Alleviating Food Insecurity in the Disabled Community

Authors’ note: The disability community is rapidly evolving to using identity-first language in place of person-first language. This is because it views disability as being a core component of identity, much like race and gender. Some members of the community, such as people with intellectual and developmental disabilities, prefer person-first language. In this issue brief, the terms are used interchangeably.

Disability and food insecurity have a close and well-documented¹ relationship. Inequities in economic opportunity for disabled people have made disability a key factor in predicting vulnerability to food insecurity;² in turn, increased food insecurity is also associated with higher rates of disabilities related to chronic illness.³

This issue brief provides background on long-standing barriers to food security and access for disabled people in the United States. It then discusses the coronavirus pandemic’s impacts and highlights disability and community organizations’ solutions to these issues. Finally, it provides recommendations for the federal government to alleviate food insecurity in the disability community, including by expanding the definition of disability for anti-poverty programs, disaggregating data to include disability in hunger and food systems research, increasing federal funding to target food insecurity, and expanding and making permanent the online food purchasing pilot program⁴ in all states.

Centering the experiences of community organizations that have worked to meet people’s basic needs on a day-to-day basis—coupled with necessary policy changes at the federal level—is essential to beginning to address hunger in the disability community, both during and after the pandemic.

Barriers to food security for disabled people

Even before the pandemic, disabled people faced numerous barriers to accessing food, most commonly including high unemployment rates, low wages, restrictions around eligibility for social safety net programs, and physical and transportation barriers.

Following the onset of the pandemic, disabled people have seen significantly lower employment rates than nondisabled people. During the height of one of the first COVID-19 spikes in 2020, disabled people’s employment rate fell to 17.9 percent,⁷ translating to an unemployment rate of 12.6 percent⁸—a seven-year high.⁹ In contrast, people without disabilities experienced an employment rate of 61.8 percent and an unemployment rate of 7.9 percent during the same time period.¹⁰

People with disabilities also earn significantly lower wages, with U.S. disabled workers earning 87 cents to every dollar¹¹ earned by nondisabled workers. Moreover, this figure does not include workers who receive 14c wages¹²—an exception under the Fair Labor Standards Act allowing some employers to pay disabled employees subminimum wages—which, on average, amount to $3.34 per hour.¹³ Even when compensated fairly, disabled people may still remain food insecure due to the extra expenses related to having a disability.¹⁴

Furthermore, when accessing vital federal social safety net programs, disabled people must contend with restrictive rules around asset limits and work requirements in order to remain eligible, which can create and exacerbate cycles of poverty.¹⁵ Programs such as SNAP and Supplemental Security Income both have asset limits, making it extremely difficult for disabled people to save. With such low benefit levels, disabled people often live month to month and cannot adequately prepare for major disasters such as pandemics.

Beyond these restrictions, experts agree that programs such as SNAP and WIC do not accommodate the specific needs of the disability community. Emily Brown, founder of the Food Inequality Initiative¹⁶—who has herself experienced food insecurity with two daughters who have a variety of severe food allergies—stated in an interview that the foods they needed were not available under WIC because of brand restrictions.¹⁷ Reyma McCoy McDeid, executive director of the National Council on Independent Living (NCIL), likewise noted that the programs’ restrictions on hot food items make it difficult for disabled people to feed themselves, as some have difficulty preparing foods due to accessibility or energy constraints.¹⁸

Finally, physical accessibility remains a key factor in disabled people’s ability to access food. Efforts to address food deserts¹⁹ often focus only on geographic distance from a convenient grocery store and account only for nondisabled people’s needs. But food deserts for disabled people include a wider array of issues than just proximity to grocery stores, including physical store and transportation accessibility as well as lack of access to affordable food and sustenance options that meet the nutritional needs of people with food allergies or chronic illnesses.

The pandemic’s impacts on food insecurity

The COVID-19 pandemic not only exacerbated hunger but also revealed the extent of its prevalence in the United States. Food insufficiency rose from 10 percent in August 2020 to 13.4 percent in December 2020 during the height of one of the virus’s spikes.²⁰

The pandemic burdened the disability community even more severely. The U.S. Census Bureau’s COVID-19 Household Pulse Survey data from March 2021 revealed that 55.7 percent²¹ of disabled Medicare recipients under the age of 65 reported not having enough food or not having access to the foods they wanted. Additionally, the U.S. Department of Agriculture (USDA) calculated that, in 2020, disabled adults faced food insecurity at more than twice the rate²² of their nondisabled counterparts—with nonworking disabled adults three times more likely to be food insecure than nondisabled adults—due to the numerous adverse impacts of the pandemic. These additional challenges include concerns among disabled people who are at higher risk of COVID-19 complications about the increased risk of exposure that comes with shopping in person at the grocery store,²³ as well as difficulties with food delivery programs such as financial strains and inconvenient delivery times.²⁴

The federal government’s response to rising food insecurity during COVID-19

In light of the unprecedented public health and economic crisis, the federal government passed numerous laws and began piloting new programs aimed at reducing food insecurity during the pandemic. These efforts included the Families First Coronavirus Response Act,²⁵ passed in March 2020, which resulted in several sets of USDA guidance including emergency allotments that allowed states to opt in to access additional funds for the administration of their SNAP programs. Although this boost resulted in a 15 percent increase in SNAP benefits, it left out millions of the poorest recipients.²⁶ President Joe Biden signed an executive order to correct this issue once he took office.²⁷

Additionally, the USDA expanded its online purchasing pilot, making it available to more states;²⁸ Congress originally authorized the program in the 2014 Farm Bill.²⁹ The program allows SNAP users to purchase SNAP-approved food items online and have them delivered. The agency has worked to bring grocery retailers onboard and has redoubled efforts to recruit both national chains and local stores. The program is now operational in 47 states³⁰ and the District of Columbia, up from just five participating states in March 2020.³¹

While this pilot has certainly made it easier for people with disabilities—particularly individuals with mobility-related disabilities and those with compromised immune systems—to gain more consistent, reliable access to nutritious food during the pandemic, it has not made SNAP benefits fully accessible to everyone in the disability community. For example, the program relies on internet access, but more than 40 percent of people with disabilities over the age of 15 do not have access to the internet at home.³² Disabled people are also much less likely than nondisabled people to have computers or mobile devices.³³ Furthermore, 98 percent of online websites, many of which are food retailers, do not meet web content accessibility guidelines.³⁴

While increases and changes in benefits have helped mitigate the crisis,³⁵ benefits remain too low,³⁶ and recipients continue to run out before the end of each month. Furthermore, many emergency provisions³⁷ that have made it easier for people with disabilities to qualify are temporary. For example, Families First temporarily lifted so-called work reporting requirements for “able-bodied adults without dependents” to receive SNAP.³⁸ This provision will expire at the end of the public health emergency (as determined by the federal government), and these individuals will once again be required to demonstrate that they are either working or enrolled in an approved training program at least 80 hours per month and will face arbitrary time limits on receiving benefits. Because SNAP defines disability so narrowly³⁹—excluding potentially millions of people who are disabled—this population will be left highly vulnerable. Given that disabled people additionally struggle with higher costs of living⁴⁰ and are more likely to experience higher rates of poverty than their nondisabled peers,⁴¹ they will be disproportionately harmed by expiring provisions.

Community food programs’ solutions to rising food insecurity and inaccessibility during COVID-19

Food programs that tailor their services around specific accessibility accommodations or nutritional needs remain rare. Previous research indicates that many organizations view disability accommodations such as delivery as too extravagant.⁴² However, the Food Equality Initiative was founded to address the needs of people with food allergies or specific nutritional needs. It initially provided food through pantries but moved to an online ordering and delivery service with the onset of the pandemic, giving $155 per month to clients who are referred by partners.⁴³ The initiative found that this method served clients more effectively and with more dignity.

A few centers for independent living (CIL)—resource centers that help support disabled people in their communities—also began offering food access assistance during the pandemic. CILs did not provide significant support of this kind before the pandemic, although some, including Access Living⁴⁴ and CIL of the Keys,⁴⁵ provided referral services to federal programs such as WIC and SNAP. McCoy McDeid of the NCIL stated, “[B]y and large, I think it’s been kind of a pervasive challenge to get CILs on board with prioritizing food.”⁴⁶

The Coronavirus Aid, Relief, and Economic Security (CARES) Act⁴⁷ provided additional funds through Administration for Community Living (ACL) grants to either create or expand food programs at CILs across the country.⁴⁸ Disability Network West Michigan, for example, partnered with an outside food bank and provided guidance on making their programs more accessible.⁴⁹ A few programs, including Endependence Center Incorporated⁵⁰ and the Northern Nevada Center for Independent Living,⁵¹ enabled clients to order food online and arranged delivery with the organization or vendor. Two CIL leaders interviewed by the authors—Ami Hyten with the Topeka Independent Living Resource Center⁵² and McCoy McDeid⁵³—described how they created their own programs by partnering with outside organizations to deliver food directly to clients’ homes.

Topeka Independent Living Resource Center

The Topeka Independent Living Resource Center program started as a mutual aid program that utilized the local CIL’s space to help feed individuals. The mutual aid program merged with the CIL after noticing that many of the people receiving food were also either current or potential clients. After the merge, the program began delivering boxes of food to individuals transitioning out of congregate facilities, including homeless shelters. The community in which the CIL was located was small enough to be able to easily cater to each participant.

Hyten stated, “We know—here’s somebody who has high blood pressure, so you’re gonna look at low sodium stuff in their box. Here’s somebody who has diabetes. We just sort of know this from being part of the community.”⁵⁴ She said that when the pandemic hit, she reevaluated the program and found that many more CIL clients needed services. Using private grant funds and CARES Act grants, the Topeka Independent Living Resource Center program was able to deliver food boxes to each identified client. Once Kansas allowed SNAP recipients to participate in the online purchasing pilot program, which allowed clients to purchase hot food and have groceries delivered, the Topeka CIL also helped clients get internet access and iPads. Hyten stated, “We’re spending less time shopping for people. People are being able to exercise greater autonomy and choice and meet their own dietary and, quite frankly, what they want to eat [through the SNAP pilot program].”

Central Iowa Center for Independent Living

The Central Iowa Center for Independent Living used a portion of their CARES Act funds to partner with the Des Moines Area Religious Council to create a mobile food pantry that delivered boxes of food to clients’ doorsteps. They targeted aid to previous consumers who could not get their food boxes due to quarantine restrictions. The program specifically made accommodations beyond dietary needs to be inclusive of religiosity. The mobile food pantry project ended in September 2021 after CARES funding ran out.

Recommendations for the federal government

Research and data around food insecurity and disability are inadequate at best. In order to effectively tackle the problem—rather than merely highlight existing disparities—the United States must employ a multipronged approach that includes the following actions:

• Expand the definition of disability under SNAP. The definition of disability is currently extremely narrow—essentially including only individuals who receive federal or state disability benefits⁵⁵—meaning that a large number of people with disabilities in the United States are not counted. This is detrimental in multiple ways, from inaccurate representations of disability in SNAP data to people being excluded from benefits due to unattainable work reporting requirements. The USDA should expand the definition of disability for SNAP eligibility purposes to include people who receive other types of federal or state disability services or accommodations.
• Advocate for the inclusion of disability in key USDA hunger and food systems research and data collection. Because of the lack of disaggregated data around disability in nearly all aspects of hunger-related research and food systems data collection, it is not possible to fully or adequately address the needs of this large, diverse community.
• Increase funding to the ACL and USDA, specifically targeted to address food insecurity among disabled adults and children. COVID-related increases to SNAP were an important buffer against the exponentially increased hunger caused by the pandemic.⁵⁶ Paired with the recalculation of the USDA’s Thrifty Food Plan,⁵⁷ making those allotments and other COVID-related provisions permanent would go a long way toward reducing hunger in the long term. CARES Act grants to the ACL helped CILs successfully create innovative and flexible food programs that accommodated disabled people’s specific needs throughout the pandemic, including both nutrition and accessibility issues. Continued funding that specifically addresses food insecurity in the disability community is essential to generally reduce hunger across the United States.
• Expand the online purchasing pilot program to include all states, and continue to address disparities within the program. Geography should not pose a barrier to people with disabilities from accessing a program’s considerable benefits. Access to online ordering and hot foods, for example, has been essential to the disability community throughout the pandemic. The USDA should work to enforce Americans with Disabilities Act requirements for compliant websites and study the impacts of the pilot program on people with disabilities to determine additional ways it can adequately meet the needs of the community.

Conclusion

The United States must work to better understand the barriers to adequate nutrition that people with disabilities face every day. Until the federal government demonstrates clear intention and the political will to center disability in hunger-related data and research and involve nutrition assistance administrators on the ground—such as those who manage CIL programs—policymakers will not be able to craft the policies needed to end hunger in the United States.

The authors would like to thank Kelly’s Kitchen, Megan Buckles, Kyle Ross, and Shivam Saran for their contributions to this issue brief.