At last month’s American Academy of Pediatrics National Conference and Exhibition in Washington, DC, pediatricians were called upon to address food insecurity:
“The health effects of hunger on children are pervasive and long-lasting, which is why our new policy urges pediatricians to take action in and outside of the clinic to conquer food insecurity and promote child health,” said Sarah Jane Schwarzenberg, MD, FAAP, a lead author of the policy statement…
… “As is the case with many childhood health conditions, being malnourished or not getting enough healthy food early in life has effects that can last well into adulthood,” Dr. Schwarzenberg said.
The AAP’s new policy statement, “Promoting Food Security For All Children,” begins by presenting a problem that is, unfortunately, fairly common in the United States:
Sixteen million US children (21%) live in households without consistent access to adequate food. After multiple risk factors are considered, children who live in households that are food insecure, even at the lowest levels, are likely to be sick more often, recover from illness more slowly, and be hospitalized more frequently. Lack of adequate healthy food can impair a child’s ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence. Food insecurity can affect children in any community, not only traditionally underserved ones.
The role that poverty plays in food insecurity and the presence of “food deserts” that isolate people and families from nutritious and affordable foods are well understood by most pediatricians. Jill Daly talked to this one:
“Pediatricians are totally aware of poverty and its problems for children. Not eating well has consequences,” said a local pediatrician, Ned Ketyer. His practice, Pediatric Alliance, talks about nutritional, dietary and behavioral issues with parents and children — and emphasizes the importance of breakfast.
We’re not talking about the teenager who didn’t take the time to eat breakfast before walking out the door to catch the school bus, nor the toddler or child who chose not to eat the healthy foods their parents offered them. The kids we’re talking about don’t have the luxury of choosing whether or not to skip breakfast or be picky about mom’s meatloaf and green beans. Families without either enough money or enough access to real (not processed) and nutritious foods are unable to provide themselves and their children anything close to a balanced diet. This can lead to malnutrition and all it’s medical, cognitive, and social consequences as well as “first-world malnutrition,” where more affordable and caloric-dense processed and packaged foods lead to obesity and all its forms of societal and health problems. This, Daly says, is true even if food insecurity and malnutrition is sporadic:
In its 2014 report on food security released today, the U.S. Department of Agriculture said 9.4 percent of U.S. households with children reported they were unable at times during the year to provide enough nutritious food for them, a slightly smaller percentage than in 2013.
The USDA came to its conclusions by asking whether, in the past year, families worried that food would run out before they got money to buy more, and whether the food did run out and they didn’t have money for more.
How far would you drive, bike, or walk to buy healthy foods for you and your family? What if your only means of transportation were your feet? What if you were too sick or too old to get to a grocery store or supermarket to buy food for a balanced diet? If access to food is difficult to achieve, you might be living in a food desert. According to the CDC:
Food deserts are areas that lack access to affordable fruits, vegetables, whole grains, lowfat milk, and other foods that make up the full range of a healthy diet.
One way to bring healthy foods to food deserts is by setting up local farmer’s markets in communities without appropriately stocked stores. There are some organizations that are “Paying It Forward” by harvesting unwanted fruits and vegetables and delivering them to underserved communities. And some poorer communities now are attracting supermarket chains to take a chance and open up stores in their neighborhoods. David Templeton says that, so far, results on the one-year anniversary of the opening of the Pittsburgh Hill District’s Shop ‘n Save are mixed, but leaning toward the positive:
Sixty-eight percent of Hill District residents reported using the supermarket at least once a month. Previously, Hill District residents shopped at stores farther away with a preference for the Giant Eagle on the South Side, while many Homewood residents shopped at the Giant Eagle on Shakespeare Street in East Liberty.
“For the most part, the improvements we found reflect decreases in food intake,” the study said. “In spite of the changes we found, a key goal of the Healthy Food Financing Initiative was not achieved. We observed no improvement in weight status.”
However, the study was the first to find significant improvements in multiple dietary outcomes — such as a reduction in sugary foods — and neighborhood satisfaction among residents of a food desert after a supermarket opens.
Pediatricians can identify children and families who are at risk of malnutrition because of living in poverty, or in a food desert, or both. In order to bring food security to more citizens, government policies and private entrepreneurship will both needed to eliminate poverty and work together to create food oases within the barren food deserts of our cities and towns.