This holiday, let’s rethink our strategies for tackling hunger

The last five weeks of the year are joyful days of family feasting that also happen to underscore a lot of America’s problems with food. We sail from Thanksgiving to New Year’s Eve on a succession of huge and usually not-so-healthy meals. But others of us go hungry. 

The holidays are a time to reflect on the troubling reality that in our wealthy nation more than 13 million families are food insecure, meaning they regularly have to skip or limit the balanced meals they can’t afford.

And while millions in America worry about having enough money to pay for groceries, millions also suffer from diet-related chronic diseases. It seems like a paradox, but it’s not. Today we are swimming in cheap, tasty, often heavily processed food — and plagued by accompanying conditions like obesity, type 2 diabetes, high blood pressure, heart disease and certain types of cancer. A lot has changed since the 1960s when programs like food stamps and school lunches took on the urgent task of food security — of getting enough calories into children’s empty bellies. The country has gotten a lot more efficient since then at producing calories. 

It is as important as ever to tackle food security — to make sure no child goes hungry. But public health advocates say the focus needs to be on “nutrition security” as well — on eating nutrient-dense foods, particularly fresh fruits and vegetables, upon which good health depends.

How do we do meet great nutritional needs in a world glutted with empty calories? One solution is by using carrot rather than stick approaches — meaning, making it a lot easier for families to buy — and farmers to grow and sell — the healthy food people want and need.

One proven way is through programs like GusNIP, the Gus Schumacher Nutrition Incentive Program, run by the U.S. Department of Agriculture. Nutrition incentive programs seek to increase the purchase of fruits and vegetables among participants in the Supplemental Nutrition Assistance Program, or SNAP, the successor to food stamps. They do this by providing financial incentives at food retail outlets, including grocery stores, farmers’ markets and other places. SNAP, already an enormously important program, becomes even more powerful — addressing nutrition insecurity as well as food insecurity — when it is coupled with nutrition incentive programs. 

The Agriculture Department on Nov. 24 announced its new cohort of GusNIP grantees with more than $34 million to expand the program. This is good news for dozens of innovative nonprofit organizations nationwide that have been doubling families’ SNAP benefits this way. For example, in Connecticut, Maine, New Hampshire, Rhode Island and Vermont, the New England Nutrition Incentive Collaborative will reach over 20,000 consumers at more than 250 outlets for locally grown fruits and vegetables. 

Produce prescription programs, also funded through GusNIP, with names like “Veggie Rx,” are where nutrition security meets health care. Doctors and nurses consult with families who are vulnerable to nutrition insecurity and “prescribe” fruits and vegetables to help achieve better health. Patients who might have gone home only with drug prescriptions in the past now get vouchers for fruits and vegetables. New federal funds will help to expand programs in places like Mingo County, W.Va., and Pike County, Ky., for food-insecure adults who are on Medicaid or uninsured with prediabetes, diabetes, heart disease or an at-risk pregnancy. 

The agriculture secretary, Tom Vilsack, understands the importance of both food insecurity and nutrition security. Speaking in March to the National Press Foundation, he acknowledged that food insecurity was a big problem in the United States, noting that 43 million people in America were receiving benefits from SNAP. “But I think there’s a much larger problem we have to confront,” he said: nutrition insecurity. He pointed out that 60 percent of adults in America have one chronic disease, and 40 percent have two or more. He said the Department of Agriculture and the food and agriculture industry should begin “transforming our food system” to finally tackle nutrition insecurity. 

The landscape of diet and nutrition has evolved over the last several decades but is still in some ways antiquated. All of this leads to a food system that is still in need of repair and a large portion of Americans who still needs access to affordable and healthy foods. The pandemic has further exposed this situation, as well as the juxtaposition — so obvious at the holidays — between having enough to eat and eating well. Those two things don’t have to be in conflict. The country is starting to reach a deeper understanding of how important both are and, although complex, we are working in the right direction to come up with long-lasting solutions. 

Amy Lazarus Yaroch, Ph.D. is the executive director of the Gretchen Swanson Center for Nutrition. Hilary Seligman MD is a professor at the University of California San Francisco