The next time you see a group of children, consider this: One out of every five children in Allegheny County has food insecurity.
What does “food insecurity” mean? According to Danielle Cullen, MD, MPH, resident physician at Children’s Hospital of Pittsburgh of UPMC (CHP), it is “the inability to get enough nutritionally adequate or safe foods to have a healthy and active lifestyle or the inability to get these foods in socially acceptable ways.” (“Hunger” refers more to when the body sends signals that it needs food.)
With a little more than 20 percent of our children who are food insecure, doctors in the emergency department, like Dr. Cullen, are seeing many children with problems related to nutrition. Many children are “failing to thrive”—a term doctors use for children who aren’t gaining the right amount of weight to grow or develop. Dr. Cullen says, “Some parents don’t have enough money to buy formula, so they add water for it to last longer. Children will also come in with sugar and salt imbalances from this ‘formula stretching.’ They can develop seizures from these imbalances. It keeps them from growing and developing the way they should.”
Food insecurity is about more than not having enough food. Dr. Cullen sees children who are overweight and developing type II diabetes. Yet, these children can also have food insecurity.
“Sometimes the foods their parents can afford or have easy access to are inexpensive, high-calorie foods that don’t have important nutrients. If you have a dollar to spend on food, you may choose to buy a large pack of noodles instead of an apple,” says Dr. Cullen.
Food insecurity can cause more colds, slower mental and physical development and more headaches and stomachaches. Some of these health issues can continue into adulthood. Food insecurity can make it hard for children to pay attention in school, can affect their moods and make having appropriate social interactions difficult. For parents, the inability to properly feed their children is a big burden in a possibly already stressful life.
“Sometimes we forget about families that don’t meet the traditional definition of poverty,” says Dr. Cullen. “Some people have to decide whether they’re going to pay to heat their house or buy groceries.”
Another cause of food insecurity is a lack of access to healthy foods. Some people live in what’s called a “food desert.” The U.S. Department of Agriculture defines food deserts as “urban neighborhoods and rural towns without ready access to fresh, healthy and affordable food. Instead of supermarkets and grocery stores, these communities may be served only by fast food restaurants and convenience stores.” Stigma also plays a role in families’ abilities to find nutritionally appropriate food. People aren’t always willing to identify themselves as having food insecurity. They don’t always want to sign up for benefits or go to local food banks.
Food insecurity and its effects are becoming more well-known. As a part of the Healthy, Hunger-Free Kids Act passed in 2010, Pittsburgh Public Schools offer free breakfasts and lunches to children regardless of family income. Dr. Cullen thinks this is a good step toward creating food security. In addition, Dr. Cullen is working on ways to identify children and families who may have trouble getting the nutritious food they need. In a study funded by the American Academy of Pediatrics, she and coworkers are screening families coming into CHP’s emergency department. They look at anonymous information about patients’ health insurance, demographics, where they live and age ranges. Dr. Cullen hopes the information will help her and colleagues better assist families. Families are also asked questions to see if they are food insecure. “In one month of the screening, we found 260 families who screened positive for food insecurity,” Dr. Cullen says. “These are families who felt comfortable answering the questions. They’re also families who are coming to CHP. Food insecurity may be a bigger problem in our area than the numbers show.”
If families screen positive for food insecurity, Dr. Cullen and colleagues provide resources for them to get help. One resource in Allegheny County she often recommends is the United Way of Southwest PA’s 2-1-1 line. Dialing 2-1-1 (or going to pa211sw.org) will connect families to an information hub about local services. She also recommends connecting with the Greater Pittsburgh Community Food Bank (412-460-FOOD). Its website www.pittsburghfoodbank.org/get-help can search for food banks in your area if you type in your zip code.
