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Reframing Food is Medicine as syndemic care: a multidimensional approach to food insecurity
Caroline Elizabeth Owens1, David Himmelgreen2
1Department of Anthropology, University of North Carolina Wilmington, Wilmington, NC, United States.
Abstract:
Food insecurity and chronic disease are interlinked through systemic disparities in the United States. Building on anthropological and public health scholarship, we argue that syndemic theory offers a valuable framework for analyzing these entangled conditions. A syndemic lens highlights overlapping biological, behavioral, and social mechanisms. Such as chronic stress, inflammation, and coping strategies, that exacerbate disease outcomes in populations experiencing food insecurity, while also pointing toward testable pathways for intervention. In this essay, we explore the potential promise of Food is Medicine (FIM), which includes clinically embedded approaches like medically tailored meals and produce prescriptions, as a form of syndemic care, targeting the co-occurrence of social and health vulnerabilities and risks. Emerging evidence suggests that FIM programs can improve food security, glycemic control, and support mental health. However, recent federal policy changes, including proposed cuts to Medicaid and the Supplemental Nutrition Assistance Program, threaten to undermine these interventions and syndemic care more broadly. Only by addressing both proximate needs and root causes can syndemic care disrupt entrenched cycles of disadvantage and advance population-level health and health equity.
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