NIS 5.8 Billion
The Additional Healthcare Burden of Food Insecurity in Israel
Rescuing just 20% of the food lost and wasted in Israel would be enough to close the national food-insecurity gap.
Food Insecurity in the World and in Israel – Health and Economic Impacts
Global Food Insecurity
According to the World Health Organization (WHO) and the United Nations, whose definitions are also used by Israel’s National Insurance Institute, food security is achieved when the following four criteria are met:
- Availability: There must be a sufficient quantity and quality of food available.
- Access: Households must have the economic, social, and physical means to obtain enough food to meet their dietary needs.
- Utilization: At the individual level, this includes proper nutrition, dietary diversity, and safe food consumption, supported by access to sanitation, clean water, and awareness of proper food use.
- Stability: Reliable, consistent access to adequate food across all levels and over time and not at risk from sudden shocks.
Food security is not only about preventing hunger but also about ensuring food quality. The right to food is not measured solely in caloric intake but also in nutritional value. Economic access to a healthy food basket – one that provides essential nutrients for physical, mental, and cognitive well-being – is a fundamental requirement for achieving food security.
The State of Food Security and Nutrition in the World, a report published in 2022 by the UN Food and Agriculture Organization (FAO) in collaboration with the WHO, presents estimates of food insecurity rates in countries around the world. The report’s findings include indicators showing that food security around the world has deteriorated since 2020.
Long-term effects of the COVID-19 pandemic, disruptions in global supply chains, the economic impact of the Russia-Ukraine war (particularly on grain production), and extreme climate events have all contributed to rising food prices. As a result, more people worldwide are unable to afford a healthy diet.
Data from the FAO shows that food insecurity in Israel is among the most severe in the OECD.
Food Insecurity in Israel
According to the Israel’s National Insurance Institute Poverty Report, published in January 2023, 16.2% of households in Israel experienced food insecurity in 2021[1]. Of these, 8.2% faced severe food insecurity, while 8% experienced moderate or mild food insecurity. The report also indicates that for three consecutive years, Israel has ranked as the second-highest in poverty rates among OECD countries and fifth among countries in the GINI index in terms of income inequality.
[1] The estimates within the National Insurance Institute’s Poverty Report, on which this Report’s methodology is based, should be distinguished from the Food Security Report, published on November 24.
The National Insurance Institute’s Poverty Report is based on multi-year income data from the Central Bureau of Statistics, which is official, comprehensive, and consistent, therefore allowing for comparisons between periods. The Food Security Report is based on an independent survey by the National Insurance Institute’s Research Administration, which aims to measure actual nutritional gaps.
This is a separate, complex index, which also measures food distress among households not officially defined as below the poverty line, and therefore presents higher rates. In addition, this index is less suitable for multi-year comparisons due to methodological changes that have occurred since 2021.
According to OECD data, which measures poverty rates after taxes and transfers (based on a poverty line set at 50% of median disposable income), Israel has the highest poverty rate among OECD countries, though its rate is similar to that of the United States.
The data also indicates that Israel ranks among the countries with the highest income inequality, according to the Gini Index, a measure of economic disparity within countries. Israel places fifth after the Czech Republic, Mexico, Turkey, and the United States.
Income inequality remains one of the key challenges facing the Israeli economy, with food insecurity being one of its most direct consequences.
According to the 2022 Global Food Security Index published by The Economist, Israel ranks 24th among OECD countries in terms of food security, a drop of 12 places compared to the previous year. In terms of food expenditure as a share of private consumption, Israel ranks sixth among OECD countries.
In our assessment, Israel’s unusually high level of food insecurity stems from two primary factors: the relatively high proportion of household spending on food compared to overall private consumption, and the absence of a comprehensive national policy on food insecurity, marked by a lack of coordinated oversight and dedicated budgets.[1]
In Israel, food accounts for approximately 18% of private household consumption—one of the highest rates in the OECD. For example, a household spending around NIS 20,000 (USD $5,400) per month on various goods would allocate about NIS 3,600 (USD $970) to food.[2] Among food-insecure populations, this share is even higher. For households in the lowest income quintile, food expenses exceed 50% of net income, compared to just 9% in the highest quintile.
Given this context, food rescue and redistribution policies targeting vulnerable populations serve as an effective welfare strategy in Israel. Food rescue efforts that focus on fruit and vegetables as well as other healthy staples such as olive oil, tahini, and legumes, can help ensure access to nutritious food for food-insecure populations, supporting physical, mental, and cognitive functioning. The National Food Security Framework, published in 2025 by the Ministry of Welfare and the National Council for Food Security, highlights the link between poverty and food insecurity and recommends a range of measures to strengthen social resilience through improved food access.[3]
To assess the effectiveness of food rescue as a policy tool for improving food security in Israel, this Report draws on the methodology developed by Chernichovsky and Regev.[4] This approach defines normative food expenditure as an expenditure that remains constant even when a household’s income increases, thus enabling the impact of food rescue to be measured precisely.
In a comparison of per capita food spending[5] among lower-income groups to the normative benchmark of approximately NIS 990 (USD $267) per month. The findings show that in the two lowest percentiles (based on standardized per capita consumption), food expenditure reaches only about half of the normative level.
[1] Food Security in Israel: Mapping Gaps and Implementation Responsibilities, 2023
[2] Private Consumption Expenditure on Food, Beverages, and Tobacco, Including Meals Outside the Home, CBS, 2021
[3] National Food Security Framework, 2025
[4] Food Expenditure Patterns in Israel, Taub Center, 2014
[5] Excluding meals outside the home, alcoholic beverages, and soft drinks.
Nutrition, Food Security, and Health
The Israeli Ministry of Health’s national dietary guidelines[1] recommend a diet that follows the principles of the Mediterranean diet. This approach prioritizes a wide variety of mostly unprocessed plant-based foods, including vegetables, fruit, legumes, whole grains, olive oil, nuts, and seeds, alongside moderate consumption of animal-based foods such as eggs, poultry, fish, and dairy products. The guidelines also strongly advise limiting ultra-processed foods, which often contain extracted ingredients or additives, due to their strong link to obesity and chronic disease.[2] These guidelines are outlined in the Food Rainbow—a national framework that highlights the broader health, environmental, social, and economic benefits of a healthy, balanced diet.
However, historically, public policy efforts to address food insecurity have focused primarily on ensuring adequate caloric intake, with little attention to diet quality. This calorie-centered approach often overlooks the nutritional composition, diversity, and health value of the food consumed. It is essential to recognize that food insecurity spans a spectrum of severity. Accurately identifying these levels is critical for developing effective policies and tailored interventions.
At the global level, public policy aimed at combating food insecurity has been successful in reducing the prevalence of undernutrition worldwide.
However, according to the WHO and the FAO, despite its success in lowering global undernutrition rates, this policy has not promoted healthy nutrition. In fact in some cases, it has been counterproductive, by shaping food systems in a way that has made the cost of a healthy food basket up to five times higher than that of a basic food basket.[3] The latter, which consists of non-perishable or year-round available foods with a high calorie-to-cost ratio, provides the necessary daily caloric intake but lacks the variety and quantity of essential nutrients needed for proper nutrition.
In other words, global policy has focused on ensuring adequate daily caloric intake rather than providing a diverse and nutritious diet. Fruit and vegetables are a cornerstone of a healthy diet, as they provide essential nutrients such as vitamins, fiber, and antioxidants. When it comes to nutrition, variety matters just as much as quantity: a diverse intake of fruit and vegetables has been shown to lower blood pressure, reduce the risk of heart disease and stroke, help prevent certain cancers, improve digestive and eye health, and support healthy blood sugar levels.[4]
A healthy diet is a key factor in preventing non-communicable diseases (NCDs) such as diabetes, hypertension, heart disease, kidney disease, and depression. Data from the Israeli National Program for Quality Indicators in Community Healthcare indicate that the prevalence of diabetes, obesity, impaired GFR, and other health conditions increases as socioeconomic status declines.[5]
This connection between diet, chronic illness, and inequality mirrors global trends. NCDs are the leading cause of death worldwide, responsible for 75% of all fatalities—around 41 million deaths annually, including 18 million among people under the age of 70.[6] Of these premature deaths, an estimated 82% occur in low- and middle-income countries.[7]
Globally, an estimated 35.4% of the population—about 2.83 billion people—were unable to afford a healthy diet in 2022. [8] This marks a slight improvement from 2021, when 36.4% (2.88 billion) faced the same circumstance, representing an annual decrease of approximately 50.1 million people. In Israel in particular, a national study found that two-thirds of families with children could not afford the cost of a healthy diet,[9] highlighting the extent to which economic barriers shape dietary patterns even in high-income countries.
As a result, food-insecure households often rely on low-cost, nutrient-poor foods that are high in calories but low in essential nutrients. This dietary compromise significantly increases the risk of a wide range of health problems, including fatigue, cardiovascular disease, hypertension, osteoporosis, anemia, birth defects, preterm birth, and obesity.[10]
Food insecurity also contributes to a progressive decline in mental health, leading to psychological distress, depression, and anxiety. It is associated with inadequate medical care for children, reduced overall well-being, and cognitive impairments that affect learning, memory, and reasoning. Poor nutrition during critical developmental periods, both in utero and in early childhood, can cause developmental delays beginning in infancy and continuing into preschool years. These early challenges increase the risk of poor academic performance, lack of concentration in school, and early school dropout.
These cognitive and developmental effects often manifest in broader emotional and behavioral difficulties.[11] Children growing up in food-insecure households are more likely to experience lower psychosocial functioning and exhibit behavioral issues such as aggression, hyperactivity, or apathy, compared to children from food-secure environments.
Beyond the individual and family level, the broader public health impact of food insecurity is evident in its contribution to the global burden of NCDs, which are recognized as one of the greatest challenges to sustainable development. As part of the United Nations Sustainable Development Goals (SDGs), world leaders have pledged to develop national responses aimed at reducing premature mortality from NCDs by one-third by 2030, through both prevention and treatment (SDG Target 3.4). The WHO plays a central role in leading and coordinating international efforts to achieve this goal.[12]
From a broader perspective, the high cost of food relative to disposable income poses a significant barrier to maintaining a healthy diet, in both high-income and low-income countries. In light of this, rescuing and redistributing nutritious food to food-insecure populations can play a vital role in ensuring proper nutrition. By improving dietary quality among those most at risk, this approach not only promotes better health outcomes but also contributes to reducing healthcare expenditures at the national level.
[1] Dietary Guidelines Document
[2] Israeli Ministry of Health website
[3] Food Security and Nutrition in the World 2022, FAO
[4] Harvard T.H. Chan School of Public Health
[5] The National Program for Quality Indicators in Community Healthcare
[6] Noncommunicable Diseases Fact Sheet. (2022) World Health Organization, Noncommunicable diseases 2024
[7] Noncommunicable Diseases 2024
[8] The State of Food Security and Nutrition in the World
[9] https://doi.org/10.1186/s13584-025-00675-7
[10] Desrochers (2015); Tzava (2008); Niral et al. (2003); Dahl & Olson (1999)
[11] Barajas 2007; Carter, Krus, Blakely, & Collings, 2011; Drennen, et al., 2019; Loopstra, et al., 2015; Muldoon, Duff, Fielden, & Anema, 2013; Pettoello-Mantovani et al., 2018; Jacob et al., 2008
The Health Costs of Food Insecurity
While consuming a healthy food basket, particularly one rich in fruit and vegetables, can be up to five times more expensive than a basic food basket, the long-term costs of an unhealthy diet may be even greater.
A growing body of research and forecasts from around the world highlights the significant health and economic consequences of poor nutrition, affecting both public healthcare systems and individuals:
- A study conducted in the United Kingdom[1] found that approximately 46% of NHS (National Health Service) expenditures are linked to poor diet, physical inactivity, smoking, alcohol consumption, and obesity-related issues. Of the NHS’s total annual spending—around £43b—an estimated £6b is specifically attributed to diet-related diseases, including metabolic and endocrine disorders, cancer, and cardiovascular conditions. This represents the highest cost among all risk factors examined in the study.
- A 15-year longitudinal study conducted in Australia found that women who regularly consumed fruit and vegetables incurred lower healthcare costs compared to those who did not. The study also estimated that subsidizing fruit and vegetables, combined with increasing taxes on unhealthy foods, could generate annual healthcare savings of approximately $3.4b, equivalent to about 2% of Australia’s total health expenditure.
- An American study reviewing research published between 2005 and 2015 compared the incidence of various health conditions among food-secure and food-insecure populations. The findings revealed that food insecurity was linked to approximately 4% of arthritis cases, 6% of diabetes cases, 15% of dental health problems, 13% of reported vitamin deficiencies, 7% of obesity cases, 11% of mental health disorders, 30% of depression cases among adults, and 34% of prescription medication use among children.
- According to the CDC’s MMWR report on arthritis in children and adolescents in the U.S. (based on NSCH data from 2017–2021), the prevalence of arthritis was higher among children living in food-insecure households compared to those from food-secure homes.[2]
- A 2023 review published in the International Journal of Pediatric Dentistry found that children and adolescents experiencing food insecurity were twice as likely to develop tooth decay.[3] Similarly, a 2023 study published in Nutrients identified a significant association between food insecurity and anemia (AOR = 1.43).[4]
- A nationally representative cross-sectional study in the U.S. (Scientific Reports, 2024; NHANES) found a positive association between food insecurity and obesity.[5] The severity of food insecurity was directly linked to higher rates of both general and abdominal obesity, as measured by BRI and ABSI indices—an effect that was particularly pronounced among women.
- A recent U.S. study (Journal of Affective Disorders, 2024) found that food insecurity among adults was independently linked to symptoms of depression (AOR ≈ 3.04) and anxiety (AOR ≈ 2.67). [6] The association was especially strong in households with children and among women.
- A comprehensive Canadian study on children published in 2024 in the Canadian Journal of Public Health found that children from food-insecure households had higher healthcare costs and used health services and prescription medications more frequently than those from food-secure households. [7]
- A 2015 Canadian study published in the Canadian Medical Association Journal[8] examined the relationship between food insecurity and healthcare costs. The findings showed that the more severe the level of food insecurity, the higher the associated healthcare expenses. The study estimated that the average additional annual healthcare cost per adult living with food insecurity was $1,266,[9] with hospitalizations, prescription drug use, and physician services accounting for most of this increased expenditure.
[1] The Economic Burden of Ill Health due to Diet, Physical Inactivity, Smoking, Alcohol and Obesity in the UK
[2] Arthritis Among Children and Adolescents Aged <18 Years — United States, 2017–2021
[4] Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis
[5] The Association between Food Insecurity and Obesity, A Body Shape Index and Body Roundness Index among US Adults | Scientific Reports
[6] Food Insecurity and Mental Health among US adults during the COVID-19 Pandemic: Results from National Health Interview Survey, 2020–2021 – PMC
[7] The Association between Household Food Insecurity and Healthcare Costs among Canadian Children – PubMed
[8] Association between household food insecurity and annual health care costs
[9] 2012 prices adjusted to 2023 terms
Tarasuk, V., Cheng, J., De Oliveira, C., Dachner, N., Gundersen, C., Kurdyak, P. (2015). Association between household food insecurity and annual health care costs. Cmaj, 187(14), E429-E436
- Consistent with findings from Canada, a 2019 study from the United States found that adults (ages 18 and older) living in food-insecure households incurred approximately $2,100 more[1] in annual healthcare costs per person compared to those in food-secure households. Using data from the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS), the researchers analyzed the link between levels of household food insecurity and healthcare spending, estimating the additional costs associated with food insecurity across different states and counties throughout the United States.[2]
To estimate the additional healthcare costs associated with food insecurity in Israel, data from Canada and the United States were analyzed and compared to Israel’s healthcare system. The findings indicate that Canada is the most relevant comparison in terms of healthcare expenditures, as both countries have similar levels of public healthcare spending and comparable healthcare expenditures as a percentage of GDP. In contrast, the United States has significantly lower public healthcare spending than both Israel and Canada, while its total healthcare expenditure as a percentage of GDP is substantially higher. As a result, the United States is not a suitable reference point for assessing Israel’s healthcare costs.
Healthcare expenditure as a percentage of GDP, per adjusted capita, is approximately 8% in Israel, 11% in Canada, and 17% in the United States.
Additionally, government spending as a share of total healthcare expenditure is similar in Israel and Canada, standing at approximately 70%, whereas in the United States it is only around 55%.[3]
As Canada is the most relevant comparison for Israel in terms of healthcare expenditures, annual per capita healthcare costs in both countries were analyzed. World Bank data reveals that per capita healthcare spending in Canada is about 20% higher than in Israel.[1]
To reflect this difference, the additional annual per capita healthcare cost associated with food insecurity in Canada—estimated at $1,303—was adjusted downward by approximately 20%, based on differences in standardized per capita health expenditure. Following this adjustment, the corresponding figure for Israel is estimated at approximately $1,040 per person per year.
[1] 2019 prices adjusted for 2024 terms.
[2] BDO analysis of Berkowitz, S., Basu, S., Gundersen, C., Seligman, H.. (2019). State-level and county-level estimates of health care costs associated with food insecurity. American Center for Disease Control. 16, E90
[3] Based on World Bank data
[1] According to World Bank data, adjusted per capita using capitation coefficients from the Israeli Ministry of Health
This Report examines the additional health-related burden food insecurity places on the Israeli economy. The analysis in this section focuses specifically on the direct health impacts of food insecurity in Israel in 2024 and does not include indirect economic costs associated with living in food-insecure conditions.
In 2016, Bread for the World, an American anti-hunger organization, assessed the indirect impacts of food insecurity, including lost workdays due to illness among food-insecure individuals, lost workdays for family members who need to care for them, special education costs for food-insecure children in public elementary and high schools, and dropout-related costs. These indirect costs were estimated at $24b, representing a 16% increase over the direct costs associated with food insecurity estimated in the study.[1]
As such, the estimated direct health-related costs presented in this section should be viewed as a conservative baseline, serving as a starting point for future evaluations of the total economic impact of food insecurity in Israel.
[1] “Hunger Report”, Bread for the World, 2016, Appendix 2
Estimated Healthcare Costs of Food Insecurity in Israel
Data from the FAO indicates that food insecurity in Israel is among the most severe in the OECD. While Israel’s poverty rate is comparable to that of the United States, its food insecurity rate is 1.7 times higher. This means that the burden on Israel’s healthcare system as a result of food insecurity is significantly greater.
In Israel, where per capita healthcare spending is approximately 20% lower than in Canada, the additional annual healthcare cost of food insecurity is estimated at $1,040 per person, equivalent to roughly NIS 3,855 (USD $1,042) per year.
Based on the analysis presented in this Report, an estimated 1.5 million people[1] in Israel are living with food insecurity. As a result, the total additional healthcare burden to the Israeli economy is estimated at NIS 5.8b (USD $1.57b) per year—equivalent to about 4% of total national health expenditure.[2]
Food Rescue: Potential Savings for the National Economy
The amount of food needed to close the gap between actual consumption among food-insecure populations and the normative consumption level (based on average consumption in the 2nd to 5th income deciles) is estimated at approximately 530,000 tons in 2024, and valued at around NIS 4.5b (USD $1.2b). Of this, about NIS 3.3b (USD $890m) would be required to close the gap for households experiencing severe food insecurity (about 8.2% of Israeli households), while the additional NIS 1.2b (USD $324m) would be needed to address the gap for those experiencing moderate food insecurity.
Closing the food insecurity gap without relying on food rescue would require approximately NIS 4.3b (USD $1.15b) annually in direct support, highlighting the clear advantage of food rescue over alternatives such as cash transfers, donations, subsidies, or other aid to vulnerable populations. In contrast, food rescue can achieve the same goal at a significantly lower cost—just NIS 1.3b (USD $350m) per year. In other words, rescuing nutritious food, particularly fruit and vegetables, can reduce food insecurity at roughly 70% less cost. Beyond the economic savings, food rescue also delivers substantial health, social, and environmental benefits.
Food insecurity is evident not only in the overall amount spent on food, but also in how that money is spent. Compared to food-secure households, food-insecure households allocate significantly less of their budget to nutrient-rich foods such as fruit, vegetables, meat, and fish.
For example, in food categories with high nutritional value, such as meat, poultry, fish, dairy, and fresh fruit and vegetables, spending among food-insecure households is 48% to 62% lower than normative consumption levels. In contrast, for staple items such as bread, eggs, and legumes, the gap is significantly smaller, ranging from 11% to 27%.
According to economic theory, in-kind support, i.e. providing goods rather than cash, is generally considered less efficient, as it restricts recipients’ freedom to allocate resources according to their full range of needs. This concept, often summarized as “subsidize the consumer, not the product,” typically favors direct financial assistance over goods-based aid. However, when it comes to food rescue, there are unique circumstances that make in-kind support clearly more advantageous. As food rescue involves diverting surplus food that would otherwise be discarded, each 1 USD invested yields a direct economic return of 3.6 USD. When factoring in environmental benefits such as reduced greenhouse gas emissions, lower air pollution, and decreased waste management costs, the return rises to 4.2 USD per 1 dollar invested, and when the health benefits of alleviating food insecurity are included, the total return to the national economy reaches 11 USD for every 1 dollar invested.
In September 2015, the United Nations and the U.S. government adopted a national sustainable development goal to reduce food loss by 50% within 15 years. The analysis presented in this Report shows that rescuing only 20% of lost and wasted food in Israel would be enough to fully close the food consumption gap for approximately 485,000 food-insecure households in Israel, bringing their food intake up to normative levels. At the national level, this would translate into annual savings of roughly NIS 4.5b (USD $1.22b) representing the difference between the market value of the rescued food and the cost of rescuing it. Importantly, this figure does not account for the broader economic benefits of reducing poverty and inequality, nor does it include the positive environmental and health impacts food rescue would generate.
