Modeling Health Equity and Economic Impacts of National Strategies to Address Food and Nutrition Insecurity

PROJECT ABSTRACT With worsening food insecurity in the COVID-19 pandemic and rising food prices, a 2022 White House initiative sought to address diet-related diseases (e.g., obesity, diabetes, cardiovascular disease) and disparities through food and nutrition insecurity interventions. However, Policymakers lack critical evidence on the effects of

promising interventions to address food and nutrition insecurity because of no available evidence on long-term population health, effects on health disparities, and cost-effectiveness. This proposal seeks to fill these gaps by improving our understanding of the health equity and economic effects of different food and nutrition interventions

and providing important evidence to support national priorities around diet-related diseases and health disparities. Based on three criteria: (a) strategies outlined in the 2022 White House report, (b) conceptual framework based on a health impact pyramid and NIMHD research framework regarding the domains of influence (population- vs.

individual-based), and (c) availability of supporting evidence, we have identified four highly promising interventions to address food and nutrition insecurity: (1) expanding the USDA-supported Gus Schumacher Nutrition Incentive Program and (2) expanding the SNAP benefits and eligibility, (3) accelerating uptake of

food/nutrition security screening and (4) enhancing access to nutrition/obesity counseling. Using our NIH-funded, validated, state-of-the-art, and dynamic microsimulation model, this project will measure the longer-term health outcomes, health equity, and economic impact of these four highly promising policy interventions to address food

and nutrition insecurity on the US adult population and across racial/ethnic and socioeconomic groups. Through robust sensitivity and scenario analyses, our analytic framework allows us to examine the heterogeneous effects of these diverse interventions on long-term effectiveness and cost-effectiveness across population subgroups

and whether such heterogeneous effects reflect differences in baseline risks (e.g., food insecurity) or vulnerability to the risk (e.g., effects of food insecurity on outcomes) or intervention’s effects across subgroups. Our innovative approach and multidisciplinary expert research team uniquely position us to measure long-term population health

effects of food and nutrition insecurity interventions (Aim 1), estimate long-term effects on health disparity across population subgroups of food and nutrition insecurity interventions (Aim 2), quantify economic effects and cost- effectiveness of food and nutrition insecurity interventions (Aim 3). An independent dissemination aim will

improve knowledge translation to end-users by conducting legal and administrative feasibility analysis and developing a web-based interactive platform (National Food and Nutrition Policy Impact Simulator). With the growing need for more robust evidence to address food and nutrition insecurity, our project will

generate policy-relevant evidence on optimal policy choices that may depend on how different interventions affect long-term population health, certain key groups (i.e., reducing disparities), and overall cost-effectiveness. Using such evidence, policymakers can prioritize evidence-based national food and nutrition policies.