Food Insecurity: Gnawing at Your Mind

What comes to mind when thinking about the word ‘hunger’? Maybe you pictured an empty fridge, a malnourished child, or simply a grumbling stomach? But did you imagine panic attacks, sleepless nights, or shame? Probably not. 

We often do not think about hunger and food insecurity as a mental health issue, but they could not be more interconnected. 

Food insecurity does not just gnaw at your stomach, it erodes your peace of mind, leaving you more vulnerable to mental health conditions like anxiety and depression. This intertwined crisis calls for integrated solutions – ones that factor in nutrition as a critical component of mental healthcare. 

The expansion of Food is Medicine programs such as Medically Tailored Meals (MTM) and Produce Prescription (Rx) can help alleviate many of the mental health symptoms and vulnerabilities that arise when one experiences chronic hunger and food insecurity. 

Food insecurity, defined by the USDA, is the lack of consistent access to enough nutritious foods for an active, healthy lifestyle. 18 million households in the U.S. were food insecure at some point in 2023. Research has clearly found a link between food insecurity and adverse mental health outcomes. 

It is no question that both parents and children in households experiencing food insecurity are far more likely to also experience conditions such as anxiety and depression. This entanglement of food insecurity and poor mental health outcomes is a syndemic requiring urgent intervention. 

A syndemic occurs when two or more health conditions coexist and worsen one another due to social and structural factors. When a syndemic is present, the treatment approach must consider all conditions involved. Rather than treating each condition in isolation, the syndemic perspective urges us to consider a multitude of factors such as poverty, healthcare access, and inequalities that put people in vulnerable situations where multiple crises can merge.  

In the context of food insecurity and mental health, a poor diet and constant economic pressures can exacerbate depression or anxiety symptoms, which in turn makes it more difficult for individuals to secure consistent, nutritious meals for themselves and their families. 

This cyclical dynamic creates a feedback loop: the more severe the mental health challenge, the more challenging it is to have stable employment, navigate tasks like grocery shopping, and find the energy to prepare adequately nutritious meals. 

When multiple factors converge, the harm compounds. If the basic need of adequate nutrition is overlooked when addressing anxiety and depression symptoms, the well-intended treatment efforts will be stopped short. 

On the other hand, simply providing nutrition to those in desperate need misses the opportunity to address mental health challenges and psychological distress that occurs when living in unstable financial situations. Addressing one of these factors– inadequate nutrition or anxiety/depression symptoms– barely scratches the surface of true intervention.  

Syndemics can be viewed as a house. The house could have a whole host of issues– a cracked foundation, faulty wiring, and faded paint. If we just paint over some cracks in the foundation, we are leaving key structural issues unattended. 

Over time, that paint will crack once again since the foundation is fundamentally unstable. Services like standalone counseling sessions or sporadic food donations often have very short term, limited impacts. Instead, truly attending to a syndemic calls for integrated solutions that treat nutrition and mental health as an intertwined issue. 

This parallels a similar issue we see with housing. The idea that housing is healthcare teaches us that lack of safe housing can contribute to poor physical and mental health much like how individuals cannot thrive with an empty pantry. If we accept that housing is healthcare, we also need to accept that adequate nutrition is also healthcare and it is no less vital an issue. It is a non-negotiable component of well-being. 

So, what should we do to address this issue? There are many amazing programs that already exist that we need to scale up. Food is Medicine programs such as MTM and Produce Rx programs work hard to address more than just the nutritional aspect for the people they serve. Food is Medicine interventions aim to include food that “both supports health, such as medically tailored meals (MTM) or groceries (MTG), and has a nexus to the healthcare system.” 

MTMs consider many different factors including health, diagnoses, income, etc. to create a tailored plan for that individual or household. Produce Rx programs enable people, who often come from low-income households, to have access to fresh fruits and vegetables at a reduced cost or free of charge. 

The interventions include assessments to understand an individual's complete situations to best address the whole issue rather than just one aspect. These interventions also include nutritional and educational counseling. 

The strategy has been established, and programs are out there trying to help, but you probably have never heard much about them. They need to be scaled up and become the norm.  

Some argue these programs are too expensive or time consuming. Many claim that funded meal programs create a dependency or mental health can be better addressed in focused interventions outside of nutrition. A holistic approach that includes proper nutrition will in turn improve mental health outcomes that may not need further addressing after becoming food insecure. 

Many adverse mental health symptoms can often be caused by challenging situations and can be remedied by an overall improvement of day to day life. Additionally, preventing crisis-level interventions can be more costly than just addressing root causes.

This is similar to the saying “buy it nice, or buy it twice”. Investing a bit more money in the first line of defense, can mitigate the number of extremely costly last resort efforts the health system employs.  

Mental health conditions and food insecurity is a cyclical crisis. I urge policy makers to expand Food is Medicine programs under Medicare and Medicaid, or pilot them in areas with large food-insecure populations. 

I urge you as members of your respective communities to support local and national food advocacy groups, donate what you can, petition your representatives, and share stories with one another about the importance of this issue. This is a crisis that can be solved; we just need to address it in whole.