What it takes to end the epidemics of obesity and food insecurity
Obesity rates in the United States have increased considerably over the past three decades, now affecting one in six children ages 10-17. Meanwhile, at least 10 percent of our entire population has suffered from food insecurity — a lack of consistent access to food — every year for the past two decades.
These high rates have been the norm for so long that they may appear inevitable. They are not. Our policy choices have brought us here, but they can also chart a different path.
Millions of families are affected by these epidemics every day. While they may appear different at first glance, a lack of economic opportunity and discrimination fuel both of them. That is why the burdens of obesity and food insecurity disproportionately affect people of color and those with low incomes. And the economic and health consequences of each are severe: Food insecurity is closely tied to poverty, and higher obesity rates increase the risk for many chronic health conditions. No child or family should suffer these consequences, but we have not done nearly enough to prevent them.
As we pursue a fairer and more just America where everybody — regardless of skin color, gender, income level, neighborhood, immigration status or disability — has the opportunity to live the healthiest life possible, we must use every means at our disposal to end these epidemics for good.
The policy response to COVID-19 offers a revealing case study. Food insecurity increased markedly in 2020 when schools closed and businesses shed jobs and recent evidence clearly points to rising obesity rates during the pandemic. Congress and federal agencies responded with significant short-term steps, but their impact would be far greater with a long-term commitment.
The U.S Department of Agriculture (USDA) announced universal school meals for the 2021-22 school year. That’s unquestionably the right move, pandemic or no pandemic. A systematic review from Healthy Eating Research finds that universal school meal programs can improve diet quality, reduce food insecurity, assist schools financially and help children academically.
But universal school meals will end in June.
Congress expanded the Child Tax Credit and finally closed the loophole that made those with no or very low incomes ineligible for this support. The impact was immediate: Within one month of higher payments being issued, the number of people reporting food insecurity decreased by 24 percent. The expanded credit would cut childhood poverty by more than 40 percent in a typical year.
But the proposed expansion is for one year only.
Congress also increased Supplemental Nutrition Assistance Program (SNAP) benefits by 15 percent. The return on such an investment is clear. SNAP is proven to reduce poverty, lower food insecurity, boost children’s health and learning and encourage healthier eating. Every $1 billion increase in SNAP funding during an economic downturn increases economic growth and supports thousands of jobs.
But this increase expired in September.
We have seen some longer-term steps. With the temporarily higher SNAP benefits on the verge of expiring, USDA used authority under the 2018 Farm Bill to update the Thrifty Food Plan, the program that determines SNAP benefits. This will be a game-changer for many families; a 27 percent increase in benefits, on average, compared with pre-pandemic levels. But even with these updates, SNAP benefits will still fall short of meal costs in 21 percent of U.S. counties. Clearly, there is additional room for improvement.
One key lesson from the pandemic is that ignoring a crisis will not make it go away. We must heed this lesson with respect to food insecurity and obesity. We are heartened that the budget reconciliation measure currently before Congress includes, among other provisions, a year-long extension of the expanded and fully refundable Child Tax Credit and a significant expansion of the Community Eligibility Program that allows schools in high poverty areas to serve free meals to all students regardless of family income. But more is needed. The forthcoming Farm Bill and Child Nutrition Act reauthorizations provide additional opportunities for more permanent policy change.
A proper response to high rates of obesity and food insecurity should start with the principle of nutrition security: Everybody deserves access to affordable, healthy foods. SNAP benefits should cover meal costs in 100 percent of counties; we must increase benefits to accomplish that goal while expanding eligibility and simplifying enrollment. Universal school meals should be permanent and we should build on the stronger nutrition standards that have made those meals considerably healthier over the past decade. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) covers nearly half of all children born in the U.S.; updated nutrition standards for the WIC food package have been effective, and obesity rates among children enrolled in WIC actually declined between 2010 and 2018 across all racial and ethnic groups studied. WIC should be expanded to postpartum mothers through the first two years of a child’s life and to children through age six when they are all eligible for school meal programs.
We must also consider broader economic and social factors. The impact of the expanded Child Tax Credit illustrates the immediate and direct connections between household income and access to healthy food. Other examples abound. Increasing housing assistance can lower food insecurity and expanding access to child care provides more children with nutritious foods. On the flip side, the declining value of the minimum wage can lead to increases in body mass index.
Imagine the progress we could make toward eliminating obesity and food insecurity if everyone had quality and affordable healthcare; if every worker received a living wage and paid leave; if every parent and caregiver had accessible child care; if every family had safe and secure housing and if policies like the expanded Child Tax Credit did not simply disappear.
Our response to the pandemic has offered a fleeting glimpse of the type of nation we could become. We can end obesity, food insecurity and poverty. The solutions are right in front of us if we would only summon the courage and resolve to act on them.
Avenel Joseph, Ph.D., is the vice president for Policy at the Robert Wood Johnson Foundation. Twitter: @DrAvenelJoseph. Megan Lott, MPH, RDN, is the deputy director at Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. Twitter: @HEResearch
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