6 Four Levels of Action: Supporting Families and Systems to Reduce Food Insecurity and Poor Nutrition

According to the non-profit Feeding America, 14 million children faced hunger in 2023 (Feeding America, n.d.b). Food insecurity means not having regular access to enough food or healthy food (Feeding America, n.d.c).

Children who face food insecurity can suffer from serious health problems, such as malnutrition, heart disease, diabetes, depression, anxiety, stress, social isolation, stigma, shame, trouble focusing, stunted growth, low energy, and higher susceptibility to illness. These issues can cause children to miss school and parents to miss work, which lowers family income and keeps the cycle of food insecurity going (Feeding America, n.d.c; International Food Policy Research Institute, 2015).

Families may struggle to buy food because of low income, job loss, or high living costs. These unforeseen expenses often force them to spend money on other needs instead of healthy food (The Annie E. Casey Foundation, 2023). Parents who work long hours may also be too tired or busy to cook healthy meals (Devine et al., 2006).

Health advocates can help these families find resources for food insecurity in the United States.

Individual

Children growing up with food insecurity are often raised on processed foods, which can lower their self-efficacy (Martin et al., 2016). This means they may not be accustomed to or educated to choose nutritious options when healthier food becomes available. Children who are food insecure can develop unhealthy eating patterns like binge eating (Duke University Health System, 2023).

Food insecurity also affects concentration in school and increases the risk of obesity since families often only have access to cheap, unhealthy, and ultra-processed foods (Feeding America, n.d.c). These patterns can lead to chronic conditions such as diabetes and heart disease (International Food Policy Research Institute, 2015).

To address food insecurity at the individual level, evidence-based strategies focus on improving access to nutritious foods, offering nutrition education, and reducing financial barriers. Food is Medicine (FIM) programs are one example, integrating food-based interventions into healthcare to improve diet-related health outcomes and reduce food insecurity (Office of Disease Prevention and Health Promotion, n.d.b).

FIM interventions often include personalized nutrition counseling provided by registered dietitians or trained healthcare professionals. These sessions offer tailored guidance on choosing and preparing healthy foods, understanding portion sizes, and managing dietary needs related to chronic conditions. By improving nutritional literacy, individuals are more capable of making informed food choices that support their overall health (Office of Disease Prevention and Health Promotion, n.d.b).

FIM also includes food prescription programs, where healthcare providers prescribe fresh fruits and vegetables, often paired with vouchers that can be used at local markets. One study found that participants in these produce prescription programs experienced a decrease in body mass index (BMI), suggesting benefits for weight management, improved nutrition and reduced food insecurity (Sharma & Sharma, 2024).

Relationship

A caregiver’s social environment and daily barriers can affect a family’s food insecurity. Many caregivers depend on family members, neighbors, or peers for transportation to access food. Food insecurity often overlaps with other unmet social needs, which makes social capital especially important (Tablazon et al., 2022). In this context, social capital refers to the trusting and supportive relationships that help people access nutritious food. It improves food security by helping individuals share information about programs and resources and by exchanging food to increase access (Nostrabadi et al., 2020).

Programs that use peer mentorship have been developed to support the well-being of low-income families and also help build social capital (Abbott et al., 2019). Peer mentors are often individuals with lived experience of food insecurity who offer emotional support and practical guidance. These programs help educate families, build skills, and create social networks that encourage positive behavior change by sharing information and providing social support (Smith, 2011).

Although peer mentorship for nutrition education and food insecurity in at-risk families is still an emerging area, early results are promising. One example is the Community Cooks program, which used a peer-mentorship model to provide nutrition education inside a food pantry (Oliver et al., 2020). In the nine 60-minute sessions, mentors taught basic cooking skills, healthy eating habits, and recipes using common pantry items. Mentors reported that the information was useful and relevant for families experiencing food insecurity. While the program faced challenges, more research is needed to strengthen and expand this approach at the relationship level (Oliver et al., 2020).

Family strengthening programs can reduce the effects of food insecurity on children by strengthening family bonds (Centers for Disease Control and Prevention, 2024). Talking to children about food insecurity, whether they experience it or not, can help build empathy and create a more aware and compassionate community as they grow up (Tormollen, 2024). Feeding America also offers educational materials to help parents talk with their children about food insecurity. These resources include practical steps families can take together and an activity sheet where children can draw their ideas of a better world (Feeding America, n.d.e).

Community

Schools and community organizations are important support systems for families facing food insecurity. The national charity working to end hunger in the United States is Feeding America. They run food banks and pantries nationwide and support laws that improve food access (Feeding America, n.d.a).

When food pantries use a client choice model where people choose their own food it helps promote autonomy, dignity, and self-efficacy. This sense of control has been shown to help reduce food insecurity (Martin et al., 2016). For example, the Food Wellness Pantry at East Cooper Community Outreach in Mount Pleasant, South Carolina, follows the client choice model. Clients choose the food they need online. A farmers market provides fresh fruits and vegetables. In 2023-2024, this program supported over 965 households (East Cooper Community Outreach, n.d.).

Another important strategy at the community level is creating programs led by local residents. These locally led efforts are more effective long-term and provide more relevant and meaningful support compared to savior approaches, which result in lower community trust and participation (Gorecki et al., 2024). In Ohio, local leaders organized mentorship programs, community-run affordable grocery stores, and community gardens. These programs also provided hands-on education about the importance of fresh produce (Gorecki et al., 2024).

Societal

The U.S. federal government recognizes food insecurity and addresses it through programs like the Women, Infants and Children (WIC) Nutrition Program, the National School Lunch Program (NSLP), and the Supplemental Nutrition Assistance Program (SNAP) (Office of Disease Prevention and Health Promotion, n.d.a). NSLP provides free or reduced-price breakfast and lunch during school based on income and family size. It also reimburses snacks for after-school educational programs (U.S. Department of Agriculture, Food and Nutrition Service, 2017). In South Carolina, families qualifying for reduced lunch pay 40 cents per meal, and the program meets strict nutrition standards, making it a strong option for children with poor nutrition at home (South Carolina Department of Education, 2025).

Unfortunately, due to summer break, NSLP is unable to provide meals year-round, but families can use SNAP benefits to help fill this gap. According to Feeding America (n.d.d), SNAP, the largest anti-hunger program in the U.S., provides benefits based on income and expenses. Accepted families receive a card loaded with funds to buy food at grocery stores, farmers markets, convenience stores, and now online, which can be useful for busy parents (Feeding America, n.d.d). SNAP funds can be used for food, beverages, and fruits and vegetable seeds for gardens, but not alcohol, medicine, vitamins, or non-food items (Feeding America, n.d.d).

SNAP can also support food assistance programs like FoodShare Greenville, which offers fresh, affordable produce boxes to families in need. Families receive nutrition education, recipe cards in English and Spanish, and produce. The boxes cost $5 for SNAP cardholders, $20 for low-to-moderate income families, and $25 for the general public.

The National Library of Medicine reports that SNAP reduces food insecurity by 30% or more and improves health outcomes (Keith-Jennings et al., 2019). The average benefit is $187 per person monthly or $6.16 per day. For a household of four, that’s about $726/month, which helps ease the cost of healthy food and free up funds for other essentials (Center on Budget and Policy Priorities, 2024).

WIC fills these gaps for baby products that SNAP and NSLP do not cover. According to the South Carolina Department of Public Health, WIC is a free program offering nutrition education, breastfeeding and formula support, and monthly food assistance. WIC covers items such as infant formula, milk, cheese, yogurt, fruits, vegetables (fresh, canned, or frozen), vegetable juice, whole wheat bread, canned fish, and peanut butter. These items are labeled as WIC-approved in stores to meet specific government nutrition requirements and to make shopping easier for customers. (U.S. Department of Agriculture, Food and Nutrition Service, n.d.). Families with young children who utilize WIC services can reduce food insecurity by 20% (Carlson & Neuberger, 2021).

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