Food Insecurity’s Role on Cancer’s Toll

Over 19 million Americans are currently living in a food desert. Food deserts are an area where more than ⅓ of the population lives greater than one mile (ten miles for rural areas) from a supermarket. Moreover, 1 in 4 Americans are food insecure and do not have the ability to secure adequate and nutritional food due to insufficient household resources. Thus, for many people, fast food is the only way to obtain cheap and reliable food to feed their families. Unfortunately, the constant consumption of fast food and other cheap, processed foods has led to a surge in chronic illnesses. Although it is commonly accepted that “bad nutrition” leads to chronic illnesses like hypertension and diabetes, the USDA also found that the prevalence of all types of cancers increases as the severity of food insecurity increases (Patel, 2019). The increase in cancer from food insecurity is due to a variety of biological and socioeconomic reasons.

Figure 1. This chart indicates the prevalence of food insecurity in between states with the most food insecure regions.

Cancer consists of uncontrolled division of cells and is usually due to a mutation in the DNA.These cells can then metastasize (spread) to other parts of the body. The CDC named cancer as the second leading cause of death in the US after heart disease in 2019. Food insecure regions see higher rates of onset with prostate, breast, pancreatic, and colorectal cancers as well as higher rates of overall cancer mortalities (Fong, 2020).

Poor diets associated with food insecurity, high in processed carbohydrates and fat, affects human epigenetics and this leads to disease onset and progression. Nutritional epigenetics explains that what we put in our bodies leads to effects in gene expression Scientists are starting to realize that epigenetics can play a large role in disease onset. In terms of cancer, many environmental stressors that food insecure patients endure plays  a large part in the high cancer rates (Landecker, 2011). 

Many studies show that FI is associated with poor dietary choices including diets high in calories due to the increased intake of . There is evidence that eating certain carbohydrates that are high in sugar and saturated fats has effects with the epigenetics of cells which may cause mutations or a continuous reciprocal interaction between cancer tumors and neighboring cells (Landecker, 2011).

There are also a variety of other biological factors observed in food insecure populations that can increase cancer onset and mortality. For instance, increased inflammation due to poor diet also has been associated with many cancers (Croussens, 2010). And thirteen types of cancers are associated with obesity and food insecure adults are 32% more likely to be obese than their food secure counterparts due to poor diet (CDC) (Gundersen and Ziliak, 2015).

Figure 2. A summary of some of the most common carcinogenic dietary risks.

Food insecure populations face a web of socioeconomic factors, which may lead to increased cancer onset and mortality. Insurance, or the lack of health insurance, is an especially pressing issue. Food insecure families are less likely to hold public or private health insurance than food secure families. Healthcare expenditures are 121% higher for an average food insecure individual than food secure person, due to the lack of insurance (Tarasuk et. al, 2015). 

The distress and mental health concerns that may affect treatment adherence can be detrimental to the physical health of the patient. FI patients are more likely to be affected by distress when feeding a family is a concern on top of their cancer diagnosis (Myers, 2020). Transportation to healthcare facilities is also a topic of concern since health providers are harder to find in many FI regions compared to non-FI communities. Even FI children, who do not have to worry about providing, experience an increase in distress due to their food situation (Leung et. al, 2020). And this distress is connected with patient nonadherence to physician prescribed orders, treatments, and medications which is a significant issue (Smolderen 2013).

Fortunately, there are solutions that have been implemented in the past and are being considered in the future. Many people are demanding increased access to government-provided health insurance to cope with the ever-increasing health costs that may disproportionately affect FI regions. 

Additionally, some clinics and hospitals alike have been providing free food for both inpatient and outpatients who are food insecure (Weisburg, 2020). Hospitals are also starting to implement patient navigation programs which consists of set teams of nurses and social workers that are trained in treating the patient as a whole person rather than a medical case and providing care and assistance to food insecure individuals and families. Such programs have been proven to help with patient adherence.

Overall, understanding the importance of nutrition and knowing the problems with America’s healthcare and food systems will ultimately lead to more effective solutions for food insecurity in the future.

Edited by Aditya Jhaveri

References

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Tarasuk, V., Cheng, J., de Oliveira, C., Dachner, N., Gundersen, C., & Kurdyak, P. (2015). Association between household food insecurity and annual health care costs. CMAJ : Canadian Medical Association Journal, 187(14), E429–E436. https://doi.org/10.1503/cmaj.150234

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Weisburg, T. F. (2020). Improving Cancer Care By Addressing Food Insecurity. Acc-cancer.org, https://www.accc-cancer.org/docs/documents/oncology-issues/articles/ja20/ja20-improving-cancer-care-by-addressing-food-insecurity.pdf?sfvrsn=26d31058_9

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Image References

USDA Economic Research Service, https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.aspx

World Cancer Research Fund, www.wcrf.org/sites/default/files/TER-Recommendation-2018-DUAL-WEB.jpg. 

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