On Sept. 28, we will observe the one-year anniversary of the White House Conference for Hunger, Nutrition and Health and the week of Sept. 18–22, the 11th anniversary of Malnutrition Awareness Week. Both further the work of helping prevent, identify, and treat malnutrition and food insecurity, including for older adults.
The White House Conference on Hunger, Nutrition, and Health was authored in the FY22 omnibus bill, which called for a conference to “develop a roadmap to end hunger and improve nutrition by 2030,” and the law further called for a “whole of government approach to addressing issues.”
It was the first such conference since 1969, held Sept. 28, 2022, and opened with Biden’s remarks, “Meeting our bold goals requires … a whole-of-government approach and a whole-of-society effort.” The conference was not age-specific in its focus, which was to its advantage, allowing advocacy groups to shape strategy. Work focused on five pillars: Pillar 1: Improve food access and affordability; Pillar 2: Integrate nutrition and health; Pillar 3: Empower all consumers to make and have access to healthy food; Pillar 4: Support physical activity for all; and Pillar 5: Enhance nutrition and food security research.
Older Adult Provisions in the National Strategy
As a representative of the National Association of Nutrition and Aging Services Programs (NANASP) and Defeat Malnutrition Today (DMT), I worked with other aging groups and am pleased that seven provisions related to aging ended up making it into the national strategy. These included increasing funding for Older Americans Act (OAA) nutrition programs and universal screening for food insecurity in federal healthcare systems as well as incentivizing other payors and providers to screen for food insecurity and other social determinants of health.
To further the work, $8 billion private sector commitments were announced in fall 2022 from AARP expanding research on older adults’ access to the Supplemental Nutrition Assistance Program (SNAP) (results coming 2024) to DoorDash partnering with 18 cities to address transportation barriers to healthy food. More private sector commitments will be announced in fall 2023.
In the past year, many strategies have been acted upon. The Centers for Medicare & Medicaid Services (CMS) Food as Medicine pilot program to cover medically tailored meals in Medicaid 1115 waivers has been approved in multiple states to cover housing, nutrition support/medically tailored meals/30 days of groceries. More retailers are now able to accept SNAP as payment for online grocery orders, especially with a $5 million grant to the National Grocers Association Foundation to help smaller stores to participate.
Further strategies are developing through the USDA National Summit on Nutrition Security and Healthcare “Come to the Table”—a set of seven regional summits on intersections between healthcare and nutrition security with USDA, ProMedica, and The Root Cause Coalition.
Two lofty long-term goals related to the White House Conference are achieving nutrition security, and changing the food pricing paradigm.
Legislatively, a new bill introduced by Sen. Casey (D-PA) Senior Hunger Prevention Act of 2023 (S.1036) seeks to amend the Food and Nutrition Act of 2008 to streamline nutrition access for older adults and adults with disabilities. This summer, the Administration for Community Living (ACL) issued a draft of updated regulations for the Older Americans Act (OAA), the rules that govern OAA programs, including a proposal to add malnutrition screening and treatment to local area aging plans.
One straightforward strategy, increasing funding for OAA nutrition programs, will be difficult this year. The debt ceiling agreement in spring agreed to freeze funding for OAA and other federal programs two years to FY23 levels, which would be a cut, or worse. The current House appropriations process has set base spending caps at FY22, which would result in a cut of $100 million for OAA programs. Further, the continued funding struggles may stall the Farm bill, perhaps for the rest of the year. The Farm bill, reauthorized every five years, funds many federal nutrition programs, including SNAP and the Senior Farmer’s Market.
Two lofty long-term goals related to the White House Conference are achieving nutrition security, defined as having consistent access, availability and affordability of foods and beverages that promote well-being and prevent and treat disease. Second is changing the food pricing paradigm to rebalance the low cost of nutrient poor food and high cost of nutrient dense food. Hopefully, an eventual appropriations bill for the U.S. Department of Agriculture (USDA) will remove the rider barring the USDA from setting stronger standards for SNAP retailers to stock a variety of healthy foods as a basic requirement to participate as a SNAP retailer.
The White House Conference’s goal of ending hunger and improving nutrition by 2030 intersects with Malnutrition Awareness Week, highlighting the importance of nutrition quality, not just quantity. These initiatives emphasize that addressing malnutrition involves not only access to food but also the need for nutritious, balanced meals. As we observe Malnutrition Awareness week, we can recognize this connection and work together to raise awareness about malnutrition’s impact and strive for a future where everyone enjoys healthy food.
Bob Blancato, MPA, is the executive director of NANASP and the national coordinator of DMT in Washington, DC.
