LA County faces dual challenge: Food insecurity and nutrition insecurity

While food insecurity has long been the focus of local and national policymakers and researchers, nutrition insecurity has largely been overlooked. A new study by the Institute for Food System Equity (IFSE) at the USC Dornsife College of Letters, Arts and Sciences aims to change that.

This is the first study in Los Angeles County to identify the populations most affected by nutrition insecurity, distinct from food insecurity. Nutrition insecurity refers to a lack of access to healthy food that meets personal preferences, including cultural, religious and dietary needs, whereas food insecurity simply focuses on a lack of access to enough food.
The study also examined specific health outcomes linked to a lack of nutritious food versus a lack of food in general.

Why it matters: The vast majority of Americans don’t eat a nutritious diet because many factors, such as cost, access and time, make it very difficult to do so.

• Nutrition insecurity has not been analyzed as extensively as food insecurity, leaving gaps in information about how to address this issue, and the specific health problems linked directly to nutrition insecurity.
• Nationally, poor diets are a leading cause of death. To address the problem, it’s essential to know which demographic groups are most impacted by nutrition insecurity.

In her words: “To tackle the leading causes of chronic diseases such as diabetes and mental health issues, we need to track both nutrition insecurity and food insecurity in L.A. County,” said Kayla de la Haye, founding director of IFSE at USC Dornsife’s Center for Economic and Social Research. “Addressing food insecurity is critical to ensuring people have enough food, but we must also understand who faces barriers to eating a healthy diet.”

What they did: The researchers surveyed more than 1,000 adults in L.A. County from Dec. 5, 2022, to Jan. 4, 2023, to determine the rates of food and nutrition insecurity among county residents.

What they found: In 2022, nearly one in four residents experienced food insecurity. A similar proportion reported experiencing nutrition insecurity. Interestingly, almost half of those who experienced nutrition insecurity did not report food insecurity, and vice versa.

• 24% of Angelenos were food insecure, and 25% were nutrition insecure, while 14% were food and nutrition insecure. That means that 1.4 million residents don’t have money to buy enough food and can’t access food that is both healthy and aligned with their personal preferences.
• 6 million Asian residents — 16% of the county’s population — were more than twice as likely as white residents to be nutrition insecure, despite not being at higher risk for food insecurity. This disparity may be due to lack of access to foods that are both healthy and culturally appropriate rather than an inability to afford enough food.
• Conversely, Hispanics, who make up almost half of the county’s population, are twice as likely as non-Hispanic whites to experience food insecurity but were not at higher risk for nutrition insecurity. This signals a challenge in affording sufficient food overall but not a challenge in accessing healthy food that meets their personal preferences.
• Adults 18–40 and those 41–64 are about 5 times more likely to face both food and nutrition insecurity compared to people 65 and older.

Big picture: Nutrition insecurity is widely tracked in low- and middle-income countries confronted with food shortages and malnutrition. In high-income countries such as the United States, however, access to healthy options is often unequal despite an abundance of food.

• The White House emphasized the importance of access to nutritious food by announcing in February that nearly $1.7 billion will be allocated to end hunger and increase healthy eating by 2030.

Zoom in: Both food and nutrition insecurity are valuable predictors of diet-related health outcomes in L.A. County, including diabetes and poor mental health, but not cardiovascular disease, according to the researchers.

• People who were either nutrition or food insecure were 2 times more likely to report having diabetes than those who were both nutrition and food secure.
• The research suggests that nutrition insecurity is more closely linked to diabetes than food insecurity.

What else: Both food and nutrition insecurity are equally linked to poor mental health. The study’s findings align with a new field of research on ‘food and mood’ documenting how poor nutrition, a consequence of food insecurity, increases the risk for depression, anxiety and stress.

• Those who are food insecure are nearly 4.5 times more likely to have poor mental health compared to those who have access to enough food.
• Those who are nutrition insecure are 3.5 times more likely to have poor mental health than those who are well-nourished.
• Experiencing both food and nutrition insecurity triples the chances of poor mental health compared to those experiencing neither.

Next Steps: The researchers recommend that governments and public health officials monitor both food and nutrition insecurity and that food programs strive to address both issues to improve food access and address barriers to healthy diets.

L.A. County government has long tracked food insecurity and added measures of nutrition insecurity to their public health surveillance for the first time in 2023.