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September 16, 2022 02:43 PM

Opinion: More Americans are unhealthy. Food may be the best medicine.

Dr. Bechara Choucair
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    Dr. Bechara Choucair

    Dr. Bechara Choucair is senior vice president and chief health officer at Kaiser Permanente. Kaiser Permanente is the participating healthcare organization on the task force informing the White House Conference on Hunger, Nutrition, and Health.

    It has been more than 50 years since the White House Conference on Food, Nutrition, and Health was held in 1969, which led to the establishment and expansion of our country’s foundational food support systems–the Supplemental Nutrition Assistance Program (SNAP), the National School Lunch Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our understanding of the role nutrition and food security play in overall health has grown significantly in those intervening years.

    With the second Conference on Hunger, Nutrition, and Health set for Sept. 28 in Washington, D.C., the healthcare sector has a chance to meaningfully contribute to the conversation and positively impact the health of the more than 42 million Americans facing food insecurity today.

    When people are hungry or cannot access nutritious food, they are less likely to get or stay healthy. Food and nutrition insecurity are directly correlated with poor health, including higher rates of diabetes, hypertension and heart disease. The wide-ranging chronic health issues driven by hunger are estimated to increase the cost of healthcare by $160 billion each year and, because of the racial inequities associated with hunger and nutrition, food insecurity is also a driver of health disparities that are so persistent in our country.

    Building the evidence base


    Healthcare providers know a lot about the causes of diet-related diseases, but we have not yet built a full body of evidence around solutions. The upcoming White House conference provides a major opportunity for cross-industry collaborations throughout the private sector to implement and rigorously evaluate programs to determine the best ways to improve food and nutritional security and to demonstrate the impact these improvements have on health outcomes.

    The industry is uniquely positioned to test whether programs that give free or discounted access to specific types of foods improve health for people with diet-related diseases. These “food is medicine” programs could include medically tailored meals delivered to households or prescriptions for produce that can be filled at grocery stores and farmers markets. 

    An untapped opportunity exists to broaden the evidence base for these tools with Medicare and Medicaid beneficiaries and a potential for Congress to eventually codify them as permanent benefits, if proven to be effective and cost effective. Building this evidence base is crucial, because it is what will guide the way the healthcare system as a whole approaches food insecurity. It will show–and justify–where to invest time, energy and resources.

    Advancing equity


    We also know that to move the needle on these issues, we must address the inequities in hunger and nutrition. According to the Food Research and Action Center, from 2021 to 2022 Black Americans were more than three times more likely to be food insecure than white Americans, while Latino Americans were twice as likely to lack adequate access to food. This reality is a result of systemic, upstream factors that range from historic and ongoing underinvestment in these communities, poor access to healthcare services, and nutrition scarcity created by food deserts.

    Among the pathways to shift this dynamic, we must build a diverse healthcare workforce and integrate with appropriate training in diet and health. Evidence shows that conversations around nutrition, behavioral counseling, and health are enhanced by a diverse clinical care team that understands its patient population.

    Healthcare’s pivotal role


    Finally, the expertise health systems have and the trusted role they play in patients’ lives should be leveraged in this work. Asking patients about nutrition and food insecurity the same way we screen for alcohol or tobacco use is a clear opportunity. And, given their role as anchor institutions in many communities, hospitals should lead by example –serving nutritious and environmentally sustainable foods, which can also help stimulate the local and regional food economies.

    The healthcare sector has a major role to play in advancing and developing sustainable programs and policies to address our hunger and nutrition challenges, and we have much to gain from making our voices heard now.

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