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{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7454258","sourcedb":"PMC","sourceid":"7454258","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7454258","text":"Poor nutrition also contributes to profound disparities. Prior to COVID-19, food insecurity was a significant challenge for 1 in 8 Americans (66, 67), and is expected to more than double this year. A total of 37 million Americans, including 11 million children, experienced food insecurity in 2018 (68, 69). The dramatic increase in unemployment with COVID-19 is expected to cause food insecurity for an additional 18 million US children, bringing the total to 40% of all US youth (70). Americans are also experiencing ever-widening disparities in diet quality and diet-related chronic diseases by race/ethnicity, education, and income (22, 71–75). While social and economic factors such as lower education, poverty, bias, and reduced opportunities are major contributors to population disparities, they are likewise major barriers to healthy food access and proper nutrition. Poor diets lead to a harsh cycle of lower academic achievement in school, lost productivity at work, increased chronic disease risk, increased out-of-pocket health costs, and poverty for the most vulnerable Americans (76). Addressing these profound diet-related disparities experienced by rural, low-income, and minority populations requires a better understanding of their multilevel and interrelated individual, social, and environmental determinants, and corresponding translational solutions (77–80). As one example, the 2015 DGAC concluded that the current body of evidence on the links between access to retail food outlets and dietary intake was limited and inconsistent 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