Telehealth Use Higher Among Food-Insecure Patients | Bidisha Mandal, PhD

Food insecurity in the United States is increasingly linked to how people access healthcare, with novel research indicating that individuals struggling to afford food are more likely to utilize telehealth services than those who are food secure. A study led by Bidisha Mandal, PhD, of Washington State University, published in January 2026 in The American Journal of Managed Care, reveals a complex relationship between nutritional hardship, consistent access to a healthcare provider, and the growing trend of virtual medical appointments.

The Interplay of Food Security and Healthcare Access

The study, which analyzed data from the 2020-2022 Medical Expenditure Panel Survey, found that food-insecure individuals experienced a 7.2% lower rate of overall healthcare visits – both in-person and telehealth – compared to their food-secure counterparts. However, a notable trend emerged: food insecurity was associated with a 1.7-percentage point increase in the proportion of visits conducted via telehealth. This suggests that while financial hardship can create barriers to healthcare telehealth may offer a crucial alternative for those facing difficulties. The full study details these findings and their implications.

This isn’t simply about convenience. The research highlights that the increased reliance on telehealth among food-insecure individuals is particularly pronounced when travel time to a healthcare provider is significant. Specifically, those with food insecurity and a travel time of 15 to 30 minutes were 2.6 percentage points more likely to opt for a telehealth visit, while those with travel times exceeding 30 minutes showed a 4 percentage point increase. This suggests that transportation barriers, often exacerbated by financial constraints, are a key driver in the shift towards virtual care.

Telehealth’s Economic Impact: Lowering Costs Per Visit

Beyond access, the study also examined the economic implications of telehealth utilization. Researchers found that for every 1-percentage point increase in the share of telehealth visits, there was a corresponding $117.64 reduction in healthcare expenditures per visit. This cost-effectiveness could be particularly beneficial for food-insecure populations, who often face competing financial demands and may be more sensitive to healthcare costs. Dr. Mandal’s profile on AJMC further emphasizes the importance of this research.

Understanding the Study’s Methodology and Limitations

It’s important to understand the methodology employed in this research. The study utilized a retrospective analysis of nationally representative data, meaning it examined existing data rather than conducting a new experiment. Logistic regression models were used to assess access to care, Poisson models to analyze visit counts, and 2-stage Heckman selection models to evaluate telehealth utilization and associated expenditures. While this approach allows for broad insights, it’s crucial to acknowledge its limitations.

The study establishes an association between food insecurity and telehealth use, but it does not prove causation. Other factors, such as access to broadband internet and digital literacy, could also play a role. The data analyzed covers the period of 2020-2022, which coincided with the COVID-19 pandemic and a surge in telehealth adoption. It remains to be seen whether these trends will persist as pandemic-related restrictions ease. The study also doesn’t delve into the quality of care received through telehealth versus in-person visits, which is an important consideration for future research.

Defining Food Insecurity and its Broader Health Consequences

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. It’s a complex issue with far-reaching health consequences, extending beyond nutritional deficiencies. Individuals experiencing food insecurity are more likely to suffer from chronic diseases such as diabetes, heart disease, and depression. They also tend to have poorer overall health outcomes and higher rates of hospitalization. Addressing food insecurity is therefore not only a matter of social justice but also a critical component of public health.

What This Means for Patients and Providers

The findings underscore the need for healthcare providers to be aware of the potential impact of food insecurity on their patients’ access to care. Integrating food insecurity screening into routine healthcare visits could facilitate identify individuals who may benefit from telehealth services or other support programs. Developing hybrid telehealth models, such as mobile clinics that combine virtual consultations with in-person services, could also help bridge the gap in access for food-insecure populations.

For patients, understanding the availability of telehealth options and advocating for their use can be empowering, particularly if transportation or financial constraints pose challenges to in-person care. However, it’s essential to ensure that telehealth services are accessible and equitable, with attention paid to digital literacy and internet access.

The Evolving Landscape of Telehealth and Public Health Surveillance

The increased utilization of telehealth, as highlighted by Dr. Mandal’s research, is part of a broader trend reshaping the healthcare landscape. The Centers for Disease Control and Prevention (CDC) actively monitors telehealth trends and their impact on health equity. The CDC’s telehealth resources provide guidance for healthcare providers and patients alike.

Public health surveillance systems are also adapting to incorporate telehealth data, allowing for more comprehensive monitoring of healthcare access and utilization patterns. This data can inform policy decisions and resource allocation, ensuring that healthcare services are targeted to those who need them most.

Looking Ahead: Further Research and Policy Considerations

Further research is needed to explore the long-term effects of telehealth on health outcomes for food-insecure populations. Studies should investigate the quality of care delivered through telehealth, the impact on chronic disease management, and the potential for telehealth to reduce health disparities.

Policy initiatives aimed at addressing food insecurity and expanding access to affordable healthcare are also crucial. This includes strengthening food assistance programs, increasing funding for telehealth infrastructure, and promoting digital literacy among vulnerable populations. The January 2026 issue of The American Journal of Managed Care, where Dr. Mandal’s study was published, features additional articles on emerging trends in healthcare access and affordability.

addressing the complex interplay between food insecurity and healthcare access requires a multi-faceted approach that combines clinical interventions, public health initiatives, and policy changes. By recognizing the unique challenges faced by food-insecure individuals and leveraging the potential of telehealth, People can work towards a more equitable and accessible healthcare system for all.