Have you ever gone to bed wondering when you would have your next meal? Gotten up the next morning and stood in your kitchen and stared at bare cupboards with nothing to relieve the hunger pain deep in your gut? What if you had a child standing beside you, looking up to you, tears in their eyes, waiting for even a cracker to nibble on? Sounds like a third world country right? What if this was your next door neighbor?
According to Feeding America, in 2018, 1 in 9 Americans were food insecure. This equaled 37 million Americans, including 11 million children. The recent pandemic had an alarming effect on these numbers, in that as many as 1 in 6 children faced hunger in 2020. The USDA defines food insecurity as, “the lack of consistent access to enough food for an active, healthy life” (Feedingamerica.org, 2021). Access to food is a social determinant of health, as the lack of healthy, nutritious food is a contributing factor to both acute and chronic disease.
Food insecurity is a complex problem. Lack of food can be due to the lack of resources, such as individuals and families living below the poverty line and not being able to afford enough food or high quality food for their families; or it can be due to access to food, meaning that the lack of food is not related to socioeconomic status but geographic availability. Likewise, there are degrees of food insecurity. Families may have reduced quality, variety and the types of foods that they desire, but the quantity of food is sufficient and their normal eating patterns are not interrupted. However, there are families that are insecure to the point that their eating patterns are interrupted and their food intake is significantly reduced due to lack of access.
VALOR Class V recently visited Washington, D.C. and Northern Virginia to discuss urban agriculture and agriculture policy. While there, the visited the Smithsonian Anacostia Community Museum which had an exhibit called Food for the People: Eating and Activism in Greater Washington. This exhibited highlighted food insecurities in the District. I learned many facts from this exhibit:
- There are 41 full service grocery stores in Washington, D.C., only 3 are located in Wards 7 and 8.
- In DC Ward 3, the wealthiest ward and the ward with the largest population of Caucasian residents, there is 1 full service grocery store for every 9,336 residents.
- In DC Ward 8, the ward with the most poverty and is mostly African American, there is 1 full service grocery store for every 85,160 residents.
- Washington, D.C. has the largest life expectancy gap between Blacks and Whites in the country, black men die 17 years earlier and black women 12 years earlier on average than their white counterparts. Heart disease is one of the primary causes.
- Produce Rx is a program that has been started in DC that allows participating healthcare providers to write prescriptions for fresh fruits and vegetables that are provided to patients at no charge through partnering farmers markets and grocery stores.
As mentioned earlier, food insecurity has a significant impact on population health. Seniors may be forced to choose between medications to manage chronic conditions and food. Children that face hunger are more like to have asthma or suffer from anemia and have more problems in school, including repeating grades, developmental impairments such as language and motor skills, and behavioral problems. Individuals that are food insecure are more likely to be obese and suffer from high blood pressure and diabetes. Each year, food insecurities can cost the healthcare system an extra $77.5 billion (Feedingamerica.org, 2021).
As a healthcare provider and agricultural producer, I think it is important for these two sectors to work together to address food insecurities in the communities that they serve. In 2010, Children’s Health Watch released a peer-reviewed, validated tool, the “Hunger Vital Sign” as a 2-question screening tool to be used in healthcare settings to identify individuals and families that may be experiencing food insecurities ( https://childrenshealthwatch.org/public-policy/hunger-vital-sign/ ). This allows for them to be referred for interventions through community access programs. To prevent food waste, local producers, farmer’s markets and groceries can work with food backs to ensure that there are supplies necessary to fulfill the needs in the community. Food insecurity is a multifactorial complex problem that can only be addressed through the cooperation of community partners. The first step though is recognizing that access to food is a real problem that is occurring here in your community, maybe right next door.