According to Feeding America, one in nine people in Indiana faces hunger. While many Hoosiers have rebounded from the challenges posed by the early months of the COVID-19 pandemic, things are worse for many in our communities, particularly when it comes to food insecurity. The impending end of the federal public health emergency will likely mean less government aid, particularly in Black and brown communities, which were devastated by the pandemic and may never recover. Jobs and family members have been lost, local businesses have closed and grocery stores have folded, causing significant food insecurity in both urban and rural areas.
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As a managed care entity in Indiana, we see how social issues, such as inadequate food, are reflected in a number of gaps in care, such as preventive health measures that are not completed. For example, immunization rates continue to be a cause for concern, with many families falling behind in standard immunizations and other wellness related youth care. There are many drivers of these gaps, but one of the largest is the fact that families must manage competing priorities. If they are concerned with meeting their most basic needs, such as food, then they may not have the capacity to positively engage with the health care system.
Other factors that may limit one’s ability to obtain care include lack of transportation, limited awareness of preventive health recommendations, inadequate child care and other familial responsibilities. Access to nutritious food is perhaps the most important social determinant impacting one’s health. We must recognize how food insecurity affects individuals and the ever-growing need for action plus education to positively influence Hoosiers’ health outcomes.
We have critical health disparities in the U.S., especially in Central Indiana. We see this with diabetes, hypertension, heart disease, cancer and in obstetrics specifically with maternal and infant mortality, to name a few. If we look at the causes of some of those disparities, it comes down to meeting basic needs. Access to and availability of healthy food is one of those needs. It is not enough to provide quantity; the quality of the food is critical as well. Many people can access food, but it’s food from a convenience store that isn’t the healthiest. These unhealthy choices increase the rates of obesity, contributing to the development of chronic diseases such as diabetes, heart disease and hypertension. By providing access to consistent, healthy, nutritious food, the body’s physiology is able to work properly, and the rate of chronic diseases decreases. This is where food becomes medicine.
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Proper nutrition is significant for having a healthy pregnancy. Toxic stress, elevated by factors such as food insecurity, can have a detrimental effect on the health of both the mother and the baby. Providing mothers with high-quality food can help tremendously to offset some of the negative health consequences we’re seeing here in Indiana
We also often hear jokes about being “hangry.” What if you felt that way all the time? What if you were a child that had to go to school every day, expected to perform and learn, but you hadn’t had enough to eat? It can be nearly impossible. Hunger has been shown to lead to cognitive issues, anxiety, anger and depression. Proper diet can help avoid these mental health consequences.
We must understand food in terms of the history behind why we eat what we eat. Speaking specifically for the Black community, many of the foods considered normal and comforting come from the time of slavery, where Black people had to eat scraps and whatever else was leftover. They learned to improve the taste of those foods by loading on the seasoning and butter to make them palatable. Now those flavors, which may be derived from unhealthy ingredients, have become normal and expected to us. Other populations, too, have traditional foods and preparations that may not serve them well from a health perspective.
Our work should not stop at giving out nutritious food. We must educate and explain why certain foods serve one’s body better and how to incorporate them into cooking. We need to recruit respected leaders in the community, from places people congregate, to provide nutrition and cooking education. This will help people understand why it’s okay to adopt a new way of eating, and how they’re not turning their back on their culture or history.
Mobile pantries are wonderful to bring food to communities. However, in addition to this, we need to make sure we get the food to the end user and figure out where we can create more opportunities to bring food directly into the neighborhoods that need it ― through mobile units, food stands, local farmers, more grocery stores or more public transportation to locations with grocery stores. We need to look at systems such as our public transportation system and make it more adequate so that healthy food can get into the hands of the people who need it most.
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Once you provide food to the community, you can subsequently tackle other issues that affect health outcomes as well. For example, immunizations and health screenings could be offered at places that provide food. Additionally, social media can help in sharing data on food insecurity and the different conversations that take place around the topic with followers, family and friends, to help raise awareness. That awareness can then perhaps generate donations.
Dr. Cameual Wright is an OBGYN and vice president and market chief medical officer with CareSource.
