How we can help families move from hardship to health
One of the most remarkable things about pediatric medicine is the simple fact that most of the time, sick kids get better. I’ll admit – few things are as terrifying as being a new parent and having your toddler admitted to the hospital’s pediatric intensive care unit for an acute asthma attack. But it’s true, even really sick kids often recover and go on to live healthy, happy lives.
First, let’s be clear – the reason sick kids become healthy is because we make sure they receive the most breakthrough treatments and strongest medicine we have available. But sometimes the best medicine doesn’t come from a pill bottle. As a network of pediatricians, public health researchers, and child health and policy experts, we know that the public policies our elected officials prescribe undoubtedly influence the health and development of our young children. Children’s HealthWatch has demonstrated this for nearly 20 years. And since 1998 there has not been a more harmful set of policy prescriptions as the American Health Care Act (AHCA) passed by the House and President Trump’s budget plan. These proposals do nothing to move children and families from hardship to health. In fact, they do just the opposite by moving families from health to hardship.
Knowing from clinical experience and conversations with our Children’s HealthWatch families that hardships can be dynamic – for better or worse, we set out to answer the question – “Do young children in food-insecure families experience improvements?”
In our new report card, From Hardship to Health, we examined the changes in food security status among 913 families who participated in the Children’s HealthWatch survey at least twice, (on average 12 months apart) and who reported being food insecure in their first visit. Among this sample of families facing hardship, nearly half (48%) of families surveyed became food secure by the second visit. The remaining 52% either remained food insecure or became more severely food insecure. However, the same families who became food secure by their second visit were also more likely to report being able to afford a stable home, home energy, and prescription medicine and medical than those who were persistently food insecure at both visits.
While we are still investigating why these families became food secure and were also more likely to experience reductions in other hardships, compared to families who remained food insecure, I think a key lesson to be learned here is that the medical community has an important to role to play in addressing the social needs of families with young children to ensure better health outcomes and lower health care costs on a systems level – it’s estimated that the health-related costs of food insecurity in 2014 were $160 Billion. By first asking “how can we address this family’s hardships?” the answer to “How can we treat this child’s asthma and make sure she doesn’t return to the emergency room in a few weeks or months?” will be less vexing to figure out.
This proposition is not new, and I’m happy to say that health care providers across the country are working together and forming innovative partnerships to move more families from hardship to health while simultaneously bending the health care cost curve. Here are two ways this is being accomplished:
- Identifying and addressing food insecurity in clinical settings
- Ensuring enrollment for families eligible for assistance programs
Led by Children’s HealthWatch and FRAC, the Hunger Vital Sign™ National Community of Practice works to facilitate conversations and collective action among a wide-range of stakeholders interested in addressing food insecurity through a health care lens (physicians, public health researchers, anti-hunger agencies, health care professionals, and policy experts). The Hunger Vital Sign™ National Community of Practice provides targeted and largely virtual capacity-building and knowledge support to more than 80 individuals from dozens of organizations across the United States engaged in screening and intervening to address food insecurity. The Community of Practice seeks to:
- Identify research on the connections between food insecurity and health
- Promote the use of the 2-item Hunger Vital Sign™ to screen for food insecurity
- Champion effective interventions to address food insecurity both at the practice and policy level to ensure enrollment for families eligible for assistance programs.
With the release of this new report card, we have a clear picture of how some families move from hardship to health while others do not. For those families who remain food insecure, we need to ask ourselves why? – and more importantly – what can we do to alleviate their food insecurity and ultimately improve their health? So, through the work of the Hunger Vital Sign™ National Community of Practice, we are demonstrating that when we have the right diagnosis and treatment plan it’s possible to move from hardship to health – giving families the economic stability they need to thrive. Our elected officials should shift their misguided focus from the current obsession over taxes cuts for the wealthiest among us towards moving families from hardship to health. That is what will ultimately improve health outcomes, bend the cost curve, and likely improve several other markers for societal health – economic strength, a thriving workforce, even national security. Otherwise, were simply not going to get better by denying struggling families access to health care and nutritional assistance.