Compassion Key to Helping Families Experiencing Food Insecurity

By: Saba Khan, MD

CHOP’s Food Pharmacy 2.0, launched in March 2021, is an expansion of the original Food Pharmacy (FP), which offered healthy food to food-insecure families with a child in the Healthy Weight Program. FP 2.0, based out of the Nicholas and Athena Karabots Primary Care Center, aims to surround Karabots families that identify as food insecure during screening with supports beyond three days’ worth of dry foods and a monthly delivered box of fresh produce. Participants are invited to complete a social needs assessment and receive short-term case management to address identified needs related to broader social determinants of health, such as housing issues, difficulty paying utility bills, and transportation challenges.

Here is a composite patient family scenario:

“Hi, Ms S. It’s Sarah from the Food Pharmacy. I just called to see if you got the box and that the produce you got was fresh. I will try later. Have a good day.”

Sarah had called to see if the produce box was fresh. What was she talking about? The box was beautiful! Ms S. was thrilled she had a large box of farm fresh fruits and vegetables delivered to her home for free, with no contact with the driver (but several texts updating the delivery status). After opening the box, Mya—12 and dramatic—squealed in delight and Ms S. knew why: The contents looked straight out of a magazine. Mya asked her mom why she was a little choked up, and Ms S. replied, “It is like the people who sent us this box really care about the folks who are going to eat it.”

“Mom, it’s just some fruits and vegetables that look pretty!” And with that, Mya went off to log on to virtual class. But it was not that the box had been put together with such care; it was the whole thing.

From the start, Ms S. had sheepishly answered “yes” to the definitely triggering questions at her 9-month-old’s doctor’s visit about whether she struggled getting food on the family’s table. It was only because the questions were on the iPad she had even clicked “sometimes.” She regretted it and had a sinking feeling the whole visit, but if the doctor or nurse knew, they—thankfully—didn’t say anything. She didn’t need to feel judged or, worse yet, pitied.

Yes, it was hard raising 4 youngsters, 2 being strapping teenagers, while taking care of her beloved mom, and picking up hours at the local deli (which had been non-existent since COVID-19 hit). But she was surviving. Everyone assumed she was in this situation because she had made bad choices. But there were no bad choices, just unfair circumstances and a system stacked against her and her community.

When she got a follow-up call a few hours after the appointment, asking if she may be interested in finding out about a “Food Pharmacy” that told Ms S. about the program. With great tact, Sarah mentioned that a lot of folks struggled to manage all the expenses of raising children, and sometimes getting healthy food into the home could be tough. Sarah asked Ms S., if she were to enroll, to be honest about her experience with the Food Pharmacy. Sarah even joked about wanting to be told if she was being annoying!

Sarah explained the program also had someone called a “resource navigator,” named Jasminder, who was like a hotel concierge, but for the community. If Ms S. was OK with it, Jasminder would check in with her once a month to see if there were other things she could assist with, things like finding out about affordable daycare, getting transportation to medical visits, receiving free diapers, or even getting help with budgeting or filing her taxes.

Ms S. was wary. Life had not been kind, especially since her sweet husband died just 2 months after the baby was born. She had always paid her taxes, but this year had been crazed with having her fourth child, losing her husband, and dealing with a pandemic while still caring for a full household. For a moment, she considered Jasminder might be useful. Ms S. thought again: No, she didn’t need folks in her business. The fruits and veggies were good, but that was it.

The voicemail from Sarah about the quality of the food changed her mind. It gave Ms S. faith that there were folks who cared about the quality of care and service they provided her family. They offered their services in a respectful manner. She would answer when Jasminder called.

Food Insecurity: at a glance

• The U.S. Department of Agriculture (USDA) estimates that 1 in 6 children live in households that are food insecure, defined as lack of access to adequate food due to limited money and/or other resources.
• 31% of female-headed households reported food insecurity, compared to 12% for all households (USDA 2016 data).
• 16.6% of households with children under age 6 were food insecure compared to all United States households (12%).
• Over 20% of African American or Black households and 19% of Latinx households reported food insecurity, compared to 10% of white households.
• About 40 million Americans receive average monthly food stamp (SNAP) benefits of about $1.40 a meal.
• It is estimated that food insecurity has tripled among households with children during the pandemic.