Addressing hunger disparities saves lives and money

In April, attorneys general from 23 states and the City of New York banded together to demand that the USDA suspend rulemaking that would have cut food assistance for 3.1 million people. These essential programs — including SNAP (Supplemental Nutrition Assistance Program) — prevent families from going hungry when over 36 million Americans have lost their jobs in the last two months

Despite the need for these programs, there are those who argue that we can’t afford to address hunger and other social issues today in the midst of a pandemic. They say that now — when federal resources are limited — is not the time.

That’s wrong; now is exactly the time to address issues that impact public health, and we cannot rely solely on government or charitable sectors alone. The time is right for cross-sector collaborations that tackle social issues disproportionately affecting the nation’s most vulnerable. The health and lives of all of us depend upon it. 

In a pandemic, disease finds footholds among the least healthy. Those suffering from diabetes, cancers, and renal and cardiovascular diseases including hypertension, are particularly at risk of serious illness or death from COVID-19. 

People facing food insecurity or who live in food deserts and lack fresh fruits and vegetables are particularly vulnerable to these chronic conditions. Many also lack nutritional education, cooking skills, and tools such as pots, pans, utensils, refrigeration, and cooktops needed to prepare healthy meals at home. COVID-19 has hit low-income workers hard; 40 percent of households making $40,000 or less annually saw at least one member lose a job in the last two months, increasing their food insecurity. 

We’re also seeing that the poorest and most vulnerable in our society are a large part of our essential workforce. Taking on low-paying, unglamorous jobs, essential workers — many of the people of color — are staffing grocery and convenience stores, and working in maintenance, cleaning, food industries, and health care. Sheltering in place turns out to be a luxury for the poorest, who still take public transit to work and face bigger risks than those who are more well off, doing jobs that enable many of us to maintain the safety of our work-from-home existence 

While we look to Washington to strengthen the Federal safety net, demand at local food banks is at an unprecedented high; lines stretched over a mile at a Dallas food bank on May 14th. This further underscores our need to invest in resources and programs that address food access barriers that America’s low-income residents face. 

What’s being done in Massachusetts can serve as a national example. The commonwealth’s new Flexible Services program provides us with ideal opportunities to partner with, and invest in, experienced social services organizations (SSO) to expand capacity to address food insecurity and housing instability as social determinants of health during this critical time. 

MassHealth has dedicated funding that can be leveraged to create SSO partnerships that offer an immediate response to COVID-19 for some of our organization’s most vulnerable patients. In April, we launched nutrition programs statewide, supporting healthy food access through food vouchers and medically tailored meals. This month, we launch a Flexible Services program to help stabilize housing situations. These programs are based on research that suggests addressing these root causes of poor health improves patients’ self-efficacy and their ability to manage chronic diseases; sometimes, they appear as a gift to those who receive them.

Receiving a $100 food voucher has brought some of the people we serve to tears. They know what access to the food, nutritional information, and pots, pans, and utensils needed to cook meals means to their families’ health. We can use this opportunity to help those we serve to eat well and live with stability, even after funding stops and the crisis is over.

Taking on chronic diseases by addressing root causes will also make a dent in skyrocketing costs that we all pay for. In 2015, four million in Massachusetts suffered from at least one chronic disease and 1.6 million had two or more, including diabetes, hypertension, heart disease, mental health disorders, and substance use disorders. The projected total cost of chronic diseases in Massachusetts from 2016 to 2030 is $870 billion, with an annual average of $41.4 billion in medical costs and $16.6 billion in lost productivity — according to the Partnership to Fight Chronic Disease. 

Nationally, the numbers are even more staggering. In 2016 alone, U.S. costs for direct treatment of chronic health conditions totaled $1.1 trillion. The CDC notes that annually, treating chronic disease accounts for about 75 percent of all U.S. health care spending.

There can be no more graphic illustration of our interdependence: once established in communities, infectious diseases can form clusters and flashpoints occur, spreading contagion faster and amplifying a virus’s impact and reach. In public health, our safety net is only as strong as its weakest part. This means that we must support those who are most vulnerable through innovative partnerships that provide the services they need in order to stay healthy. We are truly in this together and helping those who are impacted negatively by health-related social factors benefits and secures the health and safety of all of us. 

Christina Severin is president and CEO of Community Care Cooperative (C3), the Accountable Care Organization (ACO) that advances community-based care for MassHealth members through its network of 19 health centers throughout Massachusetts.