The CEO at his desk. “Christmas bonus??? Put another brick of Ramen noodles on the fire and be glad the Food Bank offers you gainful employment, Bob Cratchit.”
Twas the night before Christmas when all through the food bank
Not a creature was stirring not even a mouse…
(Especially not a mouse, or those AIB inspectors will be down on us like a ton of moldy potatoes)
If you search the web for the words ‘hunger’ and ‘hope’ together, you will get a hundred and fifty four million hits. The idea has gained currency over the years that not only does the food we provide fill bellies, but that we are also offering something else, something that will not break our programmatic budget to provide: the ‘hope’ of a better day tomorrow.
Let me be direct and say that I don’t see much hope at the average unadorned food distribution: “I hope the line moves quicker,” and “I hope they don’t make me feel too embarrassed.” This feeling of disempowerment has nothing to do with the sincerity or charitable spirit of those volunteers or staff running the distribution. Some are run in a very compassionate and sensitive way, yet however we sugar the pill, people are still held back by the unequal relationship between ‘giver’ and ‘taker.’
Please, hold your snowballs to my face until the end, because in this special holiday cheermeister edition of ‘From Hunger to Health’ I want to briefly question the benefits of trading so freely in ‘hope’, as we turn to looking at shortening the line for our services, and avoiding the institutionalization of ’emergency food’ as a handy alternative to paying people enough money to live on.
First, hold my hand and fly through the chilly winter air, avoiding the Amazon drones, and let us alight in a town and peer through the brightly-lit windows of two food distributions. One is a standard ‘Come, Wait, Wait Some More, Take your Bag and Go’ distribution and the other is a distribution that offers wrap-around or holistic services. The sights we see are very different, as we will see as we tamp the snow off our boots and go inside.
Yet, what is this? Before we can enter, the ‘Ghost of Foundation Cash Yet to Come’ taps its boney finger on our shoulder and commands us to “E-VAL-U-ATE” in a deep and terrifying voice. “Okay”, we say back to him, “You want us to evaluate our programs and those of our partners? Here is a metric that is way more sophisticated than any that could be developed by the boys and girls at the ‘Stanford Social Innovation Review.’ It is called eye contact.” This simple (and quite literally) straight-faced test measures the amount of eye contact the programmatic interaction elicits from clients.
We actually did this test last week on two programs a few miles apart in our service area. At the standard distribution, virtually no one met your eye when they could avoid it and wanted to get away as quickly as possible. At the other, one of our Healthy School Pantry programs where we are running what is for all intents and purposes a ‘health fair’ with a lot of activities and opportunities designed to build community, we saw a much different picture. People were generous in their eye contact saying how much they were enjoying being there and appreciating learning and being a part of something where they felt empowered and valued as equals.
But you’re giving them hope too, I hear you say. What’s the difference?
Let me begin to answer that question by looking at the national perspective. We can offer people the solid reassurance that we will fight to protect their meagre food stamps and commodity benefits from more punitive cuts. Yet, we certainly can’t offer the real hope that people are crying out for: a society where working hard at a job will enable you be able to feed and provide a roof over the heads of your loved ones.
We know from our work that more and more people cannot earn enough money to support their families without help from the food bank network and its partners. People run faster and faster on the hamster wheel of low-pay, no-benefit jobs. If we continue to apply the current strategies, it is hard for me to see the ‘hope’ for anything beyond endless SNAP wars, more companies expecting food banks to cover the tab for their food insecurity-level wages and the growth of the ‘hunger industrial complex’ to keep the whole mess from boiling over into civic unrest. Sorry to be such a downer in this season of ‘Goodwill to All men’, but I have enormous respect for the hardworking families we work with, certainly enough to want to level with them.
I think when they said “Goodwill to all Men,” they didn’t mean it quite so literally, that we’d all end up shopping at Goodwill because we that was all we could afford.
I don’t believe I am being fatalistic or even negative. I’m not noble enough for lost causes and so I am sincerely convinced that we will end hunger in America and become a more equitable and healthier country. It’s just that I’m not getting any younger and I’m impatient about waiting millennia for it to happen.
So why should our daily ‘hope distributions’ be slowing this process down?
Humor me for a moment as we consider the words of my guru, Buddhist monk, poet, teacher and all-round cool dude in black pajamas, Thich Nhat Hanh. Hanh said:
“The future is made of a series of present moments. Therefore the best way to take care of the future is to take care of the present moment. That is why hope is sometimes an obstacle. People tend to hope because they feel helpless in the present moment. The present moment is so heavy, so unbearable to endure, which is why they invest in the future with hope. ‘I hope tomorrow will be better.’ They get a little bit of relief because of this investment. However, to do this we have to spend a lot of energy hoping for the future and there isn’t much energy left for us to take care of the present. Without enough energy, we cannot have a breakthrough. If we can bring more energy back to the present, we find this breakthrough.”
[Transcribed from the recording of retreat as ‘The Art of Mindful Living’ (2000), Sounds True Audio with occasional paraphrasing to make it less Vietnamesely monkish on the printed page.]
Thich Nhat Hanh rocks the wooly hat. “You think this is a Gap ad? Let’s talk about the gap between happiness and forgetfulness???
This is, for me, the danger of focusing too much on ‘hope’ rather than action to transform our society in the present moment. I am not talking about it in a literal, mean-spirited fashion that we should promote hopelessness. We want to give joy and love in everything we do. However I am advocating every day we focus on real change and the actions required to make that happen. Our organizations, because we are concerned with the most basic tool (food) that can sustain and help and bring people together, can play a huge role in leveraging this change.
Have a wonderful Holiday season, and heartfelt thanks from Scrooge to everyone working to build food security in the USA.
Here’s to 2014!
Season’s Greetings and remember, our Food Bank is now accepting cuts of pork and frogs legs as part of our grocery rescue. Even you Tiny Tim…
Food banks and other nonprofit organizations typically start off as wholly volunteer groups coming together around a (chipped and borrowed) table to plot a community response to a social problem or a social opportunity (such as, how to repurpose excess food).
Lousy table, great ideas
Assuming the nonprofit does not pass away in its scrawny infancy, it goes through a steady year by year cycle of increasing professionalism. It needs to build a machine for the long-term. That machine is comprised of an increasing number of paid staff.
This cycle may continue until volunteers become something of an appendage. A phantom limb that takes on the shape of the purpose it used to have, but is no longer vital to the continued health of the organization. Instead volunteers become a way of connecting the community to the organization it supports. An interim stage to a cash donation. Busy work volunteer tasks are sometimes created to keep them occupied. (Anyone who is reading this post, put your hand on your heart and promise that you never laboriously created a volunteer opportunity for a corporate sponsor). A group of corporate volunteers may don a t-shirt descend like locusts and to ‘make a difference’ in two hours and then depart.
We’re grateful for their interest and support, but it is not fair to them if it is in support of an antiquated use of volunteers, tied into an old model of operating. It’s not like there is a shortage of work to be done, and in fact there is an urgent need for new strategies in volunteer management.
Why, Erik? Why does there have to be a new damn strategy every five minutes for every little thing? Why can’t we just – for once – keep things the way they are?
Well dear reader, in this case it is because we will all fail in our long-term goals without it. We can continue being the teenie ‘Dora the Explorer’ band aid covering the suppurating wound, but we will never reach the ‘scale’ required to solve the problems we want if we rely on the old paradigm of strict separation between professional staff and traditional volunteers.
“Thanks for the plug, mijo.” Who’d have thought half the world’s band aid use would be by kids who want an external demonstration of some social or psychological owee!
We need a new approach that is scalable and sustainable. And the only way to do that is to let the community into our organizations in a whole new way – a way where they have real power and influence, and also parity in many ways with paid staff.
‘Scary!’ as my two-year old would say.
Two years old and already shilling for the Foodbank. Has the father no shame?
I am talking about the use of what I call ‘community leaders’ and which you may already call ‘skills-based’ volunteers. These are people who want to do more than de-stress over a huge bin of gently rotting carrot nubs. In this post I want to talk about how our embrace of this approach is bringing our food bank back to the community we serve, building long-term sustainability and forcing us all to improve our game and our leadership skills.
I know, folks, being nice to people from the community, rather than grouching at your paid employees is hard work. That’s why to understand why we needed to do this, you first need to understand why there was literally no other way we could actually plan a way to achieve our mission.
I would have taken the low road, really I would!
So why did we start this? Because it was the only way we could have the numbers to move from the endless ‘war on hunger’ approach to food banking and social service provision to a specific destination that we could state as a vision and then back up with metrics detailing achievable steps along the way.
We moved from a traditionally cautious mission statement about storing and distributing food safely to a kind of combo version of vision and Mission Statement as below:
The above is putting a lot of the onus on the community to solve the community’s problems. You might even view it as having some kind of nerve to ask folks for money and then to throw the thing back at them and say: ‘You do it, we’ll help.” I suppose it is somewhat cheeky, but the reality is that there is no other way we’re going to get beyond Dora and her sticky non-solution. It can also be viewed as a positive thing, that we are inviting the community in – especially if your focus is health and nutrition. It is an invitation to a celebration of what we can achieve together.
Running isolated programs is not going to get us to our destination, because they come or go, depending on funding / leader preference etc. That means we need to move from programs to ‘pathways’
To give you an example of this type of approach, we can look at our ‘Feed the Future series of children’s programs.
The below demonstration of the sequential nature of our children’s programs shows how they are taken along a progressing pathway of programs with the clear destination of nutritionally independent young adults.
If we’re going to talk about sustainability, we need to talk a little about the flow of energy – human energy. So, I ask, which of these progressions is more sustainable?
Okay, so the questions start easy. Obviously that ecologically right-on looking circle of arrows is more sustainable. So let’s look at these two energy flows applied to the world we operate within:
Most of us live in the space between these two places, sometimes going back to charity and sometimes reaching ahead to a true state of community engagement.
Here is what the one way arrow has always looked like:
And this is what a more circular form of community engagement looks like. The example is a flow diagram showing how our Healthy School Pantries operate, with people entering at the top right of the diagram, trying a recipe, then learning how to cook it, then receiving the actual food they need to make the meal they are tasting.
So lets look at what are the differences between a volunteer and a community leader:
Of course there is still a place for regular volunteers. We are talking about ‘super volunteers’ overseeing other volunteers or knowledge philanthropists that might run a short-term task force or provide special knowledge.
This all sounds great! Except, remember we are going for that nice circular, sustainable energy flow thing. How, therefore, can we draw Community Leaders from our client base? To this we also need to factor in the unspoken tension between volunteers coming into a community to ‘fix’ their problems (before leaving) and the community itself.
Our solution to this is our Nutrition Advocates.
This is a grassroots organizing framework that allows the Foodbank to act as a catalyst to encourage micro-communities to take ownership of their own nutritional health and that of their friends and neighbors. The NAs are Foodbank program clients who have become engaged beyond the traditional modality of client-based food bank volunteerism.
If you are interested in more detailed information about the Nutrition Advocates, you can download this application we submitted to Feeding America for some innovation award.Foodbank of Santa Barbara County – Nutrition Advocates
I have identified two distinct strand of involving volunteers. The first are Community Leaders that have been recruited in the traditional manner with some of the typical expectations of volunteer service:
And then you have Community Leaders drawn from our engagement with clients with a slightly different entry point, but ultimately a similar satisfaction and result. Empowerment and connection for all involved:
Bringing together these two different types of volunteers certainly makes for a more interesting volunteer recognition event. Awkward at first, when you shove together two sets of people used to playing the roles of ‘beneficiary’ and ‘benefactor’, but I am confident that after a few years, this will become the norm with the lines between those helping and being helped becoming ever more fuzzy and permeable.
Of course the outside world is the easy stuff. You just have to move heaven and earth. The real heavy lifting is within your own organization.
We had training from an outside consultant (Vantage Point consulting – based in Canada, experts in this field) to a pretty wide group of managers and developed materials, like simple sample contracts stating what is expected of both parties, yet the reality was that ‘culture eats strategy for breakfast’ and if we did not find a way to steadily (yet urgently) evolve our culture, then all these types of approach were doomed to eventual demise, while everyone subtly folded their hands and waited for the ED to get interested in something else, something less threatening!
I put it to my staff that we want to work with motivated staff who care about our organization and the people in it, and who are open to working in new ways to ensure that the organization continues to develop and move forward. If they are open to us improving how we do things, and open to working with a wide variety of people, then there is a long and successful career for them at the Foodbank. (Staying positive!)
I explained that the number one attribute we are looking for in ALL staff is leadership potential. We want to help them develop that potential. Of course they wondered how can everyone be leaders, right? Who’s going to do all the darn work!! Well, the way it can work is for everyone is for all to be responsible for leading and working with others from the community who connect with the organization. Leadership doesn’t mean making speeches or bossing around people. It means being committed to moving forward the organization and to developing their own skills and those of their team members; it means realizing that all of them are leaders in our community, representing and drawing people to the Foodbank; it means that all of them have to be able to work with, lead and inspire a whole range of volunteers and community leaders to come into the organization (after all, it is their organization as much as ours ) to enable us to achieve much more than we could have done by ourselves.
I sincerely believe this approach actually means a much stronger career path for everyone on our staff, because all of us are able to multiply the results of what we do. I think that is exciting and a great opportunity for everyone to be a leader, whether you are a warehouse assistant working with teams of community leaders or a senior manager with a bunch of knowledge philanthropists running task forces for you.
Our experience over the last 18 months or suggests that these are the challenges:
I believe that sticking to this whole approach is becoming less and less crazy and looking more prescient as time goes on. It is concurrently both a programmatic and a development activity that is working with the community to build community.
There are times when I feel like I am an insignificant toiler in a great and serious national bureaucracy – the business of hunger in America.
Imagine our prospectus to potential investors:
Ladies and Gentlemen, business has been outstanding since the Great Boom of 2009, with emergency food organizations bringing in record amounts of money and building ever more impressive infrastructures ready to take the art and science of hunger relief into the 22nd Century. We have diversified into new business areas, and got our brand message and talking points over to lawmakers and the public through advocacy.
So, my fellow Americans, you might be for hunger or against it, but you can’t deny that as a vibrant concern, we are here to stay. Thank you and please give generously.
Okay, so I am getting a little carried away, but maybe that’s because this is the last moment to think for a second before we enter into that slalom run down to ‘The Holidays.’
This is the gravy season for emergency hunger organizations when genuine loving concern for one’s fellow man, paired with a side order of good old-fashioned guilt allows us to make a sizeable chunk of our operating nut for the coming year.
Shakin’ the Tree
Before we board this seasonal gravy (and turkey) train once more, I thought it would be good for us to ask ourselves a hard question. We say we want to shorten the line and end hunger in America. That is a laudable goal, but how exactly are we going to do it? What is our ‘Theory of Change’ (the detailed measurable steps contained in a logic model) that are going to take us from here to there.
It’s at this stage in the conversation that Mr. Spock might begin to find our logic a little “…illogical, Captain.” We might say that the problem can be ‘solved’ by protecting and strengthening the federal safety net; finding more money for advocacy to engage the public in ‘the fight’; generating way more TEFAP; providing generous funding for a strong food bank network. Oh, yes, and Farm Bill, Farm Bill, Farm Bill.
All great things, but nowhere near a theory of change. In reality they are far closer to a ‘Theory of Stasis.’
Theory of Change? Well, I’m halfway there.
Logic models and theories of change are something we find easier to deal with on a small-scale programmatic level where we have more control over the environment we are operating in. (Here is a resource from the Kellogg Foundation on applying Theory of Change to your mission).
Years ago, a local foundation provided me with a handy flow chart on which I had to chart how my program would lead to positive changes in client behavior. (Over time, I came to refer to this flow chart as the ‘Human Sausage Machine’ – clients and food were stuffed in at one end and changed humans miraculously popped out of the other end). We were veritable Willy Wonkas of nutrition with our INCREDIBLE BEHAVIOR-CHANGING MACnCHEESE!!
John Arnold surveys his children.
I must confess that the community kitchen I ran at that time had to make a few ‘creative leaps’ when demonstrating how we would actually change behavior. I would resort to my earnest protestations that children can’t learn if they haven’t had breakfast, or that people can’t look for jobs if they are hungry. All absolutely true, but the other truth was that we were not in the behavior change business. We were in the emergency hash slinging business, a subdivision of the ‘maintenance of things as they are’ business and that we should be funded because there was plenty of demand for those services.
Change my behavior? Alright, pass the salt, PLEASE!!
Fast forward to the present day and I have to wonder whether we don’t have that same problem on a national level? We are stuck in the maintenance business rather than the transformational business. And how much fun is that?
Those of us working in the area of food insecurity have real problems articulating a persuasive theory of significant, sustainable change. We can talk convincingly of all the things that need to be done, but not how all this busyness will come together to actually change the situation. We have great theories for increasing the size of the band aid we are applying to the patient, but no clear idea about how to cure the patient. This is not a criticism of Feeding America or any other group. I think all national hunger-related organizations have the same challenge.
We will now explain our Theory of Change for ending food insecurity in America. First slide, please!
Can you end food insecurity in America by doing more of what we are doing? After 11 years in the hunger sphere, I can put my hand on my heart and give a hearty “No!”
From my perspective, I think one problem is that we have been stuck looking at too narrow an area – that of food insecurity. This has been a small enough area for us to operate proficiently and to demonstrate unique excellence in our nonprofit services, but it is not large enough to actually solve the problem that we are trying to deal with. When challenged about this, we tend to retract like a poked sea slug, saying that anything else is ‘too complex and we just have to stick to doing what we know.’
To my mind, this is a big mistake. We need to expand and take the helicopter up higher, not lower.
Touch me one more time, kid. One more time!
We are stuck dealing with complex health and social problems in an overly simplistic fashion. It has created a culture of food banking as a continuous shift in an ER ward, where we’re all too busy with the suffering and drama of the moment to give enough thought to how we can do anything more than get through. No time to think! Lives are in the balance!
Another 50cc’s of creamed rice, nurse. We’re losing him!
Until recently we were talking pounds of food per person in poverty as the solution to ending hunger, now the metric has shifted to numbers of meals provided (even if those meals are a theoretical construct, made up of pounds of soda, candy or whatever the total ‘food’ poundage of a food bank might be). These metrics are too crude to really help us move up from our current level of support and national focus.
Closing the meal gap
We got into using the term ‘Food security’ because hunger was too reductive an explanation for what we were dealing with (useful for fundraising, but not able to explain the broad need for food assistance). Yet food security has become it’s own little prison, constricting our room for bold maneuver.
Which brings me back to asking what is our ‘Theory of Change’, both with individuals, communities and with the nation as a whole? In our little gnat bite of a California county are piecing together our own local ‘theory of change’ which I will share in another post, but to come up with a workable ‘theory’ on a national level we need a whole new set of relationships and collaborations between hunger, health, nutrition, anti-poverty, job creation and community development organizations nationwide.
This partnership would form a continuum of help to keep people healthy and connected to building and maintaining vibrant communities. Food insecurity is really only one part of a longer engagement and relationship with people
It is clear that none of this can be achieved by a single organization or by a purely top-down approach. It is also clear – to me at least – that these things cannot be achieved purely within a sphere of operations labeled ‘hunger relief.’ No matter how many millions we collect it will still always be a ‘sop for the needy’ – not enough to actually deal with the issue.
However, if we were to pivot to focusing on the issue as one of public health where we were going to commit to marshaling our efforts and those of our 64,000 member agencies to raise the baseline health of Americans in the simplest and most cost effective way possible – by raising the standard of their nutrition, it would be a historic game changer.
It would have the power to bring in the Department of Health and Human Services as an additional funding partner. (I know we came to the dance with the USDA, but my feet are getting tired and so are theirs, I imagine, as they’ve been asked to do impossible limbo dances beyond their original dance card).
To make such a pivot at the national Federal agency level requires us to get our collaborative shit together with a broad coalition of national charities, prepared to use nutritional literacy and health as a pump-primer for other next stage activities, such as community development and job creation.
We know what we do is providing the most basic need possible, but we are leaving the potential for huge positive change in people’s lives on the table walking away from leveraging that basic food need, and the access it affords into people’s lives, to help them get ahead.
We need to reframe the issue from the negative one of charity for ‘the needy’ to a positive engagement with people to ensure long-lasting nutritional health is seen as a vital and attainable public health goal.
Lack of adequate healthy food and the skills to use it need to be presented as issues of unacceptable public health and should be addressed, treated and funded in that fashion. The food bank and emergency food network remains the sleeping giant of the public health world. We can be the engine of the largest improvement in health since indoor plumbing.
To do this we need to have the ability to demonstrate the efficacy of our nutritional and educational interventions using acceptable public health criteria. Evaluation is the key to opening the door to a new approach and new funding from the Feds, from health insurers and from donors who want to see a major long-term return on their social investment.
For me, this represents the broad strokes true ‘theory of change’ that will enable us to move people from hunger to health.
Sign up now at thehungergap.org
I look forward to seeing you at the upcoming ‘Closing the Hunger Gap’ conference in Tucson on Sept 15. If you weren’t planning on coming, maybe you should. This is not a national learning conference put on by a national body, but a grass roots effort staged by a single food bank, determined to do what it can to provide a forum for a range of types of organizations to come together how to move forward this vital work on both a local and national level.
Stanford Social Innovation Review is one of the best journals of its kind, talking about the evolving lines between non-profit organizations, business and government. Of course the kind of journal we are referring to deal with issues that are a lot easier to talk and theorize about then to actually achieve in a focused, sustainable way. And here at ‘From Hunger Into Health’ we’re dreamers and idealists, but also hard-nosed types who have to live by our wits, and where the first question out of our lips is: “Sounds great, but is it free?”
That’s why it’s always been great that SSIR holds a yearly conference at Stanford Alumni Center that focuses much more in the art of the practical. Real nonprofit leaders from around the world come together for a couple of days to hear some of the latest ideas and share their tales from the trenches.
Stanford Alumni Center – Why is the Alumni center always one of the flashiest buildings on campus? Because the development department knows where the graduates are, and they will track you down…
This was my third year of attending. I always like to go as it is a nice stimulus. Of course my staff dread me attending, because it means I will return with EVEN MORE NEW IDEAS THAT I WILL EXPECT OTHERS TO EXECUTE. Not entirely true, as a lot of execution has to come from me too. I thought that this year it would be good to share some of my learnings on this blog, so saving you money and freeing up your time. I’ll do a number of posts in the coming few months. We start off with MAKING BETTER BOLDER DECISIONS, a lecture given by Stanford faculty member Chip Heath, which will be (surprise, surprise) drawn from his upcoming book.
Chip Heath
Yes, wisdom can come from the mouth of someone called Chip, and Chip Heath is (with the assistance of his brother Dan) the author of the book ‘Switch: How to Change Things when Change is Hard’ (Broadway Books) which made a pretty good fist at dealing with what is a daily subject here at Food Bank Central.
Chip started with some sobering statistics. (Actually he probably started with a joke, but i’ll spare you.)
60% of top business executives admit their bad decisions are as frequent as their good ones.
‘People’ decisions are the hardest and most important. Yet 40% of top level headhunting fails within 18 months.
The dropout rate amongst teachers is higher than that of students.
So how can we improve this challenging area? After all this is why they pay us the big bucks, to make decisions, right? The standard advice out there is to ‘trust your gut.’ But Chip points out that the human gut is not always particularly trustworthy. He put up a slide of a slice of the Cheesecake Factor Red Velvet Cheesecake, which has as many calories as three double cheeseburgers and a bag of Skittles.
So much for trusting the gut. (This brought back a tear of nostalgia from a Feeding America national summit a couple of years back, when we left the auditorium after a stirring discussion of good nutrition, only to find complimentary slices of Cheesecake Factory Peanut Butter Cheesecake waiting for us – hey, they were sponsors, what can you do?)
Ok, so the gut is in doubt. Other people say trust the experts, trust analysis. Ye 83% of mergers and acquisitions – which only occur after incredible degrees of expensive analysis – end up creating no financial value whatsoever. If you always said no to a merger or acquisition, you’d be right 5 times out of 6. Remember, ‘the experts are often wrong, but never in doubt.’ The average completely certain medical diagnosis is wrong 40% of the time. The average cost overrun on new plants is 56%
So, expertise is not getting us where we need to be, and the problem is compounded by the fact that with most decisions we don’t get enough specific feedback to know what was really a bad decision anyway.
There are experts…and then there is Mr. Miyagi. He’s the real deal.
Intuition, says Chip, is a machine for jumping to conclusions. It is a narrow perspective from which to view the world. It is also more about having an immediate reaction to an opportunity. He asked us to consider the concept of a ‘spotlight’, which is how we look at something that requires a decision. Spotlights are close up and good for highlighting info, but they tend to throw other options into the darkness. We need a process to help us move the spotlight around to be able to consider all aspects of a decision.
It was then that Chip hit us with his acronym. A couple of hundred note takers in the audience breathed a sigh of relief – at last a nice juicy acronym to add to our voluminous collections.
WRAP
Widen options
Reality test your assumptions
Add distance to the choice process
Prepare to be wrong.
The problem with decisions is that if we have two choices we are very likely to choose the clunker. If we have more options it will lead to a better rounded decision. The concept of reality-testing your assumptions is because we can’t help suffering from ‘confirmation bias,’ where we go out searching for information that confirms our initial view. The concept of ‘adding distance’ is there because we need perspective to get away from the short term anxiety that clouds a decision. Distance at time of choice is valuable. The final element is ‘prepare to be wrong.’ If we can move beyond seeing the success of our decision as the only possible result, then we can be more prepared for the different future that might show up.
Let’s look at these areas in a little more detail.
Widening Options
We tend to think choices are an ‘either/or’ thing. Chip called this the decision making process most commonly adopted by teenagers. It is expressed as a ‘whether or not,’ as apparently teens rarely consider that they have multiple options.
Professor Paul Nutt at Ohio State University made a study where he looked at key decisions that business and nonprofit organizations have made. His approach was to contact multiple decision makers and also those who were involved but outside the direct decision making process. He discovered that 71% of these crucial decisions (168 in total) were simple ‘whether or not’ choices with no third option considered. This means that organizations are operating like teenagers. So if you hear ‘should we do this or not’ then alarm bells should ring warning you that you have a narrow framing of the situation without adequate options to choose from. If you view the future as range of possibilities, then you have room to make a better decision.
He brought up the example of an organization called HopeLab. They wanted to design an activity monitor for teens to measure how physically active they were and to provide some kind of reward system. (the product is called Zamzee and check it out at www.Hopelab.org – interesting company and product).
To design this product, they considered 6 or 7 potential partners. Normally it would have been a straight horse race and they would have agonized over who to bet on. Picking partners based on how they impress you in a meeting can be dangerous. (Especially if you want to move beyond the gut situation).
So HopeLab thought: why not buy the horserace? They broke down the project to smaller stages and hired five of the companies to each do the first small part of the project to see how well they did and how HopeLab worked with the outside partner. This is not as onerous as it sounds, because you can typically eliminate a couple straight out of the gate as a result of them being bad to work with or not to have any real ideas, however impressive the binders were at their presentation.
This process is also an opportunity to really look at what you are trying to achieve. If a particular approach keeps coming up as important in multiple people’s work, then it would be good to include it in the finished product or service. In HopeLab’s case, two firms had brilliant ideas. They had the luxury of combining the best features from each and now had two proven partners to choose from. At this point they could make their choice or even run the race again with the next stage of the project.
Our kneejerk response might be that by doing this, we were making at least part of the project five times more expensive than it needed to be. The rebuttal to that would be that we are improving the actualization of the project in a way that is going to save us a lot more money further down the line when things get really expensive – far more than you spent when things were cheaper at the beginning. So instead of getting stuck on ‘either/or,’ maybe think ‘this AND that’ and you may be able to achieve more.
Reality Testing Assumptions
Reality testing is doing what it takes to get the data, and not just the data that confirms what your gut tells you. ‘Confirmation bias’ is a particular problem when there is ambiguity. We want to confirm what we believe. Data that supports us is always going to interest us more than that that which does not.
Clearly sometimes there is no data to draw on. It this case, there is a value to testing. So in the case of recruiting, people put way too much store on the interview, even though this is not the most predictive indicator to future job success. Another alternative is have people do work samples. Why predict if you can know? Most of us could, with a bit of thought, come up with some way of asking people to produce a sample or demonstration of their work no matter what job they were applying for.
The best defense is to force yourself to ask disturbing questions: Why are we not likely to finish this project on time? Why should we not start this program? Sometimes non-comfirming questions can be positive.
Another element that Chip brought in for us to consider in the decision-making framework was our own attitude. Specifically, that we should be always trying to assume positive intent on the part of other people we are dealing with. Often our first reaction is to assume negative intent. We are always listening out for criticism. If we assume positive intent, we will be amazed what happens, because we are always downplaying the positive. He produced statistics showing that when married couples keep a marriage diary, where they write down the things that make them happy, that 70% of relationships improve. This is because typically we dismiss the good stuff and focus on the negative.
Add Distance to the Process
The villain in the decision making process is short-term emotion – getting caught in the here and now and not looking at the long term implications of decisions. You don’t always have the luxury of sleeping on the decision. Chip brought up an amusing example of how we would advise our best friend if he/she was asking us whether they should call an unattached person they had admired or whether they should attempt to continue making a favorable impression in their shared work/study environment for longer so that their approach might be more likely to succeed. If the friend was agonizing, we would all say ”just call him/her’. That is probably the right recommendation. Yet when the decisions are ours, then our fears and anxieties can win out or slow things down. So, next time you face a tough decision, just ask: “What would I tell my best friend to do?” Distance helps us identify the core priorities. That is the approach you should take. Identify your core priorities and enshrine them in your decision making process.
Prepare to be wrong
I think this is a much overlooked stage of the decision-making process. Overconfidence can blind you to preparing for an environment where you decision doesn’t work out.
It’s a pre-mortem, but it won’t hurt hardly at all…
As part of the decision-making process, consider conducting a ‘premortem.’ Don’t just focus on your best picture of the future. Imagine your organization a year from now, and the new project has been a disaster. Ask those involved with and impacted by the decision what happened? If you move that spotlight to what could cause a bad result, you will be surprised how accurately people can tell you what and why things went wrong.
The ‘Pre-parade’
This not only keeps you ready for the range of possibilities that is the future, but also helps you make a better decision in the first place. The process isn’t all negative either because you should also conduct a ‘pre-parade.’ This is a consideration of what happens if you are wildly successful. Will you be prepared? Will you build expectation to deliver something where you can’t meet the huge demand or interest?
The Tripwire
RETHINKING A DECISION
The final element of the decision-making process is to consider when do you rethink a decision? The need here is for tripwires. These are agreed markers of success (budgetary/timeline/project achievement) at key early stages, so you can be confident that things are starting off and continuing in the way that they need to, in order to lead to success.
Chip told us the story of rock band Van Halen and their infamous ‘no brown M&M’s’ rider. This has always been held up as an example of unbridled rock star excess. In fact the band were shrewd business people and by burying something like this in their detailed contract to perform at a venue, it acted as a tripwire to see whether the venue had read the stipulations of the contract in detail. If there were brown M&M’s in the dressing room, then this raised the alarm for a detailed check into more life or death issues such as electrical safety.
Having a process is the answer with decision making, according to research. Systematically ask questions both of the matter to be decided and also your own attitudes to it. Your decision-making can never be perfect – but it can be better.
Dr. Hilary Seligman, MD, MAS, is an Assistant Professor of Medicine within UC San Francisco’s Center For Vulnerable Populations and a general internist at San Francisco General Hospital. She is also affiliated with the UCSF Center for Obesity Assessment, Study and Treatment. Dr. Seligman’s work focuses on food security and its effect on the development and management of chronic diseases such as obesity, hypertension, diabetes and heart failure.
There is a reasonable amount of awareness about the health burden that food insecurity places on early childhood development, but not so much with adults, and I find that a really interesting element of your research.
We have largely ignored the long-term health implications of food insecurity among adults. And so what I’ve tried to do is firstly figure out if there are health implications for adults, and – yes – there do seem to be important health implications. They’re a little harder to talk about because it’s a little more complicated than just saying iron deficiency anemia, but I think the message needs to get out there that food insecurity has nutritional implications that are important, not only for children, but for adults too.
We all get so amped up trying to save the next generation that we forget the current one – and that would be you and me, folks!
A key element, which I think has wider relevance as we help our clients with their nutrition, concerns the cycles of food adequacy and inadequacy. We might expect a compensatory strategy of skipping meals, (leading to hypoglycemia) during times of food shortage, but you demonstrated that even when these people had enough food, it led to systematic overconsumption – people wanting to feast now that it was not a time of famine – which had similarly negative effects on the control of their diabetes, leading to hyperglycemia.
Yes, and food insecure adults required about five more physician encounters per year than those that are food secure.
In so far as the Food Bank Network touches an extraordinary number of people, and particularly people who are very high risk for the varied diseases that food insecurity predisposes people to, namely obesity, diabetes, and other diet-related diseases, food banks really present an unbelievable opportunity to be part of the solution to the nutritional inadequacy and the typical food-insecure adult diet.
So what do you think food banks should be doing to help address this situation?
Food banks often reach a person at least once a month, in a context that allows them to talk about diet and provide nutritious food. People are much more willing to talk about their diet when they go into an environment in anticipation of leaving with food. And then it’s the challenge of what kind of food does the food bank provide, and how much of that food will provide a high nutrient value.
As distributors of food, we can potentially get stuck in a place of having to provide clients with donated food which may provide them with an overgenerous supply of calories but that doesn’t do much to build their nutritional health. The other tough place is unsustainable spending healthier food, which even with the buying power of a food bank can be hugely expensive.
Totally. There are huge distribution and logistics challenges. I think what we have to do is take the first step which is to look at it and acknowledge that obesity and diabetes are a huge problem in the clients that are served by food banks and that food banks have the potential to greatly assist with that management.
We are now in a new situation where the ‘emergency food’ situation is becoming the new norm for a large number of our clients. Do you think that requires a greater degree of responsibility for what kind of food we are distributing?
It does. Food banks are being asked to feed people year after year after year because SNAP is underfunded. And that’s where we get the problem. It is the chronicity of use I think that makes essential an increased nutritional value in the food bank offerings. The other thing that’s changed is that an individual calorie has become so cheap that it’s really easy to get too many of them. You can get a lot of calories from poor food and feel full, but you won’t get any nutritional value from it. This is especially true of the food insecure clientele accessing services from a food bank or member agency.
Since the dawn of time, mankind has worshipped the Twinkie. (And it’s still fresh).
I’ve heard the argument that non-nutritional calories (Twinkies and chips and pretzels) are so cheap that anybody can afford those in the United States, and the food bank should only be there to provide fruits and vegetables and other very healthy food items. That is a more extreme view, right? That’s not necessarily my absolute view, but there is a certain value in considering whether clients can afford more expensive calories, and therefore considering what type of food that food banks should be providing in the future.
Why did this glorious union never capture the imagination of the Great American Public?
Particularly as access to these cheaper calories become more difficult for food banks, as corporations continue to become more efficient with their inventory. If the food in a food bank resembles the proportions of the contents of the USDA’s My Plate, that would be an ideal situation: half fruits and vegetables, a quarter whole grains and a quarter protein – lean meats and protein substitutes.
Our food bank is pursuing a steady transition to a specifically preventative healthcare agenda. Our goal is to leverage short-term relief of hunger and food insecurity into longer-term shifts of client behaviors around food leading to better health. This means an integrated series of programs starting with expectant mothers and following children through right up to the high school level. This means outcome-based evaluation, which is very challenging, yet we feel it is essential to gain the credibility to exist in this new and potentially very powerful space. However, we’re nothing if not a joyful ‘Heinz 57 Varieties’ of a network. Do you think that there is a lot that any food bank can do to move forward a healthy food agenda without having the particular focus that we have.
Yes, I think every food bank can make big strides, whatever their resources or approach. The link between dietary intake and obesity and diabetes is clear enough that just documenting an increased intake or increased access to fruits and vegetables is enough to create an important public health message to the client group.
By the same token, you don’t necessarily have to show that BMI goes down or that diabetes is better controlled, because that link is well established enough. Just showing that fruits and vegetables are desired, they’re taken, and they’re eaten at home rather than ‘they spoiled and I threw them away,’ that’s enough.
Surely education – in what we like to term food literacy – plays a key role here?
Yes, the evidence in the academic literature suggests that protein is the most significant problem, because clients are reluctant to shift to non-meat proteins. Particularly in low-income communities, it’s not considered a meal unless you have meat, and that’s not the most nutritious message. Other protein sources like beans and lentils and tofu are cheaper than meat and offer great nutritional value, but that’s an education message that we need to be communicating as well, and it’s often a hard sell.
When in doubt, have a festival! Still time to book for this August, Lentil Lovers!
What doesn’t seem to be as much of an educational issue is fruits and vegetables. People like access to fruits and vegetables and will take them it when they are available, and when they take it, they eat it. So the bigger educational barrier to me seems to be in the protein choices. In terms of fruits and vegetables, the big place where education needs to be done, I think, is with produce that people aren’t so familiar with, whether for cultural or other reasons. Particularly because these less familiar fruits and vegetables often end up at food banks.
Tell me about it! Every day for us is ‘Three Hundred Things to do with a Persimmon.’ Martha Stewart has nothing on us!
Only Martha could make Food Insecurity aspirational…
So, I would like to ask you what is your definition of optimal food security? How can we define it in an individual seeking our services and how can we measure our interaction with that person to know whether they are able to attain it?
That’s a great question. You know, this is, again, my personal opinion. People will disagree with me. But I think that the way you know someone’s food secure is they’re not coming back to the food bank. Even if you report on a food security survey that you’re not worried about running out of food because of money, 99% of people who answer that they’re food secure on a survey administered by a food bank are doing so because they have come to rely on that food bank as a chronic source of their food intake. And so they don’t need those additional food resources because they have the food bank.
I have a dream, where little white birds and little black birds pick up little spoons and feed all the boys and girls.
So where would you like to see the Food Bank Network in 5 years, as relates to this area?
I would love there to be some relatively straight forward way that food banks can record their product as high nutrient value versus standard nutrient value, so that there is a simple way to track improvement.
Feeding America is looking for other markers of success that are more nutritionally than poundage focused, and of course different food banks are already using systems such as CHOP (Choose Healthy Options Program) to rank their food.
Yes, though I think oftentimes they’re difficult to operationalize. So I would love to see that food banks can set individual quality goals around improved nutrition. Many food banks already have the skills around refrigeration and quick distribution, so it is more about developing the infrastructure for all food banks so they can respond if say a farm were to call up and say I have 100 pallets of broccoli, will you take it? Many food banks would say, no, we can’t take that much because we can’t refrigerate it or distribute it quickly enough. This is a hurdle that deserves to remain a major focus.
Hilary, thanks for your significant research in this area and for your support of and belief in the work of food banks.
BackPack provides emergency supplemental food assistance to children to ease hunger over the weekend. The backpacks (in reality plastic bags after the issue of single backpack at the beginning of the year) are full of single serve food items, typically containing protein items like tuna or peanut butter as well as snack bars, small cans of chili or franks and beans etc.
Contents of one Food Bank’s Backpack
As food banks have grown over the last decade, so has the volume of food passing through them and the funds they receive. This has resulted in many of them initiating major expansions of their backpack programs – our own organization included. The money for this is so easy to raise in the local community, because it presents such a readily understandable and direct solution to the issue of hunger for kids. (Try getting a buck for SNAP outreach, people). Packing the backpacks is also a great volunteer activity, giving corporate volunteers something to do beside freeze their ass off mindlessly sorting carrots in the warehouse. This is direct and visceral. I just filled a bag with food that will soon go directly to a kid.
This expansion of backpack has been heavily supported by Feeding America, both with a formalization of what contents are required to have a backpack program meet their guidelines and also with pass-through funding. This commitment continues with the recent study into backpack nutrition.
So why is the Foodbank of Santa Barbara County making very significant cuts in the numbers of backpacks provided for in our newly accepted 2013 budget?
Mr. Todd had a very creative idea for a food-related earned income strategy…
Is it because the CEO is some descendent of the Child Catcher in Chitty Chitty Bang Bang, determined to bring misery to the children of the land? Always a possibility.
Nevertheless, our reasoning is that backpack, despite its virtues does nothing to assist the people it serves in getting out of the situation they are in, so for us, that rung warning bells and meant the program had to come under considerable scrutiny.
Foodbank of Santa Barbara County Program Engine
Our mantra is that everything we do needs to achieve three things:
1. provide short-term hunger relief and nutritional benefit,
2. also provide long-term empowerment and education to help provide a pathway out of food insecurity and boost food literacy and
3. we have to find a way to make the initiative community driven (and therefore sustainable).
So, backpack probably logs a modest though unspectacular score for criteria 1. It logs a zero for criteria number two (I have seen the occasional glossy nutrition education pamphlet included in a backpack, doubtless paid for as one of the educational elements of a grant from a large corporation. Our work with this populace suggests that these sort of expensive and uninvolving attempts at education are quickly discarded.) And then for criteria three, it would probably get the healthiest score of all. There are plenty of people in the community who wouldn’t want the program to die and would provide cash and volunteer support.
With our goal to end hunger, rather than just ameliorate it at some supposedly acceptable level, this lack of effectiveness for criteria number 2 is a really serious issue. Hence our cuts to backpack in our overall program mix for children.
We believe these cuts will not affect those who need the program most, and will allow us to divert the funds (and more) to a major expansion of our award winning (have I mentioned this in the last five minutes) Healthy School Pantry Program which we believe represents a far more impactful and long lasting nutritional intervention for our families.
Our research showed that many of the backpacks were just being provided for kids in after school programs that happened to be run in schools with a significant number of free and reduced meal students.
Master Maxwell Jorgensen. Butter would not melt…
The situation was highlighted for me, when my own stepson Max came back from his YMCA after-school program carrying a plastic bag of food from our Food Bank. Obviously if you work in the food banking world, you are not taking home the mega bucks. Yet hopefully a backpack should be going to a family in greater need than that of the CEO of the Food Bank where the backpack originated from.
Many backpack programs go out through after school programs, but some also enter directly into the school environment. This originally came out of the hope that teachers would identify kids in need who would be the ones who would receive food. However the reality has been for many food banks, that teachers are often too busy to follow through with the admin side of having to do this, and it is logistically easier for the food bank to send a larger quantity of backpacks. We have also seen cases where larger and larger amounts of backpacks have been requested for wider distribution in lower-income schools to avoid stigmatization of those who most need help. This is an worthy consideration, but it also waters down the true intent of the program.
We did a survey of our backpack program, so that we could make sure we were basing our decisions on the real world situation rather than what we thought it might be. This survey showed that backpacks are very often shared with the children’s families, especially in a situation where a number of children in a family might be receiving a backpack. So whatever the more targeted approach that the backpack was designed for – specifically those in transitional living or homeless situations – it was increasingly being used as a simple supplement to the family diet. Plenty of those diets could benefit from supplementing, so there might be nothing wrong with this – if it weren’t for the issues of cost and nutritional value of the average backpack contents.
In Santa Barbara, our backpacks have always included fresh fruit (apples, oranges, stone fruit) or vegetables, yet we were still sometimes getting complaints from from visitors and volunteers about the quality of some of the food that went out in the backpacks.
True Confessions: These actually went out on one of our backpacks, may God have mercy on our eternal souls…
Obviously different volunteers have different perceptions of what constitutes suitable food for a child to eat. Some believe we should provide comfort to those in a tough situation by offering comfort food, whatever the ugly nutritional truth behind the bright shiny boxes. Others have a level of health zealotry such that anything we could provide would never be good enough. However I know (from my photographic proof above) that in the past, we have had poor quality food go out in backpacks. Food that I would not give my own children to eat (which surely has to be the criteria for what we provide to other children). I have also seen backpacks serve as dumping grounds for inappropriate amounts of produce that we wanted to get out. The provision of fresh produce in backpacks is still provided in a minority of food banks nationally, and through my own visits to other food banks around the country, I have seen all manner of borderline crap going out that may make the child’s nutritional situation worse.
Another (nameless) food bank’s backpack. Pop tarts, chocolate milk, ritz crackers, popcorn and mac and cheese. Not much here to grow a healthy child.
Packaging is another major issue. Feeding America requires backpacks in their programs to contain food items that should be able to be opened by a child without access to a can opener. (Does that mean we are building a generation that can’t even work a can opener?) As a result of this single ‘e-z open’ requirement, this program plays to the worst packaging excesses of the American food industry. Tiny amounts of food is entombed in containers that cost vastly more than the food they are there to protect. I should say, though, that when the zombie apocalypse comes, I’ll shotgun my way over to the backpack storage section of the food bank, because that stuff will still be in exactly the same state as the day it was incarcarated.
Remember your sensitivity training people: When someone walks into a food bank, you should never prejudge them as being either client or donor based on what they look like. However if they are shuffling with flesh hanging off and reaching for your throat, you really should consider making an exception…
We know that there is no individual child-owned solution to the nutrition challenges that kids face. Backpacks can’t solve childhood hunger. The only solution is a family solution (supported by an adequate Federal safety net, of course). Backpack is a short-term fix with no way to help the family provide better, more consistent food.
There is no doubt that there are many children who are in truly dire circumstances. They are caught in a family situation of serious deprivation, maybe as a result of parental addiction, mental issues or simply having the misfortune to be born to truly awful parents. These kids need all kinds of help and there is clearly a need for backpack in a situation where the child may have to source and prepare their own food on a regular basis. Everyone involved with emergency food has their own stories related to this kind of client need. People can sometimes better understand this type of situation when I refer to something in the wider culture. The bestselling memoir, ‘The Glass Castle’ by Jeanette Walls (soon to be made into a movie, starring Jennifer Lawrence) is an example that I sometimes use. Jeanette Wall states plainly in the book that her earliest memory was ‘of being on fire’, and we’re not talking literally. As a borderline starving three-year old left to her own devices by ‘different’ parents, she was boiling up her own hot dogs, standing on a chair in front of the stove and her dress caught on fire. (On her return from hospital, when she went right back to doing the same thing again, her mother congratulated her for being brave and ‘jumping right back in the saddle.’)
So clearly, some kids can use every backpack they can get their hands on to ward off starvation. The problem I am trying to highlight is that we have a whole program structured to deal with this kind of situation, whereas the vast majority of backpacks are going to kids who are not in such a dire emergency, and so the backpacks act as a nutritional supplement for the family. This is a clear distortion and if that is the case, the contents of the backpacks, with their small amount of food, don’t really provide a lot of nutritional benefit.
We are not the lone heretics in taking a long, hard look at backpack. In fact, an organization as close as our own PDO (Partner Distribution Organization – Definition: Food Bank that cannot qualify for membership of Feeding America, except by being partnered with a larger member organization. Note to Feeding America – Could we stop this second class citizen thing?) Our PDO, San Luis Obispo County’s Food Bank Coalition, under the leadership of Carl Hansen, no longer provides any backpacks, because they do not feel it is a cost-effective way to make a significant dent in food insecurity, preferring to focus on larger distributions to families.
So enough with the whining, Erik. What are you, with your blah-blah-blah award winning program, and your nice Santa Barbara weather, actually doing to solve the problems you have identified?
Our short-term solution is to redouble our efforts to more effectively target backpack by focusing on maintaining supply to agencies and shelters dealing with homeless families and those who need the largest short-term interventions. Within the school setting, we are looking to shift our contact point to the counselors. They are typically seeing kids who are acting out or struggling, possibly as a result of nutritional issues. Rather than just dump a pile of food on them, we want to get close to these people, provide training and to building up a real relationship to the food bank. (Having a program for the whole school which brings big benefits, like Healthy School Pantry is a great place to build such a relationship from). We can then rely on the counselors to be more effectively as a conduit for teachers to keep a wider look out for kids in need. This creates a whole host of distribution problems – remember, food banks are great at macro, not so hot at micro. So it may be individual school volunteers picking up small quantities of backpacks from a locally sited distribution center. Maybe backpacks get dropped off along with the standard other food items by an agency that is near to the school.). Will this more time consuming approach work better than the previous scattershot approach? We will have to see, but with less food around how can expect to keep to the strategy of throwing a lot of food at the community, confident that some will stick to those who need it most. We are hopeful that the school counselors, who are already advocates for children, will view backpack as one more tool in their toolbox to be used appropriately with the right kids, and that other families might be referred on to more appropriate Foodbank programs like Kid’s Farmers Market, Pink and Dude Chefs Middle School cooking program or the Grow Your Own Way program to help people grow more of their own food.
Up until now, I would suggest that within the food bank network, the backpack program has been both a sacred cow and a cash cow. Both of those elements, combined with the challenges of shifting food and education resources to other less ‘quick fix’ channels means that the backpack program as a mass feeding effort, as opposed to a highly targeted program will remain with many food banks for the foreseeable future.
So, am I talking out of my pop-top can? Please join the discussion and leave a comment.
Hippocrates made a good point in 470 BC. Maybe it’s time we dusted it off and put it to work.
When I talk about a preventative health care model, I mean that our interventions in the lives of our clients and our agency’s clients should be demonstrably beneficial to promoting their longer-term nutritional health and food security.
The evidence is there that food patterns over time lead to health disparities. The easiest way to wreck or improve people’s health is with food and exercise. That means that we have the opportunity to move from being that band aid on the unsolvable problem to a situation where we can provide the widely accepted cure for it.
Preventative medicine always makes sense, but the value proposition we are offering is way more attractive and cost effective than most healthcare strategies. Consider the below choice:
The double-blind trials are in on broccoli and lentils and poor misunderstood Mr. Kale. We know this stuff works as good as medicine, and without even the need for a gentle voice at the end of the drug commercial explaining about the possibility of nausea, sudden death and our bits dropping off if we consume it.
If we are talking to someone who says we should be focusing our attention on providing any kind of emergency food, and not waste time and money on being picky, then we would point out how those empty calories are being destructive to the health of the person we are trying to help.
All our supporters care about kids, well how about bringing these facts to their attention:
How can food banks not jump fully into the healthcare arena? We have so much opportunity to make such an incredible impact. It’s time we wrote a prescription for the health of our communities and our organizations.
Many food banks are doing amazing things to promote health by emphasizing the provision of fresh produce and providing various types of nutrition education programs. But what would happen if we got more serious and more precise about what we were doing?
What if our new health-based destination could also usefully embrace the destinations of other organizations – like the Department of Health and Human Services for example. They’re not exactly a fringe organization of tofu munching ginseng swillers. Check out their goals for 2020.
We could totally help them do that stuff! Give us the money and we’ll get it done no problem. But we can also look to our local state and county health initiatives: how can we utilize our programs to meet their goals? Nutritious food security and education are key to stop diseases of undernutrition like anemia and rickets (vit D deficiency) Nutritious food security and education are also key to stop diseases of overnutrition like obesity and diabetes
The point is food HUGELY influences both of these diseases. So why not simultaneously prevent the immediate sensation of hunger and move towards reducing these devastating diseases by providing appropriate types of food?
Funders will be motivated to work with Foodbanks who are on the frontline of prevention. Prevention is key when it comes to chronic disease because that is the only way to STOP chronic diseases from happening. Once you are obese or have diabetes it is almost impossible to completely get rid of it.
The only catch to this rosy scenario is that we have to prove we can do what we say we are going to.
If we are talking to the epidemiologists and the healthcare funders they might think that we are being a little vague when we are talking about what we do. How can we have a single ‘disease prevention and amelioration’ strategy that seems to be dealing with a range of problems. They are also going to want to know whether we are offering a long-term cure or a short-term suppression of symptoms? So it’s all down to evaluation.
Up to now, we’ve had pounds and meals and numbers served. Those are not outcomes, those are outputs. And that is not going to cut it in the healthcare world.
If we are going to be preventative healthcare organizations, we are going to have to play like the grownups play when it comes to talking about the impact of what we do. Talking only about the number of pounds we shifted is like saying we gave out a lot of Prozac, so in theory it should have made a bunch of people much happier.
Food banks can & should measure attitudes and behaviors towards healthy eating with simple questionnaires developed with local higher education establishments.
The data Food Banks won’t so easily be able to collect themselves:
Anthropometrics – Height, weight, waste circumference, body fat %
That is why collaborations are key – with clinics, hospitals and WIC.
There is a lot that Feeding America can do nationally and that State associations can do at the State level to help develop and disseminate accurate and data aligned with comparable evaluation strategies.
Each programs we undertake at our foodbank has to have its own special evaluation approach, which we believe in cooperation with the data provided by local healthcare sources will show clear anti-obesity and anti-diabetes results. Here is an example questionnaire for our award-winning Kid’s Farmers Market program.
And if we want healthcare funders to have confidence in the quality of our ‘medicine’ we need to implement programs that let us nutritionally rank the food that comes into our warehouses so that we develop a baseline to work from. We currently use a system called CHOP (Choose Healthy Options Program) which is actually too focused on nutrients, so we are looking to simplify, always simplify…
HOW ARE WE GOING TO PAY FOR ALL OF THIS MEDICINE?
Sometimes when I speak to health or multi-region foundations, I get those four dreaded words: We don’t fund foodbanks. Usually it is based on some conception of what Foodbanks were doing in 1983.
We have to prove to both the community and funders that we are different than the food bank they remember. We are not a place that the government sends processed cheese to slowly die. We are not a set of shelves to store a blue fizzy drink that did not capture the imagination of the American public. Our warehouses can be the engines of a huge leap forward in the health of millions of people.
To go after the big bucks, we can’t fall back on tending our neat little geographic fiefdoms. Healthcare funders want to see big populations – multi-county at the very least. There is a clear role for State associations and Feeding America at the national level to put together coalitions prepared to run the type of measurable programs required to meet the stringent criteria of these funders. We bitch and whine about the paperwork and voodoo activities required to get state reimbursement funds, so you can only begin to imagine the hoops for healthcare reimbursement funding. By pooling our human capital in this area, we can we succeed on a large scale.
Of course there are risks of adopting a preventative health care model – misperception of our mission, risk to existing ‘hunger’ charitable donations, and that given that our demonstrated excellence is primarily in the areas of sourcing, storage and distribution of food. So some people might consider this other stuff as being out of our wheelhouse. The upside is huge, however – a recognition that we are educating and empowering people to take responsibility for their own health and that we helping people build true food security for their families and for our country.
The end result, besides a healthy populace, could be that food bankers would one day have the same respect as doctor’s for their heroic work in preventative medicine. Don’t count on it, though! The Airforce still haven’t had a bake sale to pay for that bomber. Still, we can dream that we are George Clooneys bursting through the doors of the ER with our stethoscopes around our necks ready to administer the 100cc’s of cauliflower which are going to save little Jimmy’s life!
From Hunger to Health 