Food insecurity is a maternal health emergency in the Southeast

A mother in her third trimester in rural Georgia has just run out of SNAP benefits, but her OB told her to eat more protein and greens to manage her blood pressure. The nearest grocery store with fresh produce is a 20-minute drive, and she can’t always afford the gas. She isn’t choosing between convenience and health; instead, she is choosing between her rent and her baby’s birth weight. That choice is playing out in homes across GA, NC, SC, and TN every day, and it is showing up in the data.

The issue isn’t just financial; it poses a medical risk. This problem is associated with a higher risk of gestational diabetes A type of diabetes that develops during pregnancy in women who didn't already have diabetes, affecting blood sugar levels. , preeclampsia A serious blood pressure condition that develops during pregnancy, which can lead to complications for both mother and baby. , preterm birth, and NICU admission complications for pregnant women.¹ The Southeast has higher rates of maternal mortality and a population that is less likely to access healthcare, ultimately leading to poor overall health that will impact birth outcomes. This issue puts both mother and child in the position of a high-risk pregnancy that has the potential for negative long-term health impacts.

In 2024, the national food insecurity rate was 13.7%, placing GA, NC, SC, and TN above the national average (Table 1). Food insecurity impacts mental and physical health. One study found that food insecurity is positively associated with depression, finding that SNAP-eligible nonparticipants with very low food security had the highest risk of depression.² Another study found that food insecurity in women was associated with an increased prevalence of metabolic syndrome A cluster of conditions that occur together, increasing the risk of heart disease, stroke and type 2 diabetes. .³

These issues stem from community-level barriers. A lack of access to financing and low profitability are barriers that grocery operators face when considering store development.⁴ Furthermore, larger grocery stores require a workforce and a population to sustain them, which are low in rural areas.⁴ As a result, those in lower-income communities have lower availability of nutrient-dense foods, making energy-dense foods, which are often carbohydrate and sugar heavy, the cheaper and easier alternative.³

There are several factors impacting a pregnant woman’s health in the Southeast, including food access and use of government support programs. The maternal mortality rate in the United States between 2018 and 2022 was 23.2 per 100,000 live births, while GA, NC, SC, and TN all had at least three or more deaths per 100,000 live births compared to the national average (Table 1).

The national infant mortality average at the end of 2025 was 5.4 per 1,000 live births.⁵ However, several counties in GA, SC, NC, and TN had infant mortality rates of 13 per 1,000 live births, including Banks, GA; Marion, SC; Martin, NC; and Lauderdale, TN.⁶ This is indicative of a larger issue that puts pregnant women and their children at higher risk, which is likely driven by several factors, food access among them.

Across the four states outlined, WIC participation was below 50% for those eligible, except in NC (61.8%) (Table 1). Barriers to understanding eligibility and the time required for applications place mothers in a difficult position to understand program eligibility and how to use benefits.⁷ Furthermore, one must find WIC-eligible markets that might not be readily available in their area. Closing the participation gap starts with a policy that meets people where they are.

To protect mothers and their children, policy should focus on what works. Programs such as WIC, SNAP, and food prescriptions have potential if they extend their reach and resources. For those in low-income areas with limited access to food, mobile grocery trucks that accept participants of WIC and SNAP could improve access to energy-dense foods that can reduce pregnancy complications and improve overall health.

Furthermore, extending the hours of these trucks so those working in service jobs have access will have positive impacts on community health and engagement. Working with community members to understand their needs and where their food challenges stem from is an important next step to influence policy. WIC modernization and partnership with nonprofits that provide food access can improve WIC’s reach across food-insecure communities.