Food insecurity threatens Texas rural health

By Olayide Olay Adejumobi, Project Manager, PCCI

Food insecurity is a major factor fueling the massive chronic illness problem plaguing residents of rural Texas. The data we are seeing from a recent analysis by PCCI’s Community Vulnerability Compass (CVC) is that food insecurity is a baseline problem many rural Texans must deal with every day. The CVC found that in 149 rural Texas census tracts, that have a total population of 480,000, food insecurity is high or very high vulnerability.

As background, PCCI recently conducted an analysis of Texas rural health using our innovative CVC. It found that over 80% of rural populations live in areas highly vulnerable to life-threatening chronic diseases, with limited care options. Overall, it found that more than half of Texans living in rural census tracts, approximately 670,000 individuals, reside in areas classified as high or very high vulnerability. 

The CVC analysis also found that rural Texas also faced a critical barrier to daily health and wellness – food insecurity. As an expert in nutrition and public health, food insecurity is toxic and pernicious for families and drive factors leading to obesity which is an underlying element to most chronic illnesses. The CVC found that the 480,000 residents living in census tracts vulnerable to for food insecurity represent more than 36% of the entire rural Texas census tract population.

Considering that rural residents of Texas are highly vulnerable to chronic diseases such as coronary heart disease, cancer and high blood pressure, access to healthy food is critical to preventing and supporting these conditions. A recent study by Prairie View A&M found that 58 Texas counties are considered food deserts, with rural areas, particularly in West Texas, the Panhandle, and the border region, facing severe limited access to fresh, affordable food. When residents are limited to convenience or dollar discount stores, we see this leading to higher food insecurity and obesity rates.

Obesity is one of the primary drivers for chronic illnesses and in Texas, the CVC found that 192 census tracts are high or very high for obesity. These obesity vulnerable census tracts are a factor for the high chronic illness rates across the state. Essentially, food insecurity is the first domino to fall that leads to the high levels of chronic illness vulnerability in rural Texas.

One reason for this is simply the distance challenges Texas offers for basic healthcare. For example, the CVC’s analysis of a cluster of four counties in rural East Texas with nearly 150,000 residents found that there are only 182 inpatient hospital beds available to them within 100 miles. Concurrently, the same region has only 33 supermarkets, again, including discount stores, that serve the nutritional needs of this rural population.

The cluster includes Trinity, Angelina, Houston, and Leon counties. The city of Lufkin is roughly the center of this area, with a population of 35,000 residents, and serves as the main source of full-service supermarkets.

I have seen that populations dealing with food insecurities are subject to a variety of detrimental effects. These include:

• Overall poor health and increased likelihood of chronic illnesses such as diabetes, cancer, heart disease, and stroke
• Mental and social stresses of food insecurity can lead to social isolation and stigma, while leading to depression due to heightened stress and anxiety
• Declining academic success: Children who have food insecurities may see an adverse effect on their mental and physical health, reducing their educational opportunities

Ending in 2022, PCCI managed the DAHC, a five-year initiative that tested whether identifying and addressing health related social needs of Medicare and Medicaid beneficiaries such as housing instability and quality, food insecurity, utility needs, interpersonal safety, and transportation, would reduce both in health costs and emergency department utilization we found it did. As a part of the team, I was witness to the myriad of social, economic and health issues the most underserved residents of Dallas faced.

Food insecurity isn’t just a statistic it’s a lived reality for many in rural Texas.

I’ve seen how non-medical drivers of health can amplify health disparities and lead to adverse health outcomes when quality, nutrition, and affordable food isn’t within reach. The people in these areas grapple with food insecurity due to a complex interplay of non-medical factors. Which makes solving this issue more than just having grocery stores available in those areas, though that would definitely be a good start. The challenges these areas face include:

• Economic Challenges: Many areas of rural Texas have high poverty rates, making it a daily struggle for residents to afford nourishing food. Families often find themselves compelled to prioritize cheaper, less nutritious options due to limited financial resources.
• Transportation Barriers: Full-service grocery stores, where fresh produce and essential items are readily available, are scarce in many rural areas, and the distance to full-service supermarkets compounds the problem, preventing residents from reaching distant grocery stores and compelling them to settle for less healthy options closer to home.
• Educational Disparities: Low educational attainment in these areas leads to limited knowledge about nutrition and healthy eating, making it a daunting task for residents to make informed food choices. According to the CVC, nearly 16 percent of rural residents do not graduate from high school.

My journey inside the community data PCCI collected has been an eye-opener. But it’s not just about the numbers we see; it’s about understanding the lives and stories behind those data points. Armed with this information, we have the potential to embark on a path to address food insecurity in these communities through:

• Community Health Workers: These unsung heroes bridge the gap by providing education, resources, and emotional support to individuals and families in need. They connect people to local resources like food banks and assistance programs and help them develop coping strategies.
• Community-Led Initiatives: Data-driven strategies can empower grassroots organizations and community leaders to tackle food insecurity head-on. With the PCCIs data, we can pinpoint, at the block-level, areas of the greatest need and tailor interventions accordingly.
• Local Government Support: Guided by data-driven insights, local government officials can allocate resources more effectively. Advocacy for policies promoting the establishment of grocery stores and farmers’ markets can be rooted in this specific data.
• Education and Outreach: Customized nutrition education programs and workshops, based on PCCI’s data, can empower residents to overcome educational disparities and make healthier food choices.

For hospitals, health systems, public health teams, and community partners, food insecurity is more than a food issue. It is a community health issue that affects prevention, chronic disease management, overall well-being, and health equity. When access to nutritious food is unstable, the effects can be felt across households and across communities.

Rural food insecurity in Texas may be less visible, but it is no less important. Bringing that reality into clearer view is one step toward better-informed community health improvement efforts.

About Olayide Olay Adejumobi

Olay is a seasoned healthcare professional with ten years of clinical experience and five years of medical nutrition therapy and disease management experience. As a clinical project manager, she collaborated with cross-functional key stakeholders primarily focused on patient outcomes. She earned a Bachelor of Science in Nutritional Science and Public Health plus a master’s degree in healthcare administration and information Analytics from Texas Tech University.

About PCCI

PCCI is a mission-driven research organization with industry-leading expertise in the practical applications of artificial intelligence and Non-Medical Drivers of Health (NMDoH). We strive to leapfrog the status quo by harnessing the transformative potential of data. Our unique capabilities allow us to provide innovative, actionable solutions that more effectively identify needs, prioritize services, empower providers and engage patients.

Community Vulnerability Compass

PCCI’s Community Vulnerability Compass (CVC) is an innovative NMDoH methodology and database with a web-based tool enabling its users to visualize and more fully understand the context and complexities of a community’s most vulnerable populations across all urban and rural geographies. Through its alignment with the Healthy People 2030 framework, it focuses on the wide range of specific, actionable neighborhood risk factors known to influence the health of vulnerable populations at both the community and individual level.

In a paper titled “The Community Vulnerability Compass: a novel, scalable approach for measuring and visualizing social determinants of health insights,” PCCI authors give a deep look at how the CVC is developed and deployed to create an accurate and scalable social determinants digital measurement tool that shows the true vulnerabilities residents face across our communities.

https://pccinnovation.org/jamia-open-publishes-a-paper-on-pccis-community-vulnerability-compass-cvc/

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