One day, a couple of years ago, I was out with my BFF, and we were discussing how expensive everything is. Rents are sky high. Entertainment is practically unaffordable. Then we started discussing the cost of food. It used to be that eating out was a luxury, and those who wanted to save money, or were on a budget, needed to purchase groceries and cook at home, however, the price of groceries is sky high! I facetiously told bestie, “It’s too expensive to be alive!”
We put it into perspective. Think about it. You can get a value meal from a popular fast food joint that includes a sandwich, French fries, chicken nuggets, and a drink for $5.00. What can you purchase at the grocery store for $5.00? The last time we went to a mainstream grocery store (not a specialty store, or “bougie” market), honeycrisp apples (my favorite!) were $$3.49/lb, and each apple was nearly a pound! So, theoretically, as someone who was hungry and on a budget, I could either go to the grocery store and buy one apple and a store brand bottle of water, or I could go to the fast food restaurant and eat enough to satisfy my appetite and palate.
The problem with eating fast food due to its affordability is that the items offered at more reasonable prices are often calorie dense, yet nutritionally poor. These foods, almost always ultra-processed, are detrimental to our health as they are typically loaded with sodium, refined carbohydrates, sugar, trans and saturated fats, and untold preservatives (Wijaya et al., 2023).
Feeling that one needs to rely on ultra-processed foods because of affordability is a form of food insecurity (Calloway et al., 2023). Research has shown that consuming ultra-processed foods contributes to unfavorable health outcomes, including cardiometabolic disorders, obesity, and mental health disparities (Leung et al., 2022).
Interestingly enough, food insecurity doesn’t just mean not having enough to eat. It is not merely the lack of access to healthy nutritious food. There are various ways that people are experiencing food insecurity, and may not even be aware they are, because in their minds, they can afford food. I’ll use myself as a prime example.
I am a young woman who is single with no kids. I work full-time at a respectable profession. I am also going to school full-time. While I was conducting research for my school project, I was blown away to learn that because I was busy with work (12+ hour days), and school (didactic, homework, clinical hours), and barely had time to sleep for 4 hours per night, let alone shop for, prepare, cook, and clean up after a healthy meal, I was actually considered to be food insecure. Furthermore, if I lacked knowledge in nutrition, meal planning, or kitchen skills, regardless of whether or not I had the time to cook, I would also be considered food insecure (Calloway et al., 2023). I have begun to refer to these constructs as the three pillars of food insecurity.
Food insecurity, nutritional status, and health are relevant to me, both personally and professionally. I want to be healthy. I want my friends and family to be healthy. I am also a medical professional, and am obligated by duty, and conscience, to educate my patients on how to be the best versions of themselves.
The Department of Health and Human Service’s Office of Disease Prevention and Health Promotion (ODPHP) has listed food insecurity as a persistent social determinant of health in the United States (ODPHP, n.d.).
Although the U.S. government tends to paint the picture that the economy is all sunshine and roses, research contrasts that by telling the story of rising deep poverty and extreme poverty (Brady & Parolin, 2020). These individuals tend to be the most food insecure, especially with recent legislation limiting their monetary assistance to purchase food (One Big Beautiful Bill Act, 2025). As such, these individuals start relying more heavily on ultra-processed, affordable, shelf-stable foods, which lead to obesity, and explains why obesity rates are so high, and projected to rise (Ward et al., 2019), and are disproportionally elevated in individuals who are low-income (Daniel, 2020).
My hope is that through education, awareness, compassion, and empathy, we can truly make America healthy. We can’t afford not to.
References
Brady, D., & Parolin, Z. (2020). The levels and trends in deep and extreme poverty in the United States, 1993-2016. Demography, 57(6), 2337-2360. https://doi.org/ghhk2f
Calloway, E. E., Carpenter, L. R., Gargano, T., Sharp, J. L., & Yaroch, A. L. (2023). New measures to assess the “other” three pillars of food security – availability, utilization, and stability. International Journal of Behavioral Nutrition and Physical Activity, 20, Article 51. https://doi.org/ntxb
Daniel, C. (2020). Is healthy eating too expensive? How low-income parents evaluate the cost of food. Social Science & Medicine, 248, e112823. https://doi.org/ntjk
Leung, C. W., Fulay, A. P., Parnarouskis, L., Martinez-Steele, E., Gearhardt, A. N., & Wolfson, J. A. (2022). Food insecurity and ultra-processed food consumption: The modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP). American Journal of Clinical Nutrition, 116(1), 197-205. https://doi.org/hkdq
Office of Disease Prevention and Health Promotion. (n.d.). Reduce household food insecurity and hunger – NWS-01. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-eating/reduce-household-food-insecurity-and-hunger-nws-01
One Big Beautiful Bill Act, H.R. 1, 119th Cong. (2025). https://www.govinfo.gov/content/pkg/BILLS-119hr1enr/pdf/BILLS-119hr1enr.pdf
Ward, Z. J., Bleich, S. N., Cradock, A. L., Barrett, J. L., Giles, C. M., Flax, C., Long, M. W., & Gortmaker, S. L. (2019). Projected U.S. state-level prevalence of adult obesity and severe obesity. New England Journal of Medicine, 381(25), 2440-2450. https://doi.org/gqww
Wijaya, N. V., Dahliah, & Pancawati, E. (2023). The impact of junk food eating habits on body weight. American Journal of Open Research, 2(7), 567-573.
I appreciate your perspective and insight into what “food insecurity” is and what it may look like. According to the U.S. Department of Agriculture (2025), food security can be visualized on a spectrum from high food security, to marginal food security, to low food security, and finally, very low food security. Interestingly to me, marginal food security, marked by anxiety over possible food shortage with little or no change in diet/food intake is in the realm of food security; while low food security, marked by reduced quality, variety, or desirability in the diet with little to no change in diet/food intake is considered to be in the range of food insecurity. Yet the real-life difference between the two could be one missed or reduced paycheck, one unexpected child illness, or other unexpected life event.
Late October/early November 2025 the government shutdown led to a pause in the Supplemental Nutrition Assistance Program (SNAP) in Arizona. This was posted as an announcement on the Arizona Department of Economic Security (AzDES) official website but has since been updated to provide more current information to the public. The original announcement is retained in their official Facebook (AzDES, 2025). During this time families were unable to access their SNAP benefits and those awaiting renewal approval were left in a state of uncertainty. I imagine this national level unexpected life event sent many Arizona families from the “secure” category of “marginal food security” into the “insecure” category of “low food security” or possibly even further down the spectrum.
This is such an interesting topic because the real-life lived experience around food in America is hard to capture in peer reviewed studies or national census data. Food insecurity can look so different from person to person which brings on a whole new conversation about the importance of building a rapport with your clients.
References
Arizona Department of Economic Security. (2025, October 24). Due to instruction from the United States Department of Agriculture, the Arizona Department of Economic Security will be unable to [Status update]. Facebook. https://www.facebook.com/OfficialArizonaDES/posts/1248130714023076/
U.S. Department of Agriculture. (2025, October 1). Food security in the U.S.- Definitions of food security. Economic Research Service. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security
Thank you for making the important point that food security comes in many (excuse the pun) flavors. Can you either provide or point to a table or figure that might illustrate the multiple ways that food insecurity might be experienced? -HMR
I really appreciate you bringing attention to this food security, because it is an issue that can affect anyone, including ourselves, our families, friends, and the communities we live in. One important takeaway from your blog was that food insecurity is not just about not having enough food. It also means not having reliable access to safe, healthy, and nutritious foods, as well as experiencing disrupted eating patterns due to factors such as income, employment, disability, transportation, and other social challenges.
In 2023, the United States Department of Agriculture (USDA, 2025) reported that 13.5% of households in the United States experienced food insecurity. This was about 18 million people. That is a significant number, and it negatively affects people’s health. Odoms-Young et al. (2023) showed that food insecurity increases the risk of obesity and cardiometabolic disease by disrupting normal metabolic processes and increasing inflammation. The study also mentioned that food insecurity was highly associated with mental health problems, such as stress, anxiety, and depression.
When I was researching food insecurity, what is very concerning was that food insecurity rate has been increasing every year (USDA, 2025). This raises questions about what is not working. Is it economic condition? employment rate? or gaps in our current policies? Is there we, health care professionals, can close that gap?
While food insecurity is closely tied to poverty, Drewnowski (2022) argues that addressing food insecurity requires effective government policies rather than relying solely on food education or increasing physical access to grocery stores. The affordability of healthy food is largely driven by economics and food prices. It means that even when people know what healthy foods are, many people cannot afford them due to insufficient money. This reality is very concerning.
I found that there are several federal and state programs designed to support individuals experiencing food insecurity, including the Supplemental Nutrition Assistance Program (SNAP), the National School Lunch Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, Hazzard et al. (2024) found that about 40% of food insecure households do not use the food assistance programs. There were many barriers, such as stigma, complicated application processes, limited transportation, and limited eligibility requirements (Hazzard et al., 2024). How could we encourage individuals to participate more in the programs? Potluri et al. (2025) found that state-level policies that expanded eligibility and simplified application processes increased participation rate and helped reduce food insecurity. I believe that there is an opportunity for us to revisit state-level policies to improve access and increase participation. I am looking forward to seeing what you uncover about related policies as the course continues!
References
Cunnyngham, K. (2023). Reaching those in need: Estimates of state supplemental nutrition assistance program participation rates in 2020. United States Department of Agriculture. https://fns-prod.azureedge.us/sites/default/files/resource-files/snap-participation-2020-final-report.pdf
Drewnowski, A. (2022). Food insecurity has economic root causes. Nature Food, 3(8), 555-556. https://doi.org/10.1038/s43016-022-00577-w
Hazzard, V. M., Kunin-Batson, A. S., Trofholz, A. C., Noser, A. E., de Brito, J. N., Pitera, R. T., & Berge, J. M. (2024). Food assistance use barriers, facilitators, and recommendations: Insights from a qualitative study of racially and ethnically diverse parents. Journal of Nutritional Science, 13, e86. https://doi.org/10.1017/jns.2024.75
Odoms-Young, A., Brown, A., Agurs-Collins, T., & Glanz, K. (2023). Food insecurity, neighborhood food environment, and health disparities: State of the science, research gaps and opportunities. The American Journal of Clinical Nutrition, 119(3), 850-861. https://doi.org/10.1016/j.ajcnut.2023.12.019
Potluri, S., Venkataramani, A. S., Lorch, S. A., Illenberger, N., & Khatana, S. A. (2025). Supplemental nutrition assistance program policies and food insecurity. JAMA Health Forum, 6(12), e2555597. https://doi.org/10.1001/jamahealthforum.2025.5597
United States Department of Agriculture. (2025, January 8). Food security in the U.S. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us
Hi Marlo,
I appreciate your heart on food insecurity. It has always struck me that in the United States, obesity is most rampant among the financially insecure. This is a change from historical portrait of poverty which is the underweight. I believe this to be a direct result of the industrial age, and like you said, ultra processed foods. I am currently commenting on your blog from Kenya, East Africa, where to be obese is viewed as being associated with being wealthy. I will never forget my 2nd time meeting my father-in-law where he complimented me on having gained some weight. I knew he meant it as a compliment despite my own chagrin. I came to find out that during my last visit, many people were very concerned about me being underweight. At that time I was a healthy weight, but just short of considered being overweight. During my 2nd visit I had gained about 20 lbs and people were very pleased, believing I looked much healthier. In Kenya, food availability in the rural areas is directly tied to the rainy season and the dry season. Most people have at least a small family farm where they grow crops. But during the dry season, they have very little. Preservation of food is not commonly practiced furthering the problem. But, as you said, in the U.S. poverty has a very different look. It is not about having food or not having food. It is about the ability to afford healthy food or not. It also strikes me that the poor in Kenya eat much healthier than those in the US as they eat what they are producing themselves. At least during the rainy season.