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