Food insecure households may lack access to healthy foods and are at increased risk for diet-related disease such as overweight and obesity. Children who are food insecure are at higher risk for mental health problems such as anxiety and depression, cognitive impairment, behavioral disorders, poor academic performance, iron-deficiency anemia, and asthma. In adults, food insecurity is associated with multiple chronic conditions and can also make management of chronic conditions much more difficult. 

Food insecure households spend an average of 45% more on medical care annually.

-Center on Budget and Policy Priorities: SNAP Is Linked with Improved Nutritional Outcomes and Lower Health Care Costs.

FOCUS GROUP FINDINGS

Participants from the Older Adults focus group, reported that the foods they receive from food assistance programs are high in sodium and sugar and, as a result, are not always appropriate for those with certain health conditions such as diabetes. They expressed the desire for more whole grains, fresh produce and foods appropriate for people with diabetes. In addition, participants were concerned about the frequency and quantity of fresh produce and the likelihood of produce spoiling too quickly. 

They don’t have any specialties like for diabetics or for people that are having problems with food.

-Older Adult Food Study Respondent

Access to nutritious foods, particularly among youth, is an health equity issue for low-income households. Sugar sweetened beverages, such as soda, are often less expensive and more easily accessed than healthier options such as water and milk. There is now convincing evidence that sugary drinks are linked to development of obesity and diabetes. Fast food is also a low-cost source of calories, but frequent fast food consumption is linked to overeating and weight gain in both teens and adults. Increasing the access and affordability of healthier food choices, especially to those experiencing food insecurity, is an important upstream approach to addressing obesity.

While the consumption of sugar-sweetened beverages and fast food is linked to unhealthy weight gain, numerous studies have suggested that breastfeeding is protective against overweight and obesity in children. The World Health Organization currently recommends exclusive breastfeeding for the first six months of life to reduce the risk of overweight and obesity. Data from Napa County Women, Infants, and Children (WIC) program, which serves low income pregnant/postpartum women and children to age five, shows that 66% of participating children ages 2-5 were not at risk of overweight. Children who were not at risk for overweight were breastfed an average of 35 weeks, compared to an average of about 28 weeks for children classified as overweight or at risk of overweight. Unfortunately the data does not distinguish between exclusive breastfeeding and breastfeeding supplemented with formula.

Food insecurity and hunger are associated with overweight and obesity in developed countries. This is because, in our society, the foods that are most affordable and easily accessible tend to be processed foods that are high in calories, fat and sodium, but low in nutrients. From a public health perspective, addressing food insecurity is one upstream approach to addressing obesity and related chronic diseases. 

*Technical Notes for Overweight and/or Obesity by Age

Adults 18+: Adult respondents ages 18+ who had a body mass index (BMI) of 30.0 or above are classified as obese; a BMI of 25.0-25.99 is classified as overweight. BMI was calculated using respondent's self-reported weight and height.

Children 2-11: Results are for children 2-11 classified as overweight, which is assessed using sex, age (in months) and weight.

Children 12-17: Teen respondents ages 12-17 who ranked between the 85th and 95th percentiles were classified as overweight; teens in the 95th percentile and above were classified as obese. Percentile rankings are based on the CDC 2010 recommendations on assigning body mass index (BMI).

Obesity is a serious, chronic disease that increases the risk of many health conditions including heart disease, stroke, type 2 diabetes, certain cancers, and death (all-causes). An estimated 29.3% of adults in Napa County are obese, compared to 27.6% of adults statewide. While the prevalence of diabetes in Napa County is currently lower than the statewide prevalence, it is expected to increase if the obesity rate continues to climb. Heart disease appears to be slightly more common among adults in Napa County compared to California overall (7.2% vs. 6.3%).

*Technical Notes for Cardiovascular Disease Hospitalization Rates

Rates are age-adjusted rates per 1,000 Medicare beneficiaries. The hospitalization rate for black females in Napa County was suppressed due to small numbers.

Cardiovascular Disease includes the following diagnoses: all heart disease, coronary heart disease, acute myocardial infarction, cardiac dysrhythmia, heart failure, hypertension, all stroke, ischemic stroke, and hemorrhagic stroke. 

References

Carlson, S., Keith-Jennings, B. (2018). Center on Budget and Policy Priorities: SNAP Is Linked with Improved Nutritional Outcomes and Lower Health Care Costs. Center on Budget and Policy Priorities, 17.

Gundersen, C. & Ziliak, J.P. (2015). Food Insecurity and Health Outcomes. Health Affairs, 34(11): 1830-1839.

Horta, B. L., Victora, C. G., & Cesar, G. (2013). Long-Term Effects of Breastfeeding: A Systematic Review. Geneva, Switzerland: World Health Organization.

Hu, F. B., & Malik, V. S. (2010). Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence. Physiology & Behavior, 100(1), 47-54.

Pereira, M. A., Kartashov, A. I., Ebbeling, C. B., Van Horn, L., Slattery, M. L., Jacobs Jr, D. R., & Ludwig, D. S. (2005). Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. The Lancet, 365(9453), 36-42.

Taveras, E. M., Berkey, C. S., Rifas-Shiman, S. L., Ludwig, D. S., Rockett, H. R., Field, A. E., ... & Gillman, M. W. (2005). Association of consumption of fried food away from home with body mass index and diet quality in older children and adolescents. Pediatrics, 116(4), e518-e524.

Vartanian LR, Schwartz MB, Brownell KD. (2007). Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis. American Journal of Public Health, 97(4), 667-75.

Weng, S. F., Redsell, S. A., Swift, J. A., Yang, M., & Glazebrook, C. P. (2012). Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancyArchives of Disease in Childhood, 97(12), 1019-26.