Editor’s note: This post is part of a weekly, year-long series called the Nourishing Effect. It explores how hunger affects health through the lens of the 2016 Hunger Report. The report is an annual publication of Bread for the World Institute.
By Bread for the World Institute Staff
1965: Bolivar County, Mississippi. Dr. Jack Geiger, director of the first community health centers in the United States, recognized that malnutrition was the root cause of many of the health problems he and his staff were treating. At the Bolivar County Health Center, they developed the innovative approach of writing prescriptions for patients to purchase food at local stores. The health center paid for the food with funds set aside from the pharmacy budget.
The Bolivar County Health Center and others around the country were established with funding for the War on Poverty. When the Office of Economic Opportunity, the Washington, DC-based agency in charge of directing the War on Poverty, found out what Geiger was doing, officials told him to stop prescribing food paid for with money set aside for health care. Geiger explained that the patients were sick because they were hungry, and the best medicine he knew for hunger was food. But this was not allowed under program rules.
Little has changed since then in practical terms. Doctors still cannot routinely prescribe food for patients with conditions related to hunger or malnutrition if they expect insurance to reimburse them. Meanwhile, though, medical researchers have produced reams of studies re-confirming the relationship between nutrition and health.
Researchers from the University of California, San Francisco, found that hospital admissions for diabetic patients were significantly higher at the end of the month than at the beginning. People with diabetes must manage their blood sugar by adhering to a strict dietary regime to avoid acute episodes that could land them in the hospital. Looking at the hospital discharge records of more than two million patients from 2000 to 2008, the researchers noted that the majority of the patients lived in the poorest ZIP code zones.
Anyone who has talked with families that participate in SNAP has heard how difficult it is to stretch the benefits until the end of the month. The California study was published in early 2014, about the same time that Congress and the president agreed on a farm bill that contained $8 billion in cuts to SNAP, making it harder still for diabetic participants to manage their blood sugar levels. Government pays nearly two-thirds of the cost of treating diabetes, mostly through Medicare and Medicaid. The average cost of a hospital stay in the United States is $2,157 per day. In contrast, a key prevention strategy—SNAP benefits— costs the government about $4.50 per day per recipient.
Studies published in the British medical journal The Lancet show that investments in maternal and child nutrition in developing countries are extraordinarily cost-effective, yielding long-term gains in everything from reduced health care costs to lower poverty rates to increases in productivity and Gross Domestic Product (GDP). It is no different in the United States. A 1992 report by the Government Accountability Office (GAO) showed that WIC cost $296 million a year but saved more than $472 million in federal and state Medicaid costs—a net savings of $176 million a year.
The economic arguments for closer coordination between health care and the federal nutrition programs are persuasive even without considering society’s moral responsibility to help people who are hungry. The biggest fiscal challenge for policymakers at the federal, state, and local levels is still the rapid growth of healthcare expenditures. The United States spends more per capita on health care than any other developed country. But on most meaningful health indicators, the United States is doing worse than almost all of these peer countries. U.S. life expectancy is the lowest, infant mortality the highest.
Promoting better overall health in the U.S. population will be critical to controlling soaring healthcare costs, and keeping people healthy has a great deal to do with making sure that they are eating well.
This text originally appeared in the Introduction of the 2016 Hunger Report: The Nourishing Effect. Read the full report and find references for the information shared above.