Finances and Food – A Balancing Act

Posted on Thursday, August 13, 2020

Pay the rent or an insurance premium? Fill a prescription or purchase groceries? Follow a medically necessary diet or pay the light bill?

Those aren’t theoretical questions for the 40 million Americans who are food insecure. 1 They’re the daily decisions people without enough money for food and other necessities face as they try to make ends meet and put affordable, nutritious food on the table month after month.

What’s driving this situation? Many factors – called social determinants of health – combine to create food insecurity, including employment status, access to transportation, and the overall health of the economy where people live. Affording and accessing nutritious food is a major concern for families who live in neighborhoods that are either “food deserts,” lacking traditional grocery stores, or “food swamps,” with overwhelming amounts of fast food restaurants and convenience stores that don’t stock healthy food choices. 2

Food insecurity is a problem around the country, but the financial burden of food insecurity is particularly acute on the Northeast and in the West, where the cost per meal is the highest. According to a recent Feeding America study, the average cost per meal in New York County was almost twice the national average, making it especially difficult for residents on a limited income to afford nutritious food. 3 For these families, government nutrition assistance helps, but it still doesn’t bridge the gap.

Unhealthy coping strategies

When food budgets get tight, families and individuals resort to various coping strategies to stretch their resources including:

  • skipping bills or not paying rent in order to purchase groceries or vice versa
  • purchasing less expensive, nutrient poor foods
  • avoiding needed medical care
  • forgoing medically necessary diets
  • stretching medication use by not filling prescriptions, skipping doses, or taking smaller amounts of medication than prescribed 4

Negative health outcomes

One of the most common coping strategies for low income households and individuals – purchasing less expensive food to stretch the grocery budget – can have long-term, negative, costly health consequences. Studies show that compared to higher income households, people living on lower incomes tend to have a poor-quality diet, consume more sugary drinks, and eat fewer fruits and vegetables. 5

That poor diet leads to complications that contribute to the ongoing cycle of food insecurity for low income families and individuals. A diet high in sodium, sugar, and saturated fat, increases a person’s risk of harmful health conditions and chronic disease. According the Centers for Disease Control and Prevention (CDC), 40% of American adults are obese, putting them at higher risk for type 2 diabetes, some cancers, and heart disease. Obesity alone costs the nation’s health care system $147 billion annually. 6

And the impact of a poor diet starts early. Consider iron intake. The mineral is important for brain development in infants and children. Low iron levels in the diets of expectant mothers and young children is associated with behavioral and mental delays during childhood. 7 The repercussions of those early deficits could last a lifetime. Here’s the challenge for food insecure families: iron is commonly found in red meat, fish, poultry, and leafy greens, grocery products that are often too costly for low-income families to purchase regularly. 

Effective solutions

Helping low income individuals and families facing food insecurity is a national problem that can be addressed with support from government agencies, as well as programs from health care organizations and private companies.

The relationship between Mom’s Meals, community and government programs, and health plans is an excellent model for helping reduce food insecurity for people with low incomes. Health plans work with Mom’s Meals to deliver meals for their members covered under Medicaid or Medicare Advantage, including members who need nutritionally tailored meals to manage chronic health conditions. Mom’s Meals also works with Area Agencies on Aging (AAAs) to deliver nutritious meals to food-insecure, low income senior and disabled individuals. Find out more.


1. https://www.feedingamerica.org/sites/default/files/2019-05/2017-map-the-meal-gap-food-price-variation_0.pdf

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708005/

3. https://www.feedingamerica.org/sites/default/files/2019-05/2017-map-the-meal-gap-food-price-variation_0.pdf

4. https://frac.org/wp-content/uploads/hunger-health-impact-poverty-food-insecurity-health-well-being.pdf

5. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6546-2

6. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm

7. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm

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