Child growth is an internationally accepted outcome reflecting a child’s nutritional status. Child stunting refers to a child who is too short for his or her age and is the result of chronic or recurrent malnutrition. Stunting is a contributing risk factor to child mortality and is also a marker of inequalities in human development. Stunted children fail to reach their physical and cognitive potential.

The consequences of child stunting are both immediate and long term and include increased morbidity and mortality, poor child development and learning capacity, increased risk of infections and non-communicable diseases, increased susceptibility to accumulate fat mostly in the central region of the body, lower fat oxidation, lower energy expenditure, insulin resistance and a higher risk of developing diabetes, hypertension, dyslipidemia, lowered working capacity and unfavorable maternal reproductive outcomes in adulthood. Furthermore, stunted children who experienced rapid weight gain after 2 years have an increased risk of becoming overweight or obese later in life

During the first 2 years after birth, nutritional requirements to support rapid growth and development are very high, and thus adverse factors have a greater potential for causing growth retardation in early life. Frequent infections during the first 2 years of life also contribute to the high risk of becoming stunted during this period. Catch-up growth is possible in children older than 2 years, although stunting is often well established by this age, in many low-and middle-income countries

Of the countries most at risk of climate change, the analysis reveals that Burundi has the highest rate of stunted children (54%), followed by Niger (47%), Yemen (46%), Papua New Guinea (43%), Mozambique (42%), and Madagascar (42%).

Is stunting a problem in the US?

The United States is ‘on course’ to meet three targets for maternal, infant, and young child nutrition (MIYCN). No progress has been made towards achieving the target of reducing anemia among women of reproductive age, with 11.8% of women aged 15 to 49 years now affected. Meanwhile, there has also been no progress towards achieving the low birth weight target, with 8.0% of infants having a low weight at birth. Some progress has been made towards achieving the exclusive breastfeeding target, with 25.8% of infants aged 0 to 5 months exclusively breastfed. The United States is ‘on course’ to meet the target for stunting, but 3.4% of children under 5 years of age are still affected, which is higher than the average for the North American region (3.2%).

Poor nutrition is a leading cause of illness in the United States, associated with more than half a million deaths per year. It is linked with increased risk of obesity, diabetes, and heart disease as well as broader impacts including higher health care costs and decreased productivity.

The share of U.S. households facing hunger is rising at an alarming pace. Nearly 13% of American households were food insecure in 2022. That means some 17 million families, or 1 in 8 U.S. households, struggled to meet their nutritional needs at some point in the year, according to a new report by the U.S. Department of Agriculture. The prevalence was “significantly higher” in 2022 than in 2021, when 13.5 million households were food insecure, according to the USDA.

Malnutrition is the condition that develops when the body is deprived of vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.

Malnutrition occurs in people who are either undernourished or overnourished. In the United States, more children suffer from malnutrition due to dietary imbalances than due to nutritional deficiencies.

Undernutrition occurs when not enough essential nutrients are consumed or when they are excreted more rapidly than they can be replaced. Overnutrition occurs in people who eat too much, eat the wrong things, don’t exercise enough, or take too many vitamins or other dietary replacements. The risk of overnutrition is increased by being more than 20% overweight or consuming a diet high in fat and salt. About 1% of children in the United States suffer from chronic malnutrition.

Malnutrition and lack of nutrients

Nutritional deficiency is far from a leading cause of death in the United States, but the mortality rate has grown significantly enough in recent years to impact life expectancy.

More than 21,000 people died from malnutrition in 2022, according to data from the US Centers from Disease Control and Prevention – more than doubling over the past five years. And a 20% spike in mortality between 2021 and 2022 put nutritional deficiency among the top five factors with a negative effect on life expectancy estimates for 2022.

US life expectancy rebounded in 2022 but not back to pre-pandemic levels Poor nutrition is most deadly for the oldest Americans; More than half of the deaths attributed to nutritional deficiency in 2022 were among those 85 and older, CDC data shows. But deaths have increased across nearly all age groups.

There are 4 broad sub-forms of undernutrition: wasting, stunting, underweight, and deficiencies in vitamins and minerals. Undernutrition makes children in particular much more vulnerable to disease and death.

Low weight for height is known as wasting. It usually indicates recent and severe weight loss because a person has not had enough food to eat and/or they have had an infectious disease, such as diarrhea, which has caused them to lose weight. A young child who is moderately or severely wasted has an increased risk of death, but treatment is possible.

Low height-for-age is known as stunting. It is the result of chronic or recurrent undernutrition, usually associated with poor socioeconomic conditions, poor maternal health and nutrition, frequent illness, and/or inappropriate infant and young child feeding and care in early life. Stunting holds children back from reaching their physical and cognitive potential.

Children with low weight-for-age are known as underweight. A child who is underweight may be stunted, wasted or both. In 2022, an estimated 149 million children under the age of 5 years were suffering from stunting, while 37 million were living with overweight or obesity. Nearly half of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries.

What causes food insecurity in the U.S.?

Stagnating wages and rising living costs have created a perfect storm for food insecurity. Many Americans are finding it increasingly hard to make ends meet, with the cost of basic necessities like rent, utilities, and healthcare outpacing income growth. This economic strain is being exacerbated by escalating food prices.

Data from the Economic Research Service of the United States Department of Agriculture (USDA) shows that food prices rose about 11% from 2021 to 2022. While food prices typically increased by around 2% in prior years, this surge was attributed to a combination of factors, including inflation and supply chain disruptions.

On top of inflation, many Americans face the reality of trying to keep up with escalating costs of living while their wages remain frozen in time.

When you are food insecure, it means that you do not have reliable access to adequate nutritious food, or lack the resources to purchase it. A family is also considered food insecure when its members live in hunger, which is what you feel when you do not have enough to eat or are in fear of starvation.

There is no single face of food insecurity. The need for food assistance varies among children, seniors, college students, people with disabilities, veterans, the working poor, people experiencing homelessness, and others. Food insecurity is often episodic and cyclical. People may require food assistance a single time, for a few months, or on a more regular basis. People who face food insecurity must choose between buying food and taking care of their families. Most low-income households spend close to 70% of their income on housing, with little left to pay for utilities, childcare, transportation, food, medical care, and other basic needs. Food insecurity often goes hand in hand with housing insecurity, meaning many of the people are close to or already experiencing homelessness.

According to the U.S. Department of Agriculture, 10.8% of American households experienced hunger in 2023, up from 10.4% in 2021. These states have the highest percentages of American households who experienced hunger: Arkansas, Texas, Mississippi, Louisiana, South Carolina, Oklahoma, West Virginia, Kentucky, Alabama, and Missouri.

Food insecurity is the new pandemic

Food is a fundamental human right, much like air and water. Yet hunger and food insecurity are widespread in the United States. In 2020, almost 14 million households—10.5% of the population—did not have enough food to meet their needs, which greatly affected their health, well-being, and quality of life. From June 1 to June 13, 2022, almost 24 million households—including 11.6 million households with children under the age of 18—reported that they sometimes or often did not have enough to eat during the week. More than 7 million households were food insecure despite receiving federal food and nutrition benefits through the Supplemental Nutrition Assistance Program (SNAP), and almost 4 million of these households included children. Notably, low-income households of color, often led by single mothers, tend to have higher rates of hunger and food insecurity due to historic and structural racism and discrimination in economic opportunity, employment, education, housing, and lending.

America’s acute hunger crisis hinders the success of its people—especially children and youth—as well as its economic growth. The ongoing COVID-19 pandemic and subsequent economic crisis, coupled with supply chain issues and other challenges, have resulted in rising prices for goods and services—including food. This has worsened the U.S. hunger crisis, shining a light on decades of policy failures in the U.S. food system and the racial and poverty-related disparities that have existed for far too long.

America’s hunger crisis is not due to a lack of food production or scarcity in food supply. Rather, hunger and food insecurity in the United States are symptoms of policy choices and an economic system that prioritizes the needs of corporations and the wealthy over those of the general population. Across the nation, households experience hunger due to a combination of factors, including limited income from jobs that pay less than living wages; underemployment or unemployment, which has been exacerbated by the pandemic; few economic opportunities within communities; low rates of educational attainment; the nation’s history of discrimination based on race, gender, and disability; and more. Millions of Americans who work full-time or even at multiple jobs still find themselves in poverty due to low wages, unstable work schedules, and the high costs of child care, housing, education, transportation, and health care. Furthermore, policy choices that underfund state safety net programs or require individuals and families to jump through burdensome hoops to prove need have weakened the effectiveness of food safety net programs, resulting in a hunger crisis that is unprecedented in any peer industrial nation.

Food is a fundamental human right necessary for survival, but the United States does not consider access to affordable, healthy food a right that necessitates governmental protection. As a result, the nation has a fragmented, broken food production and distribution system that fails to meet the basic needs of millions of people.

Building a long-term, equitable, and sustainable food system that focuses on unmet needs is critical to the nation’s economic growth and success. When people’s basic needs are met, they can focus on building their own financial stability and realizing their American dreams. This helps build a stronger, more resilient economy. However public nutrition assistance programs alone cannot eliminate hunger and food insecurity. To truly eliminate hunger, the United States needs a plethora of interventions and strategies that encompass a whole-of-government approach, with coordinated and collaborative partnerships with the private and nonprofit sectors to meet the unique food needs of various communities and populations.