With the shift in healthcare to consider social determinants of health (SDOH) in improving health outcomes, nutrition plays a key role. Around 34 million Americans face food insecurity. Such statistics have implications for patient health outcomes and for costs to the healthcare system. In particular, nearly half of patients admitted to hospitals are either malnourished or at risk of malnutrition. Further, those malnourished hospitalized patients face a 54% higher chance of 30-day hospital readmission compared to those without food insecurities. Likewise, the healthcare system faces challenges, too, with 26% to 34% higher readmission costs for malnourished patients as opposed to ones with adequate food.
Several factors can hinder patients’ food security. For example, if a patient lives in a food desert, she may need to travel too far to find a grocery store. Similarly, someone living in a food swamp has access to mainly unhealthy junk food, making it challenging for him to get to healthier food options. In other cases, a patient might have a comorbidity, such as dementia, where he cannot cook without risking forgetting to turn off the burner. For other patients, caregiving obligations might hinder their ability to cook nutritious meals.
Food Connection to Chronic Diseases
What patients eat impacts their risk of developing chronic diseases like heart disease, diabetes, hypertension, and obesity. Poor nutrition can exacerbate existing health conditions and limit one’s ability to recover. Conversely, a healthy diet can potentially prevent the onset of these diseases and even help manage them.
- Heart Disease: A diet rich in fruits, vegetables, whole grains, and lean proteins can lower the risk of heart disease. These foods provide essential nutrients like fiber, antioxidants, and healthy fats, which promote cardiovascular health.
- Diabetes: High-fiber foods like legumes, whole grains, and vegetables help stabilize blood sugar levels, making them essential for preventing and managing diabetes.
- Hypertension: Reducing sodium intake and increasing potassium-rich foods like bananas, sweet potatoes, and leafy greens can help manage blood pressure
- Obesity: A balanced diet that emphasizes portion control and includes nutrient-dense foods can aid in weight management, a critical factor in preventing and treating obesity
- Cancer: Antioxidant-rich foods like berries and cruciferous vegetables may help reduce the risk of certain cancers by protecting cells from damage.
- Osteoporosis: Calcium-rich foods like dairy products, leafy greens, and fortified foods are essential for maintaining strong bones and preventing osteoporosis.
Promoting Health Equity through nutrition
Not all patients have access to healthy food, and this imbalance contributes to health disparities. Low-income communities and marginalized groups often face barriers to obtaining nutritious food, resulting in a higher burden of chronic diseases. To promote health equity, organizations can look to the following strategies:
- Address Food Deserts: Target areas lacking access to fresh, healthy food by supporting community gardens, farmers' markets, and initiatives that bring affordable, nutritious options to underserved neighborhoods.
- Nutrition Education: Implement educational programs that teach individuals and families how to make healthier food choices on a budget. Empower people with the knowledge and skills needed to improve their diets.
- Policy Changes: Advocate for policies that incentivize the production and distribution of healthy foods, such as subsidies for fruits and vegetables and regulations on junk food marketing.
- Cultural Competency: Recognize the diversity of dietary preferences and traditions within communities. Tailor nutrition programs to respect cultural differences and preferences.
- School Nutrition: Improve the quality of meals served in schools, ensuring that all children have access to nutritious options. Teach students about the importance of healthy eating.
Support for Healthcare Organizations
While working towards those suggestions, risk-bearing organizations have options readily available to help support their patients in food security. For example, a patient in a food swamp might benefit from medically tailored meals, or another might benefit from sessions with a dietician to help create a meal plan.
When deciding how to allocate resources across their patient populations, risk-bearing organizations can leverage tools. Some technology on the market can assess several complex SDOH risk factors impacting patients – zooming in more specific than a zip code, even within a community – to see the unique SDOH affecting a given patient. The technology can then offer targeted intervention recommendations for a particular patient. With so much at stake, organizations should use all such options that are on the table to improve health outcomes for their patients. Given food’s ability to prevent and treat chronic diseases, leveraging food as medicine can prove a powerful tool in the pursuit of health equity.
