Improving food security in the context of a stagnating federal minimum wage

Food insecurity (FI) affects 13.7% of American households and is a major contributor to chronic conditions including type 2 diabetes, hypertension, dyslipidemia, and obesity. Recognizing this, healthcare systems have increasingly attempted to address FI through initiatives such as Food is Medicine programs (including food pharmacies, medically tailored meals or groceries, and produce prescriptions). Yet FI does not exist in a vacuum; it is a product of various interconnected structural factors—unemployment, poverty, wealth inequality, unaffordable cost of living, racism, intergenerational trauma—that both are admittedly harder to address than FI and have received relatively less attention from the medical community. Social welfare policies such as minimum wage increases are designed to reduce both absolute poverty and relative inequality, and at the same time also have the potential to improve FI, other health-related social needs such as housing and transportation insecurity, and overall health. Understanding how such upstream policies affect downstream outcomes like FI is important if we as clinicians seek to not only manage chronic conditions but also address the structural vulnerability predisposing some individuals and not others to chronic disease.