Social Determinants Of Health: Food Security

Where We Stand

NAMI believes that all people with mental health conditions deserve access to supports that promote wellness. NAMI supports public policies and laws that help address social determinants of health, including increasing food security for individuals with mental health conditions.

Why We Care

Access to nutritious food is a critical social determinant of health. Food insecurity, which means having limited or uncertain access to adequate food, is associated with poorer health outcomes and higher odds of chronic illness.

A person’s access to healthy food can affect — and is affected by — mental health. Just as being food-insecure may contribute to stress or anxiety, having a serious mental health condition may hinder a person’s ability to work or limit the kind of work they can do, making it more difficult to afford groceries. Research by the Department of Agriculture (USDA) found that adults with a mental health disability are up to five times more likely to live in a household that is food insecure.

These hardships can affect individuals’ health across their lifespan. Among low-income families with young children, food insecurity is more likely to occur if the mother experiences depression or a psychosis spectrum disorder, and can be a predictor of higher rates of children’s behavioral problems. Among college students, a 2018 study found that food insecurity was linked to poor mental health and lower academic performance. And when adults with serious mental illness (SMI) experience very low food security, they are less likely to be able to afford mental health care and use mental health services. Even for people who do not have a diagnosed mental illness, dealing with food insecurity may contribute to anxiety and depression in adults, and emotional problems among adolescents.

Nutrition assistance programs, like the Supplemental Nutrition Assistance Program (SNAP; formerly known as food stamps) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), can help. SNAP is the nation’s largest nutrition assistance program and provides benefits to low-income individuals and families that are used at stores to purchase food. SNAP has been shown to help reduce poverty and decrease psychological distress. WIC helps low-income women, infants and children up to age five with nutritious foods and education as well as health assessments and referrals. It is associated with better childhood outcomes, including lower odds of a mental health condition diagnosis in childhood.

No individual should have to choose between food or health care. Policies that limit access to nutrition assistance programs could pose a health risk for people with SMI, and in turn, make it more difficult to hold employment or continue education. In contrast, by addressing food insecurity and related social determinants of health, NAMI believes that public policies and laws can help support the nutritional and mental health needs of all ages.

How We Talk About It

• Social determinants of health are factors in a person’s life, like the conditions in the places where a person lives, learns, works, and plays, that impact their health risks and outcomes, including their mental health.
• A person’s level of access to healthy food is tied to their mental health. At the same time, having a SMI may also impact a person’s ability to access healthy food.
• People with mental health conditions are at an increased risk of living in a household that does not have consistent access to healthy food, also known as food insecurity.
• When a person does not have the most basic human needs met, like access to food, they may have to make the unacceptable choice between things like food or health care.
• That means that some individuals with serious mental illness experiencing very low food insecurity are less likely to be able to afford mental health care.
• Nutrition assistance programs like SNAP and WIC help people with mental health conditions afford nutritious food for themselves and their families when they are underemployed, in between jobs, or caring for family members.
• NAMI believes that it is critical to address food insecurity and related social determinants of health to allow people with mental health conditions to focus on getting and staying well.

What We’ve Done

• NAMI’s regulatory comments on a federal proposal to limit SNAP eligibility