Hunger and Health

John Elliott: It means reducing the number of families in need through innovative, collaborative partnerships that solve the interconnected challenges of hunger, health, poverty, education, employment and transportation simultaneously. For those neighbors who remain in need, our second goal must be to fully close the meal gap, providing the healthiest, most-nutritious variety of food possible at the lowest per-meal cost—while ensuring everyone who needs to be “in the line” knows of and connects with resources.

Janet Kamiri: Ending hunger has to be more than just making sure everyone has enough to eat. We must make sure that people are not moving through life worried about where their next meal will come from or when they will be able to eat. In addition to having enough food, all people at every stage of life must also have access and the means to prepare healthy foods that they enjoy eating on a regular basis. 

Deanna Reinoso: Broadly speaking, ending “hunger” in the United States would mean expanding beyond simply assuring that individuals aren’t missing meals to also striving for a system where all individuals have sustainable access to the nutritious food necessary to live a long and healthy life. While ending hunger is an important goal we must strive to achieve, it would be inadequate for the vast number of individuals who may not be hungry but who don’t have access to healthy foods.

Heidi Spahn: Norman Borlaug, father of the “green revolution,” said that food is the moral right of all who are born into this world. I’m passionate, both professionally and personally, about working to address hunger. I grew up on a farm and have always had an interest in food insecurity. Too many people don’t know where their next meal will come from. Hunger is just one component of poverty but can have such huge impacts on people’s lives, including work and school performance.

Anne Swanson: When we talk about an America where no one is hungry, we’re talking about an America that is fed, nourished and supported. Feeding America believes we can accomplish this by uniting people, partners and lawmakers in the movement to end hunger. This is how we ensure that all people have reliable access to a nutritious variety of food, have the support they need to make healthy choices, and have access to economic pathways to achieve food security. This is what we mean when we talk about ending hunger.

Janet Kamiri: The first thing to do is actually take time to get to know your neighbors—know where they work and who is in their family. Having an understanding of who people are helps us be more empathetic and aware of acute needs as they arise. As a community, we can advocate for changes in the food system to ensure that people have access to high quality, affordable foods in their own neighborhoods. Food accessibility must consider forms of transportation other than cars, including by foot, bike, or public transportation.

Deanna Reinoso: Continued partnerships and increased collaboration across public, private, and philanthropic sectors are necessary to make sure that nutritious food options are available in each of our neighborhoods. There are three main reasons why disparities in food access exist: First, many people do not have the financial resources to purchase the healthy food items they need. Second, others may not have an available grocery with healthy food options for purchase in their neighborhood or they have transportation barriers to purchasing healthy foods. Lastly, some do not have the nutrition and cooking education to know how to select and use the most nutritious food items. Some people struggle with all three of these nutrition barriers. We need to begin to holistically address all these barriers to improve nutritious food access for every neighbor.

Heidi Spahn: Everyone should have the same access to healthy and nutritious food. Food security organizations have improved the types of food available to individuals, recognizing the direct correlation between health and nutrition. Some obstacles that still exist are lack of education related to healthy food and how to prepare and cook nutritious food. Within central Indiana, several organizations have started providing both healthy recipes and cooking classes to help educate individuals about food choices and cooking options. The Gleaners Fresh Connect Central produce hub is aimed at increasing the quantity, quality, and variety of produce available. This has been a huge help to local food organizations whose clients benefit from greater amounts of healthy food.

Anne Swanson: Individuals and communities face common barriers to accessing nutritious food. These barriers could be geographic and economic as well as unique to the individual—things such as awareness, stigma, and physical access. If we are to support equitable access to healthy food and opportunity for all, then we must keep the people most impacted by our fight against hunger at the center of our work. Feeding America is targeting solutions to populations with more complex needs, such as seniors and households with children. We are building partnerships with agricultural producers to increase the amount of available healthy foods, cultivating health care partnerships, and encouraging our food bank network to adopt healthy eating guidelines, according to the latest research. We have also expanded our place-based efforts by focusing on communities experiencing higher rates of food insecurity and low food access, including rural communities.

John Elliott: We must supplement the long history of generosity from food retailers with substantially more food from farmers and producers, processors, manufacturers and distributors.  But that’s not all. Food banks must develop new entrepreneurial food supply chain solution centers to gather, grow, process and distribute food in innovative and hyper-efficient ways. Those agri-hub solution centers must leverage the best talents and expertise of the for-profit, higher education, government and non-profit sectors. Those already involved must engage in additional ways even as new resources and expertise are brought into the process. Getting food into the hands of those who need it is the biggest challenge. The U.S. produces more food than any other country on the planet, and then we waste 40 percent of it every year. With food insecurity above 15 percent, we do not have a food shortage. We have a solvable supply chain opportunity.

Deanna Reinoso: Racial and ethnic inequities are pervasive and affect the social determinants of health that compound overall disparities. Socioeconomic stability and neighborhood resources greatly impact an individual’s ability to provide a nutritious diet to themselves and their family. Neighborhood inequities in transportation, employment opportunities, and housing are additional barriers to sustainable, nutritious food. Efforts to address food insecurity must also target the other social determinants of health—factors that disproportionately impact Black and Latino communities.

Anne Swanson: At Feeding America, we believe all people should have the resources they need to reach their full potential. However, we recognize that there are structural and systemic barriers that prevent this from happening. We strive to address the root causes of hunger and work to address unjust and avoidable health and economic disparities that are based on race. In doing so, we commit to using the best available data to prioritize groups that have disproportionately faced persistent and systemic food insecurity and places that have been historically under resourced.

Equitable access to food recognizes that people’s needs and preferences are based on more than just nutrients. Those needs are also informed by culture, geography, traditions, historical food access, religion, medical factors, and taste. Food banks and pantries are an important contributor to dietary intake in many households. Increasing access to healthy food, with recognition of dietary and cultural preferences, should be a priority across the charitable food system.

John Elliott: It is not enough to reduce the line and feed the line as we know it. We must do so in fair and equitable ways.  Gleaners has been working with exceptional partners like the Immigrant Welcome Center to ensure we don’t unintentionally exclude any segment of our population. This includes not only feeding a diverse population but investing considerable effort into sourcing food that is culturally appropriate and diverse, as well as ensuring that our growing nutrition-education and meal-planning resources are available in as many languages and cultural contexts as possible. At Gleaners, equity means serving urban, suburban and rural communities well and helping improve the top 10 chronic health conditions via the food we share. Minority populations are often disproportionately impacted by these same chronic health conditions. These conditions lead to an extra $1.3 billion in health care costs in our state, a figure attributable to food insecurity that increases the challenges many families face. 

Gleaners, working with Indianapolis Business Journal, began an effort to change the community’s perception of and dialogue around the convergence of hunger and health. Gleaners is involved in a growing number of partnerships with hospitals and health care companies, such as the heart healthy meal boxes we provide to cardiac patients at Humana Healthcare and the Food is Medicine national effort funded by Anthem in partnership with Eskenazi Health. While our nutrition education and meal planning is available in a growing number of languages, we continue to identify additional program and service opportunities for minority populations. 

Janet Kamiri: Black and Latino communities are disproportionately affected by food insecurity for a variety of interconnected reasons. Common rhetoric blames the individual by saying they aren’t working hard enough or want handouts. Nearly every American system, including the food system, has historically hurt Black communities. On average, Black and Latino households have lower incomes, and low-income households are more likely to be food insecure. Low-income neighborhoods are also more likely to be classified as a food desert. Changing this narrative is critical. There needs to be more investment in predominantly Black neighborhoods in ways that change systems to be equitable.

Heidi Spahn: The COVID-19 pandemic has increased food-insecurity awareness among individuals and companies. While I’ve seen more conversations and discussions about food security between the private and public sectors, we all need to work together to address the meal gap, which increased during the pandemic. All individuals and companies have something they can offer. Corteva Agriscience has had a focus on food security work both here in central Indiana and globally for more than a decade, providing expertise, volunteers, and monetary support. We have provided subject-matter experts to non-profits and encourage other companies to consider offering their employees’ expertise and time.

John Elliott: Hoosiers are uniquely generous and willing to collaborate unselfishly. Even prior to the pandemic, we were working with other organizations to grow the membership, role and impact of Indy Hunger Network, a best-in-class hunger relief collaboration that makes the work of Gleaners and other service providers easier and more impactful. In recent years, we have seen many other collaborative efforts emerge, with varying, often overlapping, intent and impact. While there is definitely enough work for all, I am becoming concerned by the sheer number of initiatives in food security, social determinants of health and poverty alleviation. We are spending too much time coordinating meetings and simply keeping track, vs. spending time on efforts that directly feed our neighbors. 

Gleaners is building a community based, neighborhood-by-neighborhood assessment of resource constraints and barriers to success in Marion County. Gleaners staff invested 15 months in individual conversations with hundreds of partners to gather information and we have begun investing resources and expertise in solving challenges for our downstream partners.

Jeff Simmons, Margie Craft and others at Elanco are leading a bold initiative in line with Gleaners’ overarching close-the-meal-gap goal—to make Indianapolis the first food-secure city in the country. Indy Chamber, Indianapolis Urban League and the Central Indiana Corporate Partnership have also included food security within their broader business-equity efforts. Anthem is working with Local Initiatives Support Corp. on a neighborhood-centric approach much like the Gleaners approach. Mayor Hogsett’s team, led by Milele Kennedy, is developing a county-wide strategy. And of course, Indy Hunger Network has been coordinating broad, collaborative efforts for many years. It is past time to communicate and coordinate, even combine efforts. We need clarity around the most effective roles for each initiative and each player—whether government, corporate, foundation, higher education or non-profit. Without clarity we will both slow and confuse progress. And more of our neighbors will remain hungry for a longer period of time. When we find that clarity, I believe we will truly close the meal gap in a sustainable way.

Janet Kamiri: While far too many individuals and families are struggling with food insecurity, progress is being made in Indianapolis. Gleaners, Second Helpings, Kroger and Walmart have been intentional in establishing partnerships with community organizations like Indianapolis Urban League, various neighborhood community centers and local school districts to address food insecurity in our community. An expansion of these efforts will be required to address the staggering needs in our community. 

Deanna Reinoso: A robust, diverse and dedicated group of collaborating partners is important to the success of our local food landscape. Indiana, and Indianapolis in particular, have wonderful leaders like Gleaners Food Bank and multiple other food access organizations that have a long history of addressing the issue of food insecurity in our state. There has been increasing collaboration between all the organizations dedicated to addressing food access, and others in the public, private and philanthropic sectors have joined the fight. Due to the magnitude of the food access barriers facing our state, it is essential to have continued collaboration and new innovative partnerships that can effectively address the health and social crisis caused by lack of access to healthy food. 

Anne Swanson: Food insecurity unfortunately has a direct impact on the health of people in need and can lead to higher likelihoods of chronic disease and poor health. One third of households that use food banks have at least one member with diabetes. Nearly half have someone with high blood pressure. And two-thirds had to choose between paying for food or paying for medicine or medical care in the last 12 months.

People receiving assistance from a food bank often have limited access to basic health care. These deficiencies increase their risk of developing chronic diet-related health issues or exacerbate existing health conditions. We believe food is medicine, and that nutrition can have a powerful effect on a patient’s health.

Janet Kamiri: An unhealthy diet is the underlying cause of many chronic health conditions. When someone is food insecure, the priority is getting enough food. Food quality often takes a back seat to quantity. Children who are food insecure may also be poorly nourished. Kids who attend school hungry are more likely to have challenges in the classroom with learning and behavior than students who are not hungry. Kids whose diets are heavy in processed foods are more likely to have obesity, which is known to contribute to a variety of chronic conditions leading to poorer health outcomes in adulthood. 

Deanna Reinoso: Multiple scientific studies demonstrate that food insecurity and poor nutrition greatly contribute to chronic medical and mental health conditions and increased health care costs. Paradoxically, food insecurity often results in obesity-related health conditions due to the lower cost of high-calorie, low-nutritional-value foods. Life expectancy disparities that we have in central Indiana—with a 16.8-year life expectancy gap from Fishers to downtown Indianapolis, according to an Indiana University Richard M. Fairbanks School of Public Health study—are complex, but we won’t be able to improve this terrible gap without addressing nutrition-access barriers in our city. Food as medicine is important not just in preventative medicine but also for the treatment of chronic illness. Integration of social care and medical care, including healthy nutrition, is essential to improving health outcomes for chronic conditions and in some cases even reversing chronic conditions, such as hypertension and diabetes.

Heidi Spahn: Overall health is dependent on nutritious food. So, in 2015 Corteva Agriscience helped start Crooked Creek Food Pantry at the Eskenazi Health Center Pecar in conjunction with Eskenazi, Gleaners, and St. Luke’s Methodist Church. Since then, health center patients have experienced improvements in overall health due to healthy food access—successes noted by the health center physicians. Corteva also contributes large amounts of fresh produce grown by employee volunteers in our Corteva Harvest for Hunger garden to Crooked Creek Food Pantry, along with other area food pantries. This year we will surpass more than 75,000 pounds of fresh produce that has been grown and donated since the garden’s inception in 2014.

Janet Kamiri: Health-related organizations are playing a vital role in providing food and nutrition education and registering families for programs, services and resources to ensure that eligible families have access to food and produce.

Deanna Reinoso: It is essential for health systems to have a comprehensive approach to food insecurity to address not only hunger, but also the full spectrum of poor nutrition leading to common chronic conditions. Eskenazi Health system has a history of comprehensively addressing food access and nutrition barriers over the past 150 years, including the Crooked Creek Food Pantry Heidi mentioned.

More recently, Eskenazi Health’s “Fresh for You Market” was launched as an innovative and unique market-pantry hybrid model to comprehensively address food access barriers. Eskenazi Health is the first health system in the U.S. to launch this type of model. It provides not only a “market” for affordable healthy food items but also a dignity designed “pantry” resource for Eskenazi patients who screen positive for food insecurity. Eskenazi dieticians are using the “Fresh for You Market” to provide education and support to empower individuals to choose the best dietary options for their health.

Anne Swanson: Nearly half of all food banks are engaging with health care partners to support access to healthy food. These partnerships generally involve identifying patients who are food insecure and referring them to existing food pantries and food bank programs or creating new distribution programs on-site in a health care setting. Referrals for SNAP application assistance and support for other benefits is another important component of this work.

Deanna Reinoso: Well-intentioned efforts without extensive partnership and collaboration between organizations and the community served can exacerbate and amplify the harmful impacts of food insecurity. The magnitude of the problem that has left so many Hoosiers struggling to access nutritious food requires every organization to evaluate how to best engage and partner in the effort. If organizations of all types unite to address food insecurity, we can lead the country with innovative efforts that assure that every person here has access to the nutritious food choices they need to live a long, healthy, and active life.

Janet Kamiri: All organizations should make hunger relief and food insecurity a priority, especially given the vast food deserts that exist throughout Indianapolis. 

Heidi Spahn: Companies should consider what they can offer to food-security non-profits and provide employees with opportunities to use their skills and expertise to help others. The Harvest for Hunger garden at Corteva was started by employees passionate about giving back to their communities and who recognized central Indiana’s huge food insecurity problem. The garden is near to our hearts and has allowed employees to focus their skills and energy on growing fresh produce for people in need. More than 300 local Corteva volunteers are working to make a difference in the fight against hunger in central Indiana.

Anne Swanson: Food insecurity is an intersectional issue. It impacts health, education, workforce, and so much more. As such, Feeding America believes that everyone and every organization has a role to play in addressing hunger. Without the engagement of federal and state governments, the generosity of the private sector (both individuals and corporations), foundations and communities, and the innovation and agility of the charitable food sector, more people would be facing hardship, especially over this last year.

Strategic donors and agricultural partners in particular play a major role in how Feeding America operates. We are regularly engaging with farmers, manufacturers and retailers across the produce, animal protein and dairy sectors to align their social and environmental strategies with donating to the Feeding America network. 

Heidi Spahn: One of the biggest challenges in getting fresh foods to neighbors is infrastructure—the refrigeration and freezer capacity needed to distribute produce and protein. Both the Indy Hunger Network and Gleaners Food Bank have been working with local non-profits to address these challenges and provide monetary donations for organizations, including pantries, to increase capacity or repair coolers and freezers. Corteva Agriscience has been providing monetary support to both Indy Hunger Network and Gleaners to help expand pantry capacity for distribution of perishable foods, which provide a high amount of daily nutrient requirements. 

Anne Swanson: Feeding America has found that a combination of national office expertise in the agri industry and a “boots-in-the-field” local and regional presence at our food banks is critical to securing and distributing more produce. We’ve built a small team of ag industry experts to build the knowledge and capacity necessary to distribute fresh foods at our food banks. We continuously improve and innovate with technologies and business models that facilitate the donation and shipping of excess products. We recently launched a new version of MealConnect, a donation matching platform that enables agricultural producers and food businesses anywhere in the country to donate their nutritious unsold product and produce to local non-profits.

John Elliott: Sourcing and distributing sufficient varieties and quantities of nutritious perishable food is highly complex or we would have solved this already. We must make progress against multiple goals simultaneously. We must invest in infrastructure and capacity across the entire food supply chain, from farms and original food producers to retailers, wholesalers and distributors and to the non-profit players of scale like Gleaners to the hundreds of downstream distribution partners like pantries and soup kitchens. All need investments in facility, fleet, equipment, workforce and more. Until we increase capacity—with temperature-controlled storage and transport for produce, dairy and protein being the most urgent—it won’t matter that Gleaners has found ways to source dramatically more food. We’ll simply throw more away due to a lack of neighborhood-level partners equipped to distribute healthier perishable foods. Until more organizations take advantage of the consolidated purchasing power and much lower cost-per-meal efficiencies that Gleaners’ food sourcing team provides, we’ll continue as a community to provide fewer meals per dollar invested than we could.

Janet Kamiri: I think there is room for innovation in helping connect people to fresh food. I would love to see large-scale, affordable home delivery of fresh food to help eliminate transportation barriers. Having to make multiple grocery or pantry stops to get affordable pantry goods, produce, meat, and milk can be a burden for families. There are already a lot of smaller-scale initiatives happening around the city. Investing in these initiatives and helping build the capacity of small organizations, community gardens and Community Supported Agriculture would help push more affordable healthy foods into neighborhoods. An easy, one-stop distribution system would make a huge difference for people who are facing hunger. Continuing to expand the reach of food banks and food pantries through partnerships with community-based organizations also helps get food closer to those in need.

Deanna Reinoso: Each neighborhood needs the infrastructure and capacity to distribute fresh food to those who can’t afford store purchases or where grocery stores don’t exist. Even though it is difficult for food pantry partners to facilitate the storage and distribution of fresh food items, it is essential to increase the availability of eggs, dairy, fresh fruits, vegetables, and proteins so that ALL individuals have access to healthy nutrition for their families.

John Elliott: I believe much of the demand has been there all along. It has increased, however, as Gleaners and others have combined efforts to educate each other and our neighbors.  The work Gleaners’ staff dietitians do as part of the training curriculum for dietetic interns at IU and Purdue, as well as medical students at IU, combined with systemic work by health care systems around social determinants of health, is educating the support side. Efforts like the Nutrition Hub part of Gleaners’ website and Cooking Matters classes by Indy Hunger Network are educating our neighbors.

Janet Kamiri: It’s no secret that fresh foods are healthier than processed foods, but they are also more expensive and require more preparation. People want healthy options, but they can’t always afford it. Processed foods are easier to find and pay for within any given neighborhood. People are seeking out healthy food through familiar sources of support, knowing that healthy foods benefit their health holistically. I also think the growth of equity and social justice movements have amplified the fact that systems, including the food system, have disproportionately negatively affected Black communities. There is increased recognition that people don’t just need food quantity, they also need food quality.

Anne Swanson: For Feeding America, innovation comes from putting the people we serve at the center of all we do. One recent example is the launch of our online grocery ordering system, OrderAhead. Oftentimes, transportation, stigma, and lack of time are reported as barriers that prevent individuals from seeking help. For people who are uncomfortable seeking food assistance, OrderAhead offers a more private and discreet experience. The program enables individuals facing hunger to order food from a Feeding America network food bank or partner organization and pick it up at convenient community locations like schools, drive-thru distributions, and libraries. To date, 14 food banks and 20 distribution sites have provided food to over 5,000 households, reaching more than 17,000 people. Over the next year, Feeding America plans to expand the OrderAhead program to an additional 20 food banks.

Heidi Spahn: Non-profits should always be thinking about how to be more entrepreneurial and innovative. While non-profits face challenges like limited resources, they need creativity and innovation to achieve sustainable long-term outcomes. I always challenge non-profits to think differently to be successful, including taking advantage of the resources of partner organizations. Many companies have subject-matter experts who can provide skill-based volunteering for non-profit organizations that would create additional value. Non-profits should clearly articulate the needs of the organization, while thinking more about the future and what will be required.

Janet Kamiri: Flanner House, Eastern Star Church and various community centers are becoming innovative and entrepreneurial by leveraging urban farming and the creation of neighborhood-based food and grocery options to address food insecurity.   

John Elliott: As the largest hunger relief organization in Indiana, Gleaners accepts disproportionate responsibility to be an entrepreneurial innovator. We recently announced the next phase of our ambition—to create an innovative agri-hub solutions center that benefits our region, our state and the entire Feeding America national network. Going beyond simply sourcing and distributing nutritious perishable products, we see Gleaners, Fresh Connect and new operating subsidiaries becoming an entrepreneurial incubator that tests and refines ideas with potential for greater impact and scalability.