09/16/2014 05:15 pm ET Updated Nov 16, 2014

Feeding People Better: Narrowing the Food Gap

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In America, 1 in 7 people utilize food pantries. Around 47 million citizens use them at least once each year. During my internship at a food pantry in Montana, I saw how much effort is required to ensure that people have food. Food pantries run on the kindness and dedication of local community members. These organizations play a crucial role in reducing the growing problem of food waste by rescuing thousands of pounds each year. Food pantries are an example of compassion in society today.

If you doubt this need of assistance from food pantry customers, please go to your local pantry. Interact with customers and hear their stories. You will see for the most part that households using food pantries are facing hardships and need both short-term and long-term assistance.

Feeding America released their 2014 report highlighting who food pantry customers really are and the day-to-day struggles they endure. The clientele who use food pantries vary from children to seniors; although, 39 percent of households using food pantries have at least one child. The majority of households who use food pantries are employed. For the most part, these people are working a job that is only part time, does not have benefits, and provides low wages.

People who use food pantries are also part of a growing population who struggle significantly when it comes to eating healthy. A recent study in the Journal of the American Medical Association (JAMA) Internal Medicine gave America a diet report card. The research showed that the highest socioeconomic class is eating healthier while the lowest socioeconomic class is falling farther behind. Similar to income inequality, we have the same issue beginning with food and health. The authors demonstrated that we have food gap of healthy eating that continued to grow between the very poor and the very rich over the past decade.

The long-term health consequences of this unhealthy food consumption are becoming more apparent across all demographics, especially low-income households. Fifty eight percent of food pantry households have high blood pressure, 47 percent say they are in poor health, and 33 percent are diabetic. Low-income households also struggle with the medical debt of chronic disease. Fifty five percent have unpaid medical bills and 66 percent during the year have to decide to either to pay for food or medical expenses.

One of the causes of the food gap and increased chronic disease rates is poverty. James McWilliams wrote a brilliant article on the connection between poverty and unhealthy food consumption. He highlighted that the main issue with poverty in America is households dealing with scarcity. Just like you and me, low-income families own smart phones, pets and televisions.The key difference is the lack of stability in their lives. As the article stated, "One unexpected medical bill, one glitch with the car, one minor brush with the law, one argument with your shift manager" and their lives are in a financial wreck. Facing instability day in and day out is stressful.

This stress leads low-income households to gravitate towards unhealthy food; an astounding 84 percent of food pantry households said they purchase inexpensive junk food to cope with the stress of poverty. Low-income households should not be blamed for this impulse. As McWilliams explains, "buying crap over carrots means that you are driven to eat by a scarcity-induced craving for the most immediate and gratifying satiation--the kind that sugar, salt, and fat excel at providing." This habit becomes even easier to understand when you realize the large amount of unhealthy food marketed targeting low-income adults and children.

While reducing poverty is crucial in helping people eat better, it does not mean that this step will be sufficient. A higher income does not necessarily equate to the consumption of whole grains, nuts, veggies and reducing ultra-processed food. An article from Health Economics looked at the connection between obesity and wealth. The authors found that an increase in wealth actually led to a higher BMI for women and an average 10-pound weight gain. The authors stated, "Overall, the results suggest that additional wealth may exacerbate rather than alleviate weight problems." Additionally, a 2011 Lancet report stated, "The most obvious environmental precondition for a population to develop obesity is sufficient wealth."

Again, ending poverty is an important step in making America healthier and stronger as a nation; however, higher incomes will not lead to a healthier diet by default. Although not at the same rates, plenty of middle class and wealthy people eat unhealthy and develop diet related diseases too. We need a multi-faceted approach to reduce our chronic junk food consumption.

Another important cause of our poor dietary report cards is our food system. As the 2011 Lancet article cited, "obesity in almost all countries seem to be driven mainly by changes in the global food system, which is producing more processed, affordable, and effectively marketed food than ever before." The system we have in place has alleviated severe nutritional deficiencies in the United States and allowed 98% of the population to pursue other jobs not related farming. The stress of producing food has been relieved for almost the entire US population.

Farmers in the United States are just doing their job by answering the demands of the market. In the past, while pursuing the worthy goals of increased productivity and lower food costs, we often neglected the nutritional implications of our food supply. Our food system has to continue to improve productivity, but we also must create policies to help incentivize farmers to produce healthier food products.

A positive sign not emphasized enough from the JAMA Internal Medicine food gap study was that we have already begun to take steps to help all citizens improve their dietary intake. As the study showed, the biggest improvement on our dietary report card has been our dramatic decrease in the consumption of harmful trans fats. The impressive 80 percent drop in the trans fat consumption was the direct result of improvement in policy. People did not stop using trans fats in their kitchens; food companies stopped using trans fats in production. With pressure from citizens and most importantly the government, food companies removed this harmful ingredient from our food supply and were required to add it on food labels.

To be fair, the labeling part was not an entirely perfect execution and still has issues. The labeling of trans fats still currently misleads consumers to think a product is trans fat free. Additionally, nine percent of packaged goods continue to contain trans fats. Nonetheless, to improve our diets we can continue to use both broad and specific demographic nutrition interventions, which can be tailored to specific population needs.

As we progress with nutrition interventions for low-income people, we need to make sure we include these individuals in the conversation and empower them to choose healthy food. Contrary to popular belief, many low-income consumers do want to eat healthy. Studies have shown that participants in the Women, Infants and Children Special Supplemental Feeding Program (WIC) supported the improved nutrition changes to the food packages. Additionally, studies have shown the Supplemental Nutrition Assistance Program (Food Stamps) participants do support nutrition improvements to the program and unhealthy food purchasing limitations, like removing sugar-sweetened beverages from the program.

It's not really a surprise that low-income people want healthier food. All people value their health to some degree and health is one of the top priorities for households, especially those with young children. No one hopes to suffer a heart attack, require weekly dialysis as the result of diabetes, or to be physically unfit to play with their children and grandchildren. Our current food environment makes it far too easy to "prioritize immediate gratification over potential long-term negative results". As a nation, we have failed to educate young people on the selection of healthy food for multiple generations.

Community members can begin to turn the tide on unhealthy food access. Instead of giving food pantries any food, let's take their health into consideration. We need to help food pantries move beyond just quantity and emphasize quality too. Those who seek food assistance deserve to receive support in the form of nutritious food that will not result in poor health. Especially, when households do depend on these programs for long-term nourishment.

Feeding people healthier might be difficult and more expensive at the start, but the financial reasons for feeding people better are quite apparent. 110 million people depend on the government run Medicaid and Medicare healthcare programs. The government already covers 62 percent of all diabetes care costs nationwide. On average, people with diagnosed type 2 diabetes incur medical expenditures up to almost 14,000 dollars each year.

In addition, for low-income households without work, consuming an unhealthy diet will not help solve the problem of unemployment. Even though weight is not always a predictor of someone's health, employers consistently and unfairly consider weight in their selection process. If you are obese, you are more likely not to get the job after an in-person interview. Sadly, women are the most impacted by this weight bias when interviewing for jobs.

Stronger nutrition education, healthy food access and polices will be far more cost-effective for society compared to mounting medical expenses. We can begin to view the act of feeding people as an investment instead of a cost. All government food programs can be used as a tool to improve the health of low-income citizens. The lesser-known Commodity Supplemental Food Program, which feeds 579,000 low-income seniors each month, can also be modified to offer more nutritious food. This focus on nutrition could go a long way to help reduce the growing medical costs of seniors with chronic diseases.

Seventy seven percent of low-income senior households deal with high blood pressure and 47 percent also have diabetes. Furthermore, The Emergency Food Assistance Program (TEFAP), which assists low-income people including seniors through food donations, can continue to set the default toward healthy food. To their credit, the program has begun to offer low-sodium vegetables, beans and healthy breakfast options.

Food pantries have also begun to change their focus towards improved nutrition. Green Light Pantries in Philadelphia have begun to emphasize staples like fresh fruits and vegetables, whole-wheat products, low-sugar cereals, eggs and beans. The food pantry I interned with in Montana emphasizes low sodium canned vegetables, low sugar cereals, quality cuts of meat and fresh produce.

Nutrition advocates need to meet people where they are at and help them eat healthier anyway possible. Even though scratch cooking can be easy, it is still out of reach for many people. Healthy food has to be as easy as household staples like Mac & Cheese and frozen pizza. All while using the same price point, convenience and flashy marketing of successful junk food companies.

Public health advocates and dietitians need to reframe the conversation around healthy eating and low-income people. Healthy eating should never be considered elitist, but rather a basic human right. Critics will attempt to turn this idea into a straw man argument of forcing poor people to eat "kale and quinoa." People should always have the right to eat whatever they want and can use their own finances to do so.

There is no specific food agenda I'm arguing for, but just for practical, culturally relevant consumption of staples like fruits, vegetables, whole grains, beans, nuts, dairy and good cuts of meat and fish. All the while helping to limit chronic consumption of the known top sources of unhealthy calories.

Low-income households have a lot of hardships to overcome. The last thing they need is the additional struggle of higher medical bills, more doctor visits, lower quality of life and less opportunity to obtain a job all due to the food we provide. We can begin to close the food gap through government policies, stronger nutrition education, and making sure nutrition is emphasized in food assistance programs.