Diagnosing and Treating Hunger in Kids

Deborah A. Frank MDProfessor of Child Health and Well-Being, Boston University School

of MedicineFounder and Principal Investigator, Children’s HealthWatch

Founder and Director, Grow Clinic for Children, Boston Medical Center 1/24/14

FOOD INSECURITY IS A PEDIATRIC DISEASE

• Households with children 2X as likely to be food insecure

• 15.9 million children (1/5) in 2012

• Younger the child the higher the risk

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FOOD INSECURITY LINKED TO MUTIPLE HARDSHIPS

Which all disproportionately

Impact families with young children

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Economic Hardship

Food Insecurity

Housing Insecurity

Energy Insecurity

Young Children Often Invisible Except to Families and Health

Providers

The First 1000 Days are Critical for Brain Growth

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WHAT’S THE PRESCRIPTION?FOOD IS THE CHEAPEST MEDICINE

70% of Benefits Go to Household with Children

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SNAP Dose Too Low Even Before ARRA Roll back

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What are the Maternal Child Health Impacts of Food

Insecurity ?

Does SNAP Help?

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Food Insecurity Associated with Pregnancy Complications

FOOD INSECURITY IN PREGNANCY (Carmichael 2007)

• Is associated with anencephaly and other neural tube defects

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Food Insecurity in Pregnancy Linked to Low Birth Weight (Borders,2007) :

SNAP DECREASES LOW BIRTHWEIGHT

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Low Birth Weight Increases Developmental Risk and Lifetime Health Costs Including Metabolic Syndromes

SNAP In Early Life Less Metabolic Syndrome

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Post-natal Child Health Impacts of Food Insecurity

• Food Insecure children suffer 2-4 times as many health problems as other children within same income level– Stomach aches, head aches, colds, ear infections

– Higher hospitalization rates

– Iron-deficiency anemia

– Decreased bone mineral density

– More susceptible to lead poisoning

– Poor oral health

Infection

Malnutrition

Cycle

Why Hospitalizations?

Post-natal Child Health Impacts of Food Insecurity

• Food Insecure children suffer 2-4 times as many health problems as other children within same income level– Stomach aches, head aches, colds, ear infections

– Higher hospitalization rates

– Iron-deficiency anemia

– Decreased bone mineral density

– More susceptible to lead poisoning

– Poor oral health

What are the Child Developmental Impacts of

Food Insecurity?

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Brain Brain structure most vulnerable to

nutritional insults early in developmentBrain function is sensitive to quality

and quantity of foods consumed throughout live span

Requires high energy consumption and can’t store energy

(Lyle et al, 1984)

Developmental RiskRose-Jacob, 2008

/

Young children in food insecure households are 40% more likely to score at developmental /behavioral risk than other low income children

Congressional Food Stamp Challenge

• “My focus and co-ordination are not sharp. I have one thought at a time and I am getting very confused – not to mention crabby.”

Developmental Functions Remain at Risk Following Early

Undernutrition

Language

Short Term Memory

Audio Visual Equivalence

Attention

Modulation of Activity and Affect

Locomotor Skills

SNAP ASSOCIATED WITH BETTER ACADEMIC ACHIEVEMENT

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Food Insecurity and SNAP Myths

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Hunger isn’t the Problem: Obesity is the Problem

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Puzzle of Poverty and Obesity

• Cyclical food deprivation/overeating

• Need to minimize per calorie cost

• Lack of access to fruits and vegetables in low income neighborhoods

• Lack of opportunity for safe exercise in low income neighborhoods

• Obesogenic practices in feeding children

• Stress hormones

Real Cost of a Healthy DietCan parents afford to purchase healthy food?

$0.79 $2.59880 calories880 calories

How do you feed them without giving them harmful things ? Witnesses to Hunger Mother Drewnowski 2004

Stop and Shop Price Check March 2010

Aren’t People Just Ignorant?

•Breastmilk is Best Milk but Does NotPrevent Child Food Insecurity

• Pizza crust and Breastmilk

SNAP Not Linked to More Child Obesity Some Studies Find

Less Obesity

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Myth: Cutting SNAP will Save Money!

• Excess Health Care Costs for Adults and Children Calculated to Exceed SNAP “savings”

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Myth: Private Charity Can Make Up the Shortfall: Would be More than 2X what

Second Harvest Can do Now

Can We Fix It?

RX: POLICY CHOICES

DX: Our Children’s Brains and Bodies Suffering From Hunger and Hardship

Young children who receive WIC more likely Good/excellent health Food secure Healthy height/weight for age Lower risk – developmental

delays

WIC can be located in hospitals and community health centers that serve obstetric and pediatric patients

Could Health ProvidersPrescribe Healthful Food?

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Could We Help People Apply for SNAP and Health Insurance at Same

Time?

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Good Medicine for the Economy

TooIf all eligible participated additional

$261 million would flow into

San Mateo/Santa Clara Counties

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WHY BOTHER?

We are Talking Real Children!

“There is no finer investment for any community than putting milk into babies.”

- Winston Churchill

Thank You!www.childrenshealthwatch.org

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