In Vermont, 1-in-5 children experience food hardship. Households with children experience food insecurity at almost double the rate of households without children. The USDA defines food insecurity as "[the] limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways."
Children living in food insecure homes have higher rates of developmental delay, emotional and physical problems, poorer health, increases in nutritional deficiencies, lower academic achievement, problems with social relatiobnships, and a greater risk of becoming overweight.
Food insecurity is a risk factor for malnutrition, the effects of which can be measured throughout childhood and into adulthood. In children under two, iron-deficiency anemia is directly related to impairments in cognitive, mental and psychomotor development. These conditions can persist even after the successful treatment of iron deficiency. The increase in risk for developmental delay and health problems occur in children living in food insecure households, even if the child has enough food. This may be due to micronutrient deficiencies resulting from a poor-quality diet or to the stress in the household and the effects of under-nutrition on the caretakers. In addition to the developmental delays associated with micronutrient deficiencies, brain development and cognition may also be undermined. Some children suffer from the effects of inadequate caloric intake and adolescents in particular can be impacted by low intake of protein, vitamin A and magnesium.
In food insecure homes, parents and children alike suffer the emotional effects of a low food supply. Mothers who are depressed may lack the energy required to provide adequate care, developmental stimulation and consistent routines. Additionally, when Mom is depressed, parent-child interactions are affected and the positive behavior that enhances her child’s growth, development and well-being is negatively impacted. It is not uncommon for children living in food insecure homes to fear being labeled as “poor” or being discovered as being “poor.” This shame, coupled with the effects of an inadequate food supply, can lead to behavioral problems such as aggression, anxiety, inattention, irritability, and hyperactivity. These kids increasingly internalize their problems, giving rise to more headaches and stomachaches. Teens in food insecure homes are at a greater risk for depression, dysthemia and attempted suicide.
Adults who experienced hunger as children create a workforce pool that is less competitive and suffers from a lower level of educational and technical skills. The World Health Organization identifies level of education as among the strongest predictors of health status. When learning is compromised by hunger, children grow into adults who aren’t as well prepared as their peers to participate in a competitive workforce. Additionally, adults with higher levels of education are better able to read and use health information services as well as to improve their social status. Studies show that children in food insecure households are at greater developmental risk in areas such as expressive and receptive language, fine and gross motor skills, general behavior, and social and emotional development. Kids aged 6-11 in food-insufficient homes have significantly lower arithmetic scores, are more likely to repeat a grade and use special education services, and have higher rates of absenteeism and tardiness. Additionally, teenagers from food-insufficient homes are more likely than their food-sufficient peers to have been suspended from school.
In 2010 and 2011, Gillian MacMurtry, in cooperation with Hunger Free Vermont, conducted a survey of 516 Vermont physicians with four specific areas of focus:
1. Perceived predictors of and barriers in communication about food insecurity;
2. Perceived effective methods of identifying and referring food insecure families to appropriate resources;
3. Referring to and familiarity with existing food and nutrition assistance/education programs in Vermont;
4. Physician interest in on-going research and edication associated with foof insecurity as it pertains to Vermotners.
The survey results suggested that 60% of Vermont physicians were not screening for food insecurity among their patients. Further, physicians were unaware of many resources available to Vermonters; however, there was an interest in learning opportunities for medical providers and resources for medical practices and physicians.
Medical professions and health care providers are in a unique position among service providers in Vermont. As providers who care for families in all stages of life and under all circumstances, physicians and their colleagues see and speak to more families in Vermont than any other provider. Many of the problems that they see in their practices may be exacerbated by or directly related to a lack of quality food in the home.
The clinical setting is the perfect place to ask about food insecurity, and the American Academy of Pediatrics agrees. The AAP mission statement is, “To attain optimal physical, mental and social health and well-being for all infants, children, adolescents and young adults.” Fulfilling the AAP mission extends the focus of the pediatric visit from medical problems into health-related social domains. These include: access to health care, housing, food security, income security, and intimate partner violence.
Hunger Free Vermont recently launched "Childhood Hunger in Vermont: The Hidden Impacts on Health, Development & Wellbeing." This course, available online, is a 1-hour accredited tutorial that focuses on the impacts of childhood hunger and provides healthcare professionals with the information and tools for screening and intervention to ensure that all Vermonters have access to enough nutritious food to thrive.
To access this course:
The course is divided into five modules:
* Introduction and overview
* How we got here, how we measure hunger, and what puts families at risk.
* What are food insecure families eating? What difficult choices are they forced to make?
* The profound effects of food insecurity on child health, development & education.
* What can you do? What is your role?
Course Participants will:
* Understand how hunger is invisible and how you can ask about it and look for risk factors.
* Understand the consequences of food insecurity, such as malnutrition, behavioral and developmental issues, and poor health.
* Understand what nutrition resources are available to Vermont children and families, and their
* Be familiar with your role as a health care provider in asking questions, screening, monitoring,
and making referrals.
Physicians are taking the course and Hunger Free Vermont hopes to have over 75 more Vermont physicians screening for childhood food insecurity before September. While the accredited tutorial is a good first step in raising awareness among Vermont's medical community, more is needed:
1. Continued education and awareness to battle stigma around who is hungry and why they're hungry;
2. Strategies for connecting physicians to the food resources to which they refer their patients;
3. Strategies for continuing to simplify the food insecurity screening process;
4. Better, stronger language for physicans when they talk to families about fod insecurity;
5. Geographically specific food resources (school meals, food panties, soup kitchens, etc);
6. Tools to encourage and aid health care provides to follow-up with patients they've identified as food insecure or at risk of food insecurity.