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The JAMA Forum
February 4, 2020

Food Insecurity and a Threatened Safety Net

Author Affiliations
  • 1Senior policy service professor at George Washington University School of Nursing’s Center for Health Policy and Media Engagement and professor emerita at Hunter College, City University of New York
JAMA. 2020;323(5):406-407. doi:10.1001/jama.2019.22150

More than 50 years ago, H. Jack Geiger, MD, and community organizer John Hatch built a community health center in the Mississippi Delta with funding from the Office of Economic Opportunity, a federal program established by President Lyndon B. Johnson in 1964 to advance the social and economic goals of the “The Great Society.” Recognizing that medications would not cure the health problems arising from poor access to nutritious foods, Geiger wrote prescriptions for healthy foods, which he stocked in the pharmacy, as medicine. And Hatch engaged Mississippi Delta residents to start community food co-ops.

Fast-forward to 2020. As the United States struggles with exorbitant health care costs and lagging health indicators, the federal government has been undermining the lesson that Geiger and Hatch learned about moving “upstream” on health. Since December 2018, the US Department of Agriculture (USDA) has changed the eligibility rules and subsidies of the Supplemental Food and Nutrition Program (SNAP), dropping more than 3 million people from the program and making up to 550 000 children ineligible for free school lunches.