Ministry addresses systemic contributors to hunger

November 15, 2011


It is common for Catholic health systems and facilities to tackle hunger concerns in their communities. They normally do so by providing emergency food aid to pantries or to individual families, and typically through food drives. While such assistance fills ongoing needs, some ministry providers are going further. They are drilling down to find the causes of food insecurity in their communities and forging collaborative partnerships to contribute to permanent solutions.

"We want to make sure our efforts are an integrated part of what the community is doing, that we are part of a strategy," said Kirsten Walter, director of the Nutrition Center of Maine, part of St. Mary's Health System of Lewiston, Maine. "We don't want to work in silos" on the hunger issue.

Seeding stores
San Francisco's Catholic Healthcare West is an anchor partner in FreshWorks. That public-private coalition has created a $220 million fund to expand access to healthy food in underserved rural and urban communities across California. CHW invested $2.5 million in FreshWorks. Other partners include banks, insurers, grocery associations, community health councils and the state of California.

Launched this summer, FreshWorks provides loans and/or grants to retailers and others aiming to bring fresh, healthy foods to areas that lack such basic goods. FreshWorks estimates that 1.7 million low-income Californians don't have a supermarket within a mile of their homes. "This makes it less likely for them to consume fresh fruits and vegetables, therefore facing higher risks of diet-related diseases such as cancer, diabetes and heart disease," according to the group's website.

FreshWorks funds, which include loans at or slightly below market rates, can be used to establish or renovate grocery stores and other food retail settings in underserved areas. The money may be used for property purchases, construction and improvements and for inventory and equipment. In time, the funded projects are to become self-sufficient, with strong prospects for long-term economic viability, loans paid off and the projects operating in the black. To be successful in applying for FreshWorks funding, applicants must promote healthful living — a requirement that can be met by selling a variety of foods from various food groups including fruits and vegetables and having at least one junk-food-free aisle in their store or by refusing to sell cigarettes.

Pablo Bravo Vial, CHW director of community grants and investments, said the loans likely will go to small, local, independent grocers, as large, national chains typically can self-finance.

FreshWorks is soliciting loan and grant applications. Vial said it has four loan applications and one grant application under consideration. It plans to make its first awards this month.

Vial said that the investment in FreshWorks is directly connected with CHW's mission. "Most of CHW hospitals' health assessments indicate diabetes as one of the issues most impacting low-income communities, and one of the causes of diabetes is not having access to healthy foods."

He noted that the FreshWorks initiative will spur economic activity in disadvantaged neighborhoods. "By financing the creation of healthy food retailers, the fund also anticipates creating jobs in communities that are in need of economic investment," he explained. He added that FreshWorks can provide grant dollars to support the cost of hiring. FreshWorks plans to work closely with municipalities on site selection and to ensure projects fit with neighborhood priorities, and Vial said some cities may consider tax incentives to assist the projects.

Lay of the land
In Chippewa County, Wis., the Chippewa Health Improvement Partnership created in part by St. Joseph's Hospital of Chippewa Falls, Wis., is trying to better understand hunger in the region and to unite local organizations to work together to address food access concerns. To do this, the partnership has convened forums of food pantry directors and others and is auditing food availability.

During the forums, directors of pantries and social service organizations and other community leaders said that pantry clients have been turning to pantries not just for food but also for household goods and transportation help — aid that most people may not associate with food pantries, said Rhonda Brown, manager of the partnership.

The partnership is conducting a formal assessment, looking at the food system around the predominantly rural Chippewa County. It's assessing what type of food is available, where and at what cost. It's looking at pantry locations and demand for food pantry stock. And, it's recording grocery store locations and food availability and prices. Researchers are conducting the assessments in different seasons to see how food availability and prices vary.

Brown said the assessment is filling in gaps in government data on poverty. Government data does not capture the depth of information on food security necessary to pinpoint areas of need, she said. Plus, Chippewa County statistics often are bunched together with data from other small counties nearby, and so it can be difficult to understand the peculiarities of each county, she said.

When the assessments are complete, Brown said the Health Improvement Partnership will use the data to map the location of food deserts. It will work with local organizations to determine whether new pantries, community gardens, farmers' markets or food distribution vans can be established in those underserved pockets.

An invisible problem
In Lewiston, St. Mary's and its nutrition center are conducting a similar assessment on food access and food barriers. St. Mary's Walter said that while the nutrition center staff believed they had a good understanding of food availability and hunger concerns around Lewiston, they decided to conduct this first-ever in-depth analysis of food availability because they needed to test their assumptions, and so they could establish an information baseline to gauge efforts to combat hunger and poor nutrition.

She said the report will explore how conditions of poverty — including transportation barriers — tie in with hunger concerns.

After the report is released, the nutrition center plans to convene small groups of Lewiston-area residents to talk about how they think hunger should be addressed. In February, the center will convene another group to review and analyze the assessment results and the input from the small groups to set priorities and a roadmap for tackling food access issues. The center then will assemble a food council of local government, not-for-profit and other leaders to take on the action items.

Walter said the effort should raise awareness of the area's hunger problem. "It's been an invisible problem up to now, because people who are affected don't want to talk about it. There are emotional factors involved with not having enough food for you and your kids. People expect you to be able to take care of yourself, and when you don't, there can be fear and shame."

Walter hopes the community wide effort will remove the stigma.

Food aid at Thanksgiving

St. Mary's Hospital in Passaic, N.J., is among the ministry hospitals that recognize that food aid is particularly important during the holiday season.

For more than 25 years, St. Mary's has been holding a Thanksgiving food drive in November so that the hospital can give food baskets to low-income people for Thanksgiving. Staff donate baskets of nonperishable Thanksgiving trimmings and a grocery store gift card that can be used for a turkey.

Here, in 2010, Sr. Marion Scranton, S.C., St. Mary's vice president of mission, and Luz Flores, a community outreach worker, show off baskets collected through the drive.

Federal push to improve access to healthy food

President Barack Obama, First Lady Michelle Obama and some U.S. congressmen have advocated a federal program that would encourage healthy food retailers to locate in food deserts.

The Healthy Food Financing Initiative would provide one-time grants and loans to supermarkets and fresh food retailers for predevelopment, property acquisition, equipment, construction and start-up costs associated with opening retail locations that sell healthy food in low- to moderate-income communities that lack access to healthy food.

The president and first lady have promoted the idea, and in December 2009 U.S. Rep. Allyson Schwartz, (D-Pa.), and 20 cosponsors introduced a congressional resolution promoting the federal legislation. While that legislation was not acted upon, there has been progress on the federal effort, according to Rebecca Flournoy, associate director of PolicyLink, a research and advocacy institute helping to promote the Healthy Food Financing Initiative. She said Obama proposed such financing in his 2011 and 2012 budget proposals, and while no earmarked funding was granted in 2011, three U.S. agencies have allocated about $45 million to support healthy food financing initiatives around the U.S. Those agencies are the U.S. Department of Agriculture, the U.S. Department of the Treasury and the U.S. Department of Health and Human Services.

Flournoy said it is unclear whether funds will be allocated to healthy food financing in the 2012 budget, as those negotiations are still under way. She noted that PolicyLink expects the bipartisan legislation for the initiative to be reintroduced in Congress in the next month or so, and it could potentially be worked into the next farm bill.

The Healthy Food Financing Initiative is modeled after a Pennsylvania program that used $30 million in state seed money to attract healthy food retail projects valued at about $190 million.

Pantries use choice model, other tactics to improve efficiency

A limited number of ministry providers operate their own food pantries for community members. Some of them are exploring how to improve their efficiency in providing food aid to community members.

One such pantry is affiliated with Mercy Franciscan at St. Raphael, a Catholic Health Partners facility in Hamilton, Ohio, that provides low-income people with social services and emergency assistance with rent or mortgage payments, food, clothing and personal care or household items. On on-site pantry at St. Raphael is among the increasing number of pantries nationwide using the choice model, in which pantry clients can choose their food instead of receiving groceries in prepackaged bags.

Similar in setup to a grocery store, the pantry stock is arranged by category — grains, fruits and dairy, among them. Food pantry staff help families make selections. Shelves have color-coded labels so that people with low literacy or language barriers can locate each food group.

The model reduces waste since families do not select food they don't like, or may not know how to prepare. It also respects recipients' dignity, said Terry Perdue, executive director at St. Raphael.

The choice model is being used in pantries across the U.S. The nationwide hunger relief charity Feeding America, which has 202 member food banks and affiliates, began using the model in 2005.

To further improve efficiency, St. Raphael has joined with a group of pantries to share data through a "virtual case manager" so they can know clients' history of accessing food. Pantries are not meant to supply all of people's food, and so when the database shows there's a client who appears to rely solely on pantries, staff may follow-up and connect that client to employment or other aid agencies.

St. Raphael soon will use a grant to hire a social worker to assess and address pantry clients' needs. The goal, Perdue said, is to "move people out of the cycle of dependency to self-sufficiency thus resulting in higher food security."

St. Mary's Health System of Lewiston, Maine, runs its food pantry as part of St. Mary's Nutrition Center of Maine. The center provides educational programs to teach community members how to prepare the food they buy or receive. Food pantry clients can take part in these nutrition center demonstrations. Also, the pantry has its own educational resources for clients. For instance, it gives pantry clients fact sheets on how to select, buy, freeze, preserve and store fruits and vegetables. Arming clients with this kind of information helps to reduce food waste.


Copyright © 2011 by the Catholic Health Association of the United States
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