Why So Many People at Risk of Hunger in DC and Nationwide?

May 19, 2016

We may all be Washington, D.C., as the Mayor’s slogan implies, but we’re not all sufficiently fed. In fact, 90,900 (13.8%) of us don’t always have enough food for an active, healthy lifestyle because we can’t afford it, according to Feeding America’s latest Map the Meal Gap report.*

The “us” here includes 29,820 children (nearly 26%) of those living in the District in 2014, the most recent year Feeding America could get data for. They’re not necessarily underfed, but they live in food insecure households and so are, at the very least, at risk of hunger.

Troublesome as these figures are, they’re better than those for the prior two years — especially 2013, when the food insecurity rate for all District residents was 15% and, for children, 30.5%.

On the other hand, the child food insecurity rate is 5% higher than the national rate, though the overall rate is slightly lower.

What can we tease out to explain such relatively high food insecurity rates in the District? First off — and this is true everywhere — families with children are more likely to be hard up for food money than families without them.

They’re still short, even with SNAP (food stamp) benefits and other federally-funded nutrition assistance, e.g., WIC, free or reduced-price school meals. Or so it seems.

Here in the District, nearly three-quarters of food insecure residents have incomes below 200% of the federal poverty line — the threshold Feeding America uses because the District has taken advantage of an option that allows residents with incomes this high to have their eligibility for SNAP considered.

Doesn’t mean they’ll all qualify. Their income, after deductions must still be no greater than 100% of the FPL But broad-based categorical eligibility, as the option is called, does seem to make a difference.

For children, Feeding America uses 185% of the FPL — the maximum income for WIC and reduced-price school meals. By this measure, somewhat over two-thirds of food insecure children qualify for nutrition assistance.

The flip side of these figures, of course, is that a quite high percent of food insecure District residents, including children have household incomes too high for any federally-funded nutrition assistance.

Both those aided and those not face a problem that the Feeding America report is really about — what it calls the meal gap, i.e., the difference between the per-meal cost of food and what individuals and families can afford.

It does some complex number-crunching to arrive at the gap — or more precisely, gaps. The end result for the nation as a whole is $2.89.

The meal gap in the District is notably higher — $3.49 per meal or more than $73 a week, assuming three meals a day, every day, as Feeding America does. This surely goes a long way toward explaining the high food insecurity rates.

On the one hand, as I’ve said, many food insecure District residents have incomes to high to qualify for SNAP, which would supplement their own budgets.

The city is also home to residents who’ve got incomes well below the threshold, but don’t qualify because they’re undocumented immigrants — or documented, but haven’t lived in the country long enough.

On the other hand, those who do qualify won’t have enough to cover the costs of reasonably healthful meals all month long. A parent with two children, for example, can get at most $511 a month — or about $1.87 per meal for each family member.

Closing the local meal gap would have cost roughly $56 million two years ago — and more than $24.5 billion nationwide. That’s a lot of money. Which tells us why Feeding America maps the gap.

The organization, as you may know, supplies food to a national network of food banks. Some of the food comes from federal agencies, it says. The rest — and far greater portion — comes from private-sector sources, e.g., food processors, grocery chains and monetary donations it uses to buy food.

The banks, in turn, channel the food to nonprofits that serve prepared meals and/or distribute groceries to poor and near-poor people in the area they serve. They too may get food from private-sector sources and buy more, using cash or cash-equivalent donations.

And they may get some from the Emergency Food Assistance Program — a variable mix that the U.S. Department of Agriculture parcels out to state agencies and they, in turn, to the banks and/or community action agencies.

Here in the District, 132 pantries, dining rooms, other programs that serve meals and/or snacks and the DC Central Kitchen, which prepares meals for some of them, depend in part on what they receive from the Capital Area Food Bank.

Narrowing the meal gap will obviously require more food — and more money to not only buy it, but distribute, store, prepare and deliver it.

We surely can’t look to this Congress, though we can hope it doesn’t widen the gap. That’s what House Republicans would do if they succeeded in converting SNAP to a block grant, as their budget plans have repeatedly envisioned.

It’s what their latest plan would probably do, even without the block grant, because it puts a tighter squeeze on non-defense programs that depend on annual spending choices. This already-shrunken part of the budget includes WIC, parts of TEFAP and several sources of funds for free or low-cost home-delivered meals.

Highly doubtful we’ll see the cuts this year. But it’s obvious that the meal gap will remain — and probably grow, as it already has — without more public funds to shrink it.

* The food insecurity rates Feeding America reports for states and the District are slightly higher than those USDA reported. This apparently is because the agency uses two-year averages to compensate for the relatively small size of its survey sample.


Children’s Doctors Prescribe Good Food … and Enough of It

March 3, 2016

The American Academy of Pediatrics issued a policy statement on children and food security some months ago. Took me awhile to get to it, but better late than never, I think, because the statement is important for several reasons — and still timely, also for several reasons.

Voice of Authority

First off and most obvious, the AAP has unusual credibility — and in some quarters, influence — as a voice for children’s well-being. It’s the professional association for some 64,000 doctors who provide primary care and specialized services to children and young adults.

It’s nonpartisan, of course, and apparently free from the conflicts of interest that can shape research and policy, including support from corporations who’ll profit more — or less — from nutrition policies, guidelines and the like. (You who’ve been following the debate over school meal nutrition standards know why I mention them.)

Big Picture From Research

The policy statement pulls together findings from reliable research on how food insecurity affects children. Some are familiar to anyone who follows anti-hunger campaigns, even casually — poorer overall health, more hospital stays, high risks of obesity, learning problems, etc.

Others are perhaps less so. For example, the shame kids feel when they see their parents eating less so they can have enough. Also the fear they’ll be labeled “poor” and shunned by their peers.

Feelings like these probably stem from the all-too-common view that poverty reflects a failure of personal responsibility. Perhaps doctors — highly respected folks who’ve surely demonstrated personal responsibility — could lend their weight to a culture shift.

Call to Action

The AAP enjoins pediatricians to advocate for federal and local policies that help ensure food security for all children and their families. It notes specifically sufficient funding for SNAP (the food stamp program) and the Child Nutrition Act programs.

It also calls for advocacy to keep foods offered in these programs “high in nutrient quality,” according to “sound nutrition science.” Respected voices needed here.

Congress has already enabled schools to get temporary waivers from two school meal nutrition requirements — a switch to use of only whole-grain food products and a gradual reduction in the total amount of sodium in the breakfasts and lunches they serve.

Now the Senate Agriculture Committee has completed a revised CNA — one of those bipartisan compromises that gives schools some flexibility on the whole grains and sodium, but not a free pass.

But we may see further compromises in the “high nutrient quality” of the meals schools serve. A bill introduced by one of the Republican members of the House subcommittee responsible for the CNA would go further toward “reducing federal mandates,” as its title proclaims. No caps at all on calories or grains, for example.

So the call is especially timely. But it’s also forward-looking because USDA will presumably review the nutrition standards and related meal plans for daycare facilities, as well as school meals now that we have new Dietary Guidelines for Americans.

At the local level, pediatricians have several advocacy opportunities. They obviously could — and should — discourage schools districts from relaxing their efforts to serve meals as healthful as the current standards require.

They could also encourage more school districts to opt for community eligibility. Schools with relatively high percents of poor and near-poor students could then serve free meals to all, regardless of their family’s income.

This, among other things, has increased the number of students served two full, well-balanced meals a day — probably in part by removing fear of the free-meal stigma.

Broader Approach to Children’s Healthcare

The AAP statement reaches furthest, I think, in its recommendations for incorporating food insecurity into pediatrics training and practices. Children’s doctors would then not only understand how it affects their patients’ health, but actually do something about it.

The AAP recommends a routine screening, using a pared-down version of the survey used for USDA’s annual food security reports.

Pediatricians, like other doctors, need the information in part to understand what the source of their patients’ problems might be — anemia, for example, chronic anxiety, both overweight and underweight.

They also need it to make sure parents can follow instructions. Pills should be taken three times a day with food. Well, will there be food in the house?

Beyond this, however, the AAP wants pediatricians to become familiar with food assistance sources in the community so they can make referrals. It envisions the screening and readiness to link families in need as a regular part of medical education.

And beyond this, it alludes to specialized training that has led to partnerships between pediatrics clinics and both social workers and pro bono attorneys.

Attorneys supplied by law firms and legal aid societies have helped parents resolve diverse problems that directly and indirectly affect their children’s health, e.g., loss of benefits they’re entitled too, substandard housing, unmet needs for special education.

This broader approach to children’s health recalls the nonprofit I’ve blogged on that partners with hospitals and clinics to secure and fill “prescriptions” for more healthful and secure living conditions.

The AAP’s recommendation could, in the best of worlds, expand the project model to a major sector of our healthcare system, shifting its focus from care to health, as the project’s founder intends.

There’d be ripple effects beyond the immediate health of children. Better health and better economic prospects for them as adults. Better health for their parents too.

Still not the be-all and end-all. The food insecurity pediatricians would identify, the further needs social workers would surface and make referrals for, the problems attorneys would tackle are all rooted in poverty — the “causes of causes,” as we’re told epidemiologists refer to it.

We’re not going to cure poverty by ensuring that malnourished children have enough of the right kinds of things to eat and a warm, mold-free place to live. But having many thousands more widely respected, vocal champions could make a difference.

 


DC Child Welfare Agency Will Treat “Traumas” of Child Poverty

November 19, 2012

Policy consultant and blogger Susie Cambria calls our attention to a grant the District of Columbia’s Child and Family Services Agency recently received.

The grant, says CFSA, will help it “make trauma-informed treatment the foundation of serving children and youth in the District [sic] child welfare system.”

The approach sounds like a good thing, but it’s far beyond my capacity to assess.

The reason I write about it is rather what Mindy Good, CFSA’s public information officer, told Cambria about the traumatic events children have experienced by the time they become part of the agency’s caseload.

Some are cases we could confidently classify as abuse, e.g., severe physical punishment, molesting.

Others bespeak neglect that could call for at least a temporary rescue, e.g., having to rely on a parent or other caretaker whose behavior is “erratic” due to substance abuse or untreated mental illness.

But many are simply consequences of living in a family that’s desperately poor, e.g., “not knowing where the next meal is coming from,” “being homeless or moving a great deal.”

Good alludes to getting the child to safety as a first step. This seems to mean, in most cases, removing children from their parents or other caretakers — itself a traumatic experience, as she notes.

Perhaps even the first traumatic experience they have. It’s by no means clear, for example, that the mere fact of living doubled up with first one family and then another induces emotional and/or behavioral problems.

Last year, CFSA confirmed about 873 cases of child neglect — 58% of all the incidents it substantiated. In 2010, neglect (unspecified) was the primary reason it put 395 children into foster care.

One can’t help wondering how many of them weren’t really neglected at all — children in food insecure families, for example, or in homeless families the District wouldn’t shelter.

Or children being cared for by strangers or tasked with caring for younger sibs — two other “traumatic events” Good cites.

There’s a ready remedy for these “traumas.” And it’s not being put into foster care.

If children justifiably fear hunger, their parents or guardians obviously need food stamps — or if they’re not eligible, assurance that their children often are.

Perhaps they also need cash assistance, since we know that food stamps often don’t cover the costs of even the U.S. Department of Agriculture’s cheapest meal plan.

If children are homeless, their families need affordable housing. Same if the family moves frequently because it has to rely on the hospitality of friends and relatives.

If children get parked with strangers or have to shoulder inappropriate child care responsibilities, perhaps the family needs a voucher to pay for daycare — and access to a provider who’ll care for kids early, late and on unpredicable schedules.

CFSA can advise families how to seek these kinds of help. And it may now be doing so, since it reports a new response model, which, in some cases, “leads to service options the family can choose to accept.”

But, of course, seeking isn’t receiving.

As recently as 2010, CFSA cited “inadequate housing” as the primary reason it put some children into foster care. Telling their parents they could apply for housing assistance would be futile, since they’d merely join the many thousands of households on the waiting list.

Though parents might enroll in the Temporary Assistance for Needy Family’s program, the cash benefits would leave them in dire poverty — perhaps still unable to stretch their food budgets till the end of the month.

They’d be eligible for child care assistance, but they might not be able to find it because the District’s provider reimbursement rates have led to a severe shortage of available slots, especially for very young children and those with disabilities.

CFSA’s new treatment approach may help children overcome whatever traumas they’ve experienced because their parents can’t afford to provide them with safe, stable housing, regular meals and the like. But it’s a second-best solution.

Perhaps the best CFSA can do, however, because our system defines “child welfare” as protection from abuse and neglect.

It’s up to other agencies — and ultimately to our elected officials — to ensure that the poor children in our community have what they need to fare well.

Or rather, it’s ultimately up to us since we’re the ones who elected them. Don’t think as many of us as could are doing as much as we might, though some are giving their all and more.


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