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The Price of Hunger in America

Much of the discussion about health in recent years has focused on new medications and technologies, expanded insurance coverage, and improved quality of care. What also demands attention is a fundamental building block of health that millions of Americans are lacking: food.
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Much of the discussion about health in recent years has focused on new medications and technologies, expanded insurance coverage, and improved quality of care. What also demands attention is a fundamental building block of health that millions of Americans are lacking: food.

When I was a young boy, my father would tell me about his childhood in a small, poor farming village in India. I particularly remember stories about when his five siblings and parents would dilute a handful of grains so they could make enough watery stew to fill each person's bowl. It was not uncommon for them to go to bed hungry. As I grew up, I discovered that hunger was not isolated to small villages halfway across the world. It existed -- and still exists -- at a shocking scale right here in America.

Last year, one of seven households in America -- including 15 million children -- experienced food insecurity. For millions of people, food insecurity means missing meals, being unable to provide enough food for your children, and dealing with the chronic stress that comes from such uncertainty.

As a physician, I have seen the consequences of hunger. I have cared for patients whose lack of access to healthy, affordable food -- and in some cases any food altogether -- made it difficult to control their diabetes or manage their weight. For nearly all of them, food insecurity was emotionally draining, making it difficult to focus on other aspects of their health.

I see the price of hunger as Surgeon General, too. As I visit communities across our country, I hear from teachers whose students come to school hungry because there isn't enough food at home. I meet parents who work two jobs but still cannot afford nutritious food options for their children.

Access to healthy, affordable food can have a profound impact on our health and our ability to lead productive, fulfilling lives. The good news is that there are effective ways to address food insecurity. Over fifty years ago, the United States created the nation's leading anti-hunger initiative: the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps. The program issues debit cards that low-income families can use at grocery stores and other authorized retailers to buy food. The vast majority of households supported by SNAP include children, the elderly, and individuals with disabilities.

A new report issued by the Council of Economic Advisors finds that SNAP does more than just feed low-income Americans. It actually makes their lives -- and health -- measurably better. In 2014 alone, SNAP lifted at least 4.7 million people, including 2.1 million children, out of poverty.

Among children, the benefits of SNAP on health begin before birth and extend into adulthood. Pregnant women who receive SNAP experience fewer poor birth outcomes, like low birth weight. Access to SNAP before birth and in early childhood also leads to better outcomes later in life. For adults who were disadvantaged as children, access to food stamps at a young age is linked to lower risks of obesity and other conditions related to heart disease and diabetes. It is also linked to other improvements, including getting more education and having greater economic self-sufficiency as adults.

The federal government isn't alone in the fight against hunger. Community organizations are creating food banks, distributing meals during the holidays, and growing food in open-access community gardens. Some schools, like Fremont High School, which I visited recently in South Los Angeles, are also teaching children how to grow fruits and vegetables so they can enjoy healthier and more affordable sources of food.

Despite the success of such programs, we know that too many families are still struggling with food insecurity. The current benefit of approximately $1.40 per person per meal is often insufficient to sustain SNAP households through the end of the month. And new research shows that SNAP recipients consume between 10 to 25 percent fewer calories as the month progresses.

Of particular concern are findings that during the end of the month compared to the beginning of the month, depleted food budgets lead to a 27 percent increase in hospital admissions for low blood sugar among low-income adults; lower test scores among school-aged children; and more disciplinary events at school. These effects, in turn, have their own human and financial costs.

The consequences of hunger are avoidable. Policies that improve families' access to adequate food are essential. Combating hunger also needs the continued commitment of community partners. And eradicating food insecurity will ultimately require a renewed national effort to address one of the most important determinants of health: poverty.

America should be a place where no one has to go hungry. By making hunger a struggle of the past, we can have a dramatic impact on the prosperity and health of our nation. We can reduce rates of obesity, diabetes, and heart disease. We can make sure children in every classroom are well nourished and ready to learn. And, most importantly, we can give millions of people a stronger foundation for a healthy life.

Dr. Vivek H. Murthy is the 19th Surgeon General of the United States and the Vice Admiral of the U.S. Public Health Service Commissioned Corps.