Hunger and Food Insecurity… in America – PediaCast 495

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  • Dr Emily Decker and Dr Millie Dolce visit the studio as we consider food insecurity. Millions of Americans lack consistent access to healthy food. We explore why it happens, the impact on children and how your family can help. We hope you can join us!

Topic

  • Food Insecurity

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  • Dial 211 to connect and access resources in YOUR community!

Transcription

Announcer 1: This is PediaCast.

 

[Music]

 

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

 

Dr. Mike Patrick: Hello, everyone and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from Nationwide Children's Hospital. We're in Columbus, Ohio.

 

It's Episode 495 for July 8th, 2021. We're calling this one "Hunger and Food Insecurity… In America". I want to welcome all of you to the program.

 

So, we have ana important topic for you this week. One that is projected to impact over 40 million Americans this year. And that topic is food insecurity.

 

0:01:06

 

Now, what exactly is that? Well, food insecurity is a condition that results when a family does not have access to enough food for every member of the household to live an active healthy life. Nearly 15% of all Americans live with food insecurity. And that includes many working families, single mothers, and lots and lots of kids.

 

In fact, did you know that 85% of kids who eat school breakfast and 70% of those who eat school lunches qualify for free or reduced cost meals based on their family's income. And these kids count on school meals to provide one-third to half of their daily calories. Which means when school is not in session for the summer or during a pandemic, millions of American kids worry about where they will find their next meal.

 

0:02:01

 

Many families with kids live on sparse wages and there are lots of important things competing for the family paycheck, right? I mean, sure, food, but also housing, medical expenses, utilities, clothes, education, transportation. And often, there just is not enough money to meet all of these needs and sacrifices must be made including within the pantry, the food department, where cheaper and often unhealthy choices take the place of nutritious but expensive options, like milk, whole grains, fruits and vegetables.

 

Now on the flip side, there is also good news in the form of communities coming together to meet the needs of local families. So today, we're going to explore the problem of hunger and food insecurity in America. And we'll consider the lifelong impact that food insecurity has on children and the many many ways in which communities can come together and make a difference.

 

0:03:01

 

In our usual PediaCast fashion, we have a couple of terrific guests joining us for the conversation. Dr. Emily Decker is a primary care pediatrician at Nationwide Children's Hospital and medical director at Columbus CAP4Kids. Dr. Millie Dolce is a clinical social worker and she's involved with the Community Wellness Initiatives Program at Nationwide Children's. Much more on that to come.

 

Before we get to them, let's run through some of our quick reminders. Don't forget, you can find PediaCast wherever podcasts are found, including the Apple and Google Podcast apps, iHeartRadio, Spotify, SoundCloud, Amazon Music and most other podcast apps for iOS and Android. If you like what you hear, please remember to subscribe to our show so you don't miss an episode.

 

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0:04:03

 

We also have that Contact link over at pediacast.org if you would like to suggest a future topic for the program.

 

Also, I want to remind you, the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your healthcare provider.

 

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org.

 

So, let's take a quick break. We'll get Dr. Emily Decker and Dr. Millie Dolce connected to the studio. And then, we will be back to talk about hunger and food insecurity in America. It's coming up right after this.

 

[Music]

 

0:05:15

 

Dr. Mike Patrick: Dr. Emily Decker is a pediatrician with Primary Care Pediatrics at Nationwide Children's Hospital and an associate professor of Pediatrics at the Ohio State University College of Medicine. She also serves as medical director of CAP4Kids in Columbus, which is an organization that helps bridge the gap between community-based social service programs and the families that need their help the most.

 

Dr. Millie Dolce is a clinical social worker and program evaluator analyst for Wellness Initiatives at Nationwide Children's, which includes our hospital's Healthy Neighborhoods Healthy Families Program, more on that to come. She also has a passion for identifying kids and families with needs and connecting those families with services that can help.

 

They're here to talk about hunger and food insecurity in America. It's an important topic. But before we discuss it, let's say hello to our guests, Dr. Emily Decker and Dr. Millie Dolce. Thank you both so much for being here today.

 

0:06:06

 

Dr. Emily Decker: Thanks for having us.

 

Dr. Millie Dolce: Yeah, thank you. Excited to talk.

 

Dr. Mike Patrick: We're really glad to have you here because you guys are such experts on this. Emily, let' start with you. What is food insecurity? It's a term that some folks may have heard of, others may not. There's sort of mystery behind what that means.  And how does it differ from hunger?

 

Dr. Emily Decker: Yeah, it's a big word but it's a pretty simple definition. The USDA defines it as a lack of access to enough food for an active healthy lifestyle. And there are really two levels of food insecurity. The first is people with low food security. And they may experience decreased food quality or variety.

 

The second more severe is very low food security. And this families experience not only decreased food quality but also decreased food intake and skipped meals.

 

0:07:04

 

And then, you mentioned hunger. That's important because they're really two different concepts even though they're related. So, food insecurity is the lack of financial resources for food, but hunger is really what happens at a physical level or a personal level. It's the physical discomfort of not having food. So, you could think of food insecurity at the household level and then hunger is what happens at an individual level.

 

Dr. Mike Patrick: Great. And what are some common myths surrounding food insecurity?

 

Dr. Emily Decker: Yeah, I hear a lot of myths in my office. So as a pediatrician, I try to dispel some of these myths. One of them, for example, is that food insecurity is easy to spot. But it's really not. People and food-insecure households, they don't look a certain way or act a certain way. I mean, we're in one of the most affluent countries in the world and yet, there are so many people who cannot fill their fridges. So, it's not easy to spot.

 

0:08:05

 

And in fact, kids and families that are food insecure are more likely to be overweight or obese because they may have food but it's less nutritious food. It's not as healthy. So, they may eat sweets instead.

 

Another myth is that it's more common in cities but it's actually more common in rural areas where crops are grown.

 

Dr. Mike Patrick: So really, we can see food insecurity in any place in America. And in fact, it most likely exists wherever you live even if you are in an affluent area. And I guess that's another one of the myths that comes up, is that it's only going to be who don't have jobs. But there are a lot of people who work very hard and still have food insecurity in America, right?

 

Dr. Emily Decker: Absolutely. Actually, the majority of people who go to food pantries have at least one working adult in the household. And another interesting statistic is that food insecurity is increasing the most in suburbs, which are traditionally areas where we don't think of there being a lot of households that are food insecure. So, this is the social determinant of health that crosses all geographic boundaries, all ethnicities, all ages.

 

0:09:16

 

Dr. Mike Patrick: How common is this in the United States?

 

Dr. Emily Decker: Just to put this in perspective, it's about one in nine people have experienced food insecurity, which is about 35 million people, which is more than the population of Canada. It's more common in households with kids.

 

There are also big disparities in terms of race and geography. For example, Black and Hispanic families have higher rates of food insecurity. People living in rural areas have higher food insecurity as well.

 

Dr. Mike Patrick: And this is one of the things that is actually not improving with time. Back in 2018, it ended up being about 37 million Americans and 11 million children that were impacted by food insecurity. And it's projected that this year, it will be 42 million Americans that's impacted by it.

 

0:10:22

 

And we'll talk more about this in a few minutes, but I'm sure the pandemic has increased the amount of food insecurity that's out there. But before we get to that, even at its baseline in 2018, 37 million Americans not able to get the nutritious food that they need, why is this so common in the United States?

 

Dr. Emily Decker: The biggest link is really poverty. And we have high rates of poverty here. People are struggling with unemployment and underemployment as well. Wages have been pretty stagnant over the past few years. Also, food cost are rising. So, foods are basic human need, and in families struggling to get food on the table, they might have to make a decision between buying food versus paying for transportation. Or paying the water bill.

 

0:11:12

 

Dr. Mike Patrick: Yeah, I mean there really are so many expenses that families have to contend with, like you mentioned. And so many of them are essential, not just food, but housing, medical care, utilities, clothes, education, transportation. It's got to be really tough for families to pick and choose which of those things to cut out.

 

And I guess from a week-to-week spending, food is probably the easiest one to have some control over. Because your housing, whether your rent is a certain amount every month, your medical care bills are coming in, your utilities. It seems like you have a little more control over food. But that can be detrimental, right? Because you don't necessarily want to be one of the first things that you cut out.

 

Dr. Emily Decker: Right. And you choose the less healthy options as well because they're cheaper.

 

0:12:00

 

Dr. Mike Patrick: Absolutely. And of course, you factor in during the pandemic and there are a lot of folks who are laid off work. You can have an accident on the job, maybe have a chronic disease that suddenly hits. A lot of folks may have a loss of a spouse or a partner. Could be car maintenance, I mean, there's just so many unexpected expenses that can pop and situations that you can't always predict. And then again, food is the easiest one then maybe to say we're going to cut back on being able to spend at the grocery store.

 

Then you can see where that does start to happen in the suburbs, because you can have someone who has a great job but then suddenly, their car's not working. And they have to get it fixed to maintain that good job. And that's a bill that comes up right now.

 

Or in a pandemic, you get laid off work or you have ana accident or chronic disease, all those things I mentioned. Folks in the suburbs are not immune to those kinds of situations. So really, everybody is to a degree at risk of this, unless you are a multimillionaire CEO of a corporation. Most of us who make a normal living can be at risk for this happening.

 

0:13:11

 

So why is this an important consideration for a pediatric podcast? Now, obviously, you think about hunger and malnutrition is being sort of medical issues related to food insecurity, but it goes way beyond that, right? There's really other health complications that we have to think about in families who are impacted by food insecurity, right?

 

Dr. Emily Decker: That's right. It's an important national health problem. It has very serious healthcare issues with it. For example, people in food insecure households are more likely to be obese. They're more likely to have heart disease, high blood pressure, diabetes, and they're also more likely to even have mental health diagnosis like depression.

 

Because people who don't have food on the table, they're stressed. They're anxious. So, all of this contribute to lifelong problems. They're more likely to be hospitalized as well.

 

0:14:08

 

And then when you look at kids, it's even more concerning because kids may have developmental or educational delay as a result of this. And that can go on to affect them the rest of their lives.

 

Dr. Mike Patrick: Yeah, absolutely. There have been some studies that show food insecure kids are more likely to miss school. They're more likely to repeat a grade. They're less likely to graduate from high school.

 

So, it impacts their development but also their education, which then is going to impact what kind of jobs they can get. And perhaps then, they'll be more likely to be in a situation where they have food insecurity the rest of their lives because of this cycle that can develop.

 

So, we mentioned the coronavirus pandemic and the increasing numbers of folks impacted by food insecurity. How has the coronavirus pandemic impacted all of this?

 

0:15:01

 

Dr. Emily Decker: It's been very detrimental. So, in 2019, which was prior to the pandemic, the rates of food insecurity were at the lowest they have been in 20 years. So, there were relatively low rates of unemployment and poverty. About 10% of people live in food insecure households.

 

Then in early 2020, the COVID pandemic swept across the US. Businesses closed; people lost their jobs. Unemployment was at the highest rate it had been since the 1940s. So, the rates of food insecurity jumped way up, one in seven people.

 

And if you look just at the subset of kids, it's even worse. About 13% of households with kids were food insecure prior to the pandemic. Well, after COVID hit, it rose to above 30%, one in five kids. So, it's really unprecedented in modern times.

 

0:16:03

 

Dr. Mike Patrick: And for folks who are interested in learning more about this, there is a report from Feeding America called The Impact of the Coronavirus Pandemic on Local Food Insecurity. Really interesting read, and I'll put a link to that in the show notes over at pediacast.org for folks who would like to learn more about all of this.

 

One thing that I came across was if you look at the numbers of people living in a food insecure household, Ohio is in the top five of all states for this. So, number one was Texas, number two California, then Florida, New York, and at number five is Ohio.

 

And in 2019, when things were kind at their low point before the pandemic, 1.5 million Ohioans were impacted by food insecurity. That went up to 1.9 million in 2020. And it's projected to come back a little bit down to about 1.6 million this year as folks do get back to work and there's increased connection with resources. Because when you're at home, it's hard to get a social worker to connect you with the resources and to figure out how you're going to get food in your house when you're isolated.

 

0:17:11

 

And then, the other thing that I found really interesting in all of these, that we all really need to keep in mind, is that there are disparities that exist with food insecurities. So even though it is a problem everywhere, there are certain communities and races and cultures that are harder hit than others. And so, we really need to keep an eye and help folks where they need help, regardless of where they or who they are, correct?

 

Dr. Emily Decker: That's right, yeah.

 

Dr. Mike Patrick: Millie, I want to bring you into the conversation. You're really involved with helping families who are dealing with food insecurity and connecting them with the resources that they need. How is Nationwide Children's tackling food insecurity here in Central Ohio?

 

Dr. Millie Dolce: That's a great question. And to answer it, I want to start by talking about social determinants of health briefly, to give some context behind what we're doing and why.

 

0:18:08

 

So, the medical community in general has been recognizing the impact of social determinants of health on communities and recognizing that we can do something about this in the clinic setting.

 

So social determinants of health, those are the conditions and the places where people live, learn, work and play. And there are things like socioeconomic factors, the physical environment, so our air quality, water quality, where we live, also health behaviors such as diet and exercise or the lack of sometimes. And these things can influence up to 80% of our health outcomes.

 

So, with this in mind, we actually begin a pilot in the summer of 2017 at Nationwide Children's Hospital in our Primary Care clinics. And we have many of them around Central Ohio. And we decided that we were going to try and screen for food insecurity.

 

0:19:07

 

So, we have a team of interns and they approached families in the lobby. Were able to recruit 700 families. We asked them about food insecurity, and we found that 54% of them identified as food insecure. And we were able to give them resources.

 

But this pilot really paved the groundwork for a larger initiative at the hospital. We used this to help our planning and implementing a standardized screen for social needs across the institution. And this was really backed by our hospital's strategic plan, which at that time really focus on population health. And I'm sure it will continue to in the future.

 

But we were tasked with screening for food security. In addition, housing instability, transportation, and utilities. And as I mentioned, we screened all patients once a year and this was embedded into our electronic medical records system.

 

0:20:07

 

We have a tiered approach. So, if patients have an urgent need and something is immediate, something's acute, we offer them a social work consult, if they would like. If their need is not urgent, then they're given a resource sheet for self-referral.

 

Dr. Mike Patrick: Great. So really, this just is a matter of finding folks who need help. And the folks who need help may not know they need help, may not know where to go for help, may not realize that there are resources available. So, it's just a matter of identifying folks who need help and getting them connected with resources that can be useful for the family.

 

And so, the screening questions, you mentioned that this is done on all patients across the campus. What are some lessons that you've learned throughout the screening process? Maybe, what happened that maybe you didn't anticipate and how did you all respond to that?

 

0:21:04

 

Dr. Millie Dolce: We've learned a lot. We're still learning and I'm sure we'll continue to. One of the takeaways is that it actually is possible to ask families these sensitive questions. There are a lot of culture change on both sides. So on the clinic staff, who's helping to administer the screen but also on the family because nobody necessarily expects when you go to the doctor to be asked how you're doing with your housing, or if your utilities are off.

 

We also learned that we can do this in variety of medical settings. So traditionally, most people screen for needs in the primary care setting. But we found that we can do this in the emergency department. We can do this in the urgent care. We can do this in inpatient and also outpatient specialty clinics.

 

Of course, there are trial and error in this screening process as with anything. And sometimes, we found that the questions that we ask needed to be adjusted or our workflow needed to be adjusted or both.

 

0:22:07

 

We also learned that it's essential to keep resources up to date and to only screen for things that we can help with. Families have told us time and time again, not to ask them question about needs that we cannot in any way help address.

 

We've also learned that it's really helpful to explore different ways of asking the questions. And here's where technology is an asset. And most importantly, I think we've seen that asking families these questions can actually make a positive impact.

 

Families have also told us, "Wow, I didn't expect to talk about this today when I came to the doctor." But we were able to help them figure out why services have not been given to them or why referrals that they've had, people had made on their behalf in the past, have not come to fruition yet and to actually help connect them to resources.

 

0:23:00

 

Dr. Mike Patrick: Have you found a disconnect between who you may have thought would need resources and those who actually did need to use them? Or is there any way to predict just first saying hi to a family, for us as physicians, when we walk in the room, is there a way to know who needs help and who doesn't?

 

Dr. Millie Dolce: Yeah, it can be difficult. So, a lot of times, people may present a certain way and we think that we know what that means and why. So, for example, if a patient or family is non-compliant, we assume that maybe they don't care, or they're not interested. Or if they're late to visit chronically, we assume it's because again, maybe they don't care, and they're not organized.

 

But some of these things can also mean that there's a social need. So, it could be they're late because they don't have transportation. They're not quote unquote compliant because they may be a language barrier. Or they have other things that are pressing on them that they cannot necessarily follow up through at this moment but have best intentions.

 

0:24:06

 

I will say that we have found social needs in many zip codes across, not only Central Ohio, but the state of Ohio, because we get patients from all over. We have found patients who have social needs across almost all of our departments. So, this is not something that is just impacting a particular demographic. I should say though that we have found certain spots or hot spots I should say of neighborhoods with larger concentrations of people who have social needs.

 

And we also see a lot of health disparities. We see racial disparities; we see ethnic disparities in these areas. And those areas incidentally are the targets for our Healthy Neighborhoods Healthy Families Initiative which I'm sure we'll talk about later.

 

0:25:00

 

Dr. Mike Patrick: Absolutely. We talked about the pandemic playing a role in increasing food insecurity in America overall. How have the trends change with the pandemic in terms of your screening process? How are you able to screen during the height of the pandemic? And what have you seen as a result of the screening process during the pandemic compared to before?

 

Dr. Millie Dolce: So before, food insecurity was reported as our most frequent need. And that actually stayed the same throughout the pandemic. The second most reported need is transportation, and that also remained the same throughout the pandemic. However, we definitely saw changes in our normal rates, quote unquote normal, what we typically see.

 

So usually, we see a food insecurity rate of about 3 to 4% of patients who are actually screened. However, at the beginning of the pandemic, this increased to 5 to 6%, but interestingly, it also declined to about 2%. So, we saw a lot of variation in those first couple of months of the pandemic.

 

0:26:13

 

Then we saw some leveling off during the summer, where rates returned to about that typical 3 to 4%. But that's not stayed the same. We saw a peak in food insecurity in late Fall, early winter to at its height, 8%.

 

So, this was also a pattern that we saw for other needs where you had a lot of a variation in the beginning of the pandemic, some leveling off and then a spike towards the end of the year. However, food insecurity was always the most frequently reported.

 

Dr. Mike Patrick: So, Emily, once you've screened and you've identified families who need resources, where do you go from there? How do you connect the family with resources that are in your community that can be useful for them?

 

Dr. Emily Decker: That's a good question. So, first in the office, I try to pay attention to their development and see how it's affecting them because that determines really ultimately where we refer them. I mean, it's a lot more complicated than just looking at a child's growth curve.

 

0:27:15

 

A child may be acting out because they're hungry or they may be depressed as a team because they don't have food on the table. Or it may manifest as attention deficit in kids because they can't pay attention in school.

 

So first, I look at them from a physical standpoint. And that's why it's so important to go into your pediatrician for your annual physical and to stay connected with your primary care team.

 

So, once we screen for food insecurity and we determine that a family needs assistance, then next step would be triaging them. We determine how urgent the need is. For example, some families might need food today, right now. Others might need food at the end of the week when their money runs out. Others might need it in a month.

 

0:28:04

 

So, these are sort of different levels of food assistance. Someone that needs it today, we would connect with emergency food assistance, something like a walk-in food pantry or free meals. Families that need longer term help, we would sign them up for some of the federal programs like SNAP and WIC and offer other resources in the community as well.

 

Dr. Mike Patrick: I want to point out for folks really quick, and this is something that, as with each of these programs, I do some research ahead of time so I can talk about thing from a little bit of educated lens. And as I was researching this, the role that the School Lunch Program plays for many many families really were just bright and glaring. That a lot of kids who are in food insecure homes, they really count on the main portion of their nutrition through the School Lunch Program and the School Breakfast Program as well.

 

0:29:04

 

And it ends up being that those meals can make up a third to a half of a child's caloric intake each day. Thirty million children participate in these programs every day, which is about 60% of all school-aged children. And what I found really interesting is that, and I think this really goes towards really showing you that these lot of food insecure kids, this is where they're getting most of their calories and their meals, is when you look at how many people qualify for free or reduced cost meals through this program.

 

So, it ends up being about 71% of kids who participate in the National School Lunch Program receive free or reduced cost meals. And 85% who participate in the School Breakfast Program receive free or reduced cost meals.

 

Now, maybe I'm making some assumptions, but you would think if you qualify, since we know this is tied to poverty, that if you qualify for free or reduced cost meals. And most of them actually are free meals. If you look at the School Lunch Program, 7.7 million kids pay full price, but 20 million, it's free. And 1.7 million get the reduced price.

 

0:30:18

 

So many kids, millions and millions of kids get reduced cost lunches and free lunches. I think you kind of tied them with families in poverty. And then those kids are most likely to be food insecure. And the point that I'm going with all of this is when you hit a pandemic and suddenly, school's out, and when school's out for the summer, a lot of these kids do have to go hungry and are not getting the nutrition that they need.

 

And so, this is a situation whereas individual Americans, you can really think about your community and what resources do schools have to provide lunch for these kids. And maybe you can get involved and be the driving force of making sure that kids are getting lunches.

 

And I know a lot of schools pivoted during the pandemic. They had bus drivers delivering lunches to families. They had pickup spots that people could drive in. But a lot of kids also got lost to the school system during the pandemic and may not have had access to those resources.

 

0:31:13

 

I guess my only point is just that the School Lunch Program is so important and serves so many kids. And any way as families that we can help out with that is certainly going to be useful.

 

Millie, I wanted to ask you, too. So, you're doing the screening with social determinants of health. You're connecting families with resources through that screening process. In what other ways is Nationwide Children's addressing the social needs of families?

 

I've mentioned that you are part of the Wellness Initiatives and we also mentioned Healthy Neighborhoods, Healthy Families. Tell us about those programs.

 

Dr. Millie Dolce: So Healthy Neighborhoods, Healthy Families is a place-based initiative that began in 2008. It's an initiative that is comprised of many partners. So, we have faith-based organizations, community development organizations, workforce development programs, non-profits, and schools.

 

0:32:10

 

And all of these groups are coming together to try to improve health outcomes and quality of life primarily for the South Side residents. I shouldn't say primarily, I should say originally perhaps for South Side residents. So, the South Side is an area the hospital and adjacent to the hospital. It's an under-resourced neighborhood in the city of Columbus.

 

And that's originally the focus of HNHF. But now, we are expanding, which is exciting to Linden which is similarly an under-resourced community in our city.

HNHF has five impact areas. And they are affordable housing, education, health and wellness, community enrichment and economic development. Now, there are many programs and initiatives and work going in these five areas. But I particularly want to highlight a couple as examples of the work that we are trying to do to impact social needs and really, by doing so, improve child health.

 

0:33:15

 

So, one has to do with economic development initiatives. So, our team this year offered free tax preparation for families who qualify based on income. And we had several sites around the city of Columbus.

 

We ended helping 469 qualifying families file personal income taxes. And this saved families about $200,000 just in tax preparation fees by being able to come to some place that would do the services for free. And we helped them access $1 million of refund, credit, and stimulus money.

 

As part of our community enrichment efforts, we offered what's called Playstreets. And Playstreets is exactly what it sounds. We close part of a street, a community block, and we kind of throw a little party on a Saturday morning.

 

0:34:14

 

So, there's… this summer but with the pandemic and everything, we're moving it to the Fall. So, we have activities for kids to do of various ages and age-appropriate activities. We have a nutritious lunch with kids. We have people come from the library. I think we have a petting zoo. At one point, we have pound’s house.

 

So, it's really just the time to promote outdoor play and also community cohesion and providing a safe place for kids to get outside and interact with one another.

 

Dr. Mike Patrick: So, the Healthy Neighborhoods, Healthy Families Program at Nationwide Children's, if we just stop and think about this, most hospitals are in a part of a city. And you're there, you open your doors, folks come in that need medical care, they leave when they're done. You know, employees come in, employees leave, and the hospital sits there.

 

0:35:06

 

And Nationwide Children's, this is really an amazing thing, that the hospital has really adopted the community around the hospital and said, "We want to make a difference here." And we want folks to have affordable housing. We want to provide education initiatives. We want to promote health and wellness.

 

We want there to be community enrichment and economic development. And really just to be a good citizen of the community in which we live. And that's pretty amazing for a healthcare institution.

 

So, I just want to say hats off to Nationwide Children's for wanting and being willing to do this. And then also to folks like you, Millie, who are involved in this program, I know it's a passion for you.

 

Just give us a few words of what it's been like to be a part of the Healthy Neighborhoods, Healthy Families Programs at Nationwide Children's. Must be really rewarding, right?

 

Dr. Millie Dolce: It is great. We have a really fantastic team of people who have a lot of different skills and talents and who are working really hard to put them to good use. So, I enjoy being on the team.

 

0:36:09

 

In my role doing program evaluation, I get the pleasure of working with all of the different programs of the five impact areas. So, I see a bird's eye view sometimes of all the work that is happening. But this is really the core of population health, is really trying to do things that can impact health at a broader community level and not just looking at what's happening per individual.

 

So, we're very committed to our neighborhoods. And as I mentioned, we're expanding to Linden. And hopefully, that is just the beginning of us being able to really concentrate effort and resources on some neighborhoods that are experiencing a disproportionate amount of health disparities.

 

Dr. Mike Patrick: Absolutely. And I'm going to put links in the show notes over at pediacast.org for folks who'd like to learn more about these initiatives. Population Health and Wellness at Nationwide Children's and then the Healthy Neighborhoods, Healthy Families Program. If you'd like to learn more about those, just head over to pediacast.org, Episode 495. And I'll have links for you so you can find that easily.

 

0:37:19

 

Emily let's talk about specific resources. I know you mentioned SNAP which is the Supplemental Nutrition Assistance Program. I think that's what used to be called food stamps, like back in the day. And then WIC, Women Infants and Children, helps to provide nutrition especially to young babies. What are some specific resources that are available for families who are challenged by food insecurity?

 

Dr. Emily Decker: Yeah, you mentioned the Summer Meal Program. That's a really important one. It's fairly easy to access. So, if families need connection with resources and they don't know where to start, really in any city, you can call 211. So that's the national call line for essential community services. It's 211. It often has connections to local food banks and pantries.

 

0:38:08

 

And like you mentioned, SNAP, that's a federal program but it's accessed at the state and local level. Eligibility is determined by income. This program is the biggest food assistance program in the US. It works. That's the great thing about it.

 

Food insecurity in households participating in SNAP are 30% lower than they would be without SNAP. It's been shown to improve health and educational outcomes. So, it's our job in the office and the community to try to connect families with these resources.

 

And people think you have to have a physical address to get SNAP benefits. You don't. You don't have to have a place to stay. You don't have to have a place to cook. Now, you can even buy groceries online at big retailers during the pandemic. So, it's fairly accessible.

 

And then so we mentioned 211. Another resource will be to go online and look at the USDA Summer Meal Finder. It's easy to find. And then, you would type in your zip code and that list all of the food distribution sites around you. They also have a hotline in English and Spanish.

 

0:39:21

 

And then, the other one that we use in clinic a lot is through No Kid Hungry. Parents and families can text the wood 'food' to 877877. It's easy to remember. And once you text that number, they ask your address. You put your address in.

 

It tells you all of the food distribution sites near you. And it also gives you the SNAP information, how to sign up. You can determine even if you're eligible by text messaging with this program. It's really simple.

 

Dr. Mike Patrick: And we'll put links to all the resources that you're mentioning in the show notes.

 

0:40:03

 

It's going to be important for individual pediatricians, family practice doctors, nurse practitioners, all the folks that are seeing kids and families to know in your local area what's available and how to connect folks with them. Because you may not have social worker in your primary care office, unfortunately. It'd be great if there were social workers in every single pediatric practice. But that's just not the case.

 

And so, as physicians, we really do need to know what's available in our community. And so, this would be a great time to investigate that. Of course, in addition to local state and federal resources, there's also a lot of faith-based organizations that have food banks and soup kitchens and offer meals certain times of the year. And so, you'll definitely want to know what your community resources are.

 

In terms of locating those community resources, we are really fortunate here in Columbus to have CAP4Kids. And so, that's another place that you can go. And we're going to talk more about CAP4Kids here in just a few minutes, but that's a terrific resource.

 

0:41:05

 

Here in Central Ohio, we have the Mid-Ohio Food Bank. And Feeding America, their website also has a way to find your local food bank. You put in your zip code and food banks and food resources that goes sort beyond government assistance can be found there.

 

Emily, what are some ways that all of us, as individuals, as families, as communities, what can we do to make a difference for our fellow Americans who are impacted by food insecurity?

 

Dr. Emily Decker: That's a good question. It's such a big problem. So, I think some people think that it's hard to help because it's so prevalent and pervasive. So, what does one person do to help?

 

But it's really easy to help. The first would be volunteer. Food banks right now, they need volunteers to sort food, to pack boxes. Meal delivery to seniors is another way to help.

 

Donations, you can donate food or money. And it doesn't have to be a lot of money. A local food pantry can stretch $5 into $20 worth of food because of bulk purchasing. So, a little bit goes a long way.

 

0:42:14

 

Donate food. A lot of food banks that in the past relied on restaurants and large retailers to stock their food, when the pandemic hit and many of these resources closed, they had a hard time filling their shelves. So, they're really relying on food donations now more than ever.

 

Another way to help, sounds kind of intimidating, but writing your local lawmaker. They want to hear from people that these federal programs are important.

SNAP is an important temporary lifeline for millions of Americans including veterans, elderly people. It's touched everyone, so it's something that's very important to support.

 

Dr. Mike Patrick: Yeah, absolutely. And you wrote a blog post called Food Insecurity: The Hidden Epidemic Someone You Know is Facing. And so, I encourage folks to check that out. We'll put a link to that in the show notes as well.

 

0:43:06

 

But even just raising awareness, talking about food insecurity with your group of friends, with your circle, and maybe brainstorming on ways that you as a group can help your community and help families who are in need. So, the more that we talk about these things and raise awareness too, we can hopefully help many many families that need it.

 

I keep mentioning CAP4Kids, Emily. I know that this is definitely passion of yours. Tell us about that.

 

Dr. Emily Decker: Yeah, thanks. CAP4Kids is a nationwide advocacy project that was started in Philadelphia by a pediatrician in 2004, Daniel Taylor. He's at St. Christopher's Hospital. The goal was to develop a website with a comprehensive up-to-date list of community resources online that parents and families could access easily and also assist physicians and community organizations and connecting families with these resources. So really bridging the gap between the many quality social service agencies in the community and the families that need their help the most.

 

0:44:17

 

So, we have 15 cities nationwide. You can go online and check it out. We want everyone to know about it because it's about helping neighbors and friends and community members and connecting with these resources that are much needed.

 

Dr. Mike Patrick: Really just an encyclopedia of local resources that are specific to your city and divided into the topics. So, whether that's food housing utilities, childcare, whatever it is, those resources are going to be listed there.

 

And we'll put links to the National CAP4Kids site and also the Columbus CAP4Kids. It's also in New York City, Philadelphia, Pittsburgh, Kansas City, Miami, St. Louis, San Antonio, Hawaii, many more places. But there's also, you mentioned, there's 15. There's a lot more cities than that in the United States.

 

0:45:09

 

And so, I suspect if someone's listening to this right now, and you go and you check out CAP4Kids and you think, "Wait, this is something that could be really beneficial for my city." Is there a way to contact someone to say, "Hey, I'm interested in starting a CAP4Kids site somewhere else?"

 

Dr. Emily Decker: Yes, absolutely. They can go online and email us, and we can walk them through the process. It's actually very easy.

 

Dr. Mike Patrick: Perfect. That sounds great. And we'll put links again to CAP4Kids in the show notes. Lots of links this week, especially if you are interested in learning more about food insecurity and hunger in the United States of America, please do head over to the website, pediacast.org, and check out those show notes.

 

So once again, Dr. Emily Decker of Primary Care Pediatrics with Nationwide Children's and also with CAP4Kids, and Dr. Millie Dolce with Community Wellness Initiatives at Nationwide Children's Hospital, thank you so much for stopping by today.

 

0:46:00

 

Dr. Emily Decker: Thank you, Dr. Mike. It's been a pleasure.

 

Dr. Millie Dolce: Thank you for having us.

 

[Music]

 

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

 

Also, thanks to our guests this week, Dr. Emily Decker and Dr. Millie Dolce, both with Nationwide Children's Hospital.

 

Don't forget, you can find us wherever podcasts are found. PediaCast is in the Apple and Google podcast apps, iHeartRadio, Spotify, SoundCloud, Amazon Music, and most other podcast apps for iOS and Android. 

 

Also, don't forget about our landing site. That's over at pediacast.org. You will find our entire archive of past programs, show notes for each episode, our Terms of Use Agreement, and that handy Contact page if you would like to suggest a future topic for the program.

 

0:47:14

 

Reviews are helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show.

 

And we love connecting with you on social media. You'll find us on Facebook, Twitter, LinkedIn, and Instagram. Simply search for PediaCast.

 

Also, don't forget about our sibling podcast, PediaCast CME. That stands for Continuing Medical Education. It is similar to this program. We do turn the science up a couple of notches and offer free Continuing Medical Education Credit for those who listen. That includes doctors, nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists.

 

And since Nationwide Children's is jointly accredited by many professional organizations, it's likely we offer the exact credits you need to fulfill your state's Continuing Medical Education requirements.

 

Of course, you want to be sure the content of the episode matches your scope of practice.

 

Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found. Simply search for PediaCast CME.

 

0:48:16

 

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids. So, long, everybody.

 

[Music]

 

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

 

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