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Mar 20, 2024


THE HEALTH IMPACT OF FOOD INSECURITY ON MOTHERS AND BABIES

 * Diversity, Equity, Inclusion
 * Environmental, Social & Corporate Governance
 * Healthier Communities

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Mothers-to-be hope for a healthy pregnancy and a healthy baby, but access to
healthy food can be a major challenge.

Food insecurity during pregnancy not only threatens the well-being of mother and
baby – putting them at risk for poor health outcomes, issues with fetal
development, and low birth weights – but it also impacts employers, coworkers,
and communities. By identifying at-risk mothers early in their pregnancies,
employers can help reduce the impact of food insecurity. The first step is
improving access to proven whole-health solutions that address food insecurity
and improve birth outcomes.


INTERCONNECTED FACTORS CONTRIBUTE TO FOOD INSECURITY

Food insecurity is on the rise. In 2022, 12.8% of U.S. households This link will
open in a new tab. reported they lacked access to adequate food due to limited
financial or other resources, up from 10.2% in 2021 and 10.5% in 2020. Women,
members of racial minorities, and low-income households are disproportionately
impacted, while households headed by single mothers experienced the highest rate
of food insecurity in 2022 at 33.1%.



Food insecurity – a particularly challenging social determinant of health (SDOH)
– is complex because its causes fall under multiple categories, including income
inequity and racial discrimination, and its impact on health and vitality is
profound. Understanding these factors is crucial to addressing the problem
proactively and comprehensively.

When a woman is pregnant, food insecurity can have additional ramifications. The
lack of access to fresh, healthy foods can trigger or worsen chronic diseases,
increasing the likelihood of emergency room visits, hospitalizations, and
readmissions. One study found families who are food insecure spend $2,500 more
per year for health care This link will open in a new tab. than families who
aren't food insecure. That’s 20% higher than the national average.


INCOME

Households that include pregnant women or children younger than age two have a
high prevalence of food insecurity, according to a 2023 meta-analysis This link
will open in a new tab.. The analysis found that key factors are unemployment
and low household income, which contribute to a limited ability to buy food. In
addition, low-income communities tend to lack markets that offer fresh, healthy
food choices. This limits dietary diversity and encourages poor diet quality
because available foods tend to be high in simple carbohydrates and are
ultra-processed, a known risk factor for diabetes This link will open in a new
tab..

Income and employment levels are closely linked to ethnicity and gender and
redispose women to lower-paid jobs. These disparities were made worse during the
pandemic and its aftermath.


RACIAL DISPARITIES

As is the case across many SDOH areas, members of racial minorities experience
higher rates of food insecurity This link will open in a new tab. than members
of other groups due to systemic disparities in our country. The rate of food
insecurity in non-Hispanic white households was 9.3% in 2022, less than half
that of Hispanic/Latino households (20.8%) and non-Hispanic African
American/Black households (22.4%).

While income inequity among these groups contributes to disparities in food
insecurity, it is not the only cause. Food accessibility, availability, and
utilization are often highly limited in communities with higher populations of
non-white households, and the absence of stores selling nutritious and
affordable foods and a lack of reliable public transportation create barriers to
food security This link will open in a new tab..


SCREENING AND STIGMA

Physicians and other health care providers who are positioned to address food
insecurity in pregnant women may have the opportunity to enhance their practices
to identify those at risk for food insecurity and to provide comprehensive
support.

For example, obstetrical providers often do not routinely screen for food
insecurity This link will open in a new tab.. At the same time, largely because
of social and cultural stigmas, most pregnant people do not willingly share that
they are experiencing food insecurity. A lack of cultural alignment and trust
between patients and providers contributes to this reluctance.


FOOD INSECURITY IMPACTS MORE THAN MOTHERS AND BABIES

The multitude of factors that contribute to food insecurity are matched by the
complexity of its impact – on families, employers, and society.

 * Mothers: One 2022 study found that women who reported food insecurity during
   pregnancy also had the highest prevalence of maternal hardships This link
   will open in a new tab.. Chronic food insecurity and resulting poor nutrition
   can lead to This link will open in a new tab. miscarriage, preterm birth,
   preeclampsia, and other health issues. It can also contribute to increased
   gestational weight gain and an increased risk of gestational diabetes.
 * Babies: Babies who were exposed as a fetus to food insecurity are at risk for
   health issues This link will open in a new tab. including low birth weight,
   Type 1 diabetes, coronary heart disease, and birth defects.
 * Employers: Employers are directly impacted by these trends, since workers
   with food insecurity This link will open in a new tab. are more likely to
   highly utilize health care resources and are more likely to miss work.
 * Society: The U.S. health care system shoulders an additional $53 billion
   annually This link will open in a new tab. as a result of the chronic
   diseases, emergency department visits, hospitalizations, and readmissions
   connected to food insecurity across the population.


HOW EMPLOYERS CAN HELP ADDRESS FOOD INSECURITY DURING PREGNANCY

There is a massive opportunity to improve the accessibility and effectiveness of
preventive health care services during pregnancy – especially for those most
impacted by food insecurity and other SDOH factors – which can benefit our
collective health and outcomes.

At The Cigna Group This link will open in a new tab., we recognize the unique
role employers can – and should – play in supporting mothers This link will open
in a new tab., which gave rise to a collaboration between Cigna Healthcare This
link will open in a new tab. and Evernorth Health Services This link will open
in a new tab. in launching their Pregnancy Support Pilot. Today, the pilot
connects customers of all backgrounds to personalized prenatal and postnatal
whole-health services that:

 * Enable early identification of at-risk expectant mothers and start
   whole-health evaluation and care.
 * Promote healthy birth outcomes and improved maternal and prenatal care for
   all, especially women who are members of minority populations.
 * Support awareness of, and access to, holistic wellness solutions, including
   risk screenings, no-cost prenatal vitamins and aspirin to prevent
   preeclampsia (when indicated by a physician), oral health services,
   behavioral health screenings for depression and anxiety, nutritional
   education and support, and free monthly home delivery of food boxes for women
   with food insecurity.

To date, almost 80% of eligible pregnant women engaged in the program; 22% of
those who enrolled were identified as high-risk and received the extra support
they need.

One participant – a 32-year-old Hispanic/Latina woman pregnant with her first
baby – said during her screening interview that she was struggling to buy food
after paying her other bills. Her case manager referred her to Foodsmart This
link will open in a new tab. – a Cigna Healthcare wellness partner – which
helped her access local resources, including the Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC). Foodsmart also connected her to
a social worker. “Foodsmart was extremely helpful, and I'm now getting the food
I need to stay healthy,” the member reported back a few weeks later.

We realize that many other mothers and mothers-to-be continue to struggle with
food insecurity, and that we need to support our communities. Because food
insecurity is connected to multiple social challenges, addressing it directly
can yield widespread benefits. Employers who provide solutions acknowledging and
addressing food insecurity proactively contribute to a workforce that is more
engaged and productive – and to mothers and babies who are healthier members of
society.

In the United States, 20% of health care costs This link will open in a new tab.
are related to poor diets. Lack of access to affordable, nutritious food puts
adults and children at increased risk for health issues. To help address these
challenges, Cigna Healthcare has partnered with meal kit company HelloFresh This
link will open in a new tab. to offer discounted access to wholesome, affordable
meals to as many as 12 million Cigna Healthcare customers through their
employers. Cigna Healthcare is also supporting HelloFresh’s Meals with Meaning
This link will open in a new tab. program, a social impact initiative that
provides free meal kits for people experiencing food insecurity in local
communities.



These efforts to fight food insecurity and improve the health and vitality of
those we serve is a step toward improving equitable health outcomes for all
– including during pregnancy.


LET’S GIVE EACH PERSON EVERY OPPORTUNITY TO LIVE WELL.

Health equity is at the heart of our business. See how The Cigna Group is
driving change.

Learn more This link will open in a new tab.

Click here to view this article with full citations. This link will open in a
new tab.


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