Sometimes, even if you do everything right, it’s still not enough. That’s how Taché Figueroa feels whenever she goes to the grocery store. Both she and her husband—her high school sweetheart—were forced to leave their jobs when thecoronavirushit last March, and with their four kids at home for breakfast, lunch and dinner, they have just $680 a month in federal food assistance to feed the family.
Making it harder is that Figueroa doesn’t want to buy just any food. She wants healthy food. Several years ago, the 31-year-old from Brockton, Massachusetts, was diagnosed with a rare brain disease and it was imperative, her doctor said, that she lose weight. High blood pressure and diabetes run in her family, though so far she has avoided them. And she also worries that one of her daughters—the one with a vicious sweet tooth—is becoming overweight.
The family has long been on a tight budget. Figueroa clips coupons, visits multiple stores to get the best deals, and took a class on making healthy budget recipes that would please the kids. But even before the pandemic—when she worked full time as a personal care assistant and her husband had a job with the local waste management company—she’d run low on money before the end of the month. “I can’t tell you how it feels when I go into a store and I only have $50 and 14 more days' worth of food to buy,” she says. “I think, ‘How am I ever going to make it work?'”
What a Day of Eating on a SNAP Budget Looks Like5 Dinners on a Shoestring Budget10 Cheap & Healthy Foods to Buy, According to a DietitianNutrition Recommendations Need To Be More Culturally Relevant—Here’s Why It Matters
What a Day of Eating on a SNAP Budget Looks Like
5 Dinners on a Shoestring Budget
10 Cheap & Healthy Foods to Buy, According to a Dietitian
Nutrition Recommendations Need To Be More Culturally Relevant—Here’s Why It Matters
In 2020, the number of Americans with food insecurity jumped from an already-whopping 35 million—nearly the entire population of Canada—to a projected 50.4 million, a level not seen since the Great Depression. And again, that dramatic spike did not hit everyone equally. Nearly 4 in 10 Black and Hispanic families struggled to put food on the table when the country shut down last spring—a rate more than double that of white families.
The average annual expenditure on health care for adults facing hunger is $1,834 higher than that of food-secure adults.
This stark divide fuels disturbing health disparities. A U.S. Department of Agriculture report found that the most food-insecure adults—who tend to have less-balanced, nutrient-poor diets—are 40% more likely to have a chronic health issue, such as diabetes, obesity, heart disease or cancer, than those who are most food-secure. As a result, the families that can least afford them face significant additional health care costs. The average annual expenditure on health care for adults facing hunger is $1,834 higher than that of food-secure adults.
Conditions like obesity and diabetes have proved especially dangerous during the pandemic. They’re among the underlying issues estimated to increase the chances of dying from COVID-19 from 1.6% (the risk for healthy individuals) to 20%, according to an early surveillance report from the Centers for Disease Control and Prevention. “We thought that a virus doesn’t discriminate. Yes it does,” says Adam Drewnowski, Ph.D., a professor of epidemiology at the University of Washington and one of the country’s leading researchers on social disparities and their impact on diet and health. “It is quite possible that we come out of this pandemic with a gap between the rich and the poor that may not be bridged again.”
The Barriers to a Healthy Diet
That socioeconomic status is intricately linked to health seems intuitive. Less money, less education and limited access to medical care translates to less stability and worse outcomes. But in America, where belief in the power of individual choice is paramount, eating an unhealthy diet has long been viewed as a moral failure.
This is true of both the left and the right, who have used the argument to serve their political agendas. As far back as the 1970s, conservatives argued that federal food assistance, such as food stamps—now known as the Supplemental Nutrition Assistance Program, or SNAP—should only be used to purchase certain foods due to rising rates of obesity among the poor. In 2011, cook and progressive writer Mark Bittman argued, in a still much-citedNew York Timesopinion piece, that junk food is not cheaper than the healthy stuff, as is widely believed. By his calculations, the ingredients for a homemade chicken dinner totaled half of the $28 it cost to buy a family of four dinner at McDonald’s. “Taking the long route to putting food on the table may not be easy, but for almost all Americans it remains a choice,” he concluded in a plea to embrace cooking at home. “If you can drive to McDonald’s you can drive to Safeway.”
Figueroa and her family experience this every day. Fruits and vegetables—the foods you are “supposed” to fill your plate with—are flat-out too expensive. “My kids love grapes,” she says. “But at $2.99 a pound, a bag costs $10. It’s like, ‘Oh my god, not this week, guys.’ Fruit is a luxury thing.”
She has tried myriad strategies to stretch her budget. For a while, she shopped once a month so she could, in theory, carefully plan out where to spend every penny. But that limited her ability to buy fresh produce, which wouldn’t last four weeks in the fridge. Then she started shopping weekly. But the occasional splurge on, say, strawberries, meant she’d end up short on funds and have to rely on frozen pizzas or corn dogs to make it through the end of the month. Figueroa tried buying food at the local dollar store, too, but found that the only items she could afford were exactly the kind she was trying to avoid. “The junk food is what is cheap in those stores,” she says. “You will find a $1 box of crackers, but it’s filled with sodium. You will find your kid a meal, but it’s full of sodium. Meanwhile, the only vegetables are these individually portioned frozen ones that cost $5.”
These frenzied efforts to provide sustenance are whatFeeding America, the nation’s largest network of food banks, calls “coping strategies.” More than half of its clients use three or more of these strategies at any one time: 40% water down food or drinks to make them last longer; 53% receive help from friends; and 35% sell or pawn personal property. But the No. 1 coping mechanism, at 79%, is purchasing inexpensive or unhealthy foods.
Beyond the high sticker price of nutritious foods, there are other, hidden costs.
O’Brien’s 4-year-old, Brycen, is a picky eater, the kind of kid who will not eat chicken that isn’t breaded. (Though when he does, he removes the breading from the chicken and eats them separately.) A plate with vegetables on it—with the exception of potatoes in fry or tot form only—is all but a declaration of war. “I don’t waste $3 or $4 on something he might not eat when I could spend it on something else,” she says.
The Food Desert Myth
But a growing body of research suggests that there is actually little to no relationship between the proximity of stores that sell healthy food and improved health outcomes. A 2017 study published in theAmerican Journal of Health Promotionfound that a year after the opening of a new supermarket in an underserved South Bronx neighborhood, residents did not report a significant change in fruit or vegetable consumption or overall dietary quality; a Minnesota analysis of that state’s food sales concluded that poor health outcomes were more strongly linked to poverty than to the distance of a well-stocked grocery store. In other words, affordability was the primary barrier to nutritious foods, not availability. A stinging critique of food-desert policies in theFordham Urban Law Journal—titled “Let Them Eat Kale”—determined that despite their failures, “Support for these interventions has nonetheless continued to grow—obscuring underlying issues and detracting from more effective strategies.”
Janet Poppendieck, Ph.D., a professor emerita at Hunter College and the author of several books on hunger, agrees. “Fundamentally, food insecurity is an income problem, not a food problem,” she says. “People go hungry because they cannot afford to purchase adequate food. And even when they can buy sufficient calories, many cannot afford the foods that promote health.”
Providing Better Food for All
It was a cool, sunny October morning, just after 9 a.m., when Rose arrived at the Storehouse food pantry in downtown Albuquerque. She had never been to one before. She had never needed one, until the pandemic.
As a public school teacher, Rose, who requested a pseudonym for privacy, hadn’t lost her job. But she felt compelled to leave. Her own children, 8 and 6, required supervision while learning at home—and in September both of her elderly parents contracted the virus and also needed care. Downtown that morning, many of the shops were closed, but there was already a line of some 30 people, all standing 6 feet apart, at the Storehouse. When a worker rolled up a shopping cart full of 100 pounds of food—quick oats, lentils, spaghetti, chicken breasts, burger patties and several bags of fruit—Rose began to cry. “I used to judge others who got free food,” she says. “Now I’m one of them. This isn’t a place where I ever thought I would be.”
It angers me that not only my family is going through this, but others. So much waste is out there and we can’t have a simple meal. —Taché Figueroa
Still, there’s increasing evidence that such measures work. A landmark report from the National Academy of Sciences concluded that subsidizing the incomes of poor U.S. families, on average, leads to better health among their children—along with more schooling and higher earnings as adults. Basic income pilots are underway in Stockton, California; St. Paul, Minnesota; and Jackson, Mississippi. “When you have economic security and a consistent amount of income coming in that allows you to support yourself, your well-being improves. There is increasing evidence that shows this,” says Sarah Berger Gonzalez, program manager for the Basic Income Lab at Stanford University.
One of the most impressive demonstrations of how health outcomes can improve when fresh food is affordable and accessible is health care provider Geisinger’s Fresh Food Farmacy program, designed for patients with diabetes and other diet-responsive conditions. Patients who enroll receive clinical treatment and educational support for their diabetes, plus free healthy food for themselves and their family. In 2016, Rita Perkins, now 55, was one of the first to sign up. She was overweight, hovering near 200 pounds at just 5-foot-3, and had long struggled with diabetes. “I’d get real tired, and I’d get the shakes really bad when my sugar was low,” Perkins, who lives in Kulpmont, Pennsylvania, remembers.
Such a transformation will not come easily. But if there’s any silver lining to the tragedy of the coronavirus pandemic, it may be that today many more Americans understand what it’s like to experience food insecurity—or know someone who has. After all, familiarity breeds compassion. It could, over time, help build a movement for change. “Prior to COVID, it was ‘they’ and ‘we.’ ‘Theyneed it.Wedon’t,'” says Swarupa Watlington, executive director of Albuquerque’s Storehouse food shelf. “Now the ‘they’ might be a business owner who was forced to shut down, or your neighbor who needs food. There’s more empathy that you could be in that situation. And you think: ‘Why not have access to the healthiest food possible?'”
Jane Blackis a Washington, D.C.-based writer who covers food politics and sustainability.
Credits
Writers:Jane Black, Maya Feller, Vanessa Rissetto, Christine Byrne, Andrea Mathis
Photography:John Stanmeyer, Leslie Grow
Visuals:Tyrel Stendahl, James Van Fleteren
Special Thanks:Anne Treadwell, Shaun Dreisbach, Jessie Price and the staff ofEatingWell.
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