Food Insecurity, Hunger Increased in the United States in 2023

The trend of food insecurity persists in the United States, with food insecurity, food expenditures, and need of assistance all reported in the country throughout 2023, according to a a new report¹ from the US Department of Agriculture (USDA).

The USDA defines food insecurity as either have a reduced quality, variety, or desirability of diet or having multiple indications of disrupted eating patterns and reduced food intake.² Food insecurity is different than hunger according to the USDA, as hunger is a physiological condition that comes as a result of food insecurity whereas food insecurity itself is an economic and social condition that indicates uncertain or limited access to food.

Food insecurity can lead to increased health care utilization | Image credit: Mikhailov Studio - stock.adobe.com

The new report found that 13.5% of households in the US were food insecure, totaling approximately 18 million households. Food insecurity in this context was defined as households who had difficulty providing enough food for their residents at some point during the year. The percentage increased from 2022 when it was 12.8%, from 2021 when it was 10.2%, and 2020 when it was 10.5%.¹ Low food security was reported in 5.1% of households in the country, which wasn’t different from the 2022 number but an increase from 3.8% reported in 2021. This food insecurity led to disrupted eating patterns through the year.

A total of 8.9% of households with children were food insecure, which is similar to the 8.8% reported in 2022 but higher than the 6.2% reported in 2021. A total of 1.0% of households reported children experiencing very low food security, which is similar to the 1.0% reported in 2022 and 0.7% reported in 2021. Skipping a meal, not eating for a whole day due to lack of resources, and children being hungry was common in these households.

Food insecurity has big implications when it comes to the health of the child and utilization of health care. A study published in The American Journal of Managed Care³ found that those who were more food insecure had a higher incidence of hospitalizations (incidence rate ratio [IRR], 1.47; 95% CI, 1.14-1.88), emergency department visits (IRR, 1.47; 95% CI, 1.12-1.93), and days hospitalized (IRR, 1.54; 95% CI, 1.06-2.24). Patients who were food insecure also had higher rates of outpatient visits (IRR, 1.30; 95% CI, 1.11-1.52).

Health care expenditures were also associated with food insecurity, as those with food insecurity had increased odds of being in the top 10% (OR, 1.73; 95% CI, 1.31-2.27), 5% (OR, 2.53; 95% CI, 1.51-3.37), and 2% (OR, 1.95; 95% CI, 1.09-3.49) of expenditures related to health care. The mean annual cost difference for health care expenditures was $5527.06 (95% CI, 2552.39-$8501.73) when comparing food-insecure and food-secure beneficiaries of Medicare. This difference decreased in patients using public insurance other than Medicare but was still substantial ($1826.40; 95% CI, $797.69-$2855.11).

The increase in food insecurity could have major consequences on the health care system as more people utilize health care resources as a product of their food insecurity. Without proper infrastructure to address the people living with food insecurity, the health care system may become overwhelmed as household food insecurity increases. Interventions to increase food security can help to not only address food insecurity nationwide but also reduce the potential utilization of health care resources due to that food insecurity.

References

1. Rabbitt MP, Reed-Jones M, Hales LJ, Burke MP. Household food security in the United States in 2023. Economic Research Service U.S. Department of Agriculture. September 4, 2024. Accessed September 5, 2024. https://ers.usda.gov/webdocs/publications/109896/err-337_summary.pdf?v=5853.3
2. Definitions of food security. USDA Economic Research Service. Updated September 4, 2024. Accessed September 5, 2024. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/definitions-of-food-security/
3. Berkowitz SA, Seligman HK, Meigs JB, Basu S. Food insecurity, healthcare utilization, and high cost: a longitudinal cohort study. Am J Manag Care. 2018;24(9):399-404.