Community Hidden Hunger: Local & State Perspectives of Food Security

1. Community Hidden Hunger: Local & State Perspectives of Food Security WI Prevention Conference September 12, 2013

2. Overview • Defining food security • Food security focus group research project • Framing food security and it’s relationship to community health

3. Defining Food Security

4. Definitions Food Security • Access by all people at all times to enough food for an active, healthy life and includes at a minimum: • The ready availability of nutritionally adequate and safe foods and • The assured ability to acquire acceptable food in socially acceptable ways Food Insecurity • Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.

5. Prevalence of Food Insecurity Food Insecurity Rates, 1996-2010

6. State averages mask regional variation in food hardship

7. State averages mask regional variation

8. Poverty is the most important predictor of food insecurity…and yet, More than half of food insecure households are not poor

9. Community Hidden Hunger: Food Security Focus Group Research Project

10. Research Team Members • University of Wisconsin-Eau Claire • Mary Canales, Nursing • Brenda Kaczmarski, Nursing student • Meghan Lynch, Nursing student • UW Extension, WI Nutrition Ed. Program • Nancy Coffey, Nutrition Coordinator • Melissa Gullickson, AmeriCorp • Feed My People Food Bank • Emily Moore, Director

11. EC County Food Insecurity • 1 in 5 children food insecure (Feeding America, 2012); • 1 in 8 residents reported food hardship (FRAC, 2011); • 1in 5 residents participated in FoodShare/SNAP (DHS, 2011); • 2 in 5 children enrolled in Free or Reduced Price lunch (WI Food Security Project, 2011).

12. Research Project Purpose • Explore meaning of food insecurity through voices of food insecure parents with young children & agency staff from food assistance programs Methods • Community-based participatory action approach • Multiple recruitment strategies • Focus group methodology used to collect data

13. Focus Group Questions • Based on community advisory discussion roundtable • Key question: What is it like to be food insecure? • Theme 1-Why are people hungry? • Theme 2- What does it mean to be hungry? • Theme 3: What is working? Suggestions?

14. Survey Data Collected • Parent: • USDA food security questions • Household demographics • Assistance programs utilized • Staff: • Job role • Work experience & education

15. Assumptions • Experience of being hungry different for parents receiving government assistance compared to those who do not • Plan=separate focus groups • Reality=include anyone self-reported • Incentives necessary to recruit • Plan=logistical & monetary incentives would be sufficient to recruit desired numbers • Reality-= insufficient; required connections

16. Funding • UWEC Office of Research and Sponsored Programs (ORSP) student-faculty collaborative research grants • Summer 2012 • Academic Year 2012-13 • UW-Extension District Innovative Grant (2012) • Feed My People (2012)

17. Human Subjects • Research team members completed human subjects certification training • Proposal submitted, reviewed& expedited by UW-EC IRB • Each participant signed consent & received a copy for own records • Requested & received permission to digitally record focus group discussions

18. Recruitment Efforts • Met with representatives from agencies affiliated with food insecure population • Focus Group Facilitator- personally experienced food insecurity • Compensation offered-$25 gift card (grocery or gas) • Convenient location-Children’s Museum; included free admission • Child care provided • Snack & beverage provided • Offered variety of dates & times of day • Reminder phone call or email day before

19. Challenges Encountered • Despite initial interest, low attendance • Touched Twice Clinic: 35 signed up; 7 agreed; 2 attended (1 group) • ECASD: 7000 bookmarks; 30 inquiries; 19 attended (3 groups) • Augusta Area School District: 12 hours visibility=1 signed up • Stigma associated with hunger negatively influenced participation • Without personal connection, limited response

20. Recruitment Tool: Bookmark

21. Successful Recruitment Approaches • Connect to staff affiliated with existing programs; build upon these relationships • Ask staff to assist with recruitment & invite potential participants • Host in location familiar & easily accessible to participants; provide transportation

22. Results Summary of Participants

23. Results from Survey Data • Over half had 2 children or less • 35% had children 5 years or under • Majority were couples or 3 generational families • 23% were minority population (Hmong) • Over half had annual income of $20,000 or less

24. Survey Results: Coping with Food Availability • During the past 12 months: • 72% participated in FoodShare & free or reduced cost school lunch • 50% participated in WIC or used food pantries • 43% reported they cut size of or skipped meals almost every month • 40% said they often could not afford balanced meals

25. Focus Group Analysis: Themes that Emerged • Falling through the cracks • Struggling physically & emotionally with hunger • Juggling to meet life’s basic needs • Desiring healthy foods without the means

26. Themes were consistent for parent and agency staff participants.

27. Parent: Falling Through the Cracks …the day I call to say, ‘Hey, I got a job. It’s a temporary position, contracted 160 hours.’ As of that day…she’s [agency staff] like ‘well, you won’t get any food stamps next month then.’ Meanwhile you’re really hungry at work and haven’t gotten paid yet. And then sometimes they hold back a check, too. Yeah, it took me 4 weeks to get my first check …

28. Staff:Falling Through the Cracks I think there are a lot of families that are falling through the cracks, that don’t qualify for programs, but still aren’t able to feed their families, especially if they have children. They aren’t necessarily homeless families or anything like that, but they’re falling through the cracks.

29. Parent: Struggling Physically & Emotionally with Hunger • …when there is enough [food], I can sleep, when there isn’t enough, I just couldn’t sleep – I can’t fall asleep. • It’s very different, because when there isn’t enough [food], the stress level there is just super high, kids will be nagging, crying, and when you do have enough it is exactly the opposite, everybody is happy.

30. Staff: Struggling Physically & Emotionally with Hunger … she [Mom] said, ‘No, that’s your dad’s cheese. He’ll be mad if you eat it.’ So she decided to give him some, so she got a little cup out and gave him about this much shredded cheese to share with his one year old sister. And then he [son] said he wanted something else to eat and she [Mom] said, ‘no you can’t have anything more.’

31. Parent: Juggling Life’s Demands When we run short on food we go to food pantries, free meal sites, just to…okay it’s getting towards the end of the month. We’re running short, we have to find ways to stretch it. But I don’t have a car so getting around is another thing, so when I’m having to spend (buy food) at the gas station it goes quick so then you have to figure out how to stretch it the rest of the month.

32. Staff: Juggling Life’s Demands We’ve had people apply and one of the big obstacles for them is medical bills, and unfortunately, our applications don’t take into consideration any medical bills. It’s based on gross income, so that’s tough for the families with medical issues.

33. Parent: Desiring healthy foods without the means …I would just love to just be able to eat healthy, you know, every single day. I, if I had the means I would eat healthy and feed my kids healthy…

34. Staff: Desiring healthy foods without the means It has to be that we’re going to teach how to choose it (other staff: uh huh), what to do with it, how to prepare it and how to store it. It’s a lot of things, it’s the reading level, it’s the recipes. Do you have the cooking ability at home? All of those things, it’s pretty complex.

35. ECC Food Security Action • Increase community awareness • Turning the Tables on Food Hardship Media Campaign • A Place at the Table documentary film event • Educate & mobilize health care providers • Foster coalitions & networks to take action to address food insecurity.

36. Framing Food Security

37. Framework for Food Security (USAID)

38. Wisconsin Food Security Project Framework for Food Security

39. Understanding how poverty impacts health The cyclical effects of poverty

40. Broadening the focus of health

41. Connecting food insecurity to health Nutritional deficiencies during pregnancy Obesity Lack of availability and access to healthy, affordable foods

42. Food insecure and obese? • Growing body of literature primarily based on cross-sectional studies, limited availability of longitudinal studies • Difficult to determine causal relationship • Most consistent findings suggest relationship of food insecurity and risk for obesity among women…children (mixed evidence) and adolescents (growing evidence) • Maternal stress/depression • Disruptive eating patterns (cycles of deprivation/overeating & sacrifice food supply) • Consumption of low-cost, poor-quality foods

43. Some factors may place low-income individuals at greater risk for obesity Lack of access to healthy, affordable foods Greater exposure to junk food marketing Cycles of Food deprivation and overeating Fewer opportunities for physical activity High levels of stress

44. ACTIVITY: Creating a strong community food security infrastructure

45. Implications: How Can Food Insecurity be Reduced? Thinking of your community: • Identify root causes/contributors of food insecurity • Brainstorm ideas to reduce food insecurity • Identify 2-3 ideas to move forward • Power Map the stakeholders you would invite to the table • Conduct 1:1 interviews with stakeholders • Take action!

46. Identify1-2 food security related health issues of major concern in your county/community

47. Considering these issues, how can the food security infrastructure in your community be strengthened? Food Security Infrastructure Your Ideas 1. 2. 3. 4. • Economic Wellbeing • Federal food and nutrition assistance programs • Local food access and availability • Emergency food assistance

48. Identify stakeholders to bring to the table 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

49. Group Discussion

50. Thank you! Today’s Presenters Mary Canales CANALEMK@uwec.edu Amber Canto amber.canto@ces.uwex.edu Nancy Coffey nancy.coffey@ces.uwex.edu Brenda Kaczmarski kaczmabj@uwec.edu