Health Disparities: Let’s start with Hunger

by Georgiana Reynal Chief Advocacy Officer, Ascension St. Vincent

Access to healthcare is an important piece of the puzzle, but it’s time to acknowledge that there are many additional factors (or social determinants) that impact health outcomes. Factors include the resources available to you and in the community where you live: whether you have a roof over your head, healthy food on the table, a decent job, access to healthcare, and transportation. It can be difficult to know where to start.

Let’s start with hunger.

Prior to the COVID-19 pandemic, food insecurity affected 35.2 million Americans — or 1 in every 10 households. With increased unemployment and the effects of COVID-19 factored in, Feeding America now estimates more than 54 million people – including 18 million children – are food insecure.

In 2019, Gleaners Food Bank of Indiana distributed an average of 3.5 million pounds a month through their network and also served an average of 5,000 families a month at their onsite food pantry. And then COVID swept into town. Many families with little savings, layoffs at work, or even unexpected car maintenance or other bills suddenly faced a choice between buying food and paying bills. By the end of April, Gleaners had more than doubled its food distribution to 7.9 million pounds. Pre-COVID, the number of families served on their onsite pantry averaged 5,000 per month. In August nearly 18,000 families were served.

It is well documented that children who struggle with food insecurity can be affected both cognitively and physically. This carries over in a tangible way to education. It’s hard to focus on your studies when you are concerned about where your next meal is coming from. And for adults, food insecurity not only makes it difficult to concentrate at work, but it is also linked to serious health problems including Type 2 Diabetes, hypertension, heart disease, and obesity, all of which can lead to poorer outcomes from COVID. In August of 2018, the Indiana Family and Social Services Administration added 10 optional questions to all online applications for health coverage, the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). The aim was to understand how resource availability impacts Indiana communities. Of the more than 300,000 assessments completed, the need most frequently identified a lack of sufficient food.

As COVID continues to wreak havoc on our communities – physically, economically, socially and emotionally – I find hope in a Public Opinion Strategies Report including data from an American Association of Medical Colleges survey that 71% of Americans polled believe it should be a top/high priority that the U.S. ensures health equity for every American.

In September, the Ascension Medical Group will be adding a once annual Social Determinants of Health Screening for patients. If a patient is found to have a barrier, he or she will be referred to Rural and Urban Access to Health (RUAH). RUAH is a community-based care coordination program sponsored by Ascension St. Vincent. RUAH’s purpose is to connect our friends, family and neighbors to a comprehensive, integrated delivery system of health, human and social services resulting in improved access and removal of barriers to needed resources.

Health Advocates assist individuals in finding a doctor, accessing medications at free or reduced cost, applying for health coverage as well as public assistance programs such as SNAP, TANF, Social Security, and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Advocates also connect individuals with connections to other community resources and agencies for assistance such as utility assistance, food, clothing, housing, etc.

In the last 6 years, RUAH has completed over 38,000 pathways related to social determinants of Health. Not surprisingly, an earlier social determinants screening pilot identified food insecurity as a top identified need. I don’t expect anything different as we roll this out.

Food insecurity is a health issue, and healthcare providers can take action to address it. September is Hunger Action Month and below are six actions we all can take, no matter what the time of the year:

  1. Thank food bank heroes for their dedication during these challenging times.
  2. Brush up on the latest hunger facts so you can debunk the myths.
  3. Fundraise for Hunger Action Month.
  4. Become a regular food bank or food pantry volunteer.
  5. Talk to your children about hunger in America.
  6. Donate to Feeding America or your local food bank.

Georgiana Reynal is Chief Advocacy Officer for Ascension St. Vincent and serves as Board Chair for Gleaners Food Bank in Indianapolis, Indiana.