Hunger is always perceived as a hyper-local issue. Smaller scale cash donors within a city or town in your service area are often very concerned that their dollars are spent for food within that community. They don’t want it to go to those folks fifty miles away who might as well be in a whole other universe. We might consider this as a parochial attitude and believe that these people don’t see the bigger picture like we do.
But, what if they’re right?
What if we’re so obsessed with total impact / poundage / meal gaps and systemic change that we can’t focus on the type of grass roots neighborhood level work which can be truly successful and sustainable?
That’s someone else’s job, right? A partner agency who can get into the weeds while we keep that big food machine humming. But we used to say that about a lot of things, like SNAP outreach or nutrition education. I’ve also always been concerned that we’re accidentally creating a ‘new norm’ of food security in that people will get increasingly used to saying: “Yes, of course I’m food secure, because I can go to this pantry on this day and then that pantry on the other day.”
In Santa Barbara, we are ready to pilot ‘Healthy Neighborhood’ programs designed to be sustainable local solutions to food security and food literacy at the micro level. They represent the next step in the (occasionally painful) realization that we can’t make or keep a community food secure by only working with those who most need our services.
Ouch, what did I just say?
Do you think we have resources to just spray around? Unlike you, we’re not in ritzy Santa Barbara with sun and sand and aging movie stars. We live in the real world and we have to concentrate resources on those most in need.
Yes, I get that perception, but we are a medium-sized food bank with a modest $4 million cash budget where cash is always tight. It would be easy for us to walk away from such an approach, but we can’t. Let me make clear that our food resources unquestionably go only to those who really need them. But educational and community building resources are going to have to be offered wider than that. Those that can pay will pay or subsidize others. While this creates short-term financial pain, it will also broaden and deepen the donor base and introduce new perceptions of the organization as a good for everyone in the community, not just those ‘disadvantaged others.’ (aka ‘the needy,’)
Consequently, Foodbank of Santa Barbara County’s Healthy Neighborhoods Initiative marks a major pivot in approach, transitioning our work in neighborhoods of high poverty and food insecurity from a client-based to a family-based model. This initiative is designed to bring together a whole neighborhood of families in the effort to build a resilient and nutritionally healthy community, where food and health become the focus for community engagement, education and economic development.
Each pilot will be based around key physical locations, operating as Community Food Access Centers, which are place-based, food-centric neighborhood revitalization efforts, uniting multiple educational, nutrition and community development functions. These centers will have a family-based focus. You may be familiar with The Stop in Toronto Canada. At this stage of the initiative’s evolution we don’t have the luxury of building one of these or utilizing a facility just for this purpose, so we have to make use of existing places with their own range of activities – community centers, schools etc.
Initially, the center will only operate one day a week, but it will be intensive. Food and age-appropriate education will be provided for the whole family to attend at a time convenient to them. Childcare and basic food literacy training will be provided for young children; culinary skills will be provided for teens. Education will be culturally as well as age appropriate.
Though there is one day per week where education and services are focused, other satellite activities will happen at other times. There will be regular communication across a number of media and communication platforms to keep the neighborhood informed and involved in the effort. Centers in targeted neighborhoods will provide low-income families with a specific place to go, where people that you know and trust will be teaching and learning with you. The idea is to break the cycle of poverty and food insecurity by including all generations; they will also work to channel partner services in a more culturally-appropriate and culturally-tailored manner, in an environment in which families and neighborhoods feel comfortable coming together and learning with each other.
Providing the life-blood of the Community Food Access Centers and supporting community involvement are neighborhood networks of volunteers – Nutrition Advocates – that provide bi-lingual peer-to-peer education, empowering community members to improve their health. Food-related programs offer the “idea bridge” for others to provide skills and knowledge training.
Other elements of this strategy are:
Small Food Business Incubator – Encouraging entry into local food economy by providing business, food safety and marketing training to Nutrition Advocates and food entrepreneurs, and the opportunity to develop small businesses.
Food as MedicinePrograms – Diabetes Education/ nutrition education/diabetes specific food support programs.
This approach builds on existing geographically local impact groups that we have been working on for the last couple of years and the relationships that have come out of them.
Collective impact projects come and go. Funding comes and goes. The idea here is to find a low-risk approach, because it involves empowering the community to help itself. Networks and relationships will grow, increasing community cohesiveness and requiring less outside stimulus.
Ultimately, a neighborhood approach does not rely on the desire to help ‘others’ but on the practical need to help ‘each other,’ by living in a neighborhood where mutual support to obtain and keep good health reframes how people engage with each other. This is incredibly challenging to our ‘big’ way of operating, but it is also exciting, representing the opportunity for a much more inclusive and empowering approach to our work, and the opportunities for new approaches to how we fund that work.
I’ll let you know how we get on.
In the meantime, why don’t you consider taking a walk and building food security street by street.
People are doing new things in the food banking world. In our search to ‘shorten the line,’ we are getting involved in areas that we had not been involved with in the past – educational programs, anti-poverty or pro-community development work – not to mention all manner of strange new alliances and partnerships.
We are discovering that our existing organizational structures are not necessarily the most efficient vehicles for getting us where we want to go. ‘Feed The Line’ and ‘Shorten The Line’ can be like two sticky gears in a truck and if you are constantly crunching between them, your engine (read staff) can become overstressed and your gearbox (read budget) may get worn out with all the upshifting and downshifting.
A standard food bank operation can feel like like tank, rumbling along, and when the situation calls for us to get all nimble and ‘ninja,’ we can find it hard to change direction. We’re brute force powerful, but maybe not so suited for the asymmetrical challenges of tackling poverty or helping clients build social capital. How can we build the nimbleness of being able to deal with both micro and macro interventions within our humble and creaky org chart?
We all hate org charts because they have this way of deadening a living, breathing thing (If you have any doubt, check out the chart of the educational establishment below):
Then of course there is the org chart according to the Executive Director’s view of the world, which is much like Steve Jobs’ view:
For us to figure out what is the best structure for our organization, we need to start by being clear where we stand in relation to the community around us. [Here you can download a good SSIR article on the ‘Networked nonprofit‘]
When I am explaining to Foodbank supporters about the evolution of our mission, I talk about how we can no longer avoid looking ‘upstream’ of where we are, to try and understand and deal with what is driving so many people to our doors – typically situational or generational poverty.
I then tell them we need to consider what is ‘downstream’ of where we are operating – this means what are the true outcomes of our interaction with clients? It may be that their long-term health has not been affected as beneficially as we hoped. These ideas are summarized in the graphics I developed below:
So, how can we restructure to meet this enlarged understanding of how we are affected by, and in turn affect the world around us?
Let’s look at some ways in which food banks are organized around these elements of the mission.
THE CLASSIC FOOD BANK
The first model is the ‘Classic’ food bank. Unreconstructed, proudly focused on the core mission and seeing no need to evolve further. Not only is it structurally unsuited for any expanded mission, it doesn’t even want to consider the possibility of one.
Typically this food bank will be in a high need / low resource area, where the only mindset accepted is ‘running faster and faster to keep in the same place.’ (Yes, I know my food bank is in hoity-toity Santa Barbara, but we serve the whole County, and of the 58 California counties, only 14 have more food insecurity than ours, so I should be at least be allowed an opinion…end of self-justifying whine!)
Another factor is that whatever food bank we are in operates the way it does for a million historical and community reasons – many of which may be hidden under the surface. ‘We’ve always done it this way’ can be a common refrain. These food banks will probably carry on much as they are, shrinking a little in size as ‘recession sympathy’ dries up further. The lack of desire to face shifting realities may be failure of leadership at the board or ED level or it could be just a lack of strongly voiced desire for anything more from the community.
Lets look at two other structural models that are currently out there in food bank land.
The Remodel is basically taking the old structure and trying to add on a few additions. It might be teaching some nutrition education classes or having some involvement in SNAP outreach.
There are many food banks are in this grouping. Whatever gets added might be as a result of ED interest, community stimulus or Feeding America encouragement. The problem here is that because the organization was not structured for this additional mission, then the new initiatives can be like vestigial limbs hanging off the org chart or they shoved in some department that feels like its original remit has become distorted.
This can lead to new initiatives being left to die by staff who feel they are already overworked, or that the program will be starved of resources once it has been there a while and is more noticeable for the problems it is causing the organization as opposed to the ‘new program paint smell’ that was so useful for fundraising in the early stages.
THE SHINING CITY ON THE HILL
Of course the polar opposite of the ‘classic’ approach to food banking is what we might call the ‘We do it all’ or even the ‘Shining City on the Hill’ food bank. They stand out from all around them. They can be like a giant snowball rolling through town, picking up all manner of diverse activities: community gardens, job training, process kitchen etc etc. These activities are typically run by food bank staff. As someone remarked at the recent Feeding America ED forum, you’ve heard of ADD, this is called EDD.
This mode of operation tends to develop in places where the food bank is very much the ‘only game in town’ in terms of dwarfing other nonprofits, or having a large geographical area and considerable financial resources relative to the local nonprofit eco-system.
The general challenge with this approach is that it is expensive, difficult to sustain and challenging to coordinate. Also if you’re throwing a ton of programmatic outreach at the wall hoping some of it sticks, how do you know what element is really moving the needle, and what is well meaning but ultimately ineffectual?
CATALYST FOR CHANGE MODEL
I would like to suggest one additional approach –one that I believe our food bank is evolving into, which is more of a bottom-up ‘redesign’ and which could be called the ‘catalyst for change’ model.
The ‘Catalyst’ model means we create an uber goal – in our case ‘ending hunger in our service area AND transforming the health of the community through good nutrition.’ This goal allows us to partner with a full range of local health and service organizations and hunger relief becomes part of a positive goal that can be measured using public health indicators.
In reality, we still have our fingers in a bunch of pies, but the difference from the ‘we do it all model’ – and this is crucial – is that the food bank needs to remain value neutral over whether things are done either by them, by their existing agencies or whether achieving something requires new forms of partnership.
The overriding thing is that your organization commits to making sure that it happens one way or another, will evaluate the results and keep the process moving forward.
We expand what may already have been a long-term role as the encouragers of an ecosystem of community partners working to improve health and food security. The difference is that this time we want results and we want to be able to measure them. It could also mean that everyone’s programs might not be adjudged as wonderful as everyone else’s.
FB’s are perfectly positioned to be the catalysts to make sure that the things that are going to help solve food security and promote health are being done in coherent and interconnected fashion.
• We’re not going anywhere soon, so we have stability.
• We have respect to broker partnerships and coalitions.
• We also have detailed knowledge of the range of programs in our service area and through our existing agency reporting we have some crude idea of the outputs of service.
• More than anything, we have the food. That has always been our ace card, but we’ve never really played it as hard as we could. We really need to leverage every pound of food we distribute to effect lasting change.
This is all based around evolving the role of food within the organization. It is still central (relax…), but now it is not the end in itself. We are not only the food sourcers, storers and distributors – we are the food investors. We are going to leverage every nutritionally dense pound of food to bring significant long-term impact to the good health of our service area.
The price of doing business in the leverage is to provide good service to those who will always need food assistance as a result of challenges of age or faculty – yet even these folks can benefit from involvement in holistic service. Nevertheless, I am putting them lovingly to one side and saying that we will always find a way to source the food needed for these folks.
That leaves people whose lives we can impact significantly – children, families, those with chronic health conditions, those who question their limited voice or power in the community, those who want to share the skills required for good nutritional health with others in their neighborhood.
Being a catalyst sounds easier than doing everything yourself, but really it is just a different kind of difficult.
The below graphic shows the resources that we are providing in our area to stimulate effective nonprofit agency responses to local nutritional health issues:
If we have a traditional org structure then provision of the above services is going to look like the many-headed hydra. It also means that it is only a matter of time before one head or other gets lopped off, because it is not sustainable.
Let’s look at an alternate structure. Enter, if you will, through the doors of perception…
The doorway is a good metaphor, because people, food and resources can pass through it in both directions. So imagine your Foodbank in the center of the community (because it’s hard to escape from our self-obsessions) and further imagine four doors around you that lead in from and out to that wider community.
I am suggesting that this kind of restructure requires you to shift how you do business to facilitate the most efficient methods of stimulating two-way traffic through these doors. It means you have to inspire and join with and prod and poke your partners in the community (starting / but not ending with your member agencies) into embracing impact and sustainability and rigorous evaluation of their activities. And if you the food bank are going to initiate something new, you need to find a way to make it sustainable long term which means planning from the start of the process how the community will have assumed ownership of the project by the time it reaches maturity.
The four doors are:
1. Partner Organizations
2. Food Bank Programs
4. Community Leadership/Volunteers
Let’s look individually at each of these ‘portals’ for food, energy, time and collective will:
Partner Organization Doorway
This is always going to be the biggest door. If we’re going to maximize our impact we need vibrant relationships with other nonprofit organizations. Yet we need to shake things up a lot in terms of how our current partnerships work.
We are already monitoring member agencies, but because our focus has been about ‘maxing’ poundage, we have not pushed/encouraged agencies to embrace a ‘shorten the line’ agenda. Agency segmentation has been helpful for us in seeing who can be the best partners for ‘shorten the line’ services, but at some point, tough decisions need to be made about what relationships need to be prioritized for the good of the community.
We are in a time when traditional donated food supplies are tight and we are all working hard to find the next ‘wave’ of available product. Consequently this is the perfect time to make every pound count and leverage existing relationships by expecting more of our partners that turning our inventory for us.
If the relationship with community partners is to become more about impact and not just poundage, then you might find yourself with a different set of partners. Some of our most successful new partnerships are not based around agencies distributing food for us. We are working with American Heart Association, who are providing some educational components to our existing educational structure with our Kid’s Farmers Market Program.
We also are working with a local ‘cradle to career’ school initiative called Thrive, where our educational programs are helping them meet funding-mandated nutrition education requirements. We are in discussion with other potential partners around working together in community building and in food systems reform.
Our educational programs typically include a distribution element, yet in at least half of them, this is really a micro distribution compared to the ‘here’s 20lbs of broccoli, good luck with your life’ approach of the past. You might feel that this is mission drift, but I know that each one of these partnerships will have more long-term impact on increasing food security then setting up another mobile pantry.
Your existing agency relations structure may not be able to work with this expanded set of partners. For us there is already a challenge in how to work with two different types of partner within our existing agency structure. We need to do more to reconcile these types of partnership, so that the ‘non-food distributing’ partner does not become the poor relation (or vice versa). Close links between agency/partner relations and the work of the development and program departments now becomes crucial. The old siloed approach to information of the past can be disastrous in this kind of relationship.
FOODBANK PROGRAM DOORWAY
We are increasingly looking at pushing out our award-winning ‘Feed the Future’ children’s programs through our member agencies as a way of bringing them to scale and thereby meet our vision objectives. The programs are run by ‘super-volunteers’ and therefore are sustainable. Tapping into other agency’s ‘super-volunteers’ will enable this sustainable scale to increase. This represents another big element of the catalyst relationship – we can develop and evaluate programs and then our agencies and partners become the natural conduit for scaling these programs.
We need to make these programs (which all include both ‘feed the line’ and ‘shorten the line’ elements) so attractive in terms of curriculum, training and food availability and so effective that agencies will want to run the programs. Do agencies pay a license fee? Do we give them away? Do we ask them to provide some shared maintenance for the food element? For us, these issues are still to be decided.
We’re not big brother, but if they want to run a different program that is fine, as long as the evaluation and data connected to their program are broadly comparable so we know they are getting the impact.
A food bank running programs and fundraising to deliver them is not really sustainable in the long-term. Yes, you can always find a donor to pay for one nutrition ed program or another, but unless you have found a way to let the community take ownership of the program long-term, it will eventually languish. Which leads us to who should be running the programs.
COMMUNITY LEADERSHIP / VOLUNTEER DOORWAY
I believe the closeness of the relationship of volunteers to non-profit organizations is cyclical. At one end of the cycle, the focus is on an all-paid workforce with an overlay of marginalized volunteers to manual tasks or food sorting or packing. This can lead to disconnection from a large part community – especially professional people who have a lot of other skills to offer. One way of telling whether your use of volunteers is truly able to help you build impact is to imagine if all your volunteers fell away – could you continue fairly easily with your mission? If so then volunteers are really window-dressing for you.
At the other end of the continuum is more of a volunteer-driven organization. Aiming to become this is a major element of the ‘catalyst’ approach for us. We have a special category of volunteer, called a ‘community leader’ who is a super-volunteer that is treated pretty much as a paid employee would be. They are typically there to focus on a particular project, but others may have long-term loyalty to a specific program.
These community leaders are paid – just not with money. This ‘payment’ might be with the provision of written references, or with respect, or with being given leadership responsibilities. These Community Leaders are held to account for what they have committed to do and reassigned or fired if they do not produce. This has helped us scale our programs significantly.
I can’t pretend this has not lead to cultural strains within the organization, which naturally wants to shift back to just having paid staff. Employees find it easier to lead people who are getting paid to listen to them, rather than having to go to the effort of inspiring volunteers will listen if we communicate effectively the power of our mission and the direct impact that volunteer can have on moving it forward.
We are making significant progress, though. I think there is something empowering for our employees in letting them know that they are all expected to be leaders of multiple volunteers, no matter what their job function is. It is all about multiplying their ability to achieve impact. Yes, we all know it feels so much easier to do something yourself rather than explain to someone else, but that is not sustainable.
The changes that this means to a traditional food bank structure is that you need a lot more ‘relationship manager’ type staff – they might be handling relationships with community leaders, short-term knowledge philanthropists that are working on a specific project, or outside organizations that we are partnering with. These are all people who need more attention / coaching/ focus than just the usual volunteer management skills. You are managing outside talent and it takes tact, organization and a clear understanding of the shared goals. We don’t really have the experience or skills in this area (besides in the fundraising arena) so it is learning a new skill and introducing a new culture, but the expectation is that staff will be managing an increasing number of community resources and so multiplying their impact as an employee.
As regards impact on the warehouse staff, if you have a rash of small scale educational programs that might require small poundage of high-quality produce or purchased items that are needed to demo a curriculum-specified recipe, these can be extremely difficult for current warehouse structures to deal with. Online ordering by programs staff becomes vital. Skills at staging and coordinating multiple micro distributions have to be developed. Drivers are overwhelmed by the number and complexity of deliveries and pick ups of programmatic materials from sites. In this situation it becomes increasingly important for volunteer drivers with loyalty to specific programs or sites to become involved.
The other side of the community leadership equation for us is the way we can erase the dividing line between ‘benefactors and beneficiaries.’ Our Nutrition Advocates come out of our programs and are encouraged to work more closely with both the Foodbank and become self-supporting groups. They are trained in food literacy, can be SNAP advocates and we also provide community organizing facilitation to help organize around any local health and community issues.
Community Leaders and Nutrition Advocates represent two powerful and brand new volunteer forces that are having a major impact in how our organization develops.
THE DEVELOPMENT DOOR
These other doorways suddenly open up a lot of other opportunities for the development department. We have community leaders teaching in programs and having direct access to working with clients so we are building the kind of long-term support from motivated professional people that no number of trips to the warehouse can generate.
The mantra in food banking has always been ‘once they go to the warehouse, they get it.’ This is true in terms of comprehending the size of our operations and the fact that we are not a glorified food pantry. However, if you really want to build long-term loyalty, you need to not show them the ‘tool,’ but involve them in what the tool has built. That means involvement in direct service with clients. The old hunger dynamic made this an awkward situation for all concerned. Now that our focus is about health, this is a way that benefactor and beneficiary can communicate as equals – we all care about being healthy, we all have ideas about how good nutrition can help with this. Teaching once a month in one of our programs is a golden way of building a whole new levels of ‘getting it.’
I used to get jealous about ‘Habitat for Humanity’ and their ability to involve supporters directly in their efforts by helping build a house and leaving them with the tangible results of what they have wrought. Community involvement with our programs now brings us ever closer to this model.
The desire to take more leadership in the health arena with local partners is also creating brand new funding opportunities with foundations, businesses and individual major givers who are looking for long term social solutions not short term charitable fixes.
One size does not fit all, and I am not suggesting that your organization should focus on the catalyst approach, like we are. Nevertheless, I would challenge you to look at your mission and how it has changed and then start asking the tough questions around organizational structure, so that you can be ready to meet the challenges of the next twenty years as we work to achieve the long-term health and food security of our communities.
NOTE TO ‘FROM HUNGER TO HEALTH’ READERS:
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If you want to be a big celery-waving food bank then it is all about increasing your poundage, or should I say increasing what is the new guise of poundage – numbers of meals. (Even though by current reckoning, meals can be comprised of things like pounds of candy).
Nevertheless, assuming that you are doing your best to distribute pounds of nutrient dense food, surely providing more and more food to the community has to be a good thing right? Absolutely.
But is it also an effective measure of the success of food banks at ending hunger?
Not necessarily, because this apparent success is also a strong indicator of the continuation (some might say institutionalization) of food insecurity in America. If we’re giving out more and more food, we are not shortening the line of people who need our services and so failing to bring lasting food security.
If times are tight for people and free food is available, then any smart person is going to take as much free food as they can get their hands on, providing that the distribution timing or environment aren’t so difficult as to make it not worth their while. People will then divert the funds they had for food to pay for some other expense for which there is not so much freely available help. It is the smart thing to do, and to be food insecure in America, you have to learn to be smart pretty quickly.
We like to give food to anyone who says they need it without much in the way of preconditions. And who doesn’t need food? Your stated mission might be to ‘ameliorate hunger’ or ‘end hunger’ or if you are windy Californians like us then you might want to ‘end hunger and transform the health of Santa Barbara County through good nutrition’. Whatever your goal, we need a way of finding out whether we are succeeding at doing more than keeping the nutritional health of millions of Americans tethered to our life support machine.
Which is where evaluation rears its head.
Food banks are still better at demonstrating outputs (pounds, meals, people served) rather than outcomes (individual behavior changes, community change and societal change). Time was we could get on our high horses and proclaim that ‘ensuring a child didn’t go to bed hungry’ was an outcome as far as we were concerned and the most import one – oh, and by the way, how dare you even ask us to justify what we are doing.
Those days are over.
Whether you buy into the whole ‘nutrition bank’ thing or not, you are will still be noticing a gradual shift in how food banks are being perceived by larger foundations. A few years of recession were good for automatic and generous funding. Even now, knocking on the foundation door generally assures us of having our request for operational funding awarded at x dollars, because ‘everyone loves the food bank.’ However, the social service organizations who are winning the award of x plus x dollars are the ones who can successfully evaluate what they are doing and demonstrate impacts in the community. And sorry, that’s typically not the food bank’s grant application.
As a Mr. Potter-like CEO, I don’t like to leave money on the table, and I believe that there is a huge pile of money sitting on the table for food banks that we are currently not able to pick up more than a few scraps of – health dollars.
The Holy Grail for a food bank like ours would be the ability to demonstrate and quantify the contribution of our programs to lowering levels of childhood obesity, diabetes, food-related cancers etc. If we could do this, we would be in a strong position to be better funded with private and federal health dollars.
I want those dollars to continue the little nutrition revolution in our service area and I want them for you too, dear reader.
Despite the importance of exercise, it is clear that when it comes to the most effective and cost-effective way of maintaining good health, ‘it’s the food, stupid.’ Food is what food banks have and it offers us the potential to make an incredible contribution to the wellness of this country.
It is my belief that in the food bank network, we are sitting on the most powerful, most cost-effective preventative healthcare machine the country has ever seen. We just need to be able to unleash its power.
The way to do that is not to collect a few dollars to feed the needy, but to collect serious bucks to keep the nation healthy. By a combination of nourishment, education and empowerment, we can move millions of people – not just out of hunger, but out of hunger and into health.
Now, to kick me off my high-horse and to get us those health dollars, it takes evidence. And that takes evaluation.
This is where Serena Fuller PhD, the Foodbank of Santa Barbara County’s Health Education and Evaluation Manager comes in. Serena is a Registered Dietician with a background in obesity research (yes, lab mice are her friends) and public health. She has been on staff for about a year and a half now. When she was brought on board, the understanding was that part of her work would be to find this Holy Grail for us and deliver it to the development department so they could ride out and return with the gold.
Good scientist that she is, she had no interest in fudging the figures or finding some woolly way of claiming direct medical benefits from our programs that we cannot really prove.
Getting over this disappointment, we moved on to a phase of having her dirty her nice white lab coat with the realities of food bank programs and for her to be involved in the creation of new programs. We also began to consider different evaluation options.
Have we found the Holy Grail? Of course not – it’s all about the quest, dude – but we did find what we believe is an important next step for us, which can also be replicated at other food banks.
It comes down to working with public health evaluation measures as opposed to medical evaluation measures.
We are now in the initial stages of piloting an evaluation approach based on the RE-AIM framework championed by Russell Glasgow. RE-AIM is an acronym for Reach, Effectiveness, Adoption, Implementation, and Maintenance and is an evaluation framework for public health type activities.
So why don’t medical measures work for food banks? Let’s get a teenie bit technical for a minute and look at the classic medical measures. (Take your motion discomfort pill if necessary)
Agencies often brag about ‘collecting BMI’ hoping that this covers a multitude of other evaluation sins. BMI is really just an indicator of later health outcomes, not what we are doing over the short term. Currently there is some question about whether BMI really is measuring what it is supposed to measure – total fat mass. It remains in use as a measure because of some clear positives: 1) it’s relatively easy to collect 2) it’s non-invasive and 3) it seems to correlate reasonably well with fat mass. Essentially some scientists have called into question whether it is good at telling whether people are actually healthy or not.
While total cholesterol, LDL and HDL cholesterol are measures for risk of heart disease that doesn’t necessarily equal myocardial infarction i.e. heart attack. Cholesterol levels have also been critiqued in the literature as not being a sensitive or specific enough measure and thus have a low(ish) predictor value. But, just as with BMI it has positives as regards ease and non-invasiveness and it seems to correlate reasonably well with risk of heart disease.
WHY FOODBANKS SHOULD NOT BE COLLECTING MEDICAL DATA
The measures discussed, especially BMI, don’t change much in the short term, which is when these labor intensive measures are typically collected (expect in instances of multi-million dollar, long term, multi-clinic studies). Based on her experience at the Foodbank, Serena formed the belief that food banks should not be in the business of measuring subject-level ‘medical’ data because of invasiveness, the cost associated with this type of data collection and because of the issues raised above with regard to commonly collected medical measures. All this meant (in her favorite phrase) that ‘the juice was not worth the squeeze.’
The take away from all of this is that food banks can find their own measures of health, that are reasonable to collect, measures that can change in shorter amounts of time and which – just as much as with ‘medical’ measures – correlate reasonably well with the true health outcomes that interest us – long-term decreases in rates of morbidity (disease) and mortality. Being hungry sucks, but being grossly unhealthy or dead really suck.
These measures that we are most interested in are ones that score diet quality and food security scores.
Medical studies typically focus on populations that need to be similar in order for the data to make sense. But food bank populations are incredibly diverse and it would be unethical to exclude clients from the study if they needed food and their diversity doesn’t bode well for showing statistically significant changes in anthropometric, clinical and biochemical measures.
There is certainly the place for a few well-funded food bank research studies at a national level* (Check suggestions for these out at end of the post).
You may remember a post last year on ‘From Hunger to Health’ where I interviewed Dr. Hilary Seligman of UCSF, who was involved in looking at food security and how it can make major improvements in people with diabetes. There is also the Bristol-Myers Squibb project with Feeding America. It was discussions with Hilary which began to move us down the pathway that led to the RE-AIM tool.
Because we want to run programs with the goal of improving the health of our community, we needed to find an evaluation framework that could capture changes in health.
RE-AIM has been used nationally to assess a broad range of community health interventions from actions to prevent child abuse through evaluating the efficacy of specific exercise programs for the elderly. A list of documents and links demonstrating some of these is contained at the end of this post.Here is a link to a monograph on using RE-AIM for program evaluation RE-AIM_issue_brief.
RE-AIM is unusual in that it moves beyond the current approach taken by the medical community to assess community-based interventions. In medical terms, the gold-standard is the Randomized Clinical Trial. In this, there is a focus on something called internal validity, which brings with it a tendency to oversimplify issues and their outcomes in order to isolate the impact of the program. Food banks don’t operate in a bubble. In particular, the emphasis on eliminating the potential for confounding factors typically results in samples of very homogeneous, highly motivated, healthy individuals which equates to samples of non-representative people.
RE-AIM hypothesizes that the overall social-change impact of an intervention is a function of all five RE-AIM dimensions not simply the client-based outcomes. The implication is that to have a substantial impact at the population level, an intervention must do reasonably well on all or most RE-AIM dimensions and thus all 5 must be evaluated or measured.
Our Foodbank RE-AIM evaluation allows summary indices which we have termed ‘Success Scores’ which determine the overall impact of individual programs as well as initiative areas. We realize that the process will be iterative as we develop more measures with high reliability (measures the same thing over time) and validity (actually measures what you think you are measuring) and which include more stakeholders.
Our Success Scores have a range of 50 points, so as to be reasonably sensitive to the different activities we are doing right or areas that need improvement. However, we may find over time that 50 points isn’t sensitive enough or is overly sensitive and we so we will change the Success Score. That is the beauty and strength of evaluation over research in a community setting conducting translational work in that it is more flexible and dynamic.
Here is a link to an excel file that shows how we set the RE-AIM measures for a number of our programs.Program Score Card
Looking to the future the E part of RE-AIM (the effect) and the M part (maintenance) allow an organization to measure the ‘medical’ outputs if resources and will permit.
We are focusing initially on diet quality and food security because just like BMI and cholesterol levels they are reasonably well correlated with our outcomes of interest – adverse health events, long-term morbidity (disease) and mortality (death). Plus if we are improving the food security status of our clients, the idea is that the demand for food bank services, in the traditional sense, will diminish and we will shorten the line.
We utilize well -accepted measurement tools for assessing good diet and food security:
To measure food security means that food banks will need to change their model to a model like our Healthy School Pantry or similar approach with wrap-round services like Fresh Place. Here are programs where people can get involved, become food literate, get enrolled in benefits, build their social assets i.e. meeting new people at the pantry, grow their own food, learn how to stretch their food dollar. This means we can track people who will still attend but move out of food insecurity.
The benefits of RE-AIM are that it can be customized to each individual food bank, community and stakeholders, is broadly focused with good external validity, assesses system-wide changes as well as individual changes, includes a maintenance component of making the program sustainable, which is vital when you looking at population-based changes in health status and food security.
RE-AIM can be undertaken by food bank staff and volunteers and doesn’t require highly trained individuals to collect the data, depending on what measures for E and M you have decided on.
The negatives are that there is still lots of data to be warehoused and collected, and that it can be cumbersome to gather the community input. The summary indices are only as good as your inputted data, and some sophistication is required in developing your measurement tools.
One example of how RE-AIM can help you monitor and make changes to what you are doing. Say you are running a distribution and conducting health education at the site. This health education is led by a trained volunteer and you collect your survey data from participants and see that you have no effective outcomes, (i.e. no changes in healthy food behaviors, self-efficacy, knowledge etc). If you were not evaluating the implementation you might just scrap the program, but utilizing the RE-AIM tool would help you notice the difference between this site and another site that had a translator. So the impact is really Impact = implementation x effect. The great part of evaluating implementation is you can learn which sites are doing great, learn from those sites and then take what you learned to other lesser performing sites.
We see the next stage as working to improve the measurement tools as well as identifying the best indicators, i.e. the measures the have the best predictive value of health impact, and tapping into the right partners so we that we can strategically collect ‘medical measures’. We want to develop an evidence library that supports food security and diet quality as the best predictors of morbidity (disease) and mortality (death) in light of community constraints, food bank constraints, invasiveness for subjects and related issues.
We believe that food banks could use RE-AIM to collect meaningful data about their impact on the health and wellness of their communities. We are developing the measurement tools, score cards and success scores, plus causal pathways and definitions.
If we all adopt this method I think we can have a large influence on what funders will expect and of what all of our respective communities view as our work. This is turn can show the true impact of our work. If we come together to say that diet quality and food insecurity are the right measures, especially when assessed in the context of RE-AIM based framework we will go very far in proving our impact from that of an earlier measure like Pounds Per Person In Poverty.
We need your input your comments on your systems, your criticisms – and yes, your dollars for continued development of a system that can bring considerable evalutory (did I just come up with a Palin-style coinage there?) benefit for the whole network. You can contact Serena at firstname.lastname@example.org with ideas and me at email@example.com with support!
* OPPORTUNITY FOR NATIONAL STUDIES – There is certainly the place for a few well-funded food bank research studies which would be at a national level* – looking at BMI, adiposity (via BIA or caliper), HTN, cholesterol levels, long term blood glucose regulation, e.g HBA1C (which is different than evaluation), plus diet quality and changes in food security.
In the first of an occasional look at how issues of poverty affect our ability to move people from hunger into health, I consider the Bridges Out of Poverty model in an interview with Debora McDermed who teaches and facilitates the ‘Bridges’ work being done through the Northern Nevada Food Bank in Reno. What use is Bridges to us? How does it work? Does it function best as a simple set of language tools or as a community-wide effort? Does this bridge lead us somewhere or is it really just a culturally insensitive set of labels which only helps further stigmatize people? Read on and find out…
First, apologies for the hiatus. This blog took a break for the last couple of months of 2013, partially because it is the crazy season for food banks. The other reason is that this isn’t a blog that features my knee-jerk reactions to the burning issues of the day like gun control (for that go here), but rather a blog with an educational focus on meaty subjects of current concern in the ‘Health into Hunger’ sphere.
In our world we love the ‘F’ word (food); there are even fans of calling people the ‘N’ word (needy) – but whatever you do, don’t mention the ‘P’ word (poverty).
I have been in rooms with dedicated, caring management teams from food banks, where mentioning fighting poverty is like waving a silver cross in front of a vampire. The fear level about this issue is huge: ‘that’s not our concern…it’s mission drift…our donors would hate it…let’s just stick to being the good guys saving the day with the big trucks of food.’
This trepidation extends beyond the food bank world. You can see it in the messaging of an organization like ‘Share Our Strength’ that is focusing on child hunger, with the mantra that ‘we may not be able to tackle poverty, but we can at least make sure that no kid goes hungry.’
My own viewpoint is that food banks cannot escape facing up to wider issues of poverty and how they impact our work. Unless we’re in this just to have long-term job security and to look good at Christmas, then we have to say we have had enough of the current status quo – a national state of rampant malnutrition which continues to weaken the health of our communities. That means we are going to have to deal with poverty to some degree or other.
Most service providers would acknowledge that they have to not only ‘feed the line’ but to do something to ‘shorten the line,’ yet addressing poverty rarely figures in these plans. You would think that poverty is the most tangible thing in the world – you can see it and smell it and touch it – yet when we want to do something about it then it becomes some nebulous mist that seems to slip away from the grasp.
There seems little shared agreement about either its causes and its cures. Consequently it joins the increasing number of subjects – such as immigration and gun control that become too uncomfortable to talk about – and therefore must be placed in some ‘no go zone’ of polite national discourse.
How does Bridges Out of Poverty enter into this discussion? It is a series of training modules designed for individuals in poverty (the ‘Getting Ahead’ course) and for communities or organizations (Bridges Strategy and Applying Concepts courses) that seek to create a framework of common understanding about why people get trapped in poverty and which offers some ways in which both individuals and their communities can move out of poverty.
Now, of course, when you have such a wide-reaching set of social concepts arising from a single person (and one presenting very modest research or epidemiological evidence, and whose trainings are sold through copyrighted trainings and books) two things are going to happen:
1. The academic community will go ape shit in their desire to expose and condemn this heretic who has dared skip the years of longitudinal studies and research to say a lot of things which in the end are only backed up by their belief in their own experience and intuition, rather than in a long history of published research. And there are certainly Bridges opponents out there. Here’s a good broadside. Bridges would argue that a lot of these critiques typically focus only on the framework and not how the framework is actually used and adapted within communities.
2. He/She who is condemned for their theories will also collect adherents– people looking for simple solutions to complex problems. These supporters will say that you need to charge ahead with what your gut tells you and not wait for some kind of historical validation, especially with such a pressing concern as poverty.
So, where does that leave the rest of us? We are not academic snobs but we also want to be sure that a new approach follows the doctor’s oath of ‘Primum no nocere’ or ‘First, do no harm’ and ensure that this will not make the situation worse.
I did some research into the Bridges work and met with Food Bank of Northern Nevada CEO, Cherie Jamason (who has spearheaded the uptake of Bridges in Reno) and Debora McDermed of The Vertical Dimension Consulting who runs the programs. Subsequently I invited Debora to present a workshop on Bridges at our annual Agency Leaders Summit.
Her presentation was a huge hit and seemed to touch a nerve with a lot of people from agencies who felt that this work was communicating something that they had believed at some level but never been able to put into words about the challenges they faced with their clients and that it offered some interesting tools for them to try on.
There’s a two-hour presentation, which is an overview. That’s ideal for CEO’s or business people who just want to get the gist. They don’t necessarily want to come to the training. Then, there is a two-day training. The first day considers what is Bridges and what does it mean and why would you be interested in it? How could you immediately put it to use? Day two looks at the tools and the techniques. The two-day version is designed primarily for service providers who want to interact with the client differently or they want to try some new program designs. This training can also be done from an institutional or community point of view. We have run courses for the healthcare, educational and judicial communities. How can these ideas help you be more effective with the client group you are working with. (Here is the flyer from a recent Bridges training conducted by Santa Cruz Food Bank) Bridges Out of Poverty 2012 Flyer
‘Getting Ahead’ is an intense program for participants who want to transition out of poverty. They meet for about two hours a week or somewhere between 10 and 16 weeks depending on the group. They learn the same thing that Bridges trainers learned in the two-day course, except they’re investigating it much more thoroughly. They look at how does poverty occur for them and their family. What are the societal influences in poverty? What are their personal individual influences? It’s really very rigorous.
As to community, once a number of trainings have taken place with different groups, often someone will say: “We need this in a big way for what we’re trying to do.” And so then the program can have a wider community focus. That’s what happened in Reno.
I think Bridges is a long-term vision but it has some short-term gratification. BridgesModel_HardDifferentiators You’re not going to end the poverty in five years. But there is something you can do immediately which I think gives people on the ground tools and techniques and ideas to implement. The training answers a lot of questions that people have never been able to find answers to around why it is so hard to help people make behavior change. I think people are invigorated by that. Poverty is defined by a lack of resources, and the USA is a country that is has severe income disparity as defined by the GINI index. Countries with this great disparity have real problems with upward mobility, hence the need for approaches like Bridges.
You mentioned about changing people’s behavior. How much of this change has to be down to the individual, and how much does the community or society have to change? Where is the line?
These are hard questions.
Sorry. This is such a thorny area, there aren’t many easy questions.
Individual change begins to happen because the program that we facilitate for people who want to transition out of poverty gives them a voice. It’s not a program that’s designed for them. It’s a program that they designed to build their own resources. That creates more ownership, more autonomy, more buy-in. Systemic change is obviously harder. It looks at the way we organize bureaucratic and administrative things to see if it actually enhances people’s ability to take responsibility or if we’re actually putting processes in place that continue to keep them stuck. The community pieces of our program identifies what the barriers are in each community – and they’re going to be different. Some communities have great public transportation. Some have none.
What barriers do we as a community need to tackle that would prevent people moving to sustainability over a period of 18 to 24 months. Can they get a job? Can they get transportation? Can they get childcare? Can they get on their feet in that period of time? Or is the community set up such that it will take much longer than this. This process shows what the individual needs to change and what the community needs to change to be able to facilitate this.
What about the blame game? Some want to heap all the blame on the individual and some want to heap it all on society. Can Bridges help with this?
I think so, because this training goes down well with those on both the political right and the left. The right likes it because it makes people accountable. The left likes it because it says it’s not all their fault and we need to make changes to bring mobility back to the United States so that people can move from their economic strata like they once could. It’s a very current, hot conversation when I’m talking to those people because I can talk about rebuilding the middle class. But I should stress that Bridges is not about making people ‘middle class,’ it is about people being able to create stability and build resources. And Bridges isn’t a program brought in from the outside, but a set of ideas. This is why Bridges and Getting Ahead are being used in Australia, Canada, Slovakia, Czech Republic etc and Detroit, Pensacola, Menominee Nation, Appalachia, etc.
Let’s talk in more detail about how the ‘Getting Ahead’ program works.
The first thing participants do is they draw a mental model of what their life looks like right now. (We have them draw because we don’t want to inhibit anyone who doesn’t read or write well.) Then, they identify those factors in their life that are affecting them dramatically. If they’re a single parent; if they are recovering or not yet recovering from substance abuse; are they dealing with the judicial system? These mental models help them build rapport with the facilitator. We call the person who teaches the course the ‘co-investigator.’ It’s not a hierarchical model.
We sit at the table with them and say we’re going to investigate the situation, your life and the situation in the community and see what is possible. They start with their own life. The theory of change that Bridges uses says that when you are in poverty, you are in the concrete virtually all the time. We call that the ‘tyranny of the moment.’ Therefore, this makes it much harder to do the abstract thinking which is where all of your planning, and many of your good decisions come from. This might include thinking such as If I spend this money on a plasma TV, I can’t go to the dentist. People in poverty, particularly generational poverty may have never learned how to do abstract thinking. We teach them how you can live in the concrete and think in the abstract. This helps them begin to step back and look at their life and analyze what’s going on and what to do about it. That’s very powerful for people. It’s also very painful. I had one person say, after they looked at their mental model, they said, “Wow, poverty really sucks.” But they were so busy just trying to eat, have shelter, some kind of job that they didn’t really have time to step back and look at it and go, “What new possibilities could I generate?”
Then, they have a lot of environmental influences like family members and neighbors who are all in the same boat who might live in ‘invisible communities,’ so they don’t know any people who could provide a different kind of help and assistance. Over a series of time, they also investigate societal change and influences. What are the societal influences that have kept people in poverty? What are the hidden rules of class? What does the middle class know that I don’t know? If I knew that, would I behave differently?
We do a lot of work in language skills, because they might habitually speak in what is called ‘casual register’ which is all about relationships and survival. It doesn’t work very well for job interviews or with a judge, or your kid’s teacher, where ‘formal register’ will be more effective. People can get marginalized because they might seem to speak disrespectfully or inappropriately. They start to learn about all the things they need to do to be able to cross this bridge. The course we run is not the end. When they graduate from it, they’ve developed a list of resources both personal and community that can help them move forward. They can’t magically change everything at once so they might decide to work on finance or emotional health.
Then, we encourage a community structure that is there to assist you when you have finished the ‘Getting Ahead’ program. Graduates are invited to meet monthly with allies, people that are wanting to understand how to make this a better community for all. We don’t call them mentors. We don’t call them coaches. We call them allies. This meeting is monthly and it is a partly social, partly educational gathering. Graduates can stay in it for 18 to 24 months past the course. They start to lead those sessions over time. They start to talk about their experiences and share with other people that are trying to transition. So, we build a network for them which can take them to the next level. They don’t have to join if they don’t want to. It’s available to them. So far, we haven’t had anybody not want to do it.
Poverty can be a lifelong challenge. For instance, one of the people who came up to me after your agency workshop who has a job and is living in a $2100 a month condo – which I guess is not hard to do in Santa Barbara. He came from poverty, raised in poverty, and even though he is now out of poverty, he said to me, “I’m haunted everyday of my life that I’m going to end up back there.” What comes out of the wider community support is that people start to get to know each other. They start to understand that people in poverty are just like them. Then, they began to form alliances, when people know somebody who has a job going, and they now have someone to call. That’s social capital. We do it all the time. People in poverty don’t have that. The only kind of capital they have is bonding capital with people who are typically in the same situation as they are, perhaps not making healthy choices or good decisions.
Sometimes they’ve had to separate from some of their family members as part of the process because their family may not be supportive of them in moving ahead, getting out of poverty. There are some emotional challenges that happen along the way, and that’s why we do the emotional resiliency piece within the training. When you start to change, not everybody around you likes it. This doesn’t stop people getting hopeful and positive. They know what they can do. They understand how to build and where to start. They understand how hard it’s going to be, and that we are in tough economic times but they have a place to start.
Why do you think that food banks are well-positioned to get involved in something like Bridges?
Food banks serve so many different agencies and clients in communities that they can act as ‘honest brokers’ in the communities. It is also an effective way for them to work to ‘shorten the line’ of clients. It’s also fun to work with people in a resource-based way versus a need-based way. I think we’re excited that we’re helping people build resources for sustainability. We’re not just giving them something to get through the week with.
What about the food banks that are getting very concerned about drifting from their mission or getting into an area where some of their donors or their board are going to freak out at them by being involved in issues of poverty.
A process of education is often required for the food bank board. In Reno, we happen to have a board chair who is a businessman. He doesn’t want to keep raising money to feed the same people every year. He wants to find a way to help people move out of the need for our services. The logic of it then, from a bottom line point of view can be very appealing. It also involves being a leader in the community in a new way.
It is also be a way of making a difference in a measurable way quite quickly. We can count the number of people we’re educating. We can count the number of people graduating our ‘Getting Ahead’ program. We can count what happens to our graduates as they begin to move on. it’s a win-win. You can lower your food procurement dollars, and you can increase sustainability in the community.
I will tell you on that the fundraising side, the funders for our Bridges work are not people that were funding the food bank before. We’re finding a lot of new funders who are interested in capacity building. They were not interested in needs-based money. There’s been no adulteration of the food bank dollars. In some cases, the same people who donate to the food bank now also give to Bridges. Like Wells Fargo Bank and Charles Schwab. They say, “Yes, we’ll still continue to give for a food distribution program, but we’re also really interested in what happens to these people in the community as they began to grow.”
I believe in a previous conversation you talked about the ‘hidden rules’ about food distribution. Would you to clarify what you mean about that?
With people in poverty, their view of food is all about scarcity and ‘having enough’. People will hoard food. They will take more than they need. This is because of scarcity being the primary focus. It doesn’t have to be good food or be cooked well. It doesn’t have to be nourishing or healthy. But there has to be enough of it. In middle class norms, people may care more about how things taste and look. With food distribution programs, those running them often care most about fairness. So you can see how these two things are going to rub up against each other, because both groups are not necessarily able to compensate for the other’s perspective.
If we have a situation where someone takes more than their allocation, then there is a breakdown in the relationship. There is agitation from the volunteer around fairness and agitation from the client around scarcity. I did a volunteers training at the Reno Food Bank. They were having these type of problems and the volunteers were pretty cranky! After they had the training, they tried some new things that they came up with on their own. There was a much better result meaning people didn’t hoard.
Give me an example of some of the things that they changed.
They changed the order in which they gave out food. People would always get there early, and they would be the same people every week. If you came later and were at the back of the line, sometimes you didn’t get anything. Now sometimes they start at the back of the line or in the middle. The second thing we did was ask the clients how they could improve the situation. The Bridges construct says that you give people in poverty a chance to be a problem-solver. You don’t solve the problem for them. The clients developed a way of trading food at the site. Somebody didn’t want bread. Somebody else wanted two cans of tuna fish, whatever. They figured it out themselves. They were happy with the result. The food bank distribution people were shocked. That’s what happened. There was a little lessening of control, but it worked to everyone’s benefit.
Deb, thanks for sharing some of your work.
To move forward the Bridges work, Santa Barbara County Foodbank will be holding a two-day training with member agencies in the first half of this year. We will also look at pairing it with a cultural awareness training component. The Bridges concept of living in the ‘tyranny of the moment’ is fascinating (because we’ve all at least vacationed there…) and so are some of the observations about poverty class vs. middle class thinking in certain areas.
There are so many great things about Bridges. But what of the current challenges I see with Bridges? I would put them in two areas. The first is the ‘class’ labeling that is used extensively, with the intention of moving people from one class outlook to another. I could see that it might be hard to avoid people feeling inferior. There are the potential dangers of what is called ‘classism’, which is prejudice or discrimination based on social class.
I was brought up in England which had its own obsession with class, which was very clear and on the surface. People opened their mouths and you knew what the deal was. In America, it is more subtle. Money can reveal, but money can also obscure.
I do find the Bridges focus on making everyone middle class a little challenging sometimes as if the middle class has all the answers. I mean if the middle class is so smart why does it seem to be steadily being annihilated through financial genocide…just a thought, folks!
I think Bridges advocates might respond that it is more a process of getting people to look at how the world is working now, to look under the hood at the engine and get a new understanding that will benefit them as they make changes that they feel the need to.
The other challenge is culture. Currently, from the small amount I have seen, the program is not very well culturally attenuated. So, within the Latino community for instance, there are many very powerful tools and relationships that help people get by in life through mutual and extended family and community support. A lot of ‘middle class white’ families might give up some of their advantages for grandma living next door to watch the kids. (I know I would!)
There is also more solidity around community development and small scale inter-community investment, both with cash and sweat equity. I have no doubt that as the Bridges program develops further within Latino communities that it will be adapted to better suit a different cultural reality, and that some elements can be accepted and others rejected.
In an upcoming post, we will look at non-profit community development and empowerment programs that use different models – such as the Just Communities program here in Santa Barbara County.
This is an exciting field, because we are getting away from a fixation on scarcity which seems to breed more scarcity, and we are empowering people to generate more. I know I sound like some kind of infomercial dude telling you to ‘generate abundance.’ Or maybe I am. Give me a better tan and a toupee and I would be glad to shill for ‘generating sufficiency’ and ‘generating sustainability.’
I encourage you to investigate the Bridges approach. It is an imperfect tool, but one that is being developed and improved in communities across the country. There is no ‘silver bullet’ (just like with gun control, as Joe Biden said – he does know how to say just the wrong thing at the wrong time, doesn’t he!) At the very least Bridges is an interesting filter for individuals,organizations and agencies to look at the world through and ask: “Does this do anything to help me see more clearly? Or “Can I combine this with some other initiative to provide a culturally and community appropriate set of tools and pathways out of poverty and into a healthy, sustainable community?”
If you were an old timer like me who came of age in the 80’s, but were painfully hip then, you will remember how the musical group ‘Gang of Four’ put it.
Previously in these pages we have questioned whether some of what we do to help clients through our distributions and programs might actually be having a negative effect on the long term health and independence of those clients. Earlier this year I interviewed Jan Poppendieck about her book Sweet Charity, which addressed some of these concerns.
The book was published last year, and this piece also draws elements from an interview with the author that took place this week.
Let’s start out with a little Rorschach test on your attitudes to our work. How does the following quote land with you?
Give once and you elicit appreciation;
Give twice and you create anticipation;
Give three times and you create expectation;
Give four times and it becomes entitlement;
Give five times and you establish dependency.
Does it piss you off? Do you default to a stance that everyone deserves enough food therefore dependency doesn’t even come into it? Or maybe you kind of agree with it. Whatever your response, I would bet that you will find a lot to chew on in Robert Lupton’s book.
“Food in our society is a chronic poverty need, not a life-threatening one. And when we respond to a chronic need as though it were a crisis, we can predict toxic results: dependency, deception, disempowerment.”
His basic supposition is that a lot of what NPOs and churches do to assist people has a negative rather than a positive result. He is not questioning people’s motivations, but rather the unintended consequences of rightly motivated efforts. He believes that if ‘emergency’ relief does not transition to development in a timely way, then compassion becomes toxic.
He provides an ‘Oath for Compassionate Service,’ which is meant to be a guide to the provision of services:
The Anatomy of Giving
Lupton describes his own experience of handing out boxes of groceries from one of his church’s food pantries. He began studying the facial expressions and the how recipients seldom gave him eye contact. The body language of the recipients was head and shoulders bent slightly forward, self-effacing smiles and meek ‘thank yous.’ He observed how quickly the response to charity devolved from gratitude to expectation to entitlement. He then observed his own part in the ‘anatomy of giving.’
“I expected gratitude in exchange for my free gifts. I actually enjoyed occupying the superior position of giver (though I covered it carefully with a façade of humility). I noted a hidden irritation at those who voiced their annoyance when free food stocks ran low. I grew weary of filtering through half-truths and manipulative ploys as I sought to equitably dispense resources.”
After 6 years of running homeless shelter kitchens I would have to agree with Bob’s observation of the attitude he observes in himself and others. He says that doing for rather than doing with those in need is the norm. Add to it the combination of pity that can become patronizing with unintended superiority and charity becomes toxic.
Big is Bad, Small is Good
Lupton spends a good chunk of his book looking at the sometimes misconceived results of church foreign aid trips, and disempowering nature of aid to Africa, but he also provides a detailed demolition job on the work of TAP (The Atlanta Project) born out of Jimmy Carter’s desire to eliminate poverty in Atlanta prior to the 1996 Olympic Games.
This top down approach to community development spent countless millions to leave behind a situation that was actually worse at the end of it. He also looks at the Faustian bargain that was the Salvation Army’s acceptance of a mega donation from the Kroc Foundation to build huge Kroc Centers that would centralize a vast array of social services. While this is convenient for the economies of scale of the service providers, it has the effect of drawing people from miles around to access the services and so distorting the normal societal fabric of the area around.
Lupton favors the Asset Based Community Development (ABCD) model (More on this in a later post) and his own organization in Atlanta operates on the smallest neighborhood by neighborhood approach. He also musters a pervasive though depressing argument about the effectiveness of microloans overseas and the reasons why they would not work in this country, except for with first generation immigrants. (He has nice things to say about ex-Feeding America CEO Vicki Escarra’s new organization, Opportunity International).
Lupton talks about ‘Parity vs Charity.’ That it is a very delicate undertaking to develop authentic parity between people of unequal power. But relationships built on reciprocal exchange (what he calls holistic compassion).
When Justice and Mercy Meet
Lupton identifies compassion as a powerful force, a stamp fo the divine nature within our spirits. It lies within us all – from tender child to hardened criminal – waiting for the right trigger to set it off. Mercy is a power that compels us to acts of compassion. He indicates that the Bible places equal emphasis on both mercy and justice. “He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy and to walk humbly with your God.” (6:8, NIV)
He breaks this down:
– Act justly. Justice is fairness or reasonableness, especially in the way people are treated or decisions are made.
– Love mercy. Mercy is compassion, kindness or forgiveness shown especially to someone over whom a person has power.
“Twinned together these commands lead us to ‘holistic involvement’. Divorced, they become deformed. Mercy without justice degenerates into dependency and entitlement, preserving the power of the giver over the recipient. Justice without mercy is cold and impersonal, more concerned about rights than relationships. The addict needs both food and treatment. The young woman needs both a safe place to sleep and a way out of her entrapping lifestyle. Street kids need both friendship and jobs. Lupton identifies that mercy combined with justice creates:
– immediate care with a future plan
– emergency relief and responsible development
– short term intervention and long-term involvement
– heart responses and engaged minds
“Mercy is a door, an opening, an invitation to touch a life, to make a difference. But it is not a destination.”
I believe that this resounds heavily within our work in ‘emergency’ food provision. We know that the vast majority of what we are now dealing with is the chronic situation not the emergency one. It is time we owned up to the responsibilities and possibilities of what we are involved in.
What is the real ROI that we are seeking with our billions of pounds of food? Those who read this blog will know that I believe that this return is in terms of a huge impact on the preventative healthcare of our communities and by using food banks to leverage and co-lead community development efforts.
What is the way from here to there? How do we transition from emergency relief to development? We could do worse than follow the steps suggested by Roger Sandberg, Haiti Director of the NGO Medair. He describes a progression of three steps:
1. Relief – Responding to the initial need. (We’ve already achieved this).
2. Rehabilitation – This overlaps with the first stage. It is anything that increases the capacity of a local community enabling them to respond to future crises. (This would include nutrition education and empowerment programs that a food bank can run or champion, and I am sure you can suggest lots of other things at this point in the continuum.
Lupton promotes food bank-supported food cooperatives as a replacement for food pantries that ‘offer free food at the price of recipient’s dignity.’ The cooperatives he mentions in his book are run by Chad Hale of the Georgia Avenue Minestries.
This organization is a member of the Atlanta Community Food Bank. Co-op members pay $3 biweekly dues for $30 worth of groceries. (More on the pros and cons this approach in a later post – if anyone wants to share any experiences, that would be great).
3. Development – This overlaps the other stages too. Development work is long term. It seeks to raise the standard of living and the quality of life for a population over many years. (This corresponds to the work a food bank can do creating jobs, assisting with community organizing and partnering with coalitions to work on long-term change in service areas).
Lupton believes that currently, the food bank network as a whole still remains on the sidelines of these efforts. Many food banks have great untapped potential to be involved in community development, but are shying away from it for a number of reasons.
“Erik, I’m glad that this discussion is coming up. It is encouraging that an increasing number of food banks are reconsidering a more community developmental approach.”
It is not unfair to Lupton to say that he doesn’t necessarily have a lot of answers about what the role of food banks should be in fostering this community development approach. He is clearer on the negative effects of some of what we do now.
That means it is up to us to create this vision for ourselves, in collaboration with our communities and our member agencies.
There is a lot of potential for new ideas and scaling of existing ideas. These are exciting times to be a food banker.
AFTERWORD:I normally stir up the odd vociferous reaction to my posts, and these sometimes upset those on the political left and the right equally. This is usually an indication that I am on to something interesting in my waggling of tooth nerves. The latest post is no exception. People are way too polite it seems to leave stinging comments on the actual blog, but send me emails instead, which is a shame. I am happy for a little public pushback.
The reactions to the Toxic Charity entry largely indicate a concern that this is some kind of right-wing agenda to ‘blame the poor’ for their situation and to cut them off from help. I don’t see it this way at all. I see it more of a case of ditching kind but ineffectual low-touch help and replacing it with long term relationship and commitment to make change in the community (which is the best help of all).
I think it is one of those situations where when we touch a sensitive area, then everyone retreats to a defensive position, sensing criticism and judgment and thinking they hear the things they are expecting and dreading to hear. I’m the most sensitive, touchiest little soul there is, so I am just assuming that others are the same.
It may be very uncomfortable for people to deal with Lupton’s criticisms of things that are close to our hearts, but I think if you look into what he is recommending in its place: Asset Based Community Development, you will see that this is not some kind of harsh ‘fend for yourself’ approach, but involves us helping each other in a deeper, more lasting way.
As I get into this work, I find the default approaches of left and right to be increasingly unhelpful and out of touch with my experience of the world.
Is there a life after food banking? Apparently so. Mari Ellen Loijens worked in development for Second Harvest Foodbank in Santa Clara and San Mateo County from 2000 to 2004, and is now the Chief Philanthropic Development and Information Officer for the Silicon Valley Foundation.
Of course it is every fundraising professional’s secret fantasy to then go on to work at a foundation and give it away rather than have beg for it. (Without appreciating the challenges that go with such a responsibility). So what’s the difference between your time in the food bank looking out, and outside the food bank looking in?
When I was at the food bank, the needs were constantly growing. There was no single year where we had to feed less people than the year before, and I had a strong sense of urgency about the growing need. Now that I’m outside, it seems like it’s endless and I’m more anxious for real solutions to the issue. It’s sort of like being an emergency room doctor, and your concern is how to bandage all the wounds for those who need immediate assistance. Then when you walk outside the emergency room, you think, “How can we avoid the people going there in the first place?”
That’s a question a lot of food bankers are asking themselves. Like me, they’ve seen the capacity of food banks grow with their success at fund raising and their ability to bring more food in to their service area. This has created more ongoing demand, so it’s kind of a spiral. How do you think that food banks could get out of this demand spiral and move towards a long-term solution?
We really need to look at some policy changes. We are a very wealthy nation and the notion that we have so many people who turn to others for such a basic need is troubling. Clearly there is something wrong with a system in which many children go to school hungry.
Food banks and other nonprofits are always very reluctant about stepping into these waters, because they worry about offending donors whose political slant may lead them to believe that we are just ‘enabling’ people. How can we navigate these waters?
I think that the problem is that we focus too narrowly on just food. If you only think, “I need to feed people,” and you think, “That’s my only issue,” then we’re back to the doctor in the emergency room who would be saying: “I’m trying to get people to stop bleeding, and it’s so expensive to keep using up all these wound dressings. So the solution is that we need more money for more wound dressings.” It’s a symptom he’s dealing with, not the cause. In the same way, hunger is the not cause, it is the symptom of a greater problem in our system. This comes down to something like minimum wage. Do we have a living wage? Are people able to earn enough where they live in order to take care of something as basic as food and shelter? We have got to move beyond pushing for increased SNAP (food stamp) benefits and into the bigger issues like: How do we make sure people, who are able, can earn enough money to feed themselves and their families?
So, are you saying that hunger is a symptom of the condition of poverty, or of something else?
I think poverty itself is also a symptom. I’m not a socialist or a communist. I don’t believe that everyone should make the same money, but I do believe that Americans, if asked, would say it’s wrong to have a system which forces people to constantly be in abject poverty and unable to get out of it, even if they are working hard, perhaps at multiple jobs. At some point, we are going to have to make decisions about how we pay for our beliefs and values. In the same way we are asked to make tough decisions now about taxes and how we want to pay for the things that we believe our country needs, such as roads or to provide the fire and police services that we want. In the same way, we have to ask ourselves the question: if we think it’s wrong for a child in a developing country to make a dollar a day sewing t-shirts, how are we going to provide an adequate minimum wage so that people in America who work a whole day can feed themselves and provide at the most basic level for their families?
And so how do you see the situation in America now?
I think we have an unspoken social contract in this country which prevents people from moving up out of poverty, and much of that is as a result of not have a living wage in most places. We also do not have systems in place that update the minimum wage as the cost of living modifies in an area. The systems that we do have reward the wealthy and do not help the poor. This means we have to really look at our whole social contract as a country and our value system and say, “Have we set in place laws that support the values that we claim are American?”
This is the point in the conversation where people begin to squabble about the meaning of the ‘American Dream.’ I see an unspoken fear in many donors I talk to. I would preface my comments by pointing out that these donors are caring and generous people who sincerely want to ‘pay it back’ and provide some level of support for those in need within their communities. However, they may have a voice deep within them, that reminds them how hard they had to struggle and sacrifice to get where they are, so why should they make it easy for someone else? They often don’t see the incredible daily sacrifices and struggles of those in poverty who can find no success story on the back of their struggle.
This is why food banks have been so successful, because there is a lot of interest in ameliorating the symptoms but a deep fear of taking the plunge to actually deal with the causes. Either donors are concerned that they will be heavily taxed and lose what they worked for, or they fear that the fabric of American society will change and everyone will expect things to be provided for them without working for them. Consequently they see America losing its ‘can do’ spirit of entrepreneurship and resourcefulness. The type of change that is required to actually deal with a problem is too scary. The same thing is true for issues of immigration, health care and the rest of the sad litany. This means we have to stand around with our hands tied or else harken back to some previous time in our country’s history where these problems were better hidden.
I think a new consensus for action needs to arise that returns the much-loved but threadbare teddy bears of left and right political philosophy to the nursery shelf, and for us to admit that we have grown out of them. They’ll always have a fond place in our heart they were both great in key moments at getting us to the point we are now at as a nation, but now they are getting in the way as our nation enters maturity. These security blankets are getting under foot and gridlocking our ability to do what we do best as Americans – which is to fix something in a no-nonsense straight-forward way.
I know from over a decade of working to assist either the homeless or the struggling, that the amount of people sitting on their gluteus maximus and freeloading their way from society (amongst poor people, anyway) is absolutely tiny, just as the amount of people defrauding SNAP benefits is a minuscule amount in relation to the total. Are we going to allow an obsession with preventing the enabling of a few who don’t want to help themselves hold us back from making huge achievements as a country for the vast majority of Americans who work so incredibly hard?
Can you imagine what greatness we could achieve as a nation if we weren’t all so consumed with fear about being able to get affordable medical help, or that we will be living in abject poverty as senior citizens? Modern free market economies are driven by so much advertising and marketing, that are showing people all the things they need to have in their lives to be happy. These forces provide a huge encouragement for people to produce more and earn more. If we can provide a counter-balancing support safety net for all Americans, it won’t extinguish this desire for more – which is equally part of the American temperament. The two can complement each other perfectly well. It’s not exactly a shining city on a hill, but it’s a workable system where we can all move forward at our own pace and to our own ability.
Forgive me for that. As a food banker, if you see a pile of pallets, then your natural inclination is to climb on top of them and start spouting off…
That’s quite all right, Erik. Keep breathing. Seriously, though, I think food banks need to get get braver about legislation. You need to move past the daily problem of feeding people, and start to collaborate with others that can focus on solutions and really start to ask the difficult questions of, “What’s the issue?” Yet for reasons that you mentioned, like when you referred to SNAP fraud, I think food banks are very afraid sometimes of moving in that area, because if you did a survey of people you feed and even one person said, “Well because I don’t feel like working.” That’s a terrible, terrible fear of food banks. Suddenly, no one might want to fund their food bank, because there is one person whose is working the system. So essentially, we are ready to punish and live in fear of that one person. Well, there is always going to be someone working the system. There are people who go to emergency rooms, because they don’t feel like paying for a doctor. We absolutely can’t set up systems to deal with that one person. We look at the big issues in our country like educations reform and how healthcare reform and you hear about those things all the time. I would love to hear our country talk about poverty reform. How we are going to help make a sweep of changes that would impact the base line of our country and help bring people who are essentially stuck because it’s impossible to move on or move out.
So, who do you think are the right people to lead this movement or does it need to come from a ground swell at a local level?
I think both. That is how the civil rights movement happened. You start with that real grass roots movement from people who are experiencing the issues and people who support those people. Then at some point you get the attention of people in a power position with legislation to be able to move those issues forward.
You mentioned that food banks are timid on the public policy front. What else do you think food banks could do to make this happen?
Well, I really like the ideas espoused in your blog about how your food bank is working on regarding entering the preventative healthcare arena. I do think that when you start to see yourself as part of a wider system rather than just an individual issue, then you are able to address bigger issues that have bigger impact. Poverty is not the root cause. People became poor for a reason. The fact that they are poor is not the issue. The fact that they became poor and can’t get out of being poor is the issue.
This requires food banks to build broad coalitions with other social service agencies in their service areas, some who may be member agencies and some who may not.
That is a challenge, because there is often reluctance for everyone to sit down and have a substantive dialogue about how do we move things forward? The subtext from non profit leaders can often be: “I don’t really want to be in a room with them. I don’t want to compete with them.”
Hey, you’ve been in some of the same rooms as me!
That’s the truth about a lot of nonprofits is they’re just completely uncomfortable with the idea of competition, and if I had the answer to this issue, I’d probably be able to save the world.
Well, we’re non profits. Competition is way too business-like and vulgar for us, right?
Yes, you’re very sensitive souls. But, it has to start with non profits admitting it is an issue. Then I think, speaking as a funder, that there is a clear role for funders in facilitating this issue. I think it’s all power dynamics. The one with the power has the obligation. Foundations really have the obligation to reach out to the nonprofits and say, “I really want to know and I really want to understand what’s going on. Why is this collaboration and conversation not working for you? Where they don’t have to sit in front of their competitor and say what their fears are. We can ask who would you want to collaborate with and how, on what terms?” I think having an honest dialogue is what moves things forward. This sort of thing needs to occur one on one or in small groups. Large gatherings can neutralize everyone’s desire to make anything happen.
I think what you say about the competition angle is very interesting, because it’s kind of taboo to talk about nonprofits competing. To be a good non profit citizen, you can only talk in the language of shared impact and collaboration. It might be very liberating for people to also have a conversation about competition and to say it is absolutely all right. I presume there is fear that we would be acknowledging duplication of service if we acknowledged competition. Certainly something for people to consider starting a discussion about in their service area.
How do you think food banks and other human services and nonprofit should be thinking about evolving their funding streams over the next few years?
I think if you are looking for systems change, at some point that goes against the grain for sustainability, right? You want to be working towards your services not being needed anymore. The ideal is that you want to be able to talk about what system changes are you creating, so that you should have to provide fewer and fewer services every year? That should be the big boast. “Last year we fed 200,000 people, but this year, thanks to our hard work, we only have to feed 150,000.”
But every nonprofit organization in the world is afraid to do that, because then they assume that the funders will come back and say, “Oh, you need less money this year.” And so the organization declines.
I think that there is a new generation of funders that have a very different way of thinking, and that what people really want to see are problems solved. People are tired of the same problems staying around for generations and generations. You’re right, though. Every nonprofit I know like to boast about how they did even more; served even more. It is a treadmill. But this new generation of funders comes from a very different way of thinking that would say: “No, no, no. The metric I care about is not how many people you serve, but that you made systemic changes so you will have to feed fewer people moving forward.“ It is a way for your organization to evolve to be truer to its mission.
Mari Ellen, thanks so much for your ideas and for your work supporting non profits.
Jan Masaoka is a leading writer and thinker on nonprofit organizations with particular emphasis on boards of directors, business planning, and the role of nonprofits in society. She has recently assumed the mantle of Executive Director of the California Association of Nonprofits. (CalNonprofits).
She is Editor-in-Chief of Blue Avocado, the essential online nonprofit magazine with an amazing 63,000 subscribers. For 14 years she was executive director of CompassPoint Non-profit Services (www.compasspoint.org), a consulting and training firm for nonprofits based in San Francisco and Silicon Valley.
She is an eight time designee as one of the “Fifty Most Influential People” in the nonprofit sector nationwide. Her recent book with Jeanne Bell and Steve Zimmerman, Nonprofit Sustainability: Making Strategic Decisions for Financial Viability, (Jossey-Bass, 2010) has quickly become a vital tool for nonprofits to truly assess the financial impact of their range of activities. (I will explore the teachings of the book in another post.) My conversation with her was an opportunity to revel in her rich experience and take-no-prisoners plain talking. This makes everything she says not so much a condemnation of how things are, but an invitation to question, question, question. And we can’t have enough of that.
Jan, you are new in your position at CalNonprofits, yet already you are involving the organization in a major initiative to get nonprofit staff, volunteers and clients signed up to vote (for the recent California elections). I have noticed that some nonprofits shy away from such activities in their direct service programs because they are fearful that some donors might say they are ‘becoming political.’ How can you deal with that?
First of all, this is non-partisan voter registration to get out the vote. We’re nottelling people how to vote. We are saying that whatever the ideals and values that brought you into contact with the non-profit sector, vote with those values.
Nonprofits are not outside of communities, they are the ways that a community organizes to take care of itself. But I also think that we don’t just serve people, we represent them. Anybody that’s serving children with disabilities, for instance, is also representing them. There is a lot of heavily lawyer-scrutinized information in the Legal FAQ’s section of CalNonprofit’s website which indicates what nonprofits can and can’t do in this area.
LOOKING UP AND DOWNSTREAM
In my discussion with Jan Poppendieck, she touched on the need for food banks and similar organizations to put more emphasis on looking up and downstream from what their own particular level of involvement was with clients.
This is vital. I can think of an example of a shelter program for runaway kids that used to be funded by the government. They received a fee for service based on a performance outcome basis. The designated outcome was reuniting kids with their families, and they would receive a certain amount of money for every kid they reunified with his or her family. But if you look downstream and think about it for 10 seconds you realize that with some kids, reunification is a good outcome but for many others, it is no. There were a lot of kids being returned to abusive homes or to a home where drugs were being used all the time. The nonprofit realized they needed another goal, of more long-term shelter for those kids who didn’t have good homes to go back to. They received no government money for this, so they had to raise it. And then looking upstream, they realized they had to advocate to get the policy changed that specified unification as the only goal. If they had only thought of themselves as a little factory of unduplicated units of service they might have remained focused on the unification numbers. But because they are representing this part of our community, they had to find the best outcome for them even if it didn’t mean they got any money for it. Standing on the sidelines is easy, but is no longer an option if we want to achieve big things.
GOVERNMENT, BUSINESS AND NONPROFITS
We hear a lot about the supposed realignment of the roles between government, business and nonprofit organizations. What is your take on this?
I think it’s about smoke and not fire. I just read in today’s paper that some country music star is going on a tour, and in each of 25 cities, he’s going to buy a house mortgage free for a veteran there. That’s wonderful, and great publicity for him. Unfortunately this is not really an example of private dollars helping veterans in a significant way, it is more about winning a lottery, and that is no way to help those around us. We have over a million veterans in the United States and he’s buying houses for 21 of them. So I think that the idea that private money is going to supplant the need for government money will never be true.
Yes. I member a California foundation that poured millions and millions into working with the schools and weren’t getting much in the way of results and someone explained that they had really only put in about as much as the lightbulb changing budget for the Los Angeles Unified School District. These problems are too big for most foundations to move the needle on, or for government to excuse themselves from.
What about the ways in which businesses and nonprofits can work together more? Don’t you think that businesses are starting to approach some things like a nonprofit and vice-versa?
Businesses always absorb what is the culture of the day, in order to sell their products. So for example there was a time when paisleyprints were radical and wild. So people who wore paisley or had long hair practically saw this as being anti-corporate. Then business took that over and people with long hair were in commercials for cars. I think that right now we have a similar cultural view, which is about doing good in the world and being community-oriented. Don’t get me wrong, it is important and valuable, but I think like every other cultural movement business uses this and when the cultural movement passes, business will pass too.
But, corporations are run by and made up of people (just ask Mitt Romney) so those people can always express their generosity and concern about the world, despite the business imperative. We’ve come a long way from Johnson and Johnson’s shareholders suing the company when it attempted to divert some dollars to philanthropic activities. Helping the community is always smart business, so I don’t see that changing.
Sure, but when doing good crashes up against consumerism is where things often grind to a halt. So, for example, all the people who are passionate about sustainable agriculture might not want to realize that the most significant thing they could do about reducing the energy cost in agriculture would be to stop eating lettuce. Lettuce uses more energy cost related to the nutrition it provides than any single produce item on the planet. And yet you don’t see environmentalist calling for the end to eating lettuce. So I think that it can become a symbol of how we want to do things and see ourselves, but we don’t really want to make any changes to our consumer lifestyle.
On a local level, how do you think that nonprofits can collaborate and get some kind of collective impact?
I think the way that food banks work with their member agencies is an excellent example of bona fide collective impact that is generating extra value. For the most part, the smoke around collective impact and collaboration is not about something that genuinely works but creating the appearance of something that’s going to work. Almost all of these efforts are funder-driven and the funders put money into them and when the funders take the money out, it collapses. And that suggests that it’s it’s not a business model that works.
So what sort of examples can you give where that’s happened?
Foundation after foundation has created local collaborations and they’re around many different areas. Sometimes they are focused around a particular neighborhood and they’ll create a collaboration of different nonprofits and businesses to work on that neighborhood. Sometimes they might be a collaborative of something like domestic violence shelters working across 6 counties or the like. Many of these collaborations have grown organically over time, so they actually work. But others failed, like the Hewlett Foundation’s neighborhood improvement initiative and Annenberg’s initiative in public schools, the San Francisco Foundation’s Lifeline collaborative. They were put together in a way that didn’t make business sense for any of them and so when the outside money disappeared, the collaborations evaporated. So the collaborative initiatives that last are the ones that genuinely make sense for people and almost all of them are started by the nonprofits themselves, not by funders and their consultants.
I think funders have got to build on existing community strengths. And if there is not an organic community strength in that particular community then maybe you can’t fund them successfully. Maybe you have to look for a different community or maybe you have to take a longer view and say maybe there are 6 or 7 weak organizations in that community but let’s take a longer view of building their strengths. Instead I think what tends to happen is that a foundation that wants to work in a particular community or field and they see 5 or 6 weak organizations, then they figure if they just had a consultant to bring them together for collective impact, then it will all work out. It won’t.
One of the things that keeps nonprofits honest is that we get feedback from the market and we have two markets – a client or patron market and then we also have a funding market, so we have to work in both of them. Whenever you’re in a situation when you don’t have to work with those markets, then things can go wrong and you’ll never know it. That’s kind of like back in the old Soviet Union when the state decided what a factory should produce. There was no reason for anybody to get any better. Any institution that is not kept in check by some kind of market goes bad and doesn’t know it.
And so how can a foundation avoid getting into that situation then?
They can support community-based efforts as opposed to starting their own initiatives. I visited a foundation recently and they had on the wall a large poster that they had created with a circle. And in the middle of that circle was their logo, very large. And then around the outside of the circle were other foundations and nonprofits. They said to me that this represents our view of how we collaborate with other people and I felt like – No! – this represents your view of how you’re in the center of the universe.
A former consulting client of mine,for example, was running an organization they did a lot of psychological counseling for people and families across the spectrum. They receivedfunding to support this work and then when that fundingdeclined, they focused more on earned income. So, they were able to successfully grow their earned income side, and their budget didn’t look any smaller. But if you look closer, they’re now primarily serving people that can afford to pay rather than across the economic spectrum. And I think that this story writ large has been the hidden story of the move toward earned income.
You don’t feel that this can be balanced by having scholarships or sliding scales?
I think it can be mitigated and it’s a partial answer for some organizations but we need to be alert that so far at least many of the earned income gains have come at the cost of helping middle class people rather than economically disadvantaged people.
Many food banks resell purchased food or require a shared maintenance fee of a few cents a pound for some food items that they provide to member agencies. Some food banks don’t do that but we have found that in situations where there is no fee, it leads to inefficiencies with organizations taking more than they need.
So you introduced in a market element, right?
Yes, we’re not charging individuals, we’re asking organizations to take a financial stake in what we’re doing.
You should realize that I’m not trying to sound like I’m anti-earned income. I’m just saying earned income is not a replacement either for charitable dollars or government money.
Yes, nonprofits that provide “the most basic anti-poverty for the poor and homeless failed at around twice the rate of more mainstream services.” Also, only about 16% of foundation funding is targeted to low income communities.
Which you lay at the doorstep of the focus on “innovation, social enterprise, outcome metrics and the coolness factor.” Jan, this is hitting me where I live!
It should! But I think food banks are hardly the type of organizations that are in this situation. They are doing some of the most important and pressing human work. And these and other organizations are where the money and focus should go.
Thanks Jan. There is a lot to think about there. Please continue to challenge us.
Jan Poppendieck’s book on the emergency food provision system, entitled ‘Sweet Charity?: Emergency Food and the End of Entitlement’ was released in 1998. It is a book I only came across a year or so ago, and for me it was like discovering some secret artifact that confirmed all the things I had come to believe after six years of running a soup kitchen for the homeless and four years running a food bank.
I now ask new leadership team members in our organization to read the book as background to why ‘charity’ alone cannot solve the nutrition issues we are facing. Jan has been active both as an academic and also serving on the board of Why Hunger? in NYC, amongst others. She has most recently written “Free for All: Fixing School Food in America,” . I spoke to Jan last week.
How have things changed since you wrote Sweet Charity?
Not enough. Nevertheless, foodbankers are escaping from the emergency mentality. They have been in this business so long now that they know that the short term emergency is not the whole story. The implication is that if we are not feeding people for only the short term, then we have to pay much closer attention to the nutritional impact of our actions. This means there has been much more awareness of the need for fresh produce within the network.
Sue Sigler, the ED of the California Association of Food Banks recently told me that she thought ‘Sweet Charity’ was almost single-handedly responsible for bringing food banks into the public policy realm, which was an area considered best avoided prior to 1999.
That’s flattering. I hope I helped move the discussion along. Certainly, the food bank network is more visible and active in public policy advocacy now, especially in the fight to protect TEFAP and SNAP. There is lots of room for more engagement too. I imagine the foodbanking network as a sleeping dragon that if it could mobilize all of the soup kitchen and pantry staff and clients and volunteers and supporters and board members, we would have a very loud voice in public policy. It is a huge challenge of course, but even mobilizing some of them could be very effective.
Do you think this group should be mobilized around what to enshrine or include in a specific piece of legislation like the Farm Bill, or do you think it has to be a wider, less specific mobilization around a cause.
That’s an interesting question. Like most others in the policy world I live from crisis to crisis or opportunity to opportunity. Fighting cutbacks on SNAP while the economy is suffering like it is now is something that has to be done, but it tends to draw all of our energy and attention. It is harder to move from responding to an immediate threat to a more visionary approach to public policy, where we are looking downstream at what kind of country we want to live in, and what kind of people do we want to be. Emergency food provision can be a tough place to start this discussion from.
That’s exactly why some are trying to find a new and powerful place – the public health arena – from where food banks and their network of 64,000 member agencies can have a fresh kind of leverage and credibility to operate from, one that is underpinned by a long-term preventative health approach. I believe this path can be less divisive within our political landscape where ‘division’ seems to be the current approach to problem solving. If we look back at the fight against tobacco, it was not couched in terms of ‘haves’ giving charity to help ameliorate the conditions of the ‘have-nots’, but in terms of what was smart for the future health of the country. We need to take that same approach with nutrition.
One of the great things about the history of public health is that it has always stressed interventions that would target hazards or sources of ill health in the population and in the environment, as well as changes in individual behavior. On your From Hunger to Health site, where you run through the ‘Lovely Leptin’ and the ‘Ghastly Ghrelin’ – that is the clearest presentation I have seen about why distributing highly processed foods leads to hunger and obesity. The education with food approach that you are taking is right, because if it leads to us to being able to draw in the grass roots – the little church food pantry in the low-income neighborhood – it could produce a massive movement for change that would lead to a demand for healthier food, and public policies which would promote the production of healthier food.
The public health community often has a top-down approach. They indicate that they’ve done the research and know what is bad for us and are busy getting the word out through all sorts of messaging. But somehow they don’t encourage a process whereby people are able to discover this out for themselves and deduce what kind of changes are needed, for instance in what is available in their local store at a fair price. If food banking could become the pathway by which food insecure Americans began to assert their power towards a healthier food supply, it would be fantastic.
That is what an increasing number of food banks are beginning to promote. Outreach in the past often meant drawing people into our programs, then it became more focused on promoting SNAP. If you look at what Santa Cruz are trying to do with their Ambassadors Program or we are trying to do with our Nutritional Advisory Committees, it is moving things to the next step of empowerment.
Certainly there is more specific interest from Feeding America out of their new strategic plan, in what is possible by ‘mobilizing the public.’ Though I believe there is still a little too much emphasis on that mobilization being focused on people ‘telling their stories’ to the end of helping us highlight the continuing seriousness of food insecurity, rather than taking the next step and empowering them to move beyond their stories and become more involved in creating a local food system that truly looks after their health. It’s hard work, but it’s the kind of ground-up work that leads to true transformation.
I think that this is how things need to happen. We can’t end hunger with more and more food. Mounting inequality means that our public policy is typically made by those who can afford private schools and boutique medical care and gated communities. They are the ones making decisions about how much to invest in the public solutions that are there for the rest of us. They need to hear the voices of those who they are there to serve, or we need to replace them with people who share our interests and problems.
Your most recent book “Free For All” looks at another puzzle palace of American nutrition, the school food system and the need for it to be reformed. Is there a link between the subject matter of these two books?
Both books are all about how average families get by. School food is so important, because the more human needs we can have met through normalized situations like the provision of a healthy school lunch, then the less people have to become marginalized and forced into seeking emergency solutions.
Also, school cafeterias used to be instructional and have an educational function – to teach kids how to eat well. I would say this is something we need more than ever, to compensate for the distortions in diet that are a consequence of the fortunes spent in selling non-nutritious food-like products to kids.