Moving from “thinking about it” to “action”… FOOD JUSTICE in our own MT communities
One of the general session speakers at the AADE annual meeting in Houston was Clancy Harrison, RD, FAND, president and nutrition coordinator of a food pantry, the founder of two national anti-hunger organizations, and national speaker and TEDx Speaker on the topic of ‘Food Justice,’ and she had me absolutely riveted to her presentation at 7:30 am on a Saturday morning. She was one of those speakers I just had to meet afterwards, but I had to stand in line and wait almost 30 minutes to have the opportunity to visit with her!
Why all the ‘buzz’ about her presentation? Why did I HAVE to meet Clancy? I had just finished a whirlwind tour of 15 health centers across Montana, talking to community health centers about the biggest needs of their diabetes population. Hands down, they all said the number one thing that their population of people with diabetes need is “access to healthy food” and “food security.”
Because I’m currently exploring how to help with diabetes education for these health centers, this issue is particularly relevant and extremely important, as how can someone really ‘manage’ their diabetes if there isn’t full access to food, let alone healthy food?! Honestly, their answer to this single question about their patients’ biggest need stunned me. I maybe I shouldn’t have been stunned. We know the statistics. But it has me consumed with how to tackle this issue in a meaningful way. I don’t have much in the way of real answers yet, but here are some of the valuable pieces of information I got from Clancy’s presentation at AADE.
Clancy describes herself as ‘recovering food elitist,’ someone who had many preconceived notions about food and healthy eating, and conversely, those that did not eat healthfully. She felt people were purposefully making ‘unhealthy’ choices, and had not considered all the social determinants of health that impact the ability to even have a choice, let alone a variety of good choices. Needless to say, she’s grown and learned, and is now doing something about it!
Most people who are food insecure are working or looking for work, are disabled, or ill. Included in those that are food insecure are nearly 50% of low-income children and 29% of poor children with at least one parent who worked full-time, year-round.
Food security is defined as: Access at ALL times to nourishing food, and is needed for ALL members of a household to live an active and healthy life.
- 40 million people and 12.5 million children are food insecure
- 29% of people who are food insecure in the U.S. don’t qualify for food assistance programs because their income is too high
- Almost 60% of Americans with multiple chronic medical conditions struggled to afford at least one basic need (health care, housing, utilities, or food) in 2017
- The extra health care cost for a person with food insecurity is $1,863/year and even greater for a person with diabetes ($4,413/year), and heart disease ($5,144/year)
Many people with health conditions forgo or postpone preventative or needed medical care, they skip food needed for medical meal plans for their conditions, and regarding medications, they skip, take less, delay filling prescriptions, and don’t take their medications with food. There are ‘spending tradeoffs,’ and decisions that are made every day, such as do I buy food, or pay my rent. This is ‘survival mode’ which is highly stressful and places people further at risk for health deterioration and risk.
And even if people are eligible for services, there is a high percentage of non-participation, due to stigma, poor treatment by staff or volunteers, work schedule, lack of knowledge, transportation issues, etc. There are so many barriers in place to getting people the help they need. However, there are ways to tackling these issues, and it starts with each of us. It starts with me. It requires ACTION.
Where do you even start? Incorporate the “Hunger Vital Sign” into your assessments and screen for hunger or food insecurity.
“Please answer often true/sometimes true/never true to the following statements:”
- “Within the past 12 months we worried whether our food would run out before we got money to buy more.”
- “Within the past 12 months the food we bout just didn’t last and we didn’t have money to buy more.”
Codes for Food Insecurity:
ICD-10 CM Diagnosis Code Z59.4 (lack of adequate food and safe drinking water)
ICD-10 CM Diagnosis Code Z59.5 (extreme poverty)
Screen all people at all visits with sensitivity, have a handout with 3-5 food assistance resources, and reach out to collaborate with WIC, other local dietitians, and local food security advocates. Get on the board of directors of your local food bank. Dive in. You can make a difference.
Clancy Harrison’s website: https://clancyharrison.com/ You can also connect with her on Facebook or Instagram.
We see every day, in our own Montana communities, the immediate need for ways to address food insecurity. We can all advocate for FOOD DIGNITY. Take those first steps. What an amazing way to help the ones that may need it the most. Diabetes Care and Education Specialists can improve a person’s outcomes by satisfying the utmost basic of needs - food.
Respectfully submitted,
Marci Butcher, RD, CDE – Diabetes Care and Education Specialist, MT Diabetes Program, MT DPHHS