Evidence suggests that children in food-insecure homes experience poor diet, impaired cognitive development, an increased risk of chronic illness in adulthood, and emotional and behavioral problems.4-7 For caregivers in food-insecure homes, purchase price is the most influential factor when making food purchasing decisions. Thus, caregivers often purchase cheaper, more calorie-dense foods, rather than more expensive, nutrient-rich foods—leading to childhood obesity.8
Relief eludes many. Federal programs, such as the National School Lunch Program, School Breakfast Program, the Summer Food Service Program, and the Child and Adult Care Food Program, provide free or reduced-price meals for school-age children. Although these programs reduce food insecurity in households that participate, program policy has established that participation is based on household income.9 This is problematic: According to the literature,2 the income of 50% of households that are food-insecure is above the federal poverty level.
It would be more effective to have these programs target families based on geography, not income, because programs would then benefit those who are food-insecure but who live above the poverty line. Location is a significant factor in identifying food-insecure populations: Households outside metropolitan areas are disproportionately affected.1 If these programs were to privilege geography over income, they would include (for example): families in school districts with a low number of grocery stores; families with poor access to public transportation; and families that live in a “food desert”—ie, where fresh, low-cost food options are overshadowed by fast food.
One such program closely applied the model of privilege based on geography: In 2010, the Healthy, Hunger-Free Kids Act was passed, with a Community Eligibility Provision (CEP) that funded school districts in which ≥ 40% of students lived below the poverty line, so that students in those districts received a free school lunch.10 Although eligibility for CEP is still based on income, benefits go to all students who live in the district, including food-insecure students who live in a household above the poverty line. If eligibility criteria were expanded with CEP so that more school districts could participate, it might solve many obstacles faced by other existing programs.
Programs that provide nutrition for households with an infant or young child—eg, the Women, Infants and Children Special Supplemental Nutrition Program (WIC) and the Supplemental Nutrition Assistance Program (SNAP)—reduce food insecurity in households by 20%. However, several unstudied factors can affect food insecurity in families beyond these programs11; some assumptions about food insecurity, for example, strongly point to the influence of maternal mental health.12
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