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Examining the Impact of Structural Racism on Food Insecurity:
Implications for Addressing Racial/Ethnic Disparities

Angela M. Odoms-Young, PhD [Associate Professor]
Department of Kinesiology and Nutrition, University of Illinois at Chicago, College of Applied
Health Sciences, 650 AHSB, MC 517, 1919 W. Taylor Street, Chicago, IL 60612

Introduction

According the United States Department of Agriculture (USDA), food insecurity “is defined

as a household-level economic and social condition of limited or uncertain access to

adequate food”.1 Recent data indicate that approximately 12.3% or 15.6 million households

in the United States (U.S.) were food insecure at least some time during the last year.1 The

adverse social, physical, and psychological outcomes associated with food insecurity are

well documented, particularly in households with children including higher rates of diabetes

and hypertension, self-reported fair or poor health, maternal depression, behavioral

problems/developmental delays in early life, and poor academic achievement.2–8 These

outcomes are not only detrimental to the health and well-being of individual children and

families but also negatively impact broader society. Based on a combination of lower worker

productivity, higher costs of public education, greater health care costs, and the cost

associated with emergency food distribution, the economic burden associated with food

insecurity has been estimated to be over $167.5 billion annually.9

For over 20 years, food insecurity has been assessed and monitored by the USDA at the

federal level. Although levels of food insecurity have declined and risen over this period, one

trend that has continued to persist is the gap in the prevalence of food insecurity between

people of color and whites.1 An analysis examining trends in food insecurity from 2001 to

2016 found that food insecurity rates for both non-Hispanic black and Hispanic households

were at least twice that of non-Hispanic white households (See Figure 1).1 Moreover, while

race/ethnic specific rates from the USDA are not available for all subgroups, other studies

assessing food insecurity among American Indian/Alaska Native (AI/AN) report similar

results.10,11 Using the Current Population Survey-Food Security Supplement, Jernigan et al.,

2017 found that from 2000 to 2010, 25% of AI/ANs remained consistently food insecure

and AI/ANs were twice as likely to be food insecure compared to whites.12

The relationship between race/ethnicity and food insecurity is complex and is clearly

intertwined with other established determinants of food insecurity including poverty,

unemployment, incarceration, and disability. Concentration of social and economic

disadvantage among people of color over the life course is clearly a significant driver of

higher rates of food insecurity. Substantial gaps in the wealth of people of color and whites

have long existed in the U.S. For example, recent data reported by the Pew Research Center

indicate that the wealth of white households was 13 times the median wealth of black and 10

HHS Public Access
Author manuscript
Fam Community Health. Author manuscript; available in PMC 2019 April 01.

Published in final edited form as:
Fam Community Health. 2018 ; 41(Suppl 2 FOOD INSECURITY AND OBESITY): S3–S6. doi:10.1097/
FCH.0000000000000183.

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times greater than Hispanic households.13 Nevertheless, despite the intersectionality of race/

ethnicity and other social/economic determinants, some evidence suggests that the higher

risk of food insecurity among people of color continue even when these other social and

economic factors are removed.14–18

More Work Needed on the Role of Discrimination and Structural Racism

Given that racial/ethnic disparities in food insecurity have continued for more than a decade,

the need to move beyond just adjusting for race/ethnicity in research to examining exposures

that may impact people of color differently from whites is warranted. There is growing

recognition in the health sciences, particularly public health, that discrimination and

structural racism are key contributors to inequity in health behaviors and outcomes.19–23

The basic definition of racial discrimination is the unequal treatment of persons or groups on

the basis of their race or ethnicity.24 As highlighted in the National Academies Press

Consensus report on Measuring Racial Discrimination, racial discrimination includes two
components: (1) “differential treatment on the basis of race that disadvantages a racial

group” (disparate treatment) and (2) “treatment on the basis of inadequately justified factors

other than race that disadvantages a racial group” (disparate impact).25 Related to the first

component, “disparate treatment”, studies have shown that racial discrimination limits

people of color’s access to educational and employment opportunities resulting in social and

economic consequences that could lead to food insecurity.26,27 The later component,

“disparate impact”, also has implications for creating racial/ethnic disparities in food

insecurity. For example, African Americans are incarcerated in state prisons at a rate that is

five times that of whites.28 Consequently, policies that restrict employment for individuals

who were previously incarcerated could disadvantage people of color, contributing to food

insecurity. Burke et al., 2016 examined the association between severity of food insecurity

and lifetime racial discrimination in a sample of African-American food-insecure

households with children in South Carolina.29 A one-unit increase in the frequency of

lifetime racial discrimination was associated with a 5% increase in the odds of being very

low food secure, even after adjusting for socioeconomic and demographic confounders.

Structural racism refers to “the totality of ways, in which societies foster racial

discrimination, via mutually reinforcing inequitable systems (e.g. housing, employment,

earnings, benefits, credit, media, health care, criminal justice, etc.)”30 Beyond interpersonal

discrimination, structural racism acknowledges the influence of historic and contemporary

policies and practices that are deeply rooted within systems.21,22,30 While it is important that

solutions to address disparities in food insecurity focus on combating interpersonal

discrimination, the need to target structural racism is critical in the fight for achieving equity

in food security and improve related outcomes in people of color.

Solutions to Address Racial Disparities in Food Insecurity

Several promising solutions to address food insecurity have been proposed including to

strengthen and make it easier for families to connect to the existing federal food and

nutrition safety net (e.g. WIC, SNAP); expand and increase access to federal income support

benefits such as Earned Income Tax Credit (EITC); increase opportunities for employment

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and ability for individuals to earn a living wage; train health care providers to screen for

food insecurity and refer individuals and families to appropriate resources and more recently,

the need to take a human rights approach.8,31–34 Still, to address persistent racial disparities

in food insecurity, food security advocates and researchers need to also examine the

potential impact of utilizing approaches that address structural racism and discrimination

more broadly (see Gee and Ford, 2011 and Bailey et al., 2017).22,30 These efforts will likely

pave the way for the emergence of policy and programmatic strategies that promote equity in

food access and health by addressing the legacy of racial, ethnic, and class inequality.

References

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16. Gundersen C. Measuring the extent, depth, and severity of food insecurity: an application to
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27. Williams DR, Mohammed SA. Discrimination and racial disparities in health: evidence and needed
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28. Nellis A. The color of justice: Racial and ethnic disparity in state prisons: Sentencing Project. 2016

29. Burke MP, Jones SJ, Frongillo EA, Fram MS, Blake CE, Freedman DA. Severity of household
food insecurity and lifetime racial discrimination among African-American households in South
Carolina. Ethn Health. 2016:1–17.

30. Bailey ZD, Krieger N, Agenor M, Graves J, Linos N, Bassett MT. Structural racism and health
inequities in the USA: evidence and interventions. Lancet. 2017; 389:1453–63. [PubMed:
28402827]

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Health. 2009; 99:1203–11. [PubMed: 19443834]

32. Medicine, Io. Research Opportunities Concerning the Causes and Consequences of Child Food
Insecurity and Hunger: Workshop Summary. Washington, DC: The National Academies Press;
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33. Vijayaraghavan M, Jacobs EA, Seligman H, Fernandez A. The association between housing
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34. Food Research and Action Center (FRAC). Washington, DC: 2015. A Plan of Action to End
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end-hunger-in-america.pdf

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http://frac.org/wp-content/uploads/2016/10/plan-to-end-hunger-in-america.pdf

http://frac.org/wp-content/uploads/2016/10/plan-to-end-hunger-in-america.pdf

Figure 1.
Source: Calculated by USDA, Economic Research Service, using Current Population Survey

Food Security Supplement data. https://www.ers.usda.gov/topics/food-nutrition-assistance/

food-security-in-the-us/

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https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/

https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/

Introduction
More Work Needed on the Role of Discrimination and Structural Racism
Solutions to Address Racial Disparities in Food Insecurity

References
Figure 1