Written by: Kristen DiFilippo, PhD, RDN
A good friend recently expressed exasperation at trying to provide healthy meals within a budget. She wanted to know if she should spend more money on healthy food or go the unhealthy route of prepackaged instant food that fits her budget, is high in calories, and low in nutrient density. She expressed a common frustration: it is not enough to have an adequate amount of food, people also need nutritious food. The USDA describes food security as “access by all people at all times to enough food for an active, healthy life” (Rabbitt et al., 2023). While my friend’s concern started with worry about affording food, her frustration centered on the latter part of this description of being able to afford enough healthy food.
There are many barriers that people face in obtaining adequate food to support a healthy life. As health professionals, the one step toward helping people overcome the barriers to healthy eating is to understand what the barriers are. A recent study interviewed people experiencing food insecurity in rural communities (Byker Shanks et al., 2022). Five main themes emerged as common struggles in providing healthy meals. These include:
- Affordability: People expressed concern with their ability to afford food. They expressed that this was impacted by many factors including job status (no job, low-paying, seasonal work), adequacy of food benefits, and food prices.
- Adequacy: People described concern about having enough food. They were especially concerned about having enough fruit, vegetables, and protein.
- Accommodation: People struggled to meet the food preferences of picky eaters. They particularly were concerned about meeting the vegetable preferences of household members.
- Appetite: People worried about meeting the needs of family members with big appetites.
- Time: People explained they lacked time to cook healthy meals. To save time, they would select convenience food instead.
The experience of food insecurity can also lead to many coping mechanisms. These coping mechanisms can have both positive and negative impacts on the overall quality of diets. Seligman et al, provide a socioecological framework for examining these coping mechanisms at various levels (2019). They describe coping mechanisms at each of the following levels:
- At the individual level, they describe shifting to less expensive food, skipping meals, binge eating when food is available, eating low-quality food, increasing cognitive focus on food access strategies, seeking additional employment, and high-risk behaviors to access food.
- At the household level, they describe tradeoffs between food and other necessities, cost-saving strategies, relying on fast food, prioritizing who has access to food, growing food or hunting, accessing other financial resources, and keeping a food stash.
- At the community level, they explain people seek support from family and friends, access resources such as food pantries, attend community events with food and seek support from health professionals.
- At the policy level, people enroll in federal nutrition programs such as SNAP, WIC, and other programs to free up resources for food.
When working with people who are experiencing food insecurity, it is important to help identify strategies that increase access to both adequate food and nutritious options. A place to start is to examine the barriers people are experiencing and the coping mechanisms individuals and families are utilizing. This can help identify strategies for overcoming barriers, reinforcing positive coping mechanisms, and identifying alternatives to coping mechanisms with long-term health consequences.
References
Byker Shanks, C., Andress, L., Hardison-Moody, A., Jilcott Pitts, S., Patton-Lopez, M., Prewitt, T. E., Dupuis, V., Wong, K., Kirk-Epstein, M., Engelhard, E., Hake, M., Osborne, I., Hoff, C., & Haynes-Maslow, L. (2022). Food Insecurity in the Rural United States: An Examination of Struggles and Coping Mechanisms to Feed a Family among Households with a Low-Income. Nutrients, 14(24), 5250. https://doi.org/10.3390/nu14245250
Rabbitt, M. P., Hales, L.J., Reed-Jones, M., & Coleman-Jensen. (2023) Food security in the US. USDA Economic Research Service. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/ Accessed January 10, 2024.
Seligman, H. K., & Berkowitz, S. A. (2019). Aligning Programs and Policies to Support Food Security and Public Health Goals in the United States. Annual review of public health, 40, 319–337. https://doi.org/10.1146/annurev-publhealth-040218-044132
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