July 6, 2025 • 33 mins
07/06/25
The Healthy Matters Podcast
S04_E19 - Hunger, Health, and Hope: Tackling Food Insecurity
With Special Guests: Dr. Dianna Cutts, MD, and Amy Harris
It’s pretty hard to concentrate, work, or pretty much do anything while you’re hungry. And while, for many of us, hunger is a passing moment, there are far too many children and adults living with this as a daily reality. Food insecurity extends well beyond the physical effects of being hungry. It can be a major stressor on the daily lives of kids in school, their parents, and our society as a whole. Hunger, the world over, is a critical issue, and in our first-world, modern American society, this definitely merits a deeper look.
On this episode of our show, we’ll dig into the complexities of it with the help of two special guests from Hennepin Healthcare. Dr. Diana Cutts is the Chair of Pediatrics and a nationally recognized leader on the subject, and Amy Harris is the Population Health Program Director and a champion of building healthier communities. We’ll go over everything from the impacts food insecurity has on both children and parents, and how those effects play out in our society as a whole. We’ll also talk about the stress it causes on families, the importance of bringing it to the fore in a clinical setting, and what can be done to help at an individual, community, state, and even national level. Food and nutrition are essential for human survival, so it’s safe to say food security is essential for the survival of our society. We hope you’ll join us.
We're open to your comments or ideas for future shows!
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Here are some links to organizations that make a difference if you want to see how you can help:
Hennepin Healthcare Foundation
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_02 (00:01):
Welcome to the Healthy Matters podcast with Dr.
David Hilden, primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare,
and what matters to you.
And now here's our host, Dr.
David Hilden.
SPEAKER_01 (00:19):
Hey, everybody, and welcome back to episode 19 of
the podcast.
I am your host, David Hilden,and let me ask you something.
Have you ever tried toconcentrate on work or school
with a little rumbling in yourstomach?
Imagine doing that every singleday.
For thousands in our community,that's not just a passing
moment, it's a daily reality.
So on today's episode, we'retackling an issue that's as
(00:39):
vital to our healthcare as anyprescription I could ever write,
and that is food insecurity.
We'll talk about what it means,why it matters, and what we here
at Hennepin Healthcare inMinneapolis are doing to make
sure make sure no one has tochoose between filling a
prescription and filling theirpantries.
Joining me today are twopowerhouse voices in this
conversation.
We have Dr.
Diana Cutts, Chair of Pediatricshere at Hennepin Healthcare.
(01:01):
She's a nationally recognizedleader in connecting the dots
between child health andnutrition, and she's been
championing this work longbefore it was on anybody's
radar.
Also joining us is Amy Harris.
She is the Population HealthDirector at Hennepin Healthcare,
and her work is all aboutbuilding healthier communities,
one program, One partnershipand, yes, one meal at a time.
(01:21):
Diana, Amy, welcome to thepodcast.
SPEAKER_04 (01:24):
Thanks, David.
Glad to be here.
SPEAKER_01 (01:25):
So maybe you could start us out, Dr.
Kutz.
What do we mean by foodinsecurity?
SPEAKER_04 (01:29):
Well, it's a little bit of a bulky term.
We used to say hunger, and wewould talk about hunger in
America or childhood hunger.
But with time, we realize thathunger is really an individual
sensation, and it's hard tomeasure that.
So instead, we have moved tothis term, food insecurity,
which is something we canmeasure.
(01:51):
And we measure it every year innational surveys using an
18-item survey.
The USDA does it.
And what it is looking for islimited or uncertain access to
adequate food for health.
And it measures it on ahousehold level.
SPEAKER_01 (02:08):
That's probably a term that might be new to some
of our listeners today, but thatdoes make some sense.
But isn't it also, hunger kindof does resonate.
People know what that means.
SPEAKER_04 (02:17):
It does.
And I think that's what's madethe term a little bit more bulky
for communication.
But we continue to do educationabout it.
And I think we are able to talkabout how hunger can be a
consequence of food insecurity.
So they do go together.
SPEAKER_01 (02:33):
You're a pediatrician.
You're the chair of pediatrics.
You've been doing this for 25 ormore years.
Frankly, Diana, how long haveyou been doing this?
SPEAKER_04 (02:41):
Over 30
SPEAKER_01 (02:41):
years.
Okay, over 30 years.
We'll say.
Over 30 years.
How does food insecurity show upin the life of a pediatrician in
the families you serve?
SPEAKER_04 (02:50):
Well, I think...
Honestly, it shows up before weeven meet a child, that all too
often it happens as a prenatalexperience and that hunger for
children often begins evenbefore their birth.
How does it show up clinically?
I think we can talk about lowerbirth weight.
(03:11):
We can talk about anemia.
We can talk about more frequentillnesses because we know poor
nutrition impacts the immunesystem and we see children who
have more ear infections or morepneumonia or when they get sick,
they're sick more severely andfor a longer period of time,
take longer to recover.
(03:33):
We can also see it in probablymost concerningly in
development.
So as children are going throughrapid periods of growth,
particularly in the first threeyears of life, their brain is
growing, growing, growing,making connections and brains
need calories and good nutritionto grow well.
(03:54):
So that's the most powerful kindof negative consequence of food
insecurity.
How do we see it clinically?
We see it in a child who may bemore apathetic and less
interactive.
Or we may see it in a child whoappears hyperactive or to have
ADHD.
Behavioral issues in childhoodand then sort of moving on along
(04:19):
the continuum, merging intomental health issues in older
children, I think are theclinical manifestations.
The last one is the oneeverybody thinks of first is
about growth.
And the truth is that childrenwho are experiencing food
insecurity can be overweight,can be underweight.
and most are normal weight.
(04:41):
So the idea that we can see itvisually or diagnose it based on
a weight, on a scale, is reallya fallacy.
SPEAKER_01 (04:49):
Yeah, that's interesting, the weight thing,
because I bet a lot of peopleare thinking, well, you see an
underweight kid, that's whatthey think of when they think of
someone who's not getting enoughto eat.
So that's fascinating to me.
The majority don't look thatway.
No.
But the majority don't.
That's true.
Yeah.
So before I move to you, Amy,I'm going to ask you about the
population level meanings offood insecurity.
(05:10):
But I'm going to ask one morequestion of you, Diana.
Is this normal in pediatricclinic visits?
I mean, do pediatriciansroutinely talk about food at the
visits?
SPEAKER_04 (05:20):
So, pediatricians, we believe in preventative care,
and nutrition is a foundationalpiece of healthy growth.
So, I think our interest innutrition has been from the
beginning of time.
But in In 2016, the AmericanAssociation of Pediatrics
recognized food insecurity as ahealth problem and issued a
(05:43):
statement and advised there bescreening for food insecurity at
every clinical visit.
And that's been altered.
Maybe it's not every clinicvisit.
Maybe it's every year, every sixmonths.
But the idea, again, was toscreen recognizing that we
couldn't visually diagnose thiscondition.
(06:05):
Makes sense.
SPEAKER_01 (06:05):
It really does.
So I'm going to turn to you, AmyHarris.
You're the Population HealthDirector at Hennepin Healthcare.
First of all, tell us just alittle bit what that role means.
And then if you could transitioninto what are the population or
community level impacts of foodinsecurity?
SPEAKER_03 (06:20):
Sure.
So when we think aboutpopulation health, we're really
talking about broader groups ofpatients and how do we think
about the needs of thosepatients to get to better health
outcomes.
Healthcare is built on anindividual basis, a provider
working with a patient, andwe're not trying to get in the
way of that.
But when we think about broadergroups of patients or groups of
community members, how do weunderstand the health indicators
(06:41):
of broader groups?
So it is a relatively newer rolein healthcare systems.
And when we think aboutpopulation health at Hennepin
Healthcare, we're not justthinking about clinical
problems, but we're reallythinking about health needs as
whole people.
And so food insecurity is one ofthe factors that contributes
directly to health and wellness,like Dr.
(07:02):
Cutts has explained.
And so when we are doing ourwork here to take care of
people, we want to think ofprocesses that help us
understand the needs of peopleas whole people.
So not just what are yourclinical needs, but what are the
other factors in your life thatcontribute to health?
And food and access to food issuch an essential part of that
equation.
We've built programs here to beable to better understand and
(07:25):
recognize where there is foodinsecurity, but we've also built
programs here to to help be ableto address the food insecurity.
So what's our resource responsewhen we know someone is food
insecure?
SPEAKER_01 (07:35):
How do you measure food insecurity at a population
level?
I mean, we kind of know it's gotto be out there.
Dr.
Cutts sees it in her clinic.
How do we know where the needsare greatest?
SPEAKER_03 (07:45):
Well, we've built an actual screening question into
the way we do our work here.
It's built into the standardwork across our clinics.
It's being used now in thehospital in a standard way.
Like Dr.
Cutts noted, There's been somedevelopment, really good
development across the countryto come up with more standard
ways to ask about foodinsecurity.
(08:06):
So we actually use atwo-question indicator here that
helps us understand the presenceof food insecurity.
And really it's asking whetheryou have in essence, run out of
food in the last 12 months, oryou've been worried your food
would run out and you wouldn'thave the money to cover that
need.
And so that two questionindicator is used as a way to
measure food insecurity.
And what we see that samequestion or the structure of
(08:29):
that question is actually used alot of other places.
One of the better data sourcesfrom a community level is that
Hennepin County does a survey, apublic health surveillance
survey called the SHAPE survey.
And in the 2022 SHAPE survey,they surveyed residents of
Hennepin County and asked awhole variety of questions of
which a couple were related tofood insecurity.
(08:49):
And so within that survey, youcan see the rate across the
whole county is about 10% ofpeople are food insecure across
the whole county.
But there are certain groups ofindividuals and certain pockets
of communities or neighborhoodsthat have much higher rates of
food insecurity.
SPEAKER_01 (09:05):
So for listeners, Hennepin County is where we all
work, where Amy Day and I allwork at the big safety net
hospital in downtownMinneapolis.
It is the county which containsthe city of many Is this done
nationwide?
Are counties and statesmeasuring this all over, or is
this something that we're doingspecifically?
SPEAKER_03 (09:23):
I think there's examples across the country
where food insecurity is beingmeasured.
I think the survey withinHennepin County is a standard
practice from the public healthteam.
And what you see inside thatdata is although the rate across
the whole county is 10%, we seesome of the neighborhoods where
many of the patients that weserve here at Hennepin County,
(09:43):
those neighborhoods can haverates somewhere in that 20 to 30
percent.
And what we also see inside thedata is that it
disproportionately infectscommunities of color.
And so the food insecurity ratesin our American Indian and Black
African American communities aregreater than 30%, whereas other
communities have much, muchlower rates.
And so it's an issue that reallydisproportionately affects
(10:06):
certain individuals, and itreally disproportionately
affects the patients we servehere at Hennepin Healthcare.
SPEAKER_01 (10:11):
And then it ought to drive our policy and
decision-making, I wouldimagine.
I don't know if it does to thedegree it should, but it ought
to.
So I'm going to delve into thata little bit more.
Do we know then how health careutilization is affected or how
health outcomes are affectedbased on the levels of food
insecurity in your particularcommunity?
SPEAKER_03 (10:33):
So we can see in our data that we know for
individuals who are foodinsecure, and we've screened
them in our clinics andidentified that they're food
insecure, those individuals havehigher disease rates.
burden, so they have morechronic conditions, we can see
that they use more healthcareresources.
And I know there's a lot ofliterature across the country
(10:54):
that could sort of validatethat, but we see it here too
within our own patientpopulation.
SPEAKER_01 (11:00):
Diana, you and your team of pediatricians, how do
you approach a parent or acaregiver in that clinic when
you have identified somebody aspotentially experiencing food
insecurity?
What do you tell that parentwho's struggling to feed their
child?
SPEAKER_04 (11:17):
Well, I hope what we do is first listen to what
they're telling us and in aneutral way because really
disclosing this for a householdis...
It's a shameful experience, andparents really suffer.
We hear things from parentslike, I let them eat, and then I
(11:39):
eat whatever's left over.
Or, you know, it's fine with me.
As long as they're eating,they're happy.
I'm okay.
I just drink coffee.
Or I use a measuring cup and weeach get a cup.
I mean, life is hard when you'rehungry because when you're
hungry, you can't even think todo nothing else.
Those are direct quotes thatwe've heard from parents in
(12:01):
clinic as they describe theenvironment that food insecurity
creates.
And, you know, as focused as Iam on children as a
pediatrician, we really have tothink to generation and we have
to remember that parents aredoing everything they can to
protect their children, as thosequotes illustrate, and that they
(12:24):
are suffering, therefore, theconsequences of food insecurity,
the chronic disease, the lack ofa prescription filled as they
trade off that expense, and thedepression.
So we want to go at it when wedo approach it as a household
issue.
How do we help households?
And I think the first thing wewant to do is make sure that a
(12:47):
family that's eligible isparticipating in every program
for which they're eligible.
SPEAKER_01 (12:53):
Food assistance programs, things like that.
SPEAKER_04 (12:56):
Yes.
SPEAKER_01 (12:56):
So I see their parents.
You see the children, and thoseare profound quotes that you
just said, because I think thatthat must be a universal truth,
that the parents are going tomake sure their child is fed
first.
But when the sum total of whatis available isn't enough for
that family, that's got to leadto long-term consequences for
that whole family.
SPEAKER_04 (13:17):
I think it does, and the research shows it does, and
for the community.
You know, as Amy pointed out,the increased cost in healthcare
utilization is for every memberof the family.
And as you think about who'smost vulnerable in the family,
it's probably the very young.
And the healthcare utilizationdollars that go into the
(13:42):
consequences of food insecurityhave been estimated to be
billions of dollars.
SPEAKER_01 (13:46):
We're going to talk a little bit more in a few
moments about the solutions andwhat we're doing.
But it strikes me is that, Amy,you've told us about what we
know.
about the communities.
You've told us where we ought tobe focusing.
And Diana, you have told us thisis what families are telling us.
So all I can think of is I'm aclinician.
I'm sitting there one-on-onewith a patient and it's almost
(14:08):
overwhelming.
So I can't imagine what yourpediatricians, you've got some
pediatricians been practicingmedicine, went in there to help
children and is dealing withthat, dealing with a family that
doesn't have enough.
And then you've got Amy, you'retelling us, we kind of know what
the solutions are.
Either one of you, what shouldbe the next steps to addressing
it.
SPEAKER_04 (14:26):
Well, I'll speak as a clinician.
You know, when I find myself inthat situation, I'm extremely
grateful for our populationhealth program, which provides
us bags of emergency food toprovide to families so that any
family who discloses thisinformation doesn't walk out
(14:46):
empty-handed.
So there's the immediate need.
I think the next level is how dowe find resources for a family?
And that's a discussion with aprovider or a social worker or a
community health worker to say,how do we connect a family to
resources in the community?
So that may be assistanceprograms, but it also may be
(15:07):
programs of food shelves or foodserving programs in our
community.
And, you know, I think we'refortunate.
We live in a community that hasmany different offerings.
So the trick is how do weconnect the family to those
resources that'll help meettheir needs?
SPEAKER_01 (15:25):
So that's what you can do in that clinical setting.
Critically important.
What about further upstream,Amy?
What steps are you taking?
Is our healthcare system takingto move upstream a little bit?
SPEAKER_03 (15:37):
I'd say one of the things that's happening on a
broader level is that there issome good movement across the
country to make screening forfood insecurity just be part of
the way in which we do healthcare.
So it's really about trying tonormalize.
You know, we ask people allkinds of questions when they
come into the hospital or theycome into a clinic.
And we're used to answering allthose questions around health
and weight and prescriptions.
(15:58):
And so making it more normal andstandard to ask questions around
what are the other things inyour life that might be
contributing to health is areally important So there's been
good movement happening acrossthe country to sort of normalize
the asking of these questions.
SPEAKER_01 (16:13):
Because as Diana said, it's embarrassing or
there's a stigma to it and youdon't want to bring this up.
I'm failing as a parent.
So normalizing the asking of itsounds like a good step.
SPEAKER_03 (16:22):
And I think people even at the beginning were like,
why are you asking me thisquestion?
What does it have to do with whyI'm coming to the clinic?
And so trying to help peopleunderstand these things are all
interconnected and we careenough to ask and know.
That's been an important part.
I would say it's still a work inprogress, but we're making good
progress, I'd say, on that inthe healthcare industry.
I think the other is thecritical way in which you ask
(16:45):
the question.
It sounds strange, but the wayin which the question is
actually asked to someone canreally make a difference in
their willingness to be morehonest and truthful.
SPEAKER_01 (16:53):
Can you give me an example of that?
SPEAKER_03 (16:55):
Well, what we've learned is that if people are
given the chance to answer thequestion on a piece of paper,
They're more honest than if theyhave to answer the same exact
question face-to-face by someoneasking them verbally.
It's just one more step for achance to be a little more
anonymous, a little morerespectful.
And so we know that the methodfor how we ask people these
(17:16):
questions really matters.
It makes a big difference to beasked the question in the
context of a trusted healthcarerelationship.
And so when your provider, likea pediatrician that you see all
the time, asks that question,that can be safe.
But if you've just sat down withsomeone in a clinic and you've
never seen that person beforeand they're saying, do you have
enough food to get you throughthe next 12 months?
(17:37):
You might be more hesitant togive a more honest answer.
So the method of asking reallydoes make a difference.
SPEAKER_01 (17:42):
Yeah, that's helpful.
That makes sense.
Okay, Amy and Diana, thank youfor laying the bedrock of what
food insecurity is and some ofthe interventions we're doing
both on a population level andon an individual clinic level.
We're going to take a shortbreak and when we come back,
we'll talk about the impact offood insecurity on health, what
can be done When HennepinHealthcare says, we're
SPEAKER_00 (18:15):
here for life, they mean here for you, your life.
and all that it brings.
Hennepin HealthCare has ahospital, HCMC, a network of
clinics in the metro area, andan integrative health clinic in
downtown Minneapolis.
They provide all of the primaryand specialty care you'd expect
to find, as well as serviceslike acupuncture and
(18:37):
chiropractic care.
Learn more athennepinhealthcare.org.
Hennepin HealthCare is here foryou and here for life.
SPEAKER_01 (18:52):
And we're back talking with Dr.
Diana Kutz and Amy Harris aboutfood insecurity.
They both work with me here atHennepin Healthcare in beautiful
downtown Minneapolis.
So let's talk a little bit aboutsystemic solutions.
What might we be able to donext?
Who wants to take that?
SPEAKER_04 (19:08):
Well, I'll jump right in here because I think we
have a wonderful example here inMinnesota, and it's called
universal school meals.
We have known for ages thatthere are children who are in
school and they need food tolearn.
And we have addressed that bymaking people eligible through
(19:29):
their income for free schoolmeals.
But In 2023, we changed that andwe made a universal policy that
took out the stigma, it took outthe paperwork, and it really
encouraged all children to eattogether without different
colored stamps or differentcolored cards that indicated who
(19:50):
was paying for their meals.
And the uptick of what the foodand the meals that were being
consumed is noteworthy.
The most important thing I thinkthat's been noted, though, is
that children are healthy.
There's better attendance inschool.
There's less behavioral problemsin school.
There's less use of the time outroom.
(20:11):
That there's more learning thatcan happen when children are fed
and particularly using thisstrategy.
So shout out to the state ofMinnesota for that legislation.
And I think we were the fourthstate to do it.
I think there are now eightstates in the country and others
considering it.
You know, you can say, what's abetter use of funding than
(20:33):
feeding children so they canlearn every day?
I'm
SPEAKER_01 (20:35):
not sure I can think of one, one thing that is a
better use of money than that.
And yet it's a little pathetic.
that 42 states don't do this.
So I have memories just aboutfour or five years ago of news
reports that say some kids gothrough the lunch line and they
don't have any money on theiraccount so they don't get to
(20:58):
eat.
And this is a six-year-old.
SPEAKER_04 (21:00):
Yeah, there were literally stories of the
lunchroom staff taking a trayand dumping it out in front of a
child who didn't have enoughmoney in their account or
instead giving them a peanutbutter and jelly sandwich Well,
SPEAKER_01 (21:15):
all the other kids are getting the whole hot lunch.
SPEAKER_04 (21:17):
Exactly.
So imagine the stigma of thatand the kinds of feelings that
it does for a young child.
You know, when we talk about theimportance of our relationships,
what does that do to ourrelationships?
You know, that kind ofcommunication as to what that
experience was like, that waspart of the effort to pass this
(21:37):
kind of legislation.
SPEAKER_01 (21:39):
And it took till 2023 to get that done.
And I, too, am very gratefulthat the state of Minnesota has
done that.
I can't believe that that's nota universal thing nationwide.
So that is a perfect example ofwhat some of the challenges are.
SPEAKER_04 (21:53):
Well, and I think it's rooted in an idea that we
have the deserving poor and theundeserving poor.
And that's a mindset that toomany hold on to that gets in the
way of the greater good for ourcommunities and for our
families, that there's somethingabout some children where they
(22:15):
don't deserve that breakfast.
SPEAKER_01 (22:18):
I'm just going to let that sit.
I've not heard that term statedwith such clarity as that.
And I hope listeners are givingthat some thought.
The deserving poor versus theundeserving poor.
And especially as those termsrelate to a child.
SPEAKER_04 (22:32):
Yeah, and I think you overlay that with what we
know about generations of racismand what that has done for the
opportunities for people.
And you really start to, I hope,clarify what is systemic
inequity and how do weperpetuate it in ways such as
(22:54):
this.
SPEAKER_01 (22:55):
Amy, in your job, what do you see as being done at
the policy level that might behelpful?
Or maybe that isn't being done,but ought to be done.
I
SPEAKER_03 (23:04):
think that there is some movement in understanding
how in the broader healthcarepolicy and healthcare payment
spaces, we can better understandthe whole needs of people.
And how does that start to comeinto, you know, one of the
challenges we have, of course,over the years is that when we
can identify someone who needsfood resources and food
supports, it's like, how do wepay for that work?
(23:25):
If it's not sort of paid forunder a traditional healthcare
payment model, we do run intochallenges of being able to fund
the So I think there is somegood movement happening across
the country.
You can see examples in certainstates where they've done some
really innovative things withintheir Medicaid program to think
about how could you not onlyidentify food needs, but
actually be able to pay for someof those food resource
(23:46):
responses.
Because food and health are sotied together.
It's all we've talked about inthis episode.
And so the movement of beingable to not just identify it,
but actually have the mechanismto pay for some of those
resource responses within thehealthcare department.
That's really an interestingspace that's, you know, State of
Minnesota at a time waspursuing, you know, a waiver
(24:09):
within their Medicaid programthat would have allowed some of
these kinds of advances thatstalled out.
But it's an example of some ofthe movement from a policy
perspective that, again, allowus to not just identify the
need, but think of it in a moreholistic fashion when you can
start to encompass it into theMedicaid program, for
SPEAKER_01 (24:28):
example.
And yet, I'll just say it,Medicaid is under some attack
right
SPEAKER_03 (24:32):
now.
Yes.
Yes, it is.
SPEAKER_01 (24:34):
And so that worries me.
SPEAKER_03 (24:35):
Yeah.
I would hope it would worry allof us.
Some of the policy decisionsthat are being made at this
time, like A great example wasthat there was and is existing
now a standard to screen forthose health needs and housing
factors and other things forevery patient across the country
that's in a hospital.
And right now...
it's actually being proposed toroll back that requirement.
(24:57):
So we would no longer have toscreen for those things in the
hospital.
And that's an example, I wouldsay, of a policy decision that
is sort of stepping us backwardsfrom this work, not
SPEAKER_01 (25:06):
moving us forward.
Seems so short-sighted.
SPEAKER_03 (25:08):
But there's plenty of other examples that are
happening right now inWashington where there's
decisions being made aboutfunding and priorities around
that funding to roll back someof the coverage, some of the
funding structures underneathMedicaid.
Within the same bill that passedout of the House, there were
cuts to the SNAP program.
SNAP is Supplemental NutritionAssistance Program.
(25:30):
It's one of those foundationalfood resource support programs.
It's a federal program.
And so the bill that was passedout of the House, and now it's
being debated in the Senate,would have cuts to SNAP as well.
And so it's a really concerningtime, I'd say, for some of these
decisions that are beingpotentially made in Washington
that will sort of And as Dr.
(25:53):
Cutts
SPEAKER_01 (25:55):
said earlier, there are longer-term consequences to
health of that individual childin front of you, but also that
individual child's family.
And that then expands up intocommunities.
And in the long run, even from apolicy level, even if you put
aside the face in front of you,isn't it just kind of
short-sighted economically?
Yeah.
to not invest earlier.
(26:17):
To not invest early.
Yeah.
SPEAKER_04 (26:18):
You know, and I think we need to think beyond
the individual.
You know, it isn't about theindividual child who is hungry
in the classroom.
It's how that affects the entireclassroom.
Every child is impacted by thatchild being hyperactive or
acting up or needing to be takenout of the classroom for poor
(26:39):
behavior.
So I think we need to look athow it impacts absolutely every
person.
Even those who feel they aresafe from this kind of hardship
are impacted by the hardship oftheir peers.
And, you know, for children,again, my focus, I admit, we're
talking about the futureworkforce of America.
(27:01):
What are we looking for?
What kind of minds do we want togrow to solve the kinds of
problems we have?
We need every mind on board hereon deck.
And we're leaving stuff on thetable by not providing providing
really good nutrition tochildren and to the parents who
need to bring their best selvesto parenting, and I think to our
community.
SPEAKER_01 (27:22):
As a wise Minnesotan once said, we all do better when
we all do better.
What tips would you give ourlisteners for how to get
involved?
SPEAKER_04 (27:30):
Well, there are lots of ways to get involved.
Every way from donating food orvolunteering with organizations
to supporting policies that youbelieve in that will be
beneficial.
And there's certainly, as Amypointed out, plenty of
opportunity right now to bedoing that.
There are a lot of very activeorganizations in Minnesota.
(27:52):
to tie into.
Any internet search will giveyou choices of the food group or
hunger solutions or secondharvest heartland, all involved
in policy work to strengthen thesafety net that holds us
together.
SPEAKER_01 (28:07):
And listeners, we can put some links to those
sites in the show notes.
Maybe you want to get involvedwith either with your time or
your energy or your money.
And at a policy level, I thinkit matters that we let our
elected officials know thatwe're concerned about it, don't
you think?
SPEAKER_03 (28:24):
Yeah, this is a critical time for people to
raise their voice.
Right now, the Senate at thefederal level is considering
some really big systemic changesto some of our safety net
programs, whether it's Medicaidor SNAP or many other things.
So it's easy to reach out to beable to just express your
concern and your hope forsupporting the sustaining the
(28:44):
programs we have today.
Lots of ways to do that, buteverybody's voice matters here
in making your concern heard.
SPEAKER_01 (28:51):
So I'm going to give each one of you an opportunity
to leave our listeners with athought.
As we close off this incredibleepisode, I do have to say it's
been an amazingly profoundepisode for me.
Each one of you, if you couldleave our listeners with one
thought about food insecurity,maybe a message of hope or a
call to action or one take-homepoint, what would that be?
SPEAKER_03 (29:11):
Well, I would ask people to think about how they
can support not just the workand the changes on a policy
level, but the local work we dohere at Hennepin Healthcare.
You know, we offer food resourceresponse programs, so when we
identify someone who is foodinsecure, we have sort of
two-pronged response.
We have the immediate responsewhere we can make these
pre-packed food bags availableto people.
(29:33):
You know, last year, we hadalmost 50,000 food bags
available.
And at the same time, we alsohave ways to make it relatively
easy for clinicians and careteams to connect people to
community partners or WIC, whichis Women, Infant, and Children
Nutrition Program.
Through our medical record,actually, we can make a referral
(29:53):
through that record.
We can get people connected toan external partner or to WIC.
The WIC referral's new, so thisis a great advancement for us
here to be able to make thateasy connection.
But last year, we sent 3,800referrals to our community
partner to help peopleunderstand if they're eligible
for SNAP and get them connectedto SNAP.
(30:13):
And those programs are anessential part of how we do work
here at Hennepin Healthcare.
And we fund that work almostexclusively through
philanthropic donations.
And so if you're interested insupporting this kind of work,
the Hennepin HealthcareFoundation website.
It's an easy way to make adonation and you can put in the
comment you want it to supportthe food program.
SPEAKER_01 (30:33):
Easy one, folks.
It's at hennepinhealthcare.organd click on the donate and just
signify food insecurity.
Dr.
Diana Kutz, what are yourthoughts?
SPEAKER_04 (30:43):
You know, I think I would just add, you know, we
have said for many years, foodinsecurity is a national problem
that can be solved.
We are the richest nation in theworld.
We have food resources that wegrow here.
We have the means to do it.
We just need the will.
And I think we need to keep thatin mind and keep pushing the
(31:04):
rock up the hill until weachieve this goal of making sure
every family, every person hasaccess to healthy nutrition.
And I would say part of that is,again, this view that this is
not an other problem.
This is an all-of-us problem.
The ripple effect affects us alleconomically and socially.
(31:27):
So this is a problem thattogether can be addressed.
We have the means to do so.
We just need the will.
SPEAKER_01 (31:35):
Diana Cutts, Chair of Pediatrics, and Amy Harris,
Director of Population Health atHennepin Healthcare, thank you
both for being on the show andfor providing us an
inspirational message today onsomething that truly does affect
us all.
Thank you for being here.
Thanks, David.
SPEAKER_04 (31:49):
Happy to be here.
SPEAKER_01 (31:50):
Listeners, this has been a great episode, in my
opinion, on a topic that affectsus all, our families, our
communities, and our wholenation.
I hope you are inspired to takeaction.
And if so, check out the linksin the show notes.
And I hope you'll join us forour next episode as well, which
will drop in two weeks' time.
But in the meantime, be healthyand be well.
SPEAKER_02 (32:11):
Thanks for listening to the Healthy Matters Podcast
with Dr.
David Hilden.
To find out more about theHealthy Matters Podcast or
browse the archive, visithealthymatters.org.
Got a question or a comment forthe show?
Email us at healthymatters athcmed.org or call 612-873-TALK.
There's also a link in the shownotes.
(32:32):
The Healthy Matters Podcast ismade possible by Hennepin
Healthcare in Minneapolis,Minnesota and engineered and
produced by John Lucas atHighball.
Executive producers are JohnLucas, and Christine Hill.
Please remember, we can onlygive general medical advice
during this program and everycase is unique.
We urge you to consult with yourphysician if you have a more
serious or pressing healthconcern.
(32:54):
Until next time, be healthy andbe well.
Welcome to the Healthy Matters podcast with Dr.
David Hilden, primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare,
and what matters to you.
And now here's our host, Dr.
David Hilden.
SPEAKER_01 (00:19):
Hey, everybody, and welcome back to episode 19 of
the podcast.
I am your host, David Hilden,and let me ask you something.
Have you ever tried toconcentrate on work or school
with a little rumbling in yourstomach?
Imagine doing that every singleday.
For thousands in our community,that's not just a passing
moment, it's a daily reality.
So on today's episode, we'retackling an issue that's as
(00:39):
vital to our healthcare as anyprescription I could ever write,
and that is food insecurity.
We'll talk about what it means,why it matters, and what we here
at Hennepin Healthcare inMinneapolis are doing to make
sure make sure no one has tochoose between filling a
prescription and filling theirpantries.
Joining me today are twopowerhouse voices in this
conversation.
We have Dr.
Diana Cutts, Chair of Pediatricshere at Hennepin Healthcare.
(01:01):
She's a nationally recognizedleader in connecting the dots
between child health andnutrition, and she's been
championing this work longbefore it was on anybody's
radar.
Also joining us is Amy Harris.
She is the Population HealthDirector at Hennepin Healthcare,
and her work is all aboutbuilding healthier communities,
one program, One partnershipand, yes, one meal at a time.
(01:21):
Diana, Amy, welcome to thepodcast.
SPEAKER_04 (01:24):
Thanks, David.
Glad to be here.
SPEAKER_01 (01:25):
So maybe you could start us out, Dr.
Kutz.
What do we mean by foodinsecurity?
SPEAKER_04 (01:29):
Well, it's a little bit of a bulky term.
We used to say hunger, and wewould talk about hunger in
America or childhood hunger.
But with time, we realize thathunger is really an individual
sensation, and it's hard tomeasure that.
So instead, we have moved tothis term, food insecurity,
which is something we canmeasure.
(01:51):
And we measure it every year innational surveys using an
18-item survey.
The USDA does it.
And what it is looking for islimited or uncertain access to
adequate food for health.
And it measures it on ahousehold level.
SPEAKER_01 (02:08):
That's probably a term that might be new to some
of our listeners today, but thatdoes make some sense.
But isn't it also, hunger kindof does resonate.
People know what that means.
SPEAKER_04 (02:17):
It does.
And I think that's what's madethe term a little bit more bulky
for communication.
But we continue to do educationabout it.
And I think we are able to talkabout how hunger can be a
consequence of food insecurity.
So they do go together.
SPEAKER_01 (02:33):
You're a pediatrician.
You're the chair of pediatrics.
You've been doing this for 25 ormore years.
Frankly, Diana, how long haveyou been doing this?
SPEAKER_04 (02:41):
Over 30
SPEAKER_01 (02:41):
years.
Okay, over 30 years.
We'll say.
Over 30 years.
How does food insecurity show upin the life of a pediatrician in
the families you serve?
SPEAKER_04 (02:50):
Well, I think...
Honestly, it shows up before weeven meet a child, that all too
often it happens as a prenatalexperience and that hunger for
children often begins evenbefore their birth.
How does it show up clinically?
I think we can talk about lowerbirth weight.
(03:11):
We can talk about anemia.
We can talk about more frequentillnesses because we know poor
nutrition impacts the immunesystem and we see children who
have more ear infections or morepneumonia or when they get sick,
they're sick more severely andfor a longer period of time,
take longer to recover.
(03:33):
We can also see it in probablymost concerningly in
development.
So as children are going throughrapid periods of growth,
particularly in the first threeyears of life, their brain is
growing, growing, growing,making connections and brains
need calories and good nutritionto grow well.
(03:54):
So that's the most powerful kindof negative consequence of food
insecurity.
How do we see it clinically?
We see it in a child who may bemore apathetic and less
interactive.
Or we may see it in a child whoappears hyperactive or to have
ADHD.
Behavioral issues in childhoodand then sort of moving on along
(04:19):
the continuum, merging intomental health issues in older
children, I think are theclinical manifestations.
The last one is the oneeverybody thinks of first is
about growth.
And the truth is that childrenwho are experiencing food
insecurity can be overweight,can be underweight.
and most are normal weight.
(04:41):
So the idea that we can see itvisually or diagnose it based on
a weight, on a scale, is reallya fallacy.
SPEAKER_01 (04:49):
Yeah, that's interesting, the weight thing,
because I bet a lot of peopleare thinking, well, you see an
underweight kid, that's whatthey think of when they think of
someone who's not getting enoughto eat.
So that's fascinating to me.
The majority don't look thatway.
No.
But the majority don't.
That's true.
Yeah.
So before I move to you, Amy,I'm going to ask you about the
population level meanings offood insecurity.
(05:10):
But I'm going to ask one morequestion of you, Diana.
Is this normal in pediatricclinic visits?
I mean, do pediatriciansroutinely talk about food at the
visits?
SPEAKER_04 (05:20):
So, pediatricians, we believe in preventative care,
and nutrition is a foundationalpiece of healthy growth.
So, I think our interest innutrition has been from the
beginning of time.
But in In 2016, the AmericanAssociation of Pediatrics
recognized food insecurity as ahealth problem and issued a
(05:43):
statement and advised there bescreening for food insecurity at
every clinical visit.
And that's been altered.
Maybe it's not every clinicvisit.
Maybe it's every year, every sixmonths.
But the idea, again, was toscreen recognizing that we
couldn't visually diagnose thiscondition.
(06:05):
Makes sense.
SPEAKER_01 (06:05):
It really does.
So I'm going to turn to you, AmyHarris.
You're the Population HealthDirector at Hennepin Healthcare.
First of all, tell us just alittle bit what that role means.
And then if you could transitioninto what are the population or
community level impacts of foodinsecurity?
SPEAKER_03 (06:20):
Sure.
So when we think aboutpopulation health, we're really
talking about broader groups ofpatients and how do we think
about the needs of thosepatients to get to better health
outcomes.
Healthcare is built on anindividual basis, a provider
working with a patient, andwe're not trying to get in the
way of that.
But when we think about broadergroups of patients or groups of
community members, how do weunderstand the health indicators
(06:41):
of broader groups?
So it is a relatively newer rolein healthcare systems.
And when we think aboutpopulation health at Hennepin
Healthcare, we're not justthinking about clinical
problems, but we're reallythinking about health needs as
whole people.
And so food insecurity is one ofthe factors that contributes
directly to health and wellness,like Dr.
(07:02):
Cutts has explained.
And so when we are doing ourwork here to take care of
people, we want to think ofprocesses that help us
understand the needs of peopleas whole people.
So not just what are yourclinical needs, but what are the
other factors in your life thatcontribute to health?
And food and access to food issuch an essential part of that
equation.
We've built programs here to beable to better understand and
(07:25):
recognize where there is foodinsecurity, but we've also built
programs here to to help be ableto address the food insecurity.
So what's our resource responsewhen we know someone is food
insecure?
SPEAKER_01 (07:35):
How do you measure food insecurity at a population
level?
I mean, we kind of know it's gotto be out there.
Dr.
Cutts sees it in her clinic.
How do we know where the needsare greatest?
SPEAKER_03 (07:45):
Well, we've built an actual screening question into
the way we do our work here.
It's built into the standardwork across our clinics.
It's being used now in thehospital in a standard way.
Like Dr.
Cutts noted, There's been somedevelopment, really good
development across the countryto come up with more standard
ways to ask about foodinsecurity.
(08:06):
So we actually use atwo-question indicator here that
helps us understand the presenceof food insecurity.
And really it's asking whetheryou have in essence, run out of
food in the last 12 months, oryou've been worried your food
would run out and you wouldn'thave the money to cover that
need.
And so that two questionindicator is used as a way to
measure food insecurity.
And what we see that samequestion or the structure of
(08:29):
that question is actually used alot of other places.
One of the better data sourcesfrom a community level is that
Hennepin County does a survey, apublic health surveillance
survey called the SHAPE survey.
And in the 2022 SHAPE survey,they surveyed residents of
Hennepin County and asked awhole variety of questions of
which a couple were related tofood insecurity.
(08:49):
And so within that survey, youcan see the rate across the
whole county is about 10% ofpeople are food insecure across
the whole county.
But there are certain groups ofindividuals and certain pockets
of communities or neighborhoodsthat have much higher rates of
food insecurity.
SPEAKER_01 (09:05):
So for listeners, Hennepin County is where we all
work, where Amy Day and I allwork at the big safety net
hospital in downtownMinneapolis.
It is the county which containsthe city of many Is this done
nationwide?
Are counties and statesmeasuring this all over, or is
this something that we're doingspecifically?
SPEAKER_03 (09:23):
I think there's examples across the country
where food insecurity is beingmeasured.
I think the survey withinHennepin County is a standard
practice from the public healthteam.
And what you see inside thatdata is although the rate across
the whole county is 10%, we seesome of the neighborhoods where
many of the patients that weserve here at Hennepin County,
(09:43):
those neighborhoods can haverates somewhere in that 20 to 30
percent.
And what we also see inside thedata is that it
disproportionately infectscommunities of color.
And so the food insecurity ratesin our American Indian and Black
African American communities aregreater than 30%, whereas other
communities have much, muchlower rates.
And so it's an issue that reallydisproportionately affects
(10:06):
certain individuals, and itreally disproportionately
affects the patients we servehere at Hennepin Healthcare.
SPEAKER_01 (10:11):
And then it ought to drive our policy and
decision-making, I wouldimagine.
I don't know if it does to thedegree it should, but it ought
to.
So I'm going to delve into thata little bit more.
Do we know then how health careutilization is affected or how
health outcomes are affectedbased on the levels of food
insecurity in your particularcommunity?
SPEAKER_03 (10:33):
So we can see in our data that we know for
individuals who are foodinsecure, and we've screened
them in our clinics andidentified that they're food
insecure, those individuals havehigher disease rates.
burden, so they have morechronic conditions, we can see
that they use more healthcareresources.
And I know there's a lot ofliterature across the country
(10:54):
that could sort of validatethat, but we see it here too
within our own patientpopulation.
SPEAKER_01 (11:00):
Diana, you and your team of pediatricians, how do
you approach a parent or acaregiver in that clinic when
you have identified somebody aspotentially experiencing food
insecurity?
What do you tell that parentwho's struggling to feed their
child?
SPEAKER_04 (11:17):
Well, I hope what we do is first listen to what
they're telling us and in aneutral way because really
disclosing this for a householdis...
It's a shameful experience, andparents really suffer.
We hear things from parentslike, I let them eat, and then I
(11:39):
eat whatever's left over.
Or, you know, it's fine with me.
As long as they're eating,they're happy.
I'm okay.
I just drink coffee.
Or I use a measuring cup and weeach get a cup.
I mean, life is hard when you'rehungry because when you're
hungry, you can't even think todo nothing else.
Those are direct quotes thatwe've heard from parents in
(12:01):
clinic as they describe theenvironment that food insecurity
creates.
And, you know, as focused as Iam on children as a
pediatrician, we really have tothink to generation and we have
to remember that parents aredoing everything they can to
protect their children, as thosequotes illustrate, and that they
(12:24):
are suffering, therefore, theconsequences of food insecurity,
the chronic disease, the lack ofa prescription filled as they
trade off that expense, and thedepression.
So we want to go at it when wedo approach it as a household
issue.
How do we help households?
And I think the first thing wewant to do is make sure that a
(12:47):
family that's eligible isparticipating in every program
for which they're eligible.
SPEAKER_01 (12:53):
Food assistance programs, things like that.
SPEAKER_04 (12:56):
Yes.
SPEAKER_01 (12:56):
So I see their parents.
You see the children, and thoseare profound quotes that you
just said, because I think thatthat must be a universal truth,
that the parents are going tomake sure their child is fed
first.
But when the sum total of whatis available isn't enough for
that family, that's got to leadto long-term consequences for
that whole family.
SPEAKER_04 (13:17):
I think it does, and the research shows it does, and
for the community.
You know, as Amy pointed out,the increased cost in healthcare
utilization is for every memberof the family.
And as you think about who'smost vulnerable in the family,
it's probably the very young.
And the healthcare utilizationdollars that go into the
(13:42):
consequences of food insecurityhave been estimated to be
billions of dollars.
SPEAKER_01 (13:46):
We're going to talk a little bit more in a few
moments about the solutions andwhat we're doing.
But it strikes me is that, Amy,you've told us about what we
know.
about the communities.
You've told us where we ought tobe focusing.
And Diana, you have told us thisis what families are telling us.
So all I can think of is I'm aclinician.
I'm sitting there one-on-onewith a patient and it's almost
(14:08):
overwhelming.
So I can't imagine what yourpediatricians, you've got some
pediatricians been practicingmedicine, went in there to help
children and is dealing withthat, dealing with a family that
doesn't have enough.
And then you've got Amy, you'retelling us, we kind of know what
the solutions are.
Either one of you, what shouldbe the next steps to addressing
it.
SPEAKER_04 (14:26):
Well, I'll speak as a clinician.
You know, when I find myself inthat situation, I'm extremely
grateful for our populationhealth program, which provides
us bags of emergency food toprovide to families so that any
family who discloses thisinformation doesn't walk out
(14:46):
empty-handed.
So there's the immediate need.
I think the next level is how dowe find resources for a family?
And that's a discussion with aprovider or a social worker or a
community health worker to say,how do we connect a family to
resources in the community?
So that may be assistanceprograms, but it also may be
(15:07):
programs of food shelves or foodserving programs in our
community.
And, you know, I think we'refortunate.
We live in a community that hasmany different offerings.
So the trick is how do weconnect the family to those
resources that'll help meettheir needs?
SPEAKER_01 (15:25):
So that's what you can do in that clinical setting.
Critically important.
What about further upstream,Amy?
What steps are you taking?
Is our healthcare system takingto move upstream a little bit?
SPEAKER_03 (15:37):
I'd say one of the things that's happening on a
broader level is that there issome good movement across the
country to make screening forfood insecurity just be part of
the way in which we do healthcare.
So it's really about trying tonormalize.
You know, we ask people allkinds of questions when they
come into the hospital or theycome into a clinic.
And we're used to answering allthose questions around health
and weight and prescriptions.
(15:58):
And so making it more normal andstandard to ask questions around
what are the other things inyour life that might be
contributing to health is areally important So there's been
good movement happening acrossthe country to sort of normalize
the asking of these questions.
SPEAKER_01 (16:13):
Because as Diana said, it's embarrassing or
there's a stigma to it and youdon't want to bring this up.
I'm failing as a parent.
So normalizing the asking of itsounds like a good step.
SPEAKER_03 (16:22):
And I think people even at the beginning were like,
why are you asking me thisquestion?
What does it have to do with whyI'm coming to the clinic?
And so trying to help peopleunderstand these things are all
interconnected and we careenough to ask and know.
That's been an important part.
I would say it's still a work inprogress, but we're making good
progress, I'd say, on that inthe healthcare industry.
I think the other is thecritical way in which you ask
(16:45):
the question.
It sounds strange, but the wayin which the question is
actually asked to someone canreally make a difference in
their willingness to be morehonest and truthful.
SPEAKER_01 (16:53):
Can you give me an example of that?
SPEAKER_03 (16:55):
Well, what we've learned is that if people are
given the chance to answer thequestion on a piece of paper,
They're more honest than if theyhave to answer the same exact
question face-to-face by someoneasking them verbally.
It's just one more step for achance to be a little more
anonymous, a little morerespectful.
And so we know that the methodfor how we ask people these
(17:16):
questions really matters.
It makes a big difference to beasked the question in the
context of a trusted healthcarerelationship.
And so when your provider, likea pediatrician that you see all
the time, asks that question,that can be safe.
But if you've just sat down withsomeone in a clinic and you've
never seen that person beforeand they're saying, do you have
enough food to get you throughthe next 12 months?
(17:37):
You might be more hesitant togive a more honest answer.
So the method of asking reallydoes make a difference.
SPEAKER_01 (17:42):
Yeah, that's helpful.
That makes sense.
Okay, Amy and Diana, thank youfor laying the bedrock of what
food insecurity is and some ofthe interventions we're doing
both on a population level andon an individual clinic level.
We're going to take a shortbreak and when we come back,
we'll talk about the impact offood insecurity on health, what
can be done When HennepinHealthcare says, we're
SPEAKER_00 (18:15):
here for life, they mean here for you, your life.
and all that it brings.
Hennepin HealthCare has ahospital, HCMC, a network of
clinics in the metro area, andan integrative health clinic in
downtown Minneapolis.
They provide all of the primaryand specialty care you'd expect
to find, as well as serviceslike acupuncture and
(18:37):
chiropractic care.
Learn more athennepinhealthcare.org.
Hennepin HealthCare is here foryou and here for life.
SPEAKER_01 (18:52):
And we're back talking with Dr.
Diana Kutz and Amy Harris aboutfood insecurity.
They both work with me here atHennepin Healthcare in beautiful
downtown Minneapolis.
So let's talk a little bit aboutsystemic solutions.
What might we be able to donext?
Who wants to take that?
SPEAKER_04 (19:08):
Well, I'll jump right in here because I think we
have a wonderful example here inMinnesota, and it's called
universal school meals.
We have known for ages thatthere are children who are in
school and they need food tolearn.
And we have addressed that bymaking people eligible through
(19:29):
their income for free schoolmeals.
But In 2023, we changed that andwe made a universal policy that
took out the stigma, it took outthe paperwork, and it really
encouraged all children to eattogether without different
colored stamps or differentcolored cards that indicated who
(19:50):
was paying for their meals.
And the uptick of what the foodand the meals that were being
consumed is noteworthy.
The most important thing I thinkthat's been noted, though, is
that children are healthy.
There's better attendance inschool.
There's less behavioral problemsin school.
There's less use of the time outroom.
(20:11):
That there's more learning thatcan happen when children are fed
and particularly using thisstrategy.
So shout out to the state ofMinnesota for that legislation.
And I think we were the fourthstate to do it.
I think there are now eightstates in the country and others
considering it.
You know, you can say, what's abetter use of funding than
(20:33):
feeding children so they canlearn every day?
I'm
SPEAKER_01 (20:35):
not sure I can think of one, one thing that is a
better use of money than that.
And yet it's a little pathetic.
that 42 states don't do this.
So I have memories just aboutfour or five years ago of news
reports that say some kids gothrough the lunch line and they
don't have any money on theiraccount so they don't get to
(20:58):
eat.
And this is a six-year-old.
SPEAKER_04 (21:00):
Yeah, there were literally stories of the
lunchroom staff taking a trayand dumping it out in front of a
child who didn't have enoughmoney in their account or
instead giving them a peanutbutter and jelly sandwich Well,
SPEAKER_01 (21:15):
all the other kids are getting the whole hot lunch.
SPEAKER_04 (21:17):
Exactly.
So imagine the stigma of thatand the kinds of feelings that
it does for a young child.
You know, when we talk about theimportance of our relationships,
what does that do to ourrelationships?
You know, that kind ofcommunication as to what that
experience was like, that waspart of the effort to pass this
(21:37):
kind of legislation.
SPEAKER_01 (21:39):
And it took till 2023 to get that done.
And I, too, am very gratefulthat the state of Minnesota has
done that.
I can't believe that that's nota universal thing nationwide.
So that is a perfect example ofwhat some of the challenges are.
SPEAKER_04 (21:53):
Well, and I think it's rooted in an idea that we
have the deserving poor and theundeserving poor.
And that's a mindset that toomany hold on to that gets in the
way of the greater good for ourcommunities and for our
families, that there's somethingabout some children where they
(22:15):
don't deserve that breakfast.
SPEAKER_01 (22:18):
I'm just going to let that sit.
I've not heard that term statedwith such clarity as that.
And I hope listeners are givingthat some thought.
The deserving poor versus theundeserving poor.
And especially as those termsrelate to a child.
SPEAKER_04 (22:32):
Yeah, and I think you overlay that with what we
know about generations of racismand what that has done for the
opportunities for people.
And you really start to, I hope,clarify what is systemic
inequity and how do weperpetuate it in ways such as
(22:54):
this.
SPEAKER_01 (22:55):
Amy, in your job, what do you see as being done at
the policy level that might behelpful?
Or maybe that isn't being done,but ought to be done.
I
SPEAKER_03 (23:04):
think that there is some movement in understanding
how in the broader healthcarepolicy and healthcare payment
spaces, we can better understandthe whole needs of people.
And how does that start to comeinto, you know, one of the
challenges we have, of course,over the years is that when we
can identify someone who needsfood resources and food
supports, it's like, how do wepay for that work?
(23:25):
If it's not sort of paid forunder a traditional healthcare
payment model, we do run intochallenges of being able to fund
the So I think there is somegood movement happening across
the country.
You can see examples in certainstates where they've done some
really innovative things withintheir Medicaid program to think
about how could you not onlyidentify food needs, but
actually be able to pay for someof those food resource
(23:46):
responses.
Because food and health are sotied together.
It's all we've talked about inthis episode.
And so the movement of beingable to not just identify it,
but actually have the mechanismto pay for some of those
resource responses within thehealthcare department.
That's really an interestingspace that's, you know, State of
Minnesota at a time waspursuing, you know, a waiver
(24:09):
within their Medicaid programthat would have allowed some of
these kinds of advances thatstalled out.
But it's an example of some ofthe movement from a policy
perspective that, again, allowus to not just identify the
need, but think of it in a moreholistic fashion when you can
start to encompass it into theMedicaid program, for
SPEAKER_01 (24:28):
example.
And yet, I'll just say it,Medicaid is under some attack
right
SPEAKER_03 (24:32):
now.
Yes.
Yes, it is.
SPEAKER_01 (24:34):
And so that worries me.
SPEAKER_03 (24:35):
Yeah.
I would hope it would worry allof us.
Some of the policy decisionsthat are being made at this
time, like A great example wasthat there was and is existing
now a standard to screen forthose health needs and housing
factors and other things forevery patient across the country
that's in a hospital.
And right now...
it's actually being proposed toroll back that requirement.
(24:57):
So we would no longer have toscreen for those things in the
hospital.
And that's an example, I wouldsay, of a policy decision that
is sort of stepping us backwardsfrom this work, not
SPEAKER_01 (25:06):
moving us forward.
Seems so short-sighted.
SPEAKER_03 (25:08):
But there's plenty of other examples that are
happening right now inWashington where there's
decisions being made aboutfunding and priorities around
that funding to roll back someof the coverage, some of the
funding structures underneathMedicaid.
Within the same bill that passedout of the House, there were
cuts to the SNAP program.
SNAP is Supplemental NutritionAssistance Program.
(25:30):
It's one of those foundationalfood resource support programs.
It's a federal program.
And so the bill that was passedout of the House, and now it's
being debated in the Senate,would have cuts to SNAP as well.
And so it's a really concerningtime, I'd say, for some of these
decisions that are beingpotentially made in Washington
that will sort of And as Dr.
(25:53):
Cutts
SPEAKER_01 (25:55):
said earlier, there are longer-term consequences to
health of that individual childin front of you, but also that
individual child's family.
And that then expands up intocommunities.
And in the long run, even from apolicy level, even if you put
aside the face in front of you,isn't it just kind of
short-sighted economically?
Yeah.
to not invest earlier.
(26:17):
To not invest early.
Yeah.
SPEAKER_04 (26:18):
You know, and I think we need to think beyond
the individual.
You know, it isn't about theindividual child who is hungry
in the classroom.
It's how that affects the entireclassroom.
Every child is impacted by thatchild being hyperactive or
acting up or needing to be takenout of the classroom for poor
(26:39):
behavior.
So I think we need to look athow it impacts absolutely every
person.
Even those who feel they aresafe from this kind of hardship
are impacted by the hardship oftheir peers.
And, you know, for children,again, my focus, I admit, we're
talking about the futureworkforce of America.
(27:01):
What are we looking for?
What kind of minds do we want togrow to solve the kinds of
problems we have?
We need every mind on board hereon deck.
And we're leaving stuff on thetable by not providing providing
really good nutrition tochildren and to the parents who
need to bring their best selvesto parenting, and I think to our
community.
SPEAKER_01 (27:22):
As a wise Minnesotan once said, we all do better when
we all do better.
What tips would you give ourlisteners for how to get
involved?
SPEAKER_04 (27:30):
Well, there are lots of ways to get involved.
Every way from donating food orvolunteering with organizations
to supporting policies that youbelieve in that will be
beneficial.
And there's certainly, as Amypointed out, plenty of
opportunity right now to bedoing that.
There are a lot of very activeorganizations in Minnesota.
(27:52):
to tie into.
Any internet search will giveyou choices of the food group or
hunger solutions or secondharvest heartland, all involved
in policy work to strengthen thesafety net that holds us
together.
SPEAKER_01 (28:07):
And listeners, we can put some links to those
sites in the show notes.
Maybe you want to get involvedwith either with your time or
your energy or your money.
And at a policy level, I thinkit matters that we let our
elected officials know thatwe're concerned about it, don't
you think?
SPEAKER_03 (28:24):
Yeah, this is a critical time for people to
raise their voice.
Right now, the Senate at thefederal level is considering
some really big systemic changesto some of our safety net
programs, whether it's Medicaidor SNAP or many other things.
So it's easy to reach out to beable to just express your
concern and your hope forsupporting the sustaining the
(28:44):
programs we have today.
Lots of ways to do that, buteverybody's voice matters here
in making your concern heard.
SPEAKER_01 (28:51):
So I'm going to give each one of you an opportunity
to leave our listeners with athought.
As we close off this incredibleepisode, I do have to say it's
been an amazingly profoundepisode for me.
Each one of you, if you couldleave our listeners with one
thought about food insecurity,maybe a message of hope or a
call to action or one take-homepoint, what would that be?
SPEAKER_03 (29:11):
Well, I would ask people to think about how they
can support not just the workand the changes on a policy
level, but the local work we dohere at Hennepin Healthcare.
You know, we offer food resourceresponse programs, so when we
identify someone who is foodinsecure, we have sort of
two-pronged response.
We have the immediate responsewhere we can make these
pre-packed food bags availableto people.
(29:33):
You know, last year, we hadalmost 50,000 food bags
available.
And at the same time, we alsohave ways to make it relatively
easy for clinicians and careteams to connect people to
community partners or WIC, whichis Women, Infant, and Children
Nutrition Program.
Through our medical record,actually, we can make a referral
(29:53):
through that record.
We can get people connected toan external partner or to WIC.
The WIC referral's new, so thisis a great advancement for us
here to be able to make thateasy connection.
But last year, we sent 3,800referrals to our community
partner to help peopleunderstand if they're eligible
for SNAP and get them connectedto SNAP.
(30:13):
And those programs are anessential part of how we do work
here at Hennepin Healthcare.
And we fund that work almostexclusively through
philanthropic donations.
And so if you're interested insupporting this kind of work,
the Hennepin HealthcareFoundation website.
It's an easy way to make adonation and you can put in the
comment you want it to supportthe food program.
SPEAKER_01 (30:33):
Easy one, folks.
It's at hennepinhealthcare.organd click on the donate and just
signify food insecurity.
Dr.
Diana Kutz, what are yourthoughts?
SPEAKER_04 (30:43):
You know, I think I would just add, you know, we
have said for many years, foodinsecurity is a national problem
that can be solved.
We are the richest nation in theworld.
We have food resources that wegrow here.
We have the means to do it.
We just need the will.
And I think we need to keep thatin mind and keep pushing the
(31:04):
rock up the hill until weachieve this goal of making sure
every family, every person hasaccess to healthy nutrition.
And I would say part of that is,again, this view that this is
not an other problem.
This is an all-of-us problem.
The ripple effect affects us alleconomically and socially.
(31:27):
So this is a problem thattogether can be addressed.
We have the means to do so.
We just need the will.
SPEAKER_01 (31:35):
Diana Cutts, Chair of Pediatrics, and Amy Harris,
Director of Population Health atHennepin Healthcare, thank you
both for being on the show andfor providing us an
inspirational message today onsomething that truly does affect
us all.
Thank you for being here.
Thanks, David.
SPEAKER_04 (31:49):
Happy to be here.
SPEAKER_01 (31:50):
Listeners, this has been a great episode, in my
opinion, on a topic that affectsus all, our families, our
communities, and our wholenation.
I hope you are inspired to takeaction.
And if so, check out the linksin the show notes.
And I hope you'll join us forour next episode as well, which
will drop in two weeks' time.
But in the meantime, be healthyand be well.
SPEAKER_02 (32:11):
Thanks for listening to the Healthy Matters Podcast
with Dr.
David Hilden.
To find out more about theHealthy Matters Podcast or
browse the archive, visithealthymatters.org.
Got a question or a comment forthe show?
Email us at healthymatters athcmed.org or call 612-873-TALK.
There's also a link in the shownotes.
(32:32):
The Healthy Matters Podcast ismade possible by Hennepin
Healthcare in Minneapolis,Minnesota and engineered and
produced by John Lucas atHighball.
Executive producers are JohnLucas, and Christine Hill.
Please remember, we can onlygive general medical advice
during this program and everycase is unique.
We urge you to consult with yourphysician if you have a more
serious or pressing healthconcern.
(32:54):
Until next time, be healthy andbe well.
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