Solutions Blog

Social determinants of hunger

If you’re low-income, hunger is not the only obstacle you face. In fact, the process of accessing nutritious food most likely highlights many of your problems. Can I safely get to a grocery store? Will my car make it? If my power fails in a snow storm will I have money to replace the food that goes bad? The lack of access to affordable, nutritious food is a public health issue. Community organizations and hospitals have been working to address these issues for years. Fortunately, we have one more tool in our belt thanks to the good ol’ Internal Revenue Service.

At the end of last year the IRS handed down a ruling on Section 501 (r) of the Patient Protection and Affordable Care Act of 2010 (ACA). Basically the IRS said that to maintain nonprofit status, hospitals have to adhere to stricter guidelines in their Community Health Needs Assessments (CHNA), this includes addressing access to adequate nutrition. This ruling basically beefed up the prior community benefit clause.

It is no major revelation to those of us in the hunger field, or to our colleagues in health care, that addressing nutrition can drastically improve health outcomes. For reference I’ve included the MN Health Department’s definition of ‘Social Determinants of Health’ below.
Health is determined through the interaction of individual behaviors and social, economic, genetic and environmental factors. Health is also determined by the systems, policies, and processes encountered in everyday life. Examples of determinants of health include job opportunities, wages, transportation options, the quality of housing and neighborhoods, the food supply, access to health care, the quality of public schools and opportunities for higher education, racism and discrimination, civic engagement, and the availability of networks of social support (

Many Minnesota based organizations have been working on these issues for years. However, the recent ruling handed down from the IRS is great news for anti-hunger organizations and for hospitals. Or, it is great news for anti-hunger organizations, and we should be poised to assist hospitals make this new regulation a ‘win-win.’

The Community Benefit clause is important for some very obvious reasons: it reifies, IN TAX CODE, the inherent connection between health and hunger and it is a new potential funding source for small organizations who are working hard to increase access to nutritious food. But what excites me most, is the space it creates for dynamic partnerships, for silos to break down, and for really creative ideas that bridge gaps, solve PSE (policy, systems, and environments) challenges, and ultimately connect Minnesotans with really tasty, nutritious food.

by John Randolph, SNAP Outreach Specialist


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