Food for thought: Serving up the truth about food access and health
When it comes to social determinants of health, access to healthy, affordable food is just as important as direct medical care.
By Anna Petrovskis, Frannie Yin, and Alex Zinicola
As important as quality medical care is, it only contributes to a fraction of our health. Nonmedical or social factors such as economic and social conditions, employment, education, race, and gender are in fact responsible for about 80% of our health outcomes.
Despite the delayed downstream benefits of public health services and the challenges of understanding the impact these social services provide to their community, it is well established that prevention costs less than urgent or emergency care or treatment and can significantly decrease mortality.
Food as a social determinant of health (SDOH)
Food insecurity is a strong predictor of both physical and mental health outcomes, yet the prevalence of food insecurity is vast and worsening every year. According to the most recent USDA report, 44 million people (including 13 million children) experienced food insecurity in the United States in 2022, accounting for the largest single-year increase in food insecurity (31% for adults and 44% for children) since 2008.
The causes of food insecurity are complex, including low-income status, unemployment, lack of affordable housing, chronic health conditions, and lack of access to healthcare. Unsurprisingly, food insecurity disproportionately affects under-resourced communities and low-income populations, contributing to the health disparities seen in these populations. Even with secure employment, factors such as housing prices and increased cost of living can create income disparities that affect a family’s ability to purchase food.
Other environmental factors include proximity to grocery stores, neighborhood conditions, lack of transportation, and varying food prices across neighborhoods. For example, rural populations have consistently higher poverty rates than urban areas (16.1% vs. 12.6%) and experience increased food insecurity (12.1% vs. 10.5%), in part due to poorer access to healthy foods and lower incomes. Rising food prices and the end of pandemic-era relief efforts have also exacerbated food insecurity, with 65% of US food banks reporting an increase in demand.
The effects of food insecurity are broad, affecting health outcomes, childhood development, and chronic disease management. Food insecurity has long been associated with higher rates of diabetes, hypertension, obesity, coronary artery disease, congestive heart failure, stroke, cancer, and asthma. Even with the government-funded Supplemental Nutrition Assistance Program (SNAP), recipients have been found to have overall poorer diet quality than non-SNAP individuals due to SNAP placing less importance on providing healthy food.
Food as medicine
Food programs, such as the Emergency Food Assistance Program (TEFAP), SNAP, and the Women, Infants, and Children (WIC) program, are essential but not sufficient in managing the food insecurity crisis. To further address food insecurity, other programs offer innovative solutions to food assistance. Researchers from University of Minnesota evaluated a mobile grocery store bus, the Twin Cities Mobile Market, which accepts SNAP/EBT payment and travels through low-income and low-access neighborhoods providing fresh fruits and vegetables. A qualitative study conducted with shoppers found the Mobile Market decreases barriers and increases access to quality, affordable healthy foods. Findings also indicated that mobile market shopping could positively influence customer behaviors and health outcomes (e.g., dietary intake and management of weight, diabetes, blood pressure, and mental health).
More recently, SNAP recipients have been able to order groceries for delivery and farmer’s markets have begun accepting SNAP payments, reducing transportation disparities and lack of access to fresh produce. This also reduces the time burden associated with healthy food access, an often-overlooked factor in low-income households where family members sometimes work multiple jobs with little time for grocery shopping and meal preparation.
The “food as medicine” movement has gained significant attention in recent years with the US Department of Health and Human Services (HHS) developing a Food is Medicine initiative in response to a 2023 Omnibus Appropriations bill. Although food therapy has long been a part of Eastern traditional medicine, the strategy has slowly gained momentum in Western medical practices with recent research finding a positive relationship with various health outcomes. Some approaches within Food is Medicine include produce prescription programs, where patients with chronic diseases, such as diabetes, receive stipends specifically for fresh fruits and vegetables or medically tailored meals.
Moreover, the National Institutes of Health (NIH) recently expanded funding research for Food is Medicine services. This includes areas such as food insecurity, health outcome mechanisms, and community participatory research methods to increase community engagement and outreach. In taking both a population and individual level approach to these programs, the primary burden of food insecurity is shifted off the individual and onto the system that creates the disparities, targeting the root causes of food insecurity.
While these programmatic advances have precipitated significant benefits, more progress must be made. While medically-tailored meal programs, prescription produce programs, and government nutrition security programs “treat” the outcomes of food insecurity, prevention of food insecurity lies in population-level healthy food policies and programs. Implementing AI and machine learning (ML) solutions can also improve the efficiency of these types of programs.
“There is tremendous potential to implement AI and machine learning (ML) capabilities to further optimize the charitable food industry.”
Real work in the food insecurity space
At Slalom, we work closely with our local communities and strive to invest in programs that enhance the health and lives of our neighbors. Since housing and food security are two key areas influencing our communities, we’re focusing on two foundational SDOH to support health equity and improve health outcomes within these communities.
Since June 2019, Slalom has partnered with Feeding America — the largest charitable food network in the US — to combat food insecurity. Composed of 200 food banks and 60,000 food pantries, Feeding America serves every county in the US. Their mission is to not only feed those in line but also end the line through innovative programming and partnerships, food bank capacity-building, and advocacy.
In collaboration with Microsoft, Slalom is helping Feeding America achieve this bold aspiration through a multiyear digital transformation, helping the organization reduce waste, streamline its food donation process, and provide the appropriate foods to the communities it serves.
Highlights of this transformation include:
- Building a charitable food-sourcing platform, MealConnect, that streamlines the donation process by connecting large produce donors with the nearest food bank
- Sourcing 300M+ pounds (and counting) of produce, translating to 217M nutritional meals
- Keeping produce out of landfills and reducing CO2 emissions by over 164M+ pounds — the equivalent of removing 16,000 passenger vehicles from the road for a year
- Using data to serve over 1M community members, advance local and state advocacy efforts, and optimize food bank service areas
- Connecting 10K+ community members with state and federal assistance programs
- Saving food banks an estimated $150M to date, with the potential to save nearly $500M in services and fees
Creating a better future
While these solutions give us a better understanding of food supply and demand, there is tremendous potential to implement AI and ML capabilities to further optimize the charitable food industry.
Imagine if a food bank could receive notifications for recently donated produce based on proximity, travel time, shelf life, and inventory levels. Or imagine helping food banks forecast patterns, allowing them to proactively source the products they need.
These possibilities may soon become a reality through our continued partnership with Feeding America. Through a market-driven approach and transformative technology capabilities, Slalom is committed to fostering healthy, thriving communities by continuing to drive progress in addressing SDOH and their most foundational needs. With advancements in technology and innovative partnerships, the impact on food security can change the lives of millions of people in food-insecure households throughout the US.
Slalom is a next-generation professional services company creating value at the intersection of business, technology, and humanity. Learn more and reach out today.
