In Utah, 11.9% of households are considered food insecure (Coleman-Jensen, Rabbitt, Gregory, & Singh, 2016). Food security is determined when “individuals have physical, social, and economic access to sufficient, safe, and nutritious food to meet dietary needs and food preferences for an active and healthy lifestyle” (US Department of Agriculture, 2016). The United States Department of Agriculture (USDA) has set a range of food security standards categorized as high, marginal, low, and very low food security. Food access, which is another component of food security, takes residential location into account. Low food access occurs when a significant number (at least 33%) of individuals in a census tract live more than ½ urban miles or 10 rural miles from a supermarket (US Department of Agriculture, 2017).
Many households experience short periods of food insecurity that repeat periodically, due to a shortage of adequate personal finances or resources. In addition to sufficient and safe food, access to nutritious food is a central criterion of food security. The USDA has recommended that individuals eat at least 5 servings of fruits and vegetables a day to maintain a healthy diet. Food insecurity and not meeting the USDA fruit and vegetable recommendations are also correlated. Food insecurity has been associated with developmental delays, nutritional inadequacy, depression, obesity, diabetes, and many other adverse health outcomes (Ivers & Cullen, 2011).
Food insecurity disproportionately affects women (Mallick & Rafi, 2010). Women are more vulnerable to food insecurity because of increased vulnerability to poverty due to the gender wage gap, job segregation, gender-based violence, disproportionate caregiver responsibilities, and economic pregnancy costs (Ivers & Cullen, 2011). Nationally, single female-headed households (women without a partner and with children) have the highest rates of food insecurity, with 30.3% of households being food insecure in comparison to 22.4% of single male-headed households (men without a partner and with children) (Coleman-Jensen et al., 2016).
Even within partnered households, women bear the brunt of food insecurity consequences. Among all food-insecure individuals, the risk of obesity is higher in women than in men (Ivers & Cullen, 2011). Additionally, the risk of depression and anxiety is higher in food-insecure women than in men (Ivers & Cullen, 2011). These consequences are not isolated to the low and very low food-secure families. Existing literature has reported that marginally food-insecure families are more similar to low and very low food-insecure families than to high food-secure families, as was traditionally thought (Franklin et al., 2012).
Utah is uniquely affected by food insecurity due to the geographic and ethnic composition of the state’s residents. Food insecurity disproportionally impacts individuals living in rural regions of the state as well as individuals who are of Hispanic and Latino/a ethnicity. According to the U.S. Census, 13.7% of the Utah population is Latino. Nationally, it is estimated that approximately 1 in 5 Latino households are food insecure (Coleman-Jensen et al., 2016). Additionally, Utah has a significant rural population that is susceptible to food insecurity. According to the 2010 U.S. Census, 9.4% of Utah’s population live in rural areas and it is estimated that 15% of rural households are food insecure (Coleman-Jensen et al., 2016). By utilizing available resources and the encouragement of local infrastructure to promote food security, communities can improve self-sufficiency and prevent adverse health outcomes.
As of 2015, food insecurity in Utah is close to the national average of 12.7%, which is an improvement compared to past years (Coleman-Jensen et al., 2016). According to a 2014 Feed America survey, within the state, the areas with the highest food insecurity prevalence are in southern Utah, with San Juan County having the highest prevalence (19.07%) of food-insecure families (Figure 1). Although Utah has similar food insecurity rates to those observed in the rest of the US, in low income areas with low food access, Utahns are doing worse than the national average.
Based on USDA 2015 data, 22.89% of the Utah population is low income and have low food access, while nationwide, 18.94% of the population is low income and have low food access. Over 50% of the population in several counties, specifically San Juan, Piute, Garfield and Daggett, have low income and low food access. Although these data document that rural areas are faring particularly poorly in Utah, this information is typically collected at the county level. Within the urban environment, specific areas of Salt Lake, Provo, and Ogden have populations in which over 50% are low income and have low food access. An example of Utah urban neighborhoods with low food access and low income is shown in Figure 2. On the county level, Utah’s urban counties fare well in food security rates, but at the census tract level some urban neighborhoods have up to 90% of the population struggling with low income and low food access.
Fruit and vegetable consumption is one way to measure overall food insecurity. Studies have found that food insecurity is associated with a lower intake of fruits and vegetables (Mello et al., 2010). In considering the average food security in Utah, the fruit and vegetable consumption is similar to the national average. Based on the Indicator Based Information Systems, 17.3% of Utah adults consume at least 3 servings of fruits and vegetables per day compared to 16.8% of all Americans. Based on data from the Centers for Disease Control, between 37.2 and 39.7% of Utah adults consume fruit less than once per day and 19.4-22.1 consume vegetables less than once per day. These figures are worse than reported measures in Utah in 2011.
In Utah, a community-based participatory research project that involved 396 members of many minority groups focused on food insecurity from a woman’s perspective (Author et al., 2016). As a measure of food insecurity within this study, 36% of participants said that they were concerned about having enough food within the past month. This study exhibited how women are the doorway to influencing a community’s health. After a 12-month evidence-based community wellness coaching program, 64% of children and 59% of spouses/partners had an increased fruit intake and 60% of children and 59% of spouses/partners had increased vegetable intake. Households where women had the primary responsibility for making food decisions were more likely to report increased fruit and vegetable intake (p=0.01). While there were 396 women directly participating in the study, 2499 family members were impacted because they lived with the women involved.
7 Domains of Health
Both food insecurity and fruit and vegetable intake are closely tied with many aspects of the 7 Domains of Health, specifically regarding environmental, physical, and emotional health. Food security and access to nutritious food are important aspects of physical health. Having access to nutritious food, and incorporating fruits and vegetables as a part of a diet, provides individuals with essential vitamins, minerals and fiber, all of which help prevent adverse health outcomes. Through a nutritious diet, including fruits and vegetables, individuals are at a decreased risk for many adverse health outcomes including obesity, diabetes mellitus, and high cholesterol (Ivers & Cullen, 2011).
Individuals with low food security, particularly women, are more likely to have poor physical health than individuals with high food security (Ivers & Cullen, 2011). Having a safe environment in which to easily obtain healthy food is connected to individual health outcomes. It is crucial for individuals to have access to locations that provide affordable and nutritious food so that cost and transportation logistical challenges do not prevent individuals from obtaining these foods. Food security is also connected to emotional health, specifically for women. Women who are food insecure, even marginally, have higher rates of depression and anxiety than women with high food security and men with any level of food security (Ivers & Cullen, 2011).
Resources and Recommendations
Throughout Utah, there are many programs that are being implemented to try to reduce food insecurity and increase access to fruits and vegetables. During the 2017 season, 23 farmer’s markets accepted food stamp benefits. Additionally, some of those markets have created a program that matches funds spent on produce (http://www. doubleupfoodbucks.org/). To increase access to fresh produce, there is a growing group of community gardens in the urbanized areas of the state. To get children involved and to ensure that their needs are met, 30 out of 80 districts in Utah participate in farm-to-school programs which utilize local produce for school breakfast, lunch, snack, and summer programs.
While these programs are slowly gaining traction, Utah ranks 50th in school breakfast program participation (Hewins, 2016). Because of this, the Utah Department of Health and Utahns against Hunger have partnered with Partners for Breakfast in the Classroom (http://breakfastinthe-classroom.org/), a program that provides assistance and grants to schools to increase breakfast participation. Schools are being encouraged to apply for the Healthy School programs, which helps schools create polices and environments to encourage healthy eating and an active lifestyle. Lastly, as seen within the Utah-based study, it is crucial to recognize the role that mothers and other women play regarding healthy eating. Through targeting women and ensuring that women’s health nutrition literacy and access is up to standard, entire families can be impacted.
- US Department of Agriculture. (2016). Definitions of Food Security. Retrieved from https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security/
- US Department of Agriculture. (2017). Documentation. Retrieved from https://www.ers.usda.gov/data-prod- ucts/food-security-in-the-united-states/documentation/
- Coleman-Jensen, A., Rabbitt, M., Gregory, C., & Singh, A. (2016). Household Food Security in the United States in 2015. In. USDA ERS. Retrieved from https://www.ers.usda.gov/publications/pub- details/?pubid=79760
- Franklin, B., Jones, A., Love, D., Puckett, S., Macklin, J., & White-Means, S. (2012). Exploring mediators of food insecurity and obesity: a review of recent literature. J Community Health, 37(1), 253-264. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21644024
- Hewins, J. (2016). School Breakfast Scorecard. In: Food Research and Action Center. Retrieved from http://frac.org/wp-content/uploads/2016/09/School_Breakfast_Scorecard_SY_2014_2015.pdf
- Ivers, L. C., & Cullen, K. A. (2011). Food insecurity: special considerations for women. Am J Clin Nutr, 94(6), 1740S-1744S. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22089447
- Mallick, D., & Rafi, M. (2010). Are Female-Headed Households More Food Insecure? Evidence from Bangladesh. In (Vol. 38). World Development. Retrieved from http://www.sciencedirect.com/science/arti- cle/pii/S0305750X09001958
- Mello, J. A., Gans, K. M., Risica, P. M., Kirtania, U., Strolla, L. O., & Fournier, L. (2010). How is food insecurity associated with dietary behaviors? An analysis with low-income, ethnically diverse participants in a nutrition intervention study. J Am Diet Assoc, 110(12), 1906-1911. Retrieved from https://www.ncbi. nlm.nih.gov/pmc/articles/PMC3005628/
- Zhang, W., Mukundente, V., Davis, F., Sanchez-Birkhead, A., Tavake-Pasi, F., . . . Digre, K. Healthy Women Lead Healthy Families: The impact of a wellness coaching program for women of color on the phys- ical activity and eating behaviors of family members. In: American Public Health Association. Oct 29- Nov 2 2016; Denver, CO.
Willis SK, Hemmert R, Baayd J, & Schliep K. (2019). Food Insecurity & 5 Fruits and Vegetables. Utah Women’s Health Review. doi: 10.26054/0KX2REJ04M.