scorecardresearch Skip to main content
Opinion | Catherine D’Amato

How Obamacare could help end hunger

Hanna Barczyk for The Boston Globe

Beyond insuring preexisting conditions and covering young adults until age 26 on their parents’ health plans — provisions singled out for support by President Barack Obama and President-elect Donald Trump — the Affordable Care Act includes a less well-known requirement worth keeping. One that has the potential to end hunger in this country.

In doing so, it would deliver better care for individuals, improve health outcomes across the population, and lower the per capita cost of care — the three overarching goals of health care reform.

The ACA mandates that nonprofit hospitals conduct a Community Health Needs Assessment and Implementation Plan every three years or risk a $50,000 tax and the loss of their nonprofit status.


This far-reaching ACA provision reflects a growing body of research, published by the Kaiser Family Foundation, the Robert Wood Johnson Foundation, the American Journal of Preventive Medicine and many others, indicating that social, economic and environmental factors, including food insecurity, significantly influence health outcomes as well as health care costs. The health-related costs attributable to food insecurity and hunger have been estimated at $160 billion annually, according to a Children’s Health Watch study.

Food insecurity means not having reliable access to enough food for an active, healthy lifestyle. In the United States, 1 in 7 people is food insecure, and in Massachusetts 1 in 9.

Adults with food insecurity are more likely to report poor physical and mental health, and have higher risks for chronic diseases like obesity, hypertension, and diabetes. Children who live in food insecure households have an increased risk for asthma and iron-deficiency anemia, increased risk for hospitalization, and increased likelihood of mental health and behavioral disorders.

It is not surprising then that Community Health Needs Assessments have reported food insecurity as a top finding among patient populations, revealing it as the public health issue it is. In response to their findings, health centers nationwide have developed Community Health Implementation Plans that address the food insecurity experienced by their patients. Partnerships between medical centers and food banks have emerged in Oregon, Colorado, Texas, Ohio, and Minnesota.


Locally, Massachusetts has always been at the forefront of treating food insecurity and hunger as a public health issue. In 2001, The Greater Boston Food Bank and Boston Medical Center established the first hospital-based food pantry in the nation.

This year, GBFB launched a public health initiative designed to support community health centers in our area. Our first partner, Charles River Community Health Center in Brighton, identified food insecurity and lack of access to healthy food among its community’s five most urgent needs in its 2015 assessment.

In addition to providing the health center with a toolkit of available resources to which patients can be connected, including local food pantries, state and federal assistance programs, and nutrition education, the Greater Boston Food Bank now operates a free monthly produce-only mobile market in its parking lot. To date, we have distributed more than 15,000 pounds of food.

The food bank entered a second partnership with the Greater Lawrence Family Health Center in August, similarly furnishing a toolkit of resources and distributing fresh fruits and vegetables that reach about 350 people a month.

The Affordable Care Act’s Community Health Needs Assessment requirement has enabled us to identify at the local level where the need is greatest and to mobilize the public and private resources to address it.


Hunger remains unabated in our country and in our state. Whether mandated or conducted by choice as good medical practice, community health assessments can save billions of dollars in health care costs simply by making people food secure. We have the food. Let’s not abandon one of our most powerful antihunger tools yet.

Catherine D’Amato is president and CEO of The Greater Boston Food Bank .