Stuffed and Starved: Hunger & Environmental NutritionMary Lindsey Simpkins

4/17/13

Presentation Overviewo Introduction: Definitions of Hunger and Food Insecurityo Food Desertso Prevalence of Hunger and Food Insecurityo Causes of Hunger and Food Insecurityo Anti-hunger Programs

Federal State Local

o Application to Our Practice o Resources/Opportunitieso Questions!o References

Objectives:o Define the terms hunger, food insecurity, and sustainable food systems.o Examine the hunger crisis on both a national and local level, with

exploration into the causes, prevalence, and trends. o Examine current efforts aimed at alleviating the hunger problem. o Explore future options, especially sustainable food systems as it relates to

the hunger crisis. o Apply the importance of food insecurity and hunger to our practice as

dietitians. o Look at the resources available for gaining knowledge and getting

involved!

Introduction: What is hunger? ______________________________________________________

The “Official” Definitionso Hunger: _______________________________________________________________________o Food Security (new definitions from United States Department of

Agriculture):

High Food Security No reported indications of food access problems or limitations.

Marginal Food Security

One or two reported indications--typically of anxiety over food sufficiency or shortage of food in the house. Little or no indication of changes in diets or food intake.

Low Food Security Reports of reduced quality, variety, or desirability of diet. Little or no indication of reduced food intake.

Very Low Food Security

Reports of multiple indications of disrupted eating patterns and reduced food intake.

Obesity and Food Insecurityo Fairly new phenomenono How can there be high rates of food insecurity and obesity in the same

areas???o ________________________________________________________________________________

People can get enough calories in and still be missing out on the nutrients their body needs to be nourished.1

o Food desert: a district with little or no access to large grocery stores that offer fresh and affordable foods needed to maintain a healthy diet

Obesity and Food Insecurityo Low-income neighborhoods frequently lack ____________________________o When available, healthy food is often more expensive, whereas

refined grains, added sugars, and fats are generally inexpensive and readily available in low-income communities.

o When available, healthy food – especially fresh produce – is often of poorer quality in lower income neighborhoods4

Lower appeal to purchaseo Greater availability of fast food restaurants, especially near schools.o Many energy-dense, nutrient-poor foods at relatively low prices.  o Those who are eating less or skipping meals to stretch food budgets

may overeat when food does become available

o Low-income families, including children, may face high levels of stress due to the financial and emotional pressures of food insecurity, low-wage work, lack of access to health care, inadequate and long-distance transportation, poor housing, neighborhood violence, and other factors.

Food Deserts: Mississippio MS has the highest rates of obesity, but also the highest rates of food

insecurity in the countryo Jonestown, MS – 3 “grocery” stores, but they don’t sell fruits (maybe

one has bananas), have vegetables in a cano Have to go to Clarksdale or Batesville (a 45-minute drive) to go

grocery shopping – 66 miles away, $10.68 in gas

Prevalenceo In 2010, 17.2 million households, 14.5 percent of households

(approximately one in seven), were food insecure, the highest number ever recorded in the United States

o In 2010, 9.8 percent of households with children were food insecure at some time during the year (3.9 million households!!!)

o The U.S. ranks WORST on IMF’s Advanced Economy Countries on food insecurity.

o The number of U.S. citizens apply to the SNAP program has tripled since 2001.

o One out of every two children will, at some point in their childhood, be on food stamps (90% of African American children will).

Where does Virginia stand?o Third lowest rate of food insecurity in the country (behind North

Dakota and New Hampshire)11

o However, 16.4% of children are food insecure o Reasons? o _____________________________________________________________________________

Case Study: Barbie Izquierdoo Single mother living in Philadelphia, PAo On public assistance, but struggles to even feed her two children

everydayo Has to take 2 buses (over an hour trip each way) to get to a grocery

store

o Gets food stamps, but they only last around 3 weeks of the montho Youngest son Aiden – has speech delay, autoimmune disease, some

developmental issues. o Attributes this to lack of good nutrition during the first year of his life

(was rejected for food stamps during that year)

Causes of Hunger and Food Insecurityo POVERTY.o #1 cause of hunger in the United States o The rate of poverty has drastically gone up since the economic

recession in 2007o In 2010, 46.9 million people were in poverty, up from 37.3 million in

2007 o 15.1% of the population is in poverty -- the largest percent since 1993o Solutions for the problem need to address this issue!o ______________________________________

Food deserts – as mentioned previously, many people live in environments where they cannot access nutritious foods.

o ______________________________________ The cost of fresh fruits and vegetables has increased 40% since

1980 On the contrary, the cost of cakes, cupcakes, and cookies has

remained about the same, if not decreased

Let’s Talk Politics. o Subsidies are ways the government assists a certain industry or

producer (in this case, agribusinesses)o The subsidies that we have now were put in place in the 1930s during

the Great Depression Farmers were the first ones hit Was created as a temporary program Family farms have turned into agribusinesses

o 85% of subsidies go to farms that produce wheat, corn, cotton, rice, and soybeans.

o Direct payments – go to the farmer no matter what the economy is like.

o This leads to a food system in which the most readily available, cheap foods are processed foods made from these grains, with little nutritional value.

Farm Bill

o Comes up around every 5 yearso Huge and complex measure that largely determines the nation’s

agricultural and nutrition support policieso Includes SNAP and several other food assistance programso Also includes agricultural subsidies

History of Hungero In the 1960s -- a documentary came out about hunger in America.o New nutrition programs (food stamps, elderly feeding, NSLP, NSBP) –

virtually eradicated hunger by the end of the 1970s. o Hunger has made a comeback – but these programs are now

underfunded. o During the Reagan years, there were a bunch of tax cuts and increase

in defense spending – to make up for this in the budget, they had to cut a lot of social programs.

o During the 80’s – the country saw a proliferation of soup kitchen, food pantries, charities, etc.

These are great, but they don’t end hunger.

Federal Programso Supplemental Nutrition Assistance Program (SNAP)17

o Formerly known as “food stamps”, now uses _____________________________o The most important food assistance program in the U.S. --- has a $75

billion budget. o 46.6 million Americans participated in 2012.

o Equals out to a little over $3/day (average of $134.9/month)o Under federal law, a household must meet three criteria to qualify:

1. Total monthly income generally must be at or below 130 percent of the poverty line, or roughly $1,980 (about $23,800 a year) for a three-person family in fiscal year 2010.

2. Its net income, or income after deductions are applied for items such as high housing costs and child care, must be less than or equal to the poverty line.

3. Its assets must fall below certain limits: households without an elderly member must have assets of $2,000 or less, and households with an elderly or disabled member must have assets of $3,000 or less.

Oh Snap!o A criticism of SNAP is that participants often have to compromise food

choices for options higher in sugar, fat and preservatives because healthy alternatives are not always affordable.

o SNAP participants consume less produce and healthy options and purchase at least 40% more sugar-sweetened beverages than any other consumer group.

o Another contributing factor to overweight and obesity issues in SNAP participants may be the lack of access participants have to healthy options because low-income areas are often served only by mini-marts with limited and generally unhealthy selections of food

o ___________________________________________: Offers “rewards” for SNAP recipients to purchase fruits and vegetables, trying to determine if this is an effective strategy for increasing purchase of fruits and vegetables.

SNAP recipients get a 30% subsidy when they purchase F/V The study is scheduled to go on in 15,000 households (half

receiving the benefit, half not receiving it) for 15 months (ended January 2013)

o Women, Infants, and Children (WIC) Provides nutritious foods, nutrition education, and referrals to

health and other social services to low-income pregnant, postpartum and breastfeeding women, and infants and children up to age 5 who are at nutrition risk

Participants family income must fall at or below 185 percent of the U.S. Poverty Income Guidelines (in 2010, $40,793 for a family of four)

o National School Lunch Program

Provides free or low cost meals to children in schools who qualify.

Must meet very strict regulations.

o “Healthy, Hunger Free Kids Act”22 – passed by Congress, 4.5 billion dollar increase over 10 years (6 cent increase per school meal) for school lunches

Expands many child nutrition programs BUT, over half the bill was paid for by cutting food stamps

o Summer Food Service Program Federally funded, but administered by states Provides free meals to low income children during the summer

(when school lunches are not available)

o National School Breakfast Program Provides cash assistance to states to operate nonprofit

breakfast programs in schools and residential childcare institutions

Participation strategies

o Farmer’s Market Promotion Program (FMPP) Offers grants to help improve and expand domestic farmers’

markets, roadside stands, community-supported agriculture programs, agri-tourism activities, and other direct producer-to-consumer market opportunities

Over $9 million in FMPP grants were awarded in fiscal year 2012.

Federal Programs/Policieso In 2008, Barack Obama made a goal of ending childhood hunger by

the year 2015. o These are his seven strategies for doing so:

Restore economic growth and create jobs with better wages for lower-income workers.

Raise the incomes of the lowest-income families. Strengthen the SNAP/Food Stamp Program. ___________________________________________________________________ Engage the entire federal government in ending childhood

hunger. Work with states, localities and nonprofits to expand and

improve participation in federal nutrition programs. Make sure all families have convenient access to reasonably

priced, healthy food.

Food Policy Actiono Organization developed last year on Earth Dayo Policies affecting food and agriculture get slipped into bills all the

time, usually without the public knowing about them. o National Food Policy Scorecard developed (first legislative scorecard

developed that focuses specifically on food)o The FPA board selected 32 floor votes—18 in the Senate, 14 in the

House—taken by Congress over the past two years that affected food safety, hunger, farm subsidies, food labeling, organic farming, and local food systems.

o Each lawmaker was then rated on how he or she voted in each case.o See how your lawmaker matches up!

http://www.foodpolicyaction.org

Food Policy Action

“It was not one single event that lead to the formation of Food Policy Action, but rather the lack of accountability year after year from members of Congress on food and farming votes…whether it be billions in subsidies to highly profitable agribusinesses and mega corn farms or cutting conservation and critical hunger programs, no one was holding Congress accountable for their votes.”

-Ken Cook, founding board, president of FPA and president of the Environmental Working Group

State Programso Virginia’s robust Farm to School Program

Seeks to bring out fresh, nutritious local foods to K-12 schools, colleges and universities

o Virginia Community Action Partnership (VACAP) Statewide membership association for Virginia’s 32 non-profit

private and public community action agencies Come together to share ideas, discuss problems, etc.

o _________________________________________________________________ More than 1,940 member agencies HUGE network to feed hungry Virginians

Local Effortso Invest an Acre – created by Warren Buffett’s son in the Midwest

Connects farmers to food banks Encourages farmers to donate one acre (or more) of crop

harvest to fight hunger in their areao Toronto Food Policy Council

Created in 1991 as a subcommittee to the City of Toronto Board of Health

Working to ensure access to healthy, affordable, sustainable and culturally acceptable food

Some of their work includes advocating for: Local and sustainable food purchasing Backyard hens to be legalized Development of an urban agriculture plan

o Many Others: Food pantries, soup kitchens, food banks Creative ideas! ________________________________________________________________

DC Central Kitcheno Programs include:

Meal distribution Food recycling Culinary job training

14 week program Teaches skills

Healthy school food Truck Farm

Urban Agricultureo Because of lack of access to healthful foods in many urban areas —

essentially food deserts — people are taking the food system back into their own hands

o Raising their own food – because grocery stores and farmers markets aren’t available in their communities

Rooftop gardens Urban aquaponics ____________________________________ Youth programs

Urban Agriculture, cont. o Chicken fee in Richmond -- Residents can now keep up to four hens

(but no roosters), provided the coops are at least 15 feet from neighboring dwellings and the owner pays a nonrefundable $60 annual permit.

o Controversies o Seeking volunteers and corporate sponsorships for “Coop Corps” –

Richmond-based organization that will provide resources and education for low-income hen raisers

In Charlottesvilleo Local Food Hub

Works to improve small farm viability and improve community access to food

Food warehouse where they purchase and aggregate locally grown fruit, vegetables, meat, eggs, and value-added items from more than 70 small family farms in Virginia

o Farmer’s Market Hosted three days/week As of 2010, accepts SNAP benefits

o Urban Agriculture Collective of Charlottesville Community gardens across the city that produce 10,000

pounds of produce per year Volunteers of all ages, genders, races People who volunteer get wooden tokens that they can

exchange for vegetables on “Market Day” Produce is distributed for free for those who live within one

mile of where it was grown Also offer seasonal-based cooking class series for families

What else can be done?o Focusing on _______________________: economic development in low-

income neighborhoodso Increase access to public transportation o Education on thrifty cooking o Support sustainable food systems to help prevent hunger in the futureo Anything you can think of?o _______________________________________________________________________________

That’s Great…How Does It Apply to My Practice?o As dietetic practitioners, it is extremely important to be aware of food

insecurity issues. o Providing relief from hunger yields positive impacts on body weight,

learning abilities, and reducing the incidence of chronic diseases—particularly among children.25

o It’s extremely important to understand the resources that patients o Know the programs and policies, on a national and local level, that

impact our patients and clients!

Abundant Resources:

o Food Environment Map: http://www.ers.usda.gov/data-products/food-environment-atlas /

o Food and Nutrition Service in the USDA. http:// www.fns.usda.gov . Information about all of the federally funded nutrition assistance programs.

o www.foodtank.org - Food Think Tank – brings together brainstormers, researchers, thinkers.

o http:// www.ruaf.org -- Resource Centres on Urban Agriculture and Food Security.

o Economic Research Service, United States Department of Agriculture – provides most of the data on food insecurity in the U.S.

o www.frac.com Food Research Action Committee. o www.takepart.com Great articles about things going on in the fields of

politics, the environment, nutrition, and social issues. o www.feedingamerica.org Has great resources for those looking to

help end hunger in the U.S.o For information about the Farm Bill:

http://www.ewg.org/ farmbill2013 o To get involved with community gardens:

http:// www.communitygarden.org .

Spread the word! o A Place at the Table – new documentary by the makers of Food, Inc.

Host a screening! o Volunteer at local charities. o Get involved on local food policy councils – we need more nutrition

experts on these anyway. o Support policies that work to end hunger and promote sustainable,

healthy food systems. o Understand what’s going on around us!

In conclusion. o Hunger is not just a global issue – it’s one that we face right here at

home and has been progressively getting worse! o To solve this problem, we need to focus on promoting healthy and

sustainable policies within our agricultural system, making sure that government programs are helping people have better access to healthy foods, and empowering our communities to provide food for themselves.

o It is our responsibility as nutrition professionals to, at the very least, have a working knowledge of this issue (if not becoming actively

involved), and to do our best to work to end hunger in our communities.

Questions??

References:

1. Larson, N. I. & Story, M. T. (2011). Food insecurity and weight status among U.S. children and families: a review of the literature. American Journal of Preventive Medicine, 40(2), 166-173.

2. Beaulac, J., Kristjansson, E., Cummins, S. (2009). A systematic review of food deserts, 1966–2007. Preventing Chronic Disease.

3. Monsivais, P., Drewnowski, A. (2007). The rising cost of low-energy-density foods. J Am Diet Assoc. 107(12):2071-6.

4. Zenk, S.N., Odoms-Young, A.M., Dallas, C., Hardy, E., Watkins, A., Hoskins-Wroten, J., Holland, L. (2011). "You have to hunt for the fruits, the vegetables": environmental barriers and adaptive strategies to acquire food in a low-income African American neighborhood. Health Educ Behav. 38(3):282-92

5. Larson, et al. 2009. 6. Dammann, K. W. & Smith, C. (2009). Factors affecting low-income women’s

food choices and the perceived impact of dietary intake and socioeconomic status on their health and weight. Journal of Nutrition Education and Behavior, 41(4), 242-253.

7. Lohman, B. J., Stewart, S., Gundersen, C., Garasky, S., & Eisenmann, J. C. (2009). Adolescent overweight and obesity: links to food insecurity and individual, maternal, and family stressors. Journal of Adolescent Health, 45(3), 230-237.

8. Coleman-Jensen, Alisha, Nord, M., Andrews, M., and Carlson, S. "Household Food Security in the United States in 2010." ERR-125, U.S. Dept. of Agriculture, Econ. Res. Serv. September 2011. http://www.ers.usda.gov/Publications/err125/ 

9. United States Department of Agriculture SNAP data system. http://www.ers.usda.gov/data-products/supplemental-nutrition-assistance-program-(snap)-data-system/time-series-data.aspx#. UW28EqU1alI .

10. Rank, M.R., Hirschl, T.A. (2009). Estimating the Risk of Food Stamp Use and Impoverishment During Childhood. Arch Pediatr Adolesc Med. 163(11):994-999.

11. Gundersen, C., E. Waxman, E. Engelhard and J. Brown. Feeding America. Map the Meal Gap 2011: Food Insecurity Estimates at the County Level.

12. Charlottesville Demographics. http ://www.charlottesville.org/index.aspx? page=2744

13. United States Department of Agriculture Environmental Map: http ://www.ers.usda.gov/data-products/food-environment-atlas/go-to-the- atlas.aspx#.UWycKaU1alIl

14. DeNavas-Walt, C., Proctor, B.D., and Smith, J.C. (2011). U.S. Census Bureau, Current Population Reports, P60-239. " Income, Poverty, and Health Insurance Coverage in the United States: 2010."  U.S. Government Printing Office, Washington, DC, 2011 http://www.census.gov/prod/2011pubs/p60-239.pdf.

15. Economic Research Service. Consumer Price Index. 16. Environmental Working Group. Farm Subsidy Database.

http://farm.ewg.org/ index.php .17. SNAP program data. http://www.fns.usda.gov/pd/snapmain.htm. 18. Shenkin, J.D., & Jacobson, M.F. (2010). Using the food stamp program and

other methods to promote healthy diets for low-income consumers. ‘‘American Journal of Public Health’’, 100(9 ) .

19. Davidow, J., The obesity crisis: a healthy diet often beyond the means of poor, hungry. ‘‘Seattle PI’’, 2004, September 09

20. Healthy Incentives Pilot. http ://www.fns.usda.gov/snap/HIP/ evaluation.htm 21. Food and Nutrition Service: Nutrition Assistance Programs.

http:// www.fns.usda.gov . 22. Congressional Bills. http://www.gpo.gov/fdsys/browse/collection.action?

collectionCode= BILLS . 23. Farmer’s Market Promotion Program.

http://www.ams.usda.gov/AMSv1.0/ FMPP . 24. “Richmond Hatches Prohibitive Chicken Fee”. Times Dispatch.

http ://www.timesdispatch.com/news/local/columnists-blogs/michael-paul- williams/williams-richmond-hatches-prohibitive-chicken-fee/article_0fcdeda0-dbb7-567f-a266-c4cc216088d6. html

25. Jeng, A.B. and Cook, J. “The Economic Impact on our Nation.” http://feedingamerica.org/SiteFiles/child-economy- study.pdf .