In 2017, 12.5% of the population was estimated to be food insecure (FI) with wide regional variation. County-level FI is closely associated with, but likely more complex, than the county-level poverty rates. Therefore, we sought to identify a more nuanced framework for understanding factors contributing to FI. In an exploratory design, we studied 32 counties stratified by high and low FI and poverty, which were defined in terms of the national averages. Once stratified, counties were analyzed across 14 metrics within four summary domains: food access, food affordability, overall health environment, and county innovation. Having a stronger health environment was correlated with lower FI; correlations between the remaining three summary domains and FI were not significant. This was an initial effort to conceptualize potential markers of FI into a coherent framework using publicly available population-level health metrics. Future research could expand the sample and add additional metrics.
Keywords: food insecurity; framework; social determinants of health.