11 (November 2015): 1830–39.
Kaur, Jasbir, Molly M. Lamb, and Cynthia L. Ogden. “The Association Between Food Insecurity and Obesity in Children—The National Health and Nutrition Examination Survey.” Journal of the Academy of Nutrition and Dietetics 115, no. 5 (May 2015): 751–58.
Knowles, Molly, Jenny Rabinowich, Stephanie Ettinger de Cuba, et al. “‘Do You Wanna Breathe or Eat?’: Parent Perspectives on Child Health Consequences of Food Insecurity, Trade-Offs, and Toxic Stress.” Maternal and Child Health Journal 20, no. 1 (January 2016): 25–32.
Makelarski, Jennifer A., Daniel Thorngren, and Stacy Tessler Landau. “Feed First, Ask Questions Later: Alleviating and Understanding Caregiver Food Insecurity in an Urban Children's Hospital.” American Journal of Public Health 105, no. 8 (August 2015): E98–104.
Oatman, Maddie. “As Diet-Related Illnesses Surge, a New Kind of Pharmacy Dispenses Fruit and Vegetables.” Mother Jones 42, no. 6 (November/December 2017): 72. https://www.motherjones.com/food/2017/12/pharmacyfruit-and-vegetables-prescriptions-preventative-foodpantry-san-francisco-boston (accessed April 12, 2018).
“The Third Horseman Returns; Famine Stalks Africa and Yemen.” Economist 423, no. 9034 (April 1, 2017): 43.
Economic Research Service. “Definitions of Food Security.” U.S. Department of Agriculture. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-inthe-us/definitions-of-food-security (accessed April 12, 2018).
Economic Research Service. “Food Security in the U.S.” U.S. Department of Agriculture. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-inthe-us (accessed April 12, 2018).
Food and Agriculture Organization of the United Nations, International Fund for Agricultural Development (IFAD), United Nations Children's Fund (UNICEF), et al. “The State of Food Security and Nutrition in the World 2017: Building Resilience for Peace and Food Security.” World Health Organization. http://www.who.int/nutrition/publications/foodsecurity/state-food-security-nutrition-2017/en (accessed April 12, 2018).
Food Security Information Network. “Global Report on Food Crises 2017—Executive Summary.” Food and Agriculture Organization of the United Nations. http://www.fao.org/3/a-br324e.pdf (accessed April 12, 2018).
High Level Panel of Experts on Food Security and Nutrition. “Nutrition and Food Systems.” Committee on World Food Security. http://www.fao.org/fileadmin/user_upload/hlpe/hlpe_documents/HLPE_Reports/HLPE-Report-12_EN.pdf (accessed April 12, 2018).
Hunger and Health. “Understand Food Insecurity.” Feeding America. https://hungerandhealth.feedingamerica.org/understand-food-insecurity (accessed April 12, 2018).
Meade, Birgit, and Karen Thome. “International Food Security Assessment, 2017–27.” U.S. Department of Agriculture. https://www.ers.usda.gov/publications/pub-details/?pubid=84101 (accessed April 12, 2018).
Media Centre. “World Hunger Again on the Rise, Driven by Conflict and Climate Change, New UN Report Says 815 Million People Now Hungry—Millions of Children at Risk from Malnutrition.” World Health Organization. http://www.who.int/mediacentre/news/releases/2017/world-hunger-report/en (accessed April 12, 2018).
Tandon, Sharad, Maurice Landes, Cheryl Christensen, et al. “Progress and Challenges in Global Food Security.” Economic Research Service, U.S. Department of
Agriculture. https://www.ers.usda.gov/publications/pub-details/?pubid=84525 (accessed April 12, 2018).
Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30329-4027, (800) CDC-INFO (232-4636), http://www.cdc.gov .
Feeding America, 35 E. Wacker Dr., Ste. 2000, Chicago, IL, 60601, (800) 771-2303, Fax: (312) 263-5626, https://secure.feedingamerica.org .
Hunger Free America, 50 Broad St., Ste. 1103, New York, NY, 10004, (212) 825-0028, email@example.com, http://www.hungerfreeamerica.org .
U.S. Department of Agriculture Economic Research Service, 1400 Independence Ave. SW, Mail Stop 1800, Washington, DC, 20250-0002, https://www.ers.usda.gov .
World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland, 27, 41 22 791 21 11, Fax: 41 22 791 31 11, http://www.who.int/en .
Margaret Alic, PhD