Combatting food insecurity in St. Louis

Food insecurity is an immediate threat to the well-being of citizens in the United States. Targeting low-income populations, food insecurity continues to wreak havoc on families who cannot access resources for maintaining a healthy diet. Ellen K. Barnidge, Ph.D., M.P.H is a Saint Louis University associate professor in the College for Public Health and Social Justice. In 2017, Barnidge published a study titled “Screening for Food Insecurity in Pediatric Clinical Settings: Opportunities and Barriers”. Barnidge’s study examines the answers of surveys given to doctors and patients at SSM Health’s Cardinal Glennon Children’s Hospital pediatric clinic. The purpose of Barnidge’s research is to gain an understanding of possible strategies physicians can employ for tracking which St. Louis residents are food insecure and the challenges of applying the strategies in a clinical setting.

Barnidge’s paper examining a small population of St. Louis residents who are at risk of food insecurity is published in the Journal of Community Health. Gene LaBarge, Kathryn Krupsky and Joshua Arthur worked alongside Barnidge to create and distribute surveys meant to identify the limitations and risks associated with doctors screening patients for food insecurity in pediatric clinical settings. The U.S. Department of Agriculture defines a household that is food insecure as,

“Uncertain of having, or unable to acquire, enough food to meet the needs of all their members because they had insufficient money or other resources for food.” (U.S. Department of Agriculture)

Bill McKelvey works directly with individuals who face food insecurity at the Missouri University Interdisciplinary Center for Food Security. McKelvey said,

“Food insecurity and hunger are significant predictors of chronic illness, lower school performance and developmental problems”

McKelvey’s sentiment on the problems that arise from food insecurity speaks to the importance of having access to healthy food options. Being aware of which communities in St. Louis experience the greatest impact of inadequate resources to obtain food is a necessary step to ensuring one’s basic needs are met. Barnidge and her team chose SSM Children’s Hospital to survey doctors’ willingness to screen patients for food insecurity because of the hospital’s diverse patient demographics. Of the doctors who answered the survey, 80% of them said they would be open to consider screening caregivers for food insecurity while only 15% of surveyed doctors currently screen for food insecurity.

The survey given to doctors in the hospital’s pediatric clinic also contains questions asking doctors to list their hesitancies regarding screening for food insecurity. According to the survey’s findings, over 45% of doctors who answered the survey indicated some level of hesitancy to conduct screenings. The doctors who are hesitant indicated they are unsure of how to handle positive screenings. Another area of concern from doctors is that caregivers might feel judged by the physician and not provide accurate answers during the screening. A lack of uniform procedures for successfully overseeing the screening prevents widespread adoption of food insecurity screenings.

Flipping the script, Barnidge sought to administer a survey that would assess caregivers’ demographics such as gender, race, number of children, level of education, household income and zip code. Over the course of 23 days, the survey was handed out to caregivers in the waiting room of the SLU Department of Pediatrics. In that time, 212 caregivers agreed to participate. The results of the survey indicate massive disparities in caregiver demographics. Barnidge found that participants identifying as ‘non-white’ are at a significantly greater disadvantage in terms of food security. Almost a quarter of participants reported their household annual income to be less than $10,000 and 40% of participants claimed they do not have enough money to buy the food they want.

Food Outreach is a local food bank near SLU dedicated to serving the St. Louis community's battle against food insecurity

Health inequity in St. Louis is a major issue that has been exacerbated by the Covid-19 pandemic. Lowell Ricketts works as a data scientist at the Federal Reserve Bank of St. Louis at the Institute for Economic Equity. Lowell has researched how the pandemic has affected the number of food insecure households. His findings suggest a 2.7% increase in households who identify as being food insecure (stlouisfed.org). Lowell and Barnidge’s efforts to identify the reasons for food insecurity in St. Louis are important for law makers to understand how to combat health inequity. Barnidge did not respond to a request for an interview. However, her faculty page on the SLU website suggests her research interests lie in community engagement, environmental policy change and examining household food security. Barnidge said,

“Authentic engagement from diverse partners is essential for progress toward health equity.” (slu.edu)

Barnidge’s research on food insecurity is indicative of the values she holds when researching methods to achieve health equity. Interpreting the results of Barnidge’s study is complicated and necessitates a deeper understanding of the history behind why food insecurity has historically targeted low-income families. Grass root measures such as screening for food insecurity are attainable goals that inspire change within systems that helps families in need.

Citations

Barnidge, E., LaBarge, G., Krupsky, K., & Arthur, J. (2016, August 4). Screening for food insecurity in pediatric clinical settings: Opportunities and barriers. Journal of Community Health. Retrieved November 30, 2021, from https://link.springer.com/article/10.1007%2Fs10900-016-0229-z.

Definitions of Food Security. USDA ERS - Definitions of Food Security. (n.d.). Retrieved November 30, 2021, from https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx.

Ellen K. Barnidge. SLU. (n.d.). Retrieved November 30, 2021, from https://www.slu.edu/public-health-social-justice/faculty/barnidge-ellen.php.

Federal Reserve Bank of St. Louis. (2021, October 29).Food insecurity in the Eighth District: St. louis fed. Saint Louis Fed Eagle. Retrieved November 30, 2021, from https://www.stlouisfed.org/publications/bridges/volume-1-2021/food-insecurity-eighth-district.