New study develops culturally-informed food insecurity screener for Navajo Nation patients

Philadelphia, September 25, 2025 – A new study published in the Journal of Nutrition Education and Behavior, published by Elsevier, highlights the development of a culturally-informed approach to screening for food insecurity among patients at Northern Navajo Medical Center (NNMC) in Shiprock, New Mexico. The alternative screener aims to reduce stigma, improve patient comfort, and reflect local food traditions and community food access better.

American Indian households experience food insecurity at disproportionately high rates—nearly four times that of the general US population. In the Navajo Nation, geographic isolation, limited grocery store access, high food costs, and transportation barriers contribute to this ongoing public health challenge. Standard screening tools, however, were developed without significant input from American Indian communities and may not capture culturally relevant dimensions of food security.

Researchers from the University of Washington and the University of California, Davis, partnered with NNMC to create an alternative screening tool that incorporated community feedback, visual aids of traditional and convenience foods, and a focus on dietary quality and satisfaction—not just quantity. In a two-phase study involving interviews and surveys with 122 adult participants, the new screener revealed different patterns of food insecurity compared to the existing two-item federal measure, suggesting it may capture unique and important aspects of the issue.

“Community members told us that the current questions can feel uncomfortable or stigmatizing. By using familiar images, acknowledging traditional foods, and focusing on strengths, we aimed to create a tool that not only identifies need but also respects cultural values that are reflective of the Navajo community in Shiprock, New Mexico,” said lead author Tia Benally, MPH, Research Coordinator at the Indigenous Wellness Research Institute, and the School of Public Health, University of Washington, Seattle. “Future initiatives should consider the assets present in the Navajo Nation, such as the close-knit family and community connections that can be further supported to provide a foundation for a food-secure future.”

The authors emphasize that while screening is critical, it should be paired with adequate resources and support to address the root causes of food insecurity. They also call for more research to refine culturally grounded screening tools for use in Navajo Nation and other Indigenous communities.