02/28/2013 10:41 am ET Updated Apr 30, 2013

From Up on High: A Movie Review of A Place at the Table

From up on high, as the helicopter cameras open this documentary film, peering down on amber fields of grain, from sea to shining sea, the United States appears prosperous, abundant in its produce, rich in its plentitude of space and foodstuffs. T. Bone Burnett's music soars, adding to the grandeur. But this is all a trope, setting the viewer up for a "take down," where we are built up only to fall all the harder.

And not without good reason, for 50 million Americans, children, adults and the elderly, are now hungry, uncertain about having food to carry them through the day or the week ahead. Presidents as divergent in their politics as Reagan, Bush I and II, Clinton and Obama have foresworn to end hunger, yet each has presided over an unceasing rise in hunger, with five times as many Americans today going hungry as there were in the 1970s.

Upon descending from up on high, A Place at the Table enters the grinding lives of: Rosie (a fifth grader) and her teacher Leslie Nichols (who in childhood also knew hunger), from Collbran, Colo., where small town life nestled beneath the awesome Rockies is rife with unemployment, unlivable wages, and hunger; Barbie, a 20-year-old single mother of two in Philadelphia, whose young son is already experiencing the developmental delays that disproportionately strike nutritionally-compromised children living in urban chaos and poverty; Tremonica, a second grader already obese and unhealthy, whose family lives in Jonestown, Miss., a state that gets the prize for ranking at the bottom of all 50 in food insecurity (a term referring to being uncertain about having or obtaining enough food to meet the needs of a household). The documentary examines unblinkingly a full-time town police officer who has to go to food pantries to feed his family, a rancher who works nights as a school janitor to put food on the table, and a cook in rural Mississippi who must drive 45 minutes to find a green grocer (and spends more than $10 in gas).

The ironies abound in this lean 84-minute documentary. Obesity in this country is shown to be often a sign of hunger and poverty, unlike in very poor, developing countries, where hunger and poverty leave people all skin and bones. Becoming employed, as did Barbie after a year of trying, left her unable to feed her family because she earned less than a living wage -- though she no longer qualified for the Supplemental Nutritional Assistance Program (food stamps). Seventy percent percent of federal agricultural subsidies go to 10 percent of U.S. farmers -- not the family farms that gave rise to this support in the crippling depression of the 1930s, but to the corporate agribusinesses that dominate farming today. These subsidies sustain the massive production of corn, wheat and soy used to make affordable (cheap) processed foods, such as chips, cookies and cakes, candies, and high-starch (and salted) foods like bread and many pastas. Since the early 1980s, the costs of processed foods have dropped by 40 percent while the costs of fruits and vegetables have increased 40 percent. Even if poor families were to try to buy healthier foods, they frequently live in "food deserts," vast swatches of rural and (even more so) urban communities, where stores shelves burst with processed foods and not an apple or head of lettuce is to be seen.

The consequences of hunger are far greater than the pain and malaise that comes with an empty stomach. A hungry child cannot pay attention in school. Nutritional deficiencies in a mother carrying a child and in the early years of life produce delays in brain development, leading to impairments in learning and behavioral disorders and to children being left behind. One in three children entering their teens today will develop Type 2 diabetes. Obesity, in time, increases the risk of hypertension, heart disease and stroke, and puts more strain on our joints leading to osteoarthritis and mobility problems.

A Place At The Table is another socially-focused film by Participant Media, which has produced documentaries such as An Inconvenient Truth, Food, Inc. and Waiting for Superman, as well as fictional stories, including Contagion and The Help, with unsparingly-honest views on contemporary issues.

The message in this documentary is that hunger in this country is not about lack of a sufficient food supply -- we have ample stores of grain. Hunger is about the denial of adequate and nutritious food to families living in poverty, whether on our great plains or occupying our inner cities. We witness the evidence in the film's stories of these families, from spokespeople like Congressman James McGovern (U.S. Representative, Massachusetts and co-chair, Congressional Hunger Center) to actor Jeff Bridges (founder of End Hunger Network), and from experts and doctors who have documented hunger in America and treated its consequences (see some examples below).

I left the theater feeling empty, not really hungry. But I went home and made myself a salad of pricey Whole Foods greens with virgin olive oil and some low-fat nuts. I have the good fortune of living in an oasis of healthy food abundance and an income to purchase nutritious food to help keep healthy. There will be those who criticize this film for promoting government programs or encouraging dependency among people living in poverty in this country. I suspect these critics will not have experienced uncertainty about where their next meal will come from or how "hunger messes with you," in the words of one young girl in A Place At The Table.

For more on hunger in America, see:

Raj Patel: Stuffed and Starved
Janet Poppendieck: Free for All; Fixing School Food in America
Marion Nestle: Food Politics
J. Larry Brown: Living Hungry in America
Barbara Ehrenreich: Nickel and Dimed
Knut Hamsun: Hunger

Dr. Sederer's book for families who have a member with a mental illness, The Family Guide to Mental Health Care will be published by WW Norton in April 2013.

The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.

For more by Lloyd I. Sederer, M.D., click here.

For more on hunger, click here.