A Rights-Based Approach to Food Insecurity in the United States

by Mariana Chilton, PhD, MPH  and Donald Rose, PhD, MPHAmerican Journal of Public Health. 2009; 99(7): 1203–1211

Certain groups, by nature of socioeconomic conditions or previous discrimination, are more vulnerable to food insecurity than others. A human rights approach entails focusing on those who are most vulnerable, understanding what causes this vulnerability or susceptibility to adverse outcomes, and changing conditions to improve their situation. For example, female-headed households have a high prevalence of household food insecurity—30.2% compared with 11.1% in the general population. A low-income female head of household may be vulnerable to food insecurity because she may have lower income and less childcare support compared with women who are married. Her low income may be related to having less education, fewer skills, less access to higher paying jobs, and, thus, more stress and anxiety about affording food. These processes may lead her to be more vulnerable to food insecurity and poor health.

The more food-insecure a woman is, the more risks she may take to get food on the table, such as taking low-wage jobs requiring long hours that may jeopardize her health; paying less for childcare and, thus, putting her children in higher-risk environments; or, at an extreme, trading sexual intercourse for money and thereby increasing her exposure to sexually transmitted diseases and violence. Among homeless or poorly housed women in Massachusetts, posttraumatic stress disorder because of adverse childhood experiences was associated with a 2-fold increase in the odds of household food insecurity.

These examples show how vulnerability can lead to food insecurity. However, food insecurity itself can exacerbate already-existing vulnerability. Food-insecure women have described experiences of alienation and anxiety coupled with worries about family strife or losing their children. In a nationally representative sample in Canada, individuals from food-insecure households reported higher odds of depression and stress. Among African American women who chronically utilize food pantries, anxiety, violence, and stress were strongly associated with the experience of hunger. Food-insecure households have documented lower nutrient intakes, poor child development, poor health, and forced trade-offs between paying for basic needs such as housing, heating, and medical care. Each trade-off situation increases vulnerability.

The vulnerability of women to hunger and food insecurity has long been recognized in the human rights documents of the United Nations. One of the greatest concerns is the intergenerational transmission of malnutrition—that is, pregnant women that are malnourished are more likely to have low-birthweight babies. As a result, their children are more susceptible to undernutrition and poor cognitive development, which in turn affects the children's ability to earn enough money to support themselves and their families when they become adults. Because women and children are especially vulnerable to food insecurity and to socioeconomic processes that cause it, ensuring women's rights is an important correlate of the right to food.