The Paper of the Month for November is 'Addressing food insecurity: what is the role of healthcare?' and is published in Proceedings of the Nutrition Society.

Food insecurity – when people cannot reliably access enough safe, nutritious, and culturally appropriate food – has become a growing concern in the UK. In our paper, we explore how healthcare systems, and especially primary care, can respond to this urgent and complex challenge.

Why food insecurity is a health issue

Food insecurity is not only about hunger; it is deeply linked to both mental and physical health. The stress and uncertainty that come with worrying about food can harm wellbeing, and limited budgets often force people towards cheaper, energy-dense foods that are high in fat, sugar, and salt. This means that food insecurity can contribute to both undernutrition and obesity – a “double burden” that disproportionately affects those already facing disadvantage.

Given these intertwined challenges, we argue that healthcare professionals cannot ignore food insecurity. Primary care, as the first point of contact for many people, offers a unique opportunity to identify and respond to those affected.

How healthcare can help

We recognise the constraints of the inverse care law – the observation that healthcare resources are often scarcest where need is greatest. However, we also highlight promising examples of innovation from within the NHS and community settings. These include community links workers who connect patients with local sources of support, and financial advice workers embedded in GP practices who help people maximise income and manage debt. Such roles do not eliminate food insecurity, but they can make a tangible difference to families’ daily lives.

Another emerging approach is screening for food insecurity in clinical settings. Although not yet routine in the UK, short, validated screening tools can help identify patients at risk and guide referrals to community or welfare support. In North America, similar models have shown that even simple questions can open the door to vital assistance.

Looking upstream

Ultimately, while healthcare can play a role in mitigating the effects of food insecurity, lasting change requires action beyond the clinic. We argue for “cash first” approaches – strengthening social security, ensuring crisis payments reach those who need them – and embedding food security within national policy. Reliance on food banks should be the exception, not the norm.

Food insecurity is both a symptom and a driver of health inequality. Primary care can be part of the solution – but only alongside wider social and policy reforms that guarantee everyone’s right to adequate, nutritious food.

David N Blane