Confronting food insecurity on many fronts

When a group of medical students, faculty and staff opened the area’s first hospital-based food pantry at the University of Chicago Comer Children’s Hospital in 2010, they followed a simple principle: feed first, ask questions later.

The food assistance comes through Feed1st, which now operates pantries in four inpatient locations at the hospital. The program run by UChicago’s Lindau Laboratory has helped more than 10,000 family members and caregivers of patients at Comer.

Its success is giving scientists an opportunity to ask questions about the persistence of food insecurity in Chicago and other U.S. cities—the subject of the “Hunger, Brain, City” workshop hosted earlier this month by Lindau Lab and UChicago Urban.

“We were seeing families, parents and caregivers who were literally starving at the bedside of children receiving medical care in our hospital,” said Stacy Lindau, AM’02, associate professor of biological sciences at UChicago and director of Lindau Lab. “We want to understand how we can not only work to alleviate hunger in our own hospital, but also in the communities where our patients live.”

For the workshop, Lindau and fellow organizers assembled more than two dozen experts from disciplines as varied as health care, economics, architecture and agriculture to examine hunger’s health effects as well as its impact on risky sexual behavior and criminal activity.

“What sometimes looks like poor choices or risky behavior on the part of teens may in fact be driven by struggles to cope with food insecurity,” said Elaine Waxman, MPP’86, PhD’09, a senior fellow at the Urban Institute and lecturer at UChicago’s School of Social Service Administration.

She said teens in particular feel pressure to shoulder some of the burden of food insecurity in a household. Older students may drop out of school to get a job, while younger teens might deliberately fail a class so they can go to summer school to get regular meals.

“We want to understand how we can not only work to alleviate hunger in our own hospital, but also in the communities where our patients live.”Assoc. Prof. Stacy Lindau

To help grasp the diversity of food insecurity causes and outcomes, the workshop included a systems science-based “group model building” that involved gathering a variety of people with different expertise in the same room to integrate their thinking. The model aims to address problems without a single root cause but rather multiple, interconnected factors working together to reinforce each other over time.

Food insecurity often is tightly woven into several feedback loops with other persistent issues, from unemployment to health. “There are a lot of people studying food insecurity, but very few studying the dynamics of the whole system,” said Ignacio Martinez-Moyano, a senior fellow at the Computation Institute, a joint initiative between UChicago and Argonne National Laboratory.

For example, as discussed with the group of experts gathered at the workshop, “unemployment makes households more likely to become food-insecure, and being food-insecure, over time, and through several mechanisms, increases the likelihood of being unemployed. This creates a reinforcing cycle that goes around and around,” said Martinez-Moyano.

Food insecurity can have similar effects on chronic health conditions. “We know individuals who are food insecure have higher risk for developing diabetes, for example. And once they have diabetes, they’re not very well positioned to manage it because part of the treatment for diabetes is eating well and eating regularly. So, that can start a cycle of poorly controlled diabetes,” Waxman said.

As the daylong workshop unfolded, solutions related to food insecurity started to emerge. Marc Berman, an assistant professor in UChicago’s psychology department, pointed to a talk about how vertical farming and urban agriculture could help address a shortage of fresh produce in city neighborhoods.

Berman studies how the physical environment affects the brain and behavior and has demonstrated how natural environments like parks, as compared to more densely urban environments, affect cognitive performance.

“A lot of research shows that interacting with nature can promote better self-control, and one of the things we know, too, is that hunger reduces self-control,” Berman said. “One of the questions I look at is whether there are ways we could tailor the environment to help counteract some of the adverse effects of hunger.”

Workshop participants will gather again at Argonne in January. Their focus will include bringing together a diverse body of research with federal food insecurity data to test the effectiveness of different strategies.

Lindau, who also serves as director of the South Side Health & Vitality Studies, said she is optimistic about what they may accomplish. “To move the needle on hunger, it is going to take all of us who care about it thinking and working together.”