Food Insecurity and Child Malnutrition in the United States

Children and the elderly are at increased risk for malnutrition, an affliction that takes place when a patient's body is deprived of the vitamins, minerals and other nutrients needed to sustain healthy tissue and organ function. Unfortunately, millions of children in the United States reside in households where food insecurity is a constant issue. The problem of food insecurity has gotten worse in the years since the official end of the Great Recession. Specialties Pediatric Article

Emily, a 9-year-old with a cinnamon skin tone and a strikingly angular face dotted by a set of chocolate-colored eyes, sits inside an examination room at the local children's outreach clinic. She comes to the clinic once a month with her siblings to have routine labs drawn and to be seen by the program's sole pediatrician, Dr. Graham.

Emily lives with her mother, stepfather and two younger brothers in a cramped one-bedroom apartment located in the southeast section of a large central Californian city where nearly one-quarter of residents' household incomes fall below the federal poverty line. Her mother works mornings as a cashier at a gas station during the week and earns extra money as a cocktail waitress on weekend nights. From the middle of March until the end of October her stepfather mows yards in an affluent suburb for a local lawn service, and during the winter months he picks up odd day labor jobs to supplement the family's income. Emily's family does not qualify for many forms of public assistance since the annual household income of $38,000 exceeds poverty level guidelines for a five-member home. Her parents receive monthly WIC vouchers for her three-year-old brother that can be redeemed for specific grocery items such as eggs, cheese, milk and cereal. However, this form of assistance will cease soon after the boy reaches his fifth birthday.

Dr. Graham glances at Emily's lab results. The albumin, prealbumin and total protein are all low. The serum iron, ferritin, TIBC, B12, folate, and other labs are all low. With a height of 4'9" and a weight of 77 pounds, Emily is very underweight. The objective and subjective indications come together to paint a picture of malnutrition, a condition that Dr. Graham has been noticing more and more in children and elderly patients during this languid economic period.

The doctor inquires, "What do you usually eat in a normal day, Emily?"

The girl pauses for a moment. Her parents have instructed her to screen all responses carefully because of their fear of authorities removing the children from their custody if it is discovered that the household runs out of food several days before payday. She fibs, "I eat toast, eggs and fruit for breakfast, whatever the school gives out for lunch, and chicken, spinach and rolls for dinner."

Dr. Graham suspects the streetwise Emily of lying. After completing her examination of the three siblings, she gives her parents a pamphlet with the addresses of local churches that offer free meals on certain days of the week. She also thanks the parents for bringing the kids in regularly.

According to the Johns Hopkins Children's Center, malnutrition occurs when the body is deprived of the vitamins, minerals and other nutrients needed to sustain healthy tissue and organ function. A balanced diet is required in order to obtain these nutrients, but millions of children in the United States live in homes where food insecurity is a pervasive problem. Recent statistics indicate that 13 million children in this country are in households where access to an adequate quantity of food is restricted. The problem of food insecurity has only worsened in the jobless recovery that has followed the depths of the Great Recession.

Many working poor families in higher cost-of-living areas are disproportionately affected by food insecurity since annual earnings tend to be slightly above the federal poverty line, but increased costs for housing, food and utilities rapidly consume residents' net pay. In addition, numerous working poor families earn a little too much to qualify for forms of public assistance such as food stamps. The heads of these households often choose between paying rent and keeping the family sufficiently fed.

RESOURCES

Malnutrition | Johns Hopkins Children's Center

Malnutrition Impairs U.S. Children’s Health, Behavior - LSU AgCenter

Malnutrition

Specializes in L & D; Postpartum.

I just stumbled on to this thread. We have ears of corn all summer long that will be 3-6 ears for $1.00

Well, I guess I could say that redlining is happening up here in the mountains. We are mostly captive to local stores and gas stations unless we drive over 70 miles one way. I routinely refuse to purchase anything other than milk or eggs at the grocery store in my town because their prices are jacked up too high. However, if that was my only choice, I could still find good nutritious food on sale and make a good healthy meal.

Most of the families up here make twice monthly trips to the big city to go to Costco or Winco or Walmart and do their big shopping. We have a high percentage of poor people here and many on food stamps.

Safeway is 20 miles down the road in the next small town and has better prices than the little grocery store here in my little town. There is also an Indian Casino 20 miles from here where the gas is way cheaper than even the city down the mountain.

Almost everyone up here has a garden in the summer and there is a once a week farmer's market. We have a pantry full of canned fruit and veggies. I slow-roast my tomatoes and freeze them for sauces and soups.

Eating healthy for less cost than junk food can be done. What I'm saying is it is a myth that junk food is less expensive than healthy food.

Oh and the veggie burgers . . . if you buy the package of 8 and I buy the package of 4, we are still paying about the same price per pound. $3.29 for 4 and $7.00 for 8.

Specializes in Pediatrics, Emergency, Trauma.
Well I guess I could say that redlining is happening up here in the mountains. We are mostly captive to local stores and gas stations unless we drive over 70 miles one way. I routinely refuse to purchase anything other than milk or eggs at the grocery store in my town because their prices are jacked up too high. However, if that was my only choice, I could still find good nutritious food on sale and make a good healthy meal. Most of the families up here make twice monthly trips to the big city to go to Costco or Winco or Walmart and do their big shopping. We have a high percentage of poor people here and many on food stamps. Safeway is 20 miles down the road in the next small town and has better prices than the little grocery store here in my little town. There is also an Indian Casino 20 miles from here where the gas is way cheaper than even the city down the mountain. Almost everyone up here has a garden in the summer and there is a once a week farmer's market. We have a pantry full of canned fruit and veggies. I slow-roast my tomatoes and freeze them for sauces and soups. Eating healthy for less cost than junk food can be done. What I'm saying is it is a myth that junk food is less expensive than healthy food. Oh and the veggie burgers . . . if you buy the package of 8 and I buy the package of 4, we are still paying about the same price per pound. $3.29 for 4 and $7.00 for 8.[/quote']

I believe you are redlined; again it's something that has occurred in many urban areas for GENERATIONS....can't "change" things overnight in terms of economic power, especially when economic power ends up shifting and eventually push proverty out or into another neighborhood.

You are at an advantage of having a garden; my point is if you live in an area where no transportation or space for a garden and the reliance of a supermarket in an area that doesn't have one, then one is WAYY behind the curveball, so one can't speak when one doesn't know or not familiar with the logistics.

As far as the veggie burgers for example, I don't get 8; I said 12 for 7 bucks...much better than 8; I get that from the shopping club I attend.

Again, I travel to get more value as well as the food I need, including sale items; until the supermarket 5 minutes away provides better produce and meat, I will continue to travel 5-15 minutes more to stock up the non perishables, and get fresher, farm grown, and Amish fresh items, and support local farmers. I know the difference of the food items, and it benefits my health. I rather have it closer, and a lot of communities need it closer, and don't have it. my point is there are other cities and communities that DON'T have it, and I'm not blind to think that they are not having the same struggles, or may be slow to have these items that I have in my city and it should not be that way. :no:

Specializes in Pediatrics, Emergency, Trauma.
All I know is I've seen people using $300 of SNAP (because all the snap cards look the same....) on frozen fried chicken appetizers pizza rolls and huge boxes of fruit loops while I dont even walk down chip and dessert aisles in order to afford food for my family of three adults and three school aged kids.... there is no way I could afford the "cheaper" junk foods. I have never been able to (im in nursing school and we have always been a one income lower enlisted military family). Ive never understood the correlation between poor and obese since when we are broke we stretxh our beans and rice pretty far... and not every poor obese person lives in a hotel... whats the stats on that figure?. It doesnt make any sense to me but I dont really argue its truth. I just dont get it. But the numbers are there I guess?[/quote']

Remember, food assistance only covers for FOOD....

Think about it, most people who are living on a low paycheck BARELY can get "dry goods", storage containers, even Reynolds Wrap, Eve the store bought kind can be hard...,ziplock bags, etc..,some people barely get soap, and tooth paste an that may be all they can get...they are going to get the "connivence" foods as a priority to make food last.

You are at an advantage of having a garden; my point is if you live in an area where no transportation or space for a garden and the reliance of a supermarket in an area that doesn't have one, then one is WAYY behind the curveball, so one can't speak when one doesn't know or not familiar with the logistics.

Again, I travel to get more value as well as the food I need, including sale items; until the supermarket 5 minutes away provides better produce and meat, I will continue to travel 5-15 minutes more to stock up the non perishables, and get fresher, farm grown, and Amish fresh items, and support local farmers. I know the difference of the food items, and it benefits my health. I rather have it closer, and a lot of communities need it closer, and don't have it. my point is there are other cities and communities that DON'T have it, and I'm not blind to think that they are not having the same struggles, or may be slow to have these items that I have in my city and it should not be that way. :no:

I'd rather focus on how to help instead of pointing fingers. With education, we could show communities that healthy food is the way to go cost-wise and health-wise. This is actually happening in many communities and has been Michelle Obama's goal.

Remember, food assistance only covers for FOOD....

Think about it, most people who are living on a low paycheck BARELY can get "dry goods", storage containers, even Reynolds Wrap, Eve the store bought kind can be hard...,ziplock bags, etc..,some people barely get soap, and tooth paste an that may be all they can get...they are going to get the "connivence" foods as a priority to make food last.

Just because folks head to "convenience" stores doesn't mean we have to give up and not try to show them why that's not a good idea.

Something has happened to the family unit - grandparents and aunts and uncles and cousins and husbands and wives and moms and dads - one generation helping the other. The focus may have to start with helping rebuild families. No one is saying we shouldn't try to help. In fact I think many of us have been giving examples of how to help.

Specializes in Pediatrics, Emergency, Trauma.

That's one thing we can agree on...but it starts with local farmer and supermarkets out reaching into the community as well...reach one, teach one...

Specializes in Pediatrics, Emergency, Trauma.
I'd rather focus on how to help instead of pointing fingers. With education we could show communities that healthy food is the way to go cost-wise and health-wise. This is actually happening in many communities and has been Michelle Obama's goal. Just because folks head to "convenience" stores doesn't mean we have to give up and not try to show them why that's not a good idea. Something has happened to the family unit - grandparents and aunts and uncles and cousins and husbands and wives and moms and dads - one generation helping the other. The focus may have to start with helping rebuild families. No one is saying we shouldn't try to help. In fact I think many of us have been giving examples of how to help.[/quote']

I also never said it was good idea...in fact, my point is that we have address the root cause economically that produces malnutrition; obesity is a form of malnutrition, IMHO...the attitudes are formed that people have the same "opportunities" when that is NOT the case. For a supermarket opening to hit newspapers, at least in my area and present the fact that several communities have a local supermarket after FORTY (yes, 4-0) years of not having one is a sad commentary on the accessibility to OPTIONS = "opportunity"

The fact remains, more purchasing power for goods=options=opportunity, that was MY point. :yes:

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Chester is an impoverished, ghettoized city located not too far from Philadelphia. Anyhow, the city received its first full service supermarket in more than 12 years:

Shoppers in Chester, Pa. welcome 1st grocery store in 12 years | 6abc.com

Without a supermarket for so long, Chester has been declared a 'food desert.' Having fresh, affordable products will change that. . . . .Shoppers seem to be thrilled with the idea of being able to buy fresh fruits and vegetables in their own neighborhood. No more taking a bus or getting in the car to go out of town to food-shop for their families.
Specializes in LTC.
Store-brand 5 pound/bag of vitamin-enriched white flour costs around $1.99 where I live. Same of whole-wheat costs $2.49. Yeast is $ 0.99/pack of three. Salt is almost free. These plus some water, and you'll get more than enough fiber, vitamins-B group, and protein-enriched, home-baked sourdough bread for a family of five for a whole week for less than $7 total, including electricity and water. 10 lbs. bag of chicken leg quarters goes for $6 in Walmart nationwide. Bag of dried beans (equals up to 8 15 oz. cans) costs between $1 and $2 there.

I can understand that people may not have money on gourmet or special healthy foods, but their "inability" to get basics like above and cook them is, IMH(onest)O is pretty close to being plain lazy and not willing to learn cooking beyond pushing "defrost" button on microwave. If I can do it all while working full time, they sure could do it too.

Do you work 2 full time jobs? Many of these people do. I grew up poor, and food insecure, often times, from around 8 years old on, the person cooking was me. I am far from a rarity, in fact, I'd say my upbringing was pretty standard for a child of the working poor.

Specializes in Pediatrics, Emergency, Trauma.
Chester is an impoverished ghettoized city located not too far from Philadelphia. Anyhow, the city received its first full service supermarket in more than 12 years: Shoppers in Chester, Pa. welcome 1st grocery store in 12 years | 6abc.com

Thank You Commuter for posting this. :yes:

This is what I am talking about; I live actually in the city. Being in home health in several neighborhoods, I am all too familiar with the lack or sub-par grocery stores, as well as when a good grocery store does to a community. :yes:

Specializes in Hospice.

I think getting the information out to communities is also important. This past spring I planted way too many cucumbers, they were coming out my ears LOL. Every other day I was picking them and taking them to our local food kitchen. This year I plan on planting a few extra rows of other items and donate them to a local church that feeds school age kids in the summer.

I believe that it takes a whole community to take care of a child.

the biggest thing we can do is to get persons to NOT have children they have no way to support/feed. public health, education. etc

Yes, I understand that a fair number are in this position d/t the economy, but how many have had more children in the last 4 years, adding to their problems?