Study finds association between food-insecure households and total health care costs

According to a recent study, households that have a tough time putting food on the table face another big challenge. In addition to being food insecure, they have higher health care costs.

"We already know that adults in households that are food insecure have more negative health outcomes than adults in food-secure households," said University of Illinois economist Craig Gundersen. "However, the cost of the negative health outcomes associated with food insecurity were unknown. This study allows us to quantify these additional costs."

Gundersen said the total health care costs were higher for food-insecure adults across numerous categories. These included inpatient hospitalization, emergency room visits, physician services, same-day surgeries, home health-care services, and prescription drugs. In total, these costs rose with increasing severity of household food insecurity.

The study analyzed data for 67,033 residents of Ontario, 18 to 64 years old, who participated in the Canadian Community Health Survey. Although the data were from 2005 to 2010, Gundersen noted that the prevalence of household food insecurity in Ontario has not changed significantly in recent years. The survey identified whether individuals were marginally, moderately, or severely food insecure. That information was linked to Ontario administrative health care data to determine individuals' direct health-care costs during that same time period.

"After adjusting for sociodemographic variables, total costs were 23 percent higher for adults in marginally food-insecure households, 49 percent higher for those in moderately food-insecure households, and 121 percent higher for those in severely food-insecure households, compared with adults in food-secure households," he said. "These higher costs are staggering."

Due to data limitations and differences in health-care systems, Gundersen said a similar analysis is not possible for the United States. However, although there are obvious differences between the United States and Canada, there are enough similarities that the general conclusions regarding the relationship between food insecurity and health care costs are likely present in the United States as well.

Gundersen mentioned three main implications for the United States. First, health-care providers should screen patients for food insecurity and then assist them to access additional supports, especially food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program). Second, when considering the benefits associated with SNAP and other food assistance programs, their effects on health-care costs should be acknowledged. Because SNAP leads to reductions in food insecurity, it also leads to reductions in health-care costs. Third, there is an increasing concern about the stubbornly high rates of food insecurity in the United States, despite the end of the Great Recession. This concern and the urgency of the search for solutions should be heightened by the higher health-care costs associated with food insecurity.

"Health care costs associated with household food insecurity in Ontario" was published in the Canadian Medical Association Journal and was written by Valerie Tarasuk and Naomi Dachner from the University of Toronto; Joyce Cheng, Claire de Oliveira, and Paul Kurdyak from the Centre for Addition and Mental Health in Toronto; and Craig Gundersen, Soybean Industry Endowed Professor in Agricultural Strategy and professor in the College of Agricultural, Consumer and Environmental Sciences Department Agricultural and Consumer Economics at the University of Illinois.