Serving the Hungry - Spring 2017 Newsletter

Impossible Choices: Food Insecurity, Diabetes and Tradeoffs

GraphicBy Morgan C. Smith, RN, PHN, CNS, CDE
Manager, Interventions for Health, Feeding America

Diabetes is a chronic disease affecting over 29 million Americans.

Another 86 million adults in the United States have prediabetes — without significant changes nearly a third of these individuals will develop type 2 diabetes in the next 5 years. The costs of diabetes are crushing. Beyond a $200+ billion price tag to the health care system and economy, diabetes places tremendous burdens on communities, families, and patients.

What do these burdens look like? A person living with diabetes faces dozens of difficult decisions each day in order to properly manage their disease. Diabetes is characterized by metabolic problems centered on the break down, use, and storage of sugar.

Everything we eat and every action we take impacts our blood sugar. A “typical” day for a diabetes patient may involve 2-3 blood sugar tests, complex meal planning and adjustments, strict adherence to treatment regimens that include multiple medications, devotion to a physical activity plan, and constant dedication to self-management planning and corrections. But no day is “typical.” Every day presents deviations from the best laid plans that challenge diabetes control. Poorly controlled diabetes can result in longterm complications (stroke, heart attack, blindness, amputation, and death) and in short-term acute crises (hypoglycemia). Diabetes management is incredibly difficult — even in the “best” of circumstances.

ChartSo what happens when circumstances aren’t optimal? Proper nutrition, blood sugar testing, and medications all come at a financial cost and require that patients have the skills and resources to best control their diabetes. By definition, food insecurity means not having reliable access to these resources. Diabetes patients living in food insecure households thus have added complexities to what was already a difficult disease to manage. Decisions come in the form of tradeoffs: do I choose to spend money today on blood testing supplies or groceries, on my medications or my rent, on a clinic co-pay or an electric bill? The consequences of these tradeoffs are dire: diabetes patients facing food insecurity have increased risk for poorer disease management and worse health outcomes.

The Hunger in America 2014 study found that two-thirds of client households reported making spending tradeoffs between food and medicine or health care. The same report found that a third of all households had at least one member living with diabetes. This intersection of diabetes and food insecurity impacts millions of Americans each year.

As a public health nurse and diabetes educator, I’ve worked for years with patients who, resiliently and creatively, deal daily with the dual challenge of diabetes and food insecurity. We learned more about these challenges during the diabetes pilot, and we are currently conducting a clinical trial to identify effective food bank-based interventions to support people with diabetes. But we have a long way to go before declaring victory.

Diabetes is just one of many chronic diseases impacted by nutrition. Hypertension, congestive heart failure, kidney disease, and a litany of other illnesses all require adequate nutrition in order to be properly cared for (or prevented in the first place). Food insecurity complicates management of these diseases as well.

Feeding America is committed to research and programming that builds evidence around effective approaches to promoting the health of food insecure households. We recognize the linkages between hunger and health are both real and consequential, and we are committed to working to alleviate food insecurity and improve health. We do this with the belief that no one should have to make these difficult and harmful tradeoffs.

In short, we are working to make the impossible, possible.

Morgan Smith is the Interventions for Health Manager on the Community Health & Nutrition Team at Feeding America. He is a Registered Public Health Nurse, Certified Diabetes Educator, and a Clinical Nurse Specialist with a focus on community health programming.

A Word from the Agency Director

FamilyThere are no traffic jams along the extra mile.
-Roger Staubach

Dear Friends,

A volunteer at Catholic Charities recalled a situation that recently happened to him while shopping at a local grocery store. “Just ahead of me in line was a mother with two children. The mother suddenly had a look of despair on her face as the clerk announced the total for their purchase. She lifted her head and frantically looked in her purse. The only money she found was enough to cover about half of what I assumed to be one week’s worth of food for her household. I moved forward and asked if I could help, but she acted as though she didn’t hear me. The woman said she didn’t know why she didn’t have enough to cover her bill. I could tell she and her children were struggling. As it turned out she needed $26 and some change to pay the bill. While she began removing some items, you could see a look of shame wash over her. I asked again if I could help, but again she did not respond. Finally, I looked at her, then the clerk and then I put enough money in the woman’s hand to cover the bill. There was an awkward pause as the woman looked in my eyes to say thank you. She paid the clerk — all the while looking like she would rather be anywhere but there. Finally, she left with her two children in tow.”

Have you ever had to make an impossible choice — like the choice between buying nutritious food for your family and paying the electric bill? For many in our communities that happens more than you think. And, often it’s children or the elderly who are most impacted.

The Clay County Youth Food Delivery Program doesn’t let impossible enter into the equation. Their mission is to feed hungry children and when the children didn’t come to the feeding site, the volunteers began to deliver food to the children. Their story is chronicled inside this newsletter. It is inspiring to see what a few people with a good idea can do when they put their hearts into action.

Earlier this year, Feeding America launched its new and improved microsite — — to educate, connect and engage professionals on the intersections of food insecurity, nutrition and health. Although designed to meet the needs and interests of nutrition, health and hunger-relief professionals seeking high-quality information and resources related to food insecurity, we encourage you to check out the wide array of content, tools and healthy recipes that it contains.

Contained in this newsletter is a blog post entitled, Impossible Choices: Food Insecurity, Diabetes and Tradeoffs taken from the site. The author discusses the tradeoffs that many food insecure individuals make and how that impacts their long-term disease management. Learning more about food insecurity and what we can do to reduce its impact in our communities is only possible if we all work together. I encourage you to visit and sign up for the Hunger and Health Digest to receive the latest news and insights.

Please let us know what your impossible choice story is and how by working together we can solve hunger. Helping each other shouldn’t be an impossible choice to make.


John C. Etling
Agency Director

Share your time and talent with us as a Foodbank volunteer! Call 812-232-1447.

Partnering to Fight Youth Food Insecurity

Person with bagsBy Lisa Beyers and Terry Barr

During the summer of 2013, the Clay County Youth Food Delivery Program began feeding the children of Clay County. Volunteers, in cooperation with the Clay County YMCA, originally prepared lunches for children at the First Baptist Church in Brazil, but no one came. The volunteers persevered. They went to the children and delivered the meals. By the end of summer 2016, 504 sack lunches were being delivered, Monday through Friday. When the 2016 Summer Program ended, volunteers started worrying about the lack of food for these children during weekends and breaks in the school year.

Based on these concerns and the belief of a few volunteers that the community would support it, the School Backpack program was born. The community did not disappoint! Churches, families, organizations, and individuals heard about the children and sent food and monetary donations to feed them.

The volunteers became experienced in cost comparing, watching sales, and soliciting donations. However, it was difficult to serve the number of children that needed food with the donations received. The funds were adequate for the present, but there was concern about being able to sustain the program through the end of the school year.

Packing Crew Then we contacted Terre Haute Catholic Charities Foodbank and learned food could be ordered at no cost and other food obtained at a reduced cost that is much lower than purchasing retail.

This worked out wonderfully, but planning became an issue, as the food items available were not known until the weekly appointment at the Foodbank. This did allow a few additional foods to be provided to the children, but the bulk of the food needed had to be ordered through retail sources the week prior.

Fortunately for the Clay County Youth Food Delivery Program, Megan Logsdon, with the Foodbank, worked with us and helped us access product in their system.

In fact when she heard the stories about our children, it seemed she took up their cause as though it was her own! She and other staff at the Foodbank worked to get the type of food needed as well as the quantity required. Perhaps the savings of a few cents per item doesn’t seem like much, but when you are purchasing 13,056 of that item, the savings are substantial. Cereal, peanut butter, fruit juice, pop-top cans of pasta, fruit snacks…the list goes on.

The partnership developed with Terre Haute Catholic Charities Foodbank has allowed the Food Program to provide so much more to the children. The Foodbank is a hero in helping feed the kids of Clay County. With summer quickly approaching, the benefits of the Food Program’s relationship with Terre Haute Catholic Charities Foodbank will multiply!

Find out more about the Clay County Youth Food Delivery Program at:

Need Help Finding Food?

If you need help finding food or know someone who does, call the National Hunger Hotline at 1-866-3-HUNGRY (1-866-348-6479). The Hunger Hotline is available Monday – Friday from 9am – 6pm. All calls are free and confidential. Help someone you know receive the nutrition they need to remain healthy and productive.

Local site Links:

Donate Now