Food insecurity, or the limited or uncertain availability of nutritionally adequate and safe foods, affects an estimated 10.2 percent of U.S. households, according to the U.S. Department of Agriculture’s Economic Research Service. In families with children at home, food insecurity is even higher, at 12.5%.
Previous studies have shown an association between food insecurity and individual health care expenditures, but there is little research on how food insecurity affects household health care utilization.
Now, researchers at Wake Forest University School of Medicine are reporting the results of a new study showing that food insecure households have higher health care costs than food insecure households.
The study was published today in the January issue of Health affairs.
We know that food insecurity has a negative impact on individual health. But we need a better understanding of the financial implications on households and health care spending.”
Deepak Palakshappa, MD, associate professor of general internal medicine at Wake Forest University School of Medicine and the study’s principal investigator
In the retrospective study, Palakshappa’s team sought to determine the association between a household’s food insecurity over the course of one year and health care costs over the following year. The researchers analyzed data from the 2016 and 2017 Medical Expenditure Panel Survey, a large-scale survey conducted annually by the Agency for Healthcare Research and Quality that is representative of the U.S. population. The survey collects information from US healthcare providers about healthcare services, health insurance, spending, and sociodemographic characteristics.
The team collected data on 14,666 individuals from 6,621 households and found that food insecure households had 20 percent more total health care spending than food insecure households, an annual difference of about $2,456.
“We found that food insecurity in 2016 was associated with increased care costs in 2017 among households, regardless of the type of insurance coverage,” Palakshappa said.
The findings also have significant implications for any potential program or policy to address food insecurity.
“Interventions that address food insecurity in one or more specific family members may also provide benefits to others in the household,” Palakshappa said. “And there is potential financial benefit for insurers investing in these programs.”
Palakshappa’s team also found that 1 in 5 households had more than one insurance plan, making it difficult to determine the full financial benefit of food insecurity interventions in households with mixed insurance coverage.
“More and more parents are enrolling their children in Medicaid or CHIP instead of their employer-sponsored health insurance due to rising out-of-pocket expenses,” Palakshappa said. “However, expanding public subsidies such as the Supplemental Nutrition Assistance Program or tax credits for children can alleviate food insecurity.”
Palakshappa said more research is needed to evaluate how addressing food insecurity during an individual patient visit might impact the health outcomes and health care utilization of other family members.
Atrium Health Wake Forest Baptist
Palakshappa, D., et al. (2022) Food insecurity was associated with higher household health care expenditures in the United States, 2016-17. Health affairs. doi.org/10.1377/hlthaff.2022.00414.