John Cook, PhD, MAEd Stephanie Ettinger de Cuba, MPH Ana Paula Poblacion, MSc Loaves & Fishes...
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John Cook, PhD, MAEd Stephanie Ettinger de Cuba, MPH Ana Paula Poblacion, MSc Loaves & Fishes Community Services Naperville, Illinois April 16-17, 2015
John Cook, PhD, MAEd Stephanie Ettinger de Cuba, MPH Ana Paula
Poblacion, MSc Loaves & Fishes Community Services Naperville,
Illinois April 16-17, 2015 Hunger is a Vital Sign; Vaccinating
Communities Against Hunger By Empowering Food-Insecure
Families
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Childrens HealthWatch Non-partisan network of pediatric &
public health researchers research & policy center MISSION:
Improve health & development of young children public policies
alleviate family economic hardships Hunger (Food Insecurity)
Unstable Housing (Housing Insecurity) Keeping Heat or Lights on
(Energy Insecurity) Provide policy makers with evidence to develop
policies that protect young childrens health and development
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Where our data come from: A household survey Interviews -
caregivers with children 0 to 4 years old invisible group critical
growth and development window Emergency Departments and Primary
Care Clinics in Boston, Baltimore, Philadelphia, Little Rock and
Minneapolis.
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Use evidence from empirical research results to: Inform
actionable policy decisions Support policy recommendations
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1.How food insecurity & hunger impact the health of
families and children. 2.How the health of families & children
influence the health of communities. 3.How empowering families to
escape food insecurity and become self-sufficient influences their
health, and the health of their community. How Do Food Insecurity
and Hunger Influence the Health of Communities? Overview
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Food Insecurity and Hunger are Linked to Other Family Hardships
Children in food-insecure families also are more likely to be:
Housing insecure (crowded, doubled-up, two or more residential
moves in last year, behind on rent/mortgage payments), Energy
insecure (threatened with or have had a utility shutoff), To have
foregone needed health care (visits for treatment or adherence to
prescription medication), To have traded off health care against
expenditures for other necessities, compared to children in
food-secure families.
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Food Insecurity and Hunger are Vital Signs Linked to Adverse
Child Health Outcomes Children in food-insecure families are more
likely to: Have been hospitalized since birth, Have their health
status reported as fair/poor versus excellent/good,** Have parents
report concerns indicating risk of developmental problems, Have
iron deficiency anemia, Have anemia without iron deficiency,
compared to children in food-secure families.
Slide 9
Food Insecurity and Hunger are Vital Signs Linked to Adverse
Maternal Health Outcomes Children in households with child food
insecurity are more likely to: Have mothers who report having
depressive symptoms, Have mothers who report their own health as
fair/poor, Have mothers with unhealthy weight status, Have mothers
with chronic diseases, e.g., diabetes, compared to children in
food-secure families.
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**NOTE: Meaning of Self-reported Health Status Based on a
question that emerged around the mid-twentieth century (exact
source unknown; maybe UN/WHO, maybe US government) Used by the US
government and RAND Corporation in early 1950s, and since in the
NHIS and NHANES, Has been validated in US, European, and Global
contexts. Would you say {your/SP's} health in general is...
(excellent, very good, good, fair, poor)?
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NOTE: Meaning of Self-rated Health Status In the US, according
to Census Bureau data: Of all children (ages co-enrollment Sandel
et al. JARC, 2015.">
Building the evidence for change > co-enrollment Sandel et
al. JARC, 2015.
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OK, this is interesting but what can I do with this
information? Well, consider this: Strong physical infrastructures;
strong bridges, buildings, roads, parks, bike paths, trains, buses,
subways, libraries, schools, ports, housing stock, utilities, are
all part of the foundation for a strong, healthy public, &
strong, healthy communities, and, Strong social infrastructures;
fire departments, faith-based institutions, police departments,
PTOs, civic organizations, mutual aid societies, private food
assistance food banks, food pantries, food rescue disaster relief,
public food, housing, & energy assistance SNAP, WIC, CACFP,
school meals, summer feeding, etc., housing subsidies, LIHEAP,
legal aid, are also essential parts of the foundation for a strong,
healthy public & communities. They enable all of us to be
healthy and to prosper. They are for all of us, and we all benefit
from them, whether we use them or not.
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Housing, Food, Energy Insecurity Policy Failures Regulatory
Failures Failures of Representative Democracy Market Failures Food,
housing, and energy insecurity are results of systemic failures,
not individuals or families failures
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(1000s)
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Bringing food security & health together for positive
change Hospital systems/health care partners Incorporating the
hunger vital sign into EHRs; screening routinely Health care
providers investing in the food security vaccine; access to healthy
food via on-site & community-based food pantries, WIC offices,
demo kitchens, nutrition education, farmers markets, etc. IRS
approved nutrition access as community benefit; tax
exemption/deduction for non-profit hospitals under the ACA Broad,
Multi-sector Coalitions Human beings arent divided into government
departments Co-enrollment for benefits, including food, housing,
energy assistance State-level EITC & Child Tax Credit
increases, minimum wage increases Advocacy/coalition building using
the health argument with partners, helping to build momentum for
empowerment and achieving economic self-sufficiency
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New understanding of interplay of food security and the health
of individuals, families, and communities Nutrition and
non-nutrition pathways of influence Toxic stress, brain plasticity,
bio-embedding, epigenetics, immune system functioning Nutrition
programming in utero affects health in later life Food security and
healthy food can act as a vaccine Provide multiple, long-lasting
benefits Differential benefits to individuals, families, and
communities A strong, healthy public, benefits to society as a
whole Food Security & Healthy Food act as a Vaccine
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WE ARE ALL IN THIS TOGETHER! Thank you! [email protected]
www.childrenshealthwatch.org @childrensHW
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Recommended reviews: Gunderson C, Kreider B, Pepper J. The
Economics of Food Insecurity in the United States. Applied Economic
Perspectives and Policy (2011) volume 33, number 3, pp. 281303.
doi:10.1093/aepp/ppr022. Nord M. Food Insecurity in Households with
Children: Prevalence, Severity, and Household Characteristics.
EIB-56. U.S. Dept. of Agriculture, Econ. Res. Serv. September 2009.
http://www.ers.usda.gov/Publications/EIB56/
http://www.ers.usda.gov/Publications/EIB56/ Cook JT, Frank DA. Food
Security, Poverty and Development in the United States. Ann. N.Y.
Acad. Sci. xxxx: 116 (2008). 2008 New York Academy of Sciences.
doi: 10.1196/annals.1425.001
http://www.childrenshealthwatch.org/page/Publications
http://www.childrenshealthwatch.org/page/Publications What Have we
Learned in 20 Years About Food Insecuritys Impacts on Child Health
& Development?
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Reviews (Contd.) Reviews from ASN EB Symposium 2012 (Food
Security and Health Across the Lifespan) Laraia BA. Food Insecurity
and Chronic Disease. Adv. Nutr. 4: 203212, 2013.
http://advances.nutrition.org/content/4/2/203.full.pdf+htmlhttp://advances.nutrition.org/content/4/2/203.full.pdf+html
Cook, JT, et al. Are Food Insecuritys Health Impacts Underestimated
in the U.S. Population? Marginal Food Security Also Predicts
Adverse Health Outcomes in Young U.S. Children and Mothers. Adv.
Nutr. 4: 5161, 2013.
http://advances.nutrition.org/content/4/2/51.full.pdf+html
http://advances.nutrition.org/content/4/2/51.full.pdf+html
Gundersen C. Food Insecurity Is an Ongoing National Concern. Adv.
Nutr. 4: 3641, 2013.
http://advances.nutrition.org/content/4/2/36.full.pdf+html
http://advances.nutrition.org/content/4/2/36.full.pdf+html In
addition, all Childrens HealthWatch publications can be found at
http://www.childrenshealthwatch.org/page/Publications