Toxic Charity : How Service Providers Can Hurt Those They Help (And How to Reverse 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.

Today on ‘From Hunger to Health’ provide a review of another book, Toxic Charity by Robert Lupton, ED of Focused Community Strategies (FCS) a respected community development organization operating in inner-city Atlanta.

Bob Lupton

The book was published last year, and this piece also draws elements from an interview with the author that took place this week.

What does it say to you?

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.

Excuse for gratuitous picture of the Toxic Avenger, for those of us of a certain age, with a certain fondness for Grade Z movies.

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.’

Step right up...

“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.

JC (the other one) and MJ at a TAP Event in 1993. It almost makes your nostalgic…

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.

Asset Based Community Development – The Ninja Star version

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).

Working for Parity of Relationships is key

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. 

Are Non-Profits afraid of Competition? How can we tackle the root causes of hunger in America? Tough Questions from a Community Grantmaker – A dialogue with Mari Ellen R. Loijens, CFRE.

Mari Ellen Loijens

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?

Want to dip your toe in…

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?”

Bumper sticker seen outside Santa Barbara’s swankest hotel.

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.

Whatever the sentiment, Uncle Sam gets pressed into service to wag that finger.

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’ve been manhandled so much, I don’t remember whether I’m Republican or Democrat.”

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?

Sounds great, we should import that stuff to America! (Cheaply, of course)

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.

Nothing wrong with a little friendly competition.

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.

What Every Emergency Food Provider Can Do To Boost Client Health: A Dialogue on Food Insecurity and the Management of Chronic Disease with Dr. Hilary Seligman

Dr. Hilary Seligman, MD, MAS

Dr. Hilary Seligman, MD, MAS, is an Assistant Professor of Medicine within UC San Francisco’s Center For Vulnerable Populations and a general internist at San Francisco General Hospital. She is also affiliated with the UCSF Center for Obesity Assessment, Study and Treatment. Dr. Seligman’s work focuses on food security and its effect on the development and management of chronic diseases such as obesity, hypertension, diabetes and heart failure.

There is a reasonable amount of awareness about the health burden that food insecurity places on early childhood development, but not so much with adults, and I find that a really interesting element of your research.

We have largely ignored the long-term health implications of food insecurity among adults.  And so what I’ve tried to do is firstly figure out if there are health implications for adults, and – yes – there do seem to be important health implications.  They’re a little harder to talk about because it’s a little more complicated than just saying iron deficiency anemia, but I think the message needs to get out there that food insecurity has nutritional implications that are important, not only for children, but for adults too.

We all get so amped up trying to save the next generation that we forget the current one – and that would be you and me, folks!

At the recent Feeding America summit, you made a presentation that used diabetes as an example of the intersection between food insecurity and the successful management of chronic disease. (Food Insecurity and Health Presentation Feeding America Network Summit 4.19.12

A key element, which I think has wider relevance as we help our clients with their nutrition, concerns the cycles of food adequacy and inadequacy. We might expect a compensatory strategy of skipping meals, (leading to hypoglycemia) during times of food shortage, but you demonstrated that even when these people had enough food, it led to systematic overconsumption – people wanting to feast now that it was not a time of famine – which had similarly negative effects on the control of their diabetes, leading to hyperglycemia.

Yes, and food insecure adults required about five more physician encounters per year than those that are food secure.

In so far as the Food Bank Network touches an extraordinary number of people, and particularly people who are very high risk for the varied diseases that food insecurity predisposes people to, namely obesity, diabetes, and other diet-related diseases, food banks really present an unbelievable opportunity to be part of the solution to the nutritional inadequacy and the typical food-insecure adult diet.

So what do you think food banks should be doing to help address this situation?

Food banks often reach a person at least once a month, in a context that allows them to talk about diet and provide nutritious food.  People are much more willing to talk about their diet when they go into an environment in anticipation of leaving with food. And then it’s the challenge of what kind of food does the food bank provide, and how much of that food will provide a high nutrient value.

As distributors of food, we can potentially get stuck in a place of having to provide clients with donated food which may provide them with an overgenerous supply of calories but  that doesn’t do much to build their nutritional health. The other tough place is unsustainable spending healthier food, which even with the buying power of a food bank can be hugely expensive.

Totally. There are huge distribution and logistics challenges. I think what we have to do is take the first step which is to look at it and acknowledge that obesity and diabetes are a huge problem in the clients that are served by food banks and that food banks have the potential to greatly assist with that management.

We are now in a new situation where the ‘emergency food’ situation is becoming the new norm for a large number of our clients. Do you think that requires a greater degree of responsibility for what kind of food we are distributing?

It does. Food banks are being asked to feed people year after year after year because SNAP is underfunded.  And that’s where we get the problem.  It is the chronicity of use I think that makes essential an increased nutritional value in the food bank offerings. The other thing that’s changed is that an individual calorie has become so cheap that it’s really easy to get too many of them. You can get a lot of calories from poor food and feel full, but you won’t get any nutritional value from it. This is especially true of the food insecure clientele accessing services from a food bank or member agency.

Since the dawn of time, mankind has worshipped the Twinkie. (And it’s still fresh).

I’ve heard the argument that non-nutritional calories (Twinkies and chips and pretzels) are so cheap that anybody can afford those in the United States, and the food bank should only be there to provide fruits and vegetables and other very healthy food items.  That is a more extreme view, right?  That’s not necessarily my absolute view, but there is a certain value in considering whether clients can afford more expensive calories, and therefore considering what type of food that food banks should be providing in the future.

Why did this glorious union never capture the imagination of the Great American Public?

Particularly as access to these cheaper calories become more difficult for food banks, as corporations continue to become more efficient with their inventory. If the food in a food bank resembles the proportions of the contents of the USDA’s My Plate, that would be an ideal situation: half fruits and vegetables, a quarter whole grains and a quarter protein – lean meats and protein substitutes.

Our food bank is pursuing a steady transition to a specifically preventative healthcare agenda. Our goal is to leverage short-term relief of hunger and food insecurity into longer-term shifts of client behaviors around food leading to better health. This means an integrated series of programs starting with expectant mothers and following children through right up to the high school level. This means outcome-based evaluation, which is very challenging, yet we feel it is essential to gain the credibility to exist in this new and potentially very powerful space. However, we’re nothing if not a joyful ‘Heinz 57 Varieties’ of a network. Do you think that there is a lot that any food bank can do to move forward a healthy food agenda without having the particular focus that we have. 

Yes, I think every food bank can make big strides, whatever their resources or approach. The link between dietary intake and obesity and diabetes is clear enough that just documenting an increased intake or increased access to fruits and vegetables is enough to create an important public health message to the client group.

By the same token, you don’t necessarily have to show that BMI goes down or that diabetes is better controlled, because that link is well established enough. Just showing that fruits and vegetables are desired, they’re taken, and they’re eaten at home rather than ‘they spoiled and I threw them away,’ that’s enough.

Surely education – in what we like to term food literacy – plays a key role here?

Yes, the evidence in the academic literature suggests that protein is the most significant problem, because clients are reluctant to shift to non-meat proteins. Particularly in low-income communities, it’s not considered a meal unless you have meat, and that’s not the most nutritious message.  Other protein sources like beans and lentils and tofu are cheaper than meat and offer great nutritional value, but that’s an education message that we need to be communicating as well, and it’s often a hard sell.

When in doubt, have a festival! Still time to book for this August, Lentil Lovers!

What doesn’t seem to be as much of an educational issue is fruits and vegetables.  People like access to fruits and vegetables and will take them it when they are available, and when they take it, they eat it.  So the bigger educational barrier to me seems to be in the protein choices. In terms of fruits and vegetables, the big place where education needs to be done, I think, is with produce that people aren’t so familiar with, whether for cultural or other reasons. Particularly because these less familiar fruits and vegetables often end up at food banks.

Tell me about it! Every day for us is ‘Three Hundred Things to do with a Persimmon.’ Martha Stewart has nothing on us!

Only Martha could make Food Insecurity aspirational…

So, I would like to ask you what is your definition of optimal food security? How can we define it in an individual seeking our services and how can we measure our interaction with that person to know whether they are able to attain it?

That’s a great question.  You know, this is, again, my personal opinion.  People will disagree with me.  But I think that the way you know someone’s food secure is they’re not coming back to the food bank. Even if you report on a food security survey that you’re not worried about running out of food because of money, 99% of people who answer that they’re food secure on a survey administered by a food bank are doing so because they have come to rely on that food bank as a chronic source of their food intake.  And so they don’t need those additional food resources because they have the food bank.

I have a dream, where little white birds and little black birds pick up little spoons and feed all the boys and girls.

So where would you like to see the Food Bank Network in 5 years, as relates to this area?

I would love there to be some relatively straight forward way that food banks can record their product as high nutrient value versus standard nutrient value, so that there is a simple way to track improvement.

Feeding America is looking for other markers of success that are more nutritionally than poundage focused, and of course different food banks are already using systems such as CHOP (Choose Healthy Options Program) to rank their food.

Yes, though I think oftentimes they’re difficult to operationalize.  So I would love to see that food banks can set individual quality goals around improved nutrition.  Many food banks already have the skills around refrigeration and quick distribution, so it is more about developing the infrastructure for all food banks so they can respond if say a farm were to call up and say I have 100 pallets of broccoli, will you take it?  Many food banks would say, no, we can’t take that much because we can’t refrigerate it or distribute it quickly enough.  This is a hurdle that deserves to remain a major focus.

Hilary, thanks for your significant research in this area and for your support of and belief in the work of food banks.

RESOURCE

Link – Journal of Nutrition, 2010 February –  Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants


The Backpack Program: Sacred Cow or Fatted Calf?

Everybody loves backpack.

It is one of the maxims of food banking.

BackPack provides emergency supplemental food assistance to children to ease hunger over the weekend. The backpacks (in reality plastic bags after the issue of single backpack at the beginning of the year) are full of single serve food items, typically containing protein items like tuna or peanut butter as well as snack bars, small cans of chili or franks and beans etc.

Contents of one Food Bank’s Backpack

As food banks have grown over the last decade, so has the volume of food passing through them and the funds they receive. This has resulted in many of them initiating major expansions of their backpack programs – our own organization included. The money for this is so easy to raise in the local community, because it presents such a readily understandable and direct solution to the issue of hunger for kids. (Try getting a buck for SNAP outreach, people). Packing the backpacks is also a great volunteer activity, giving corporate volunteers something to do beside freeze their ass off mindlessly sorting carrots in the warehouse. This is direct and visceral. I just filled a bag with food that will soon go directly to a kid.

This expansion of backpack has been heavily supported by Feeding America, both with a formalization of what contents are required to have a backpack program meet their guidelines and also with pass-through funding. This commitment continues with the recent study into backpack nutrition.

So why is the Foodbank of Santa Barbara County making very significant cuts in the numbers of backpacks provided for in our newly accepted 2013 budget?

Mr. Todd had a very creative idea for a food-related earned income strategy…

Is it because the CEO is some descendent of the Child Catcher in Chitty Chitty Bang Bang, determined to bring misery to the children of the land? Always a possibility.

Nevertheless, our reasoning is that backpack, despite its virtues does nothing to assist the people it serves in getting out of the situation they are in, so for us, that rung warning bells and meant the program had to come under considerable scrutiny.

Foodbank of Santa Barbara County Program Engine

Our mantra is that everything we do needs to achieve three things:

1. provide short-term hunger relief and nutritional benefit,

2. also provide long-term empowerment and education to help provide a pathway out of food insecurity and boost food literacy and

3. we have to find a way to make the initiative community driven (and therefore sustainable).

So, backpack probably logs a modest though unspectacular score for criteria 1. It logs a zero for criteria number two (I have seen the occasional glossy nutrition education pamphlet included in a backpack, doubtless paid for as one of the educational elements of a grant from a large corporation. Our work with this populace suggests that these sort of expensive and uninvolving attempts at education are quickly discarded.) And then for criteria three, it would probably get the healthiest score of all. There are plenty of people in the community who wouldn’t want the program to die and would provide cash and volunteer support.

With our goal to end hunger, rather than just ameliorate it at some supposedly acceptable level, this lack of effectiveness for criteria number 2 is a really serious issue. Hence our cuts to backpack in our overall program mix for children.

We believe these cuts will not affect those who need the program most, and will allow us to divert the funds (and more) to a major expansion of our award winning (have I mentioned this in the last five minutes) Healthy School Pantry Program  which we believe represents a far more impactful and long lasting nutritional intervention for our families.

Our research showed that many of the backpacks were just being provided for kids in after school programs that happened to be run in schools with a significant number of free and reduced meal students.

Master Maxwell Jorgensen. Butter would not melt…

The situation was highlighted for me, when my own stepson Max came back from his YMCA after-school program carrying a plastic bag of food from our Food Bank.  Obviously if you work in the food banking world, you are not taking home the mega bucks. Yet hopefully a backpack should be going to a family in greater need than that of the CEO of the Food Bank where the backpack originated from.

Many backpack programs go out through after school programs, but some also enter directly into the school environment. This originally came out of the hope that teachers would identify kids in need who would be the ones who would receive food. However the reality has been for many food banks, that teachers are often too busy to follow through with the admin side of having to do this, and it is logistically easier for the food bank to send a larger quantity of backpacks. We have also seen cases where larger and larger amounts of backpacks have been requested for wider distribution in lower-income schools to avoid stigmatization of those who most need help. This is an worthy consideration, but it also waters down the true intent of the program.

We did a survey of our backpack program, so that we could make sure we were basing our decisions on the real world situation rather than what we thought it might be. This survey showed that backpacks are very often shared with the children’s families, especially in a situation where a number of children in a family might be receiving a backpack. So whatever the more targeted approach that the backpack was designed for – specifically those in transitional living or homeless situations – it was increasingly being used as a simple supplement to the family diet. Plenty of those diets could benefit from supplementing, so there might be nothing wrong with this – if it weren’t for the issues of cost and nutritional value of the average backpack contents.

In Santa Barbara, our backpacks have always included fresh fruit (apples, oranges, stone fruit) or vegetables, yet we were still sometimes getting complaints from from visitors and volunteers about the quality of some of the food that went out in the backpacks.

True Confessions: These actually went out on one of our backpacks, may God have mercy on our eternal souls…

Obviously different volunteers have different perceptions of what constitutes suitable food for a child to eat. Some believe we should provide comfort to those in a tough situation by offering comfort food, whatever the ugly nutritional truth behind the bright shiny boxes. Others have a level of health zealotry such that anything we could provide would never be good enough. However I know (from my photographic proof above) that in the past, we have had  poor quality food go out in backpacks. Food that I would not give my own children to eat (which surely has to be the criteria for what we provide to other children). I have also seen backpacks serve as dumping grounds for inappropriate amounts of produce that we wanted to get out. The provision of fresh produce in backpacks is still provided in a minority of food banks nationally, and through my own visits to other food banks around the country, I have seen  all manner of borderline crap going out that may make the child’s nutritional situation worse.

Another (nameless) food bank’s  backpack. Pop tarts, chocolate milk, ritz crackers, popcorn and mac and cheese.  Not much here to grow a healthy child.

Packaging is another major issue. Feeding America requires backpacks in their programs to contain food items that should be able to be opened by a child without access to a can opener. (Does that mean we are building a generation that can’t even work a can opener?) As a result of this single ‘e-z open’ requirement, this program plays to the worst packaging excesses of the American food industry. Tiny amounts of food is entombed in containers that cost vastly more than the food they are there to protect. I should say, though, that when the zombie apocalypse comes, I’ll shotgun my way over to the backpack storage section of the food bank, because that stuff will still be in exactly the same state as the day it was incarcarated.

Remember your sensitivity training people: When someone walks into a food bank, you should never prejudge them as being either client or donor based on what they look like. However if they are shuffling with flesh hanging off and reaching for your throat, you really should consider making an exception…

We know that there is no individual child-owned solution to the nutrition challenges that kids face.  Backpacks can’t solve childhood hunger. The only solution is a family solution (supported by an adequate Federal safety net, of course).  Backpack is a short-term fix with no way to help the family provide better, more consistent food.

There is no doubt that there are many children who are in truly dire circumstances. They are caught in a family situation of serious deprivation, maybe as a result of parental addiction, mental issues or simply having the misfortune to be born to truly awful parents. These kids need all kinds of help and there is clearly a need for backpack in a situation where the child may have to source and prepare their own food on a regular basis. Everyone involved with emergency food has their own stories related to this kind of client need. People can sometimes better understand  this type of situation when I refer to something in the wider culture. The bestselling memoir, ‘The Glass Castle’ by Jeanette Walls (soon to be made into a movie, starring Jennifer Lawrence) is an example that I sometimes use. Jeanette Wall states plainly in the book that her earliest memory was ‘of being on fire’, and we’re not talking literally. As a borderline starving three-year old left to her own devices by ‘different’ parents, she was boiling up her own hot dogs, standing on a chair in front of the stove and her dress caught on fire. (On her return from hospital, when she went right back to doing the same thing again, her mother congratulated her for being brave and ‘jumping right back in the saddle.’)

So clearly, some kids can use every backpack they can get their hands on to ward off starvation. The problem I am trying to highlight is that we have a whole program structured to deal with this kind of situation, whereas the vast majority of backpacks are going to kids who are not in such a dire emergency, and so the backpacks act as a nutritional supplement for the family. This is a clear distortion and if that is the case, the contents of the backpacks, with their small amount of food,  don’t really provide a lot of nutritional benefit.

We are not the lone heretics in taking a long, hard look at backpack. In fact, an organization as close as our own PDO (Partner Distribution Organization – Definition: Food Bank that cannot qualify for membership of Feeding America, except by being partnered with a larger member organization. Note to Feeding America – Could we stop this second class citizen thing?)  Our PDO, San Luis Obispo County’s Food Bank Coalition, under the leadership of Carl Hansen, no longer provides any backpacks, because they do not feel it is a cost-effective way to make a significant dent in food insecurity, preferring to focus on larger distributions to families.

So enough with the whining, Erik. What are you, with your blah-blah-blah award winning program, and your nice Santa Barbara weather, actually doing to solve the problems you have identified?

Our short-term solution is to redouble our efforts to more effectively target backpack by focusing on maintaining supply to agencies and shelters dealing with homeless families and those who need the largest short-term interventions. Within the school setting, we are looking to shift our contact point to the counselors. They are typically seeing kids who are acting out or struggling, possibly as a result of nutritional issues. Rather than just dump a pile of food on them, we want to get close to these people, provide training and to building up a real relationship to the food bank. (Having a program for the whole school which brings big benefits, like Healthy School Pantry is a great place to build such a relationship from). We can then rely on the counselors to be more effectively as a conduit for teachers to keep a wider look out for kids in need.  This creates a whole host of distribution problems – remember, food banks are great at macro, not so hot at micro. So it may be individual school volunteers picking up small quantities of backpacks from a locally sited distribution center. Maybe backpacks get dropped off along with the standard other food items by an agency that is near to the school.). Will this more time consuming approach work better than the previous scattershot approach? We will have to see, but with less food around how can expect to keep to the strategy of throwing a lot of food at the community, confident that some will stick to those who need it most.  We are hopeful that the school counselors, who are already advocates for children, will view backpack as one more tool in their toolbox to be used appropriately with the right kids, and that other families might be referred on to more appropriate Foodbank programs like Kid’s Farmers Market, Pink and Dude Chefs Middle School cooking program or the Grow Your Own Way program to help people grow more of their own food.

Up until now, I would suggest that within the food bank network, the backpack program has been both a sacred cow and a cash cow. Both of those elements, combined with the challenges of shifting food and education resources to other less ‘quick fix’ channels means that the backpack program as a mass feeding effort, as opposed to a highly targeted program will remain with many food banks for the foreseeable future.

So, am I talking out of my pop-top can? Please join the discussion and leave a comment.

 

A Dialogue with Feeding America Director of Nutrition, Michelle Berger Marshall

Michelle Berger Marshall, MS, RD, LDN has the challenge and opportunity of helping both the national office and the network of 202 member food banks move forward to embrace a healthier food agenda. She has been with the organization in a variety of roles for three years. Prior to that she had broad experience with organizations like WIC and as a nutritional instructor at Kendall College, Chicago. I spoke to Michelle last week.

This blog encourages food banks to evolve towards a preventative healthcare approach with the idea that they will be able to find a new position of strength from which to leverage food and education to bring lasting changes in community health. How does this sit with what you are doing?

I’m a dietician and my husband is a physician, so we often have discussions about this area. If I succeed at my job as a dietician, I would hope to make his job far less difficult. Most of the people he is seeing in public health clinics have conditions which at the very least are exacerbated by diet. Prevention is the only way we can get back on track with the health of this country, and food banks have a relatively untapped power to address some of these complex issues in a simple way.

On your ‘From Hunger to Health’ website, you have laid out a framework of change that is incredibly powerful. As we ourselves have tried to engage with ‘public health’ organizations, it has been interesting to see what a disconnect there is between those who consider themselves anti-hunger advocates and those who have more of a community health or healthcare focus. We have a lot of work to do to bridge these conversations.

How would you typify the split?

One issue is that the public health sector traditionally doesn’t know or talk about food insecurity. At the same time I don’t think that anti-hunger groups have considered they are promoting or providing health. We find it easy to talk about negative aspects, like children not being able to concentrate in school without proper nutrition, but we haven’t been able to holistically tell the story about how all elements of the health argument connect together. However, we have made strides in making sure that we are now at the table with public health. At the local level, more food banks are joining obesity coalitions and such, and we are doing the same at the national level.

My belief is that for these partnerships to work, both sides have to bring something the other group wants to the table so that it becomes more than another well-meaning but ineffective conversation around nutrition. Food banks have an incredibly valuable asset – their clientele. We also have the food that can draw people to programs and screenings. If our local public health department are running a diabetes screening, that is not going to provoke a stampede to attend. But food is always a draw. Our Healthy School Pantry program is getting huge interest from our public health, because we bring back the same population each month. That is the kind of data they want, and the kind they can share with us to help us with our evaluations – that is what they bring to the table.

Absolutely, and the Bristol Myers Squibb Diabetes Project has been the perfect tool for us to begin to build closer links. We’re 9 months into 3 years of the pilot. Over the next year we will get some great data which can inform future projects. It has sparked a lot of interest. (An explanation of this Project is contained at the bottom of this post) I agree with your analysis on these blog pages that foundations are driving a lot of the new emphasis about impact, and in many ways we haven’t been able to provide that kind of demonstration of ‘here is the intervention and here is the impact.’ We as a network have a ways to go, but we’re getting there. We’re trying to bring in public health nutritionists and get them engaged in our projects to help us evaluate them. We recently undertook a nutritional analysis of the Backpack Program, with the University of Minnesota School of Public Health. ( Abstract or Final Report) Feeding America’s 2014 Hunger study will also include a series of health related questions for the first time.

The latest in cause-marketing technology – the begging bowl??

We always wrestle with language in this field. ‘Hunger’ is easily understood and can raise certain kinds of dollars, but is not always as accurate as ‘food insecurity’ which as an emotive rallying cry hasn’t exactly taken America by storm. Nevertheless, food security and nutritional health are so closely tied together that we are stuck with it for the foreseeable future. What is your definition of optimal food security?

We use the USDA definition (access by all people at all times to enough nutritious food for an active, healthy life). But I try to remind people that the key element of that is ‘active and healthy’ and I think that when we bring ourselves back to our core mission and to Vicki Escarra’s (Feeding America CEO) remarks at the recent Summit in Detroit, one part of our mission is moving food, but the other is addressing long-term food insecurity, and this makes us all think differently, not only about the types of food we are providing, but our engagement and the range of our activities in making sure that people can afford and access and consume the food that we know (and they know) is health promoting.

You have been heavily involved with the Nutrition Task Force, which produced a draft report that was discussed at Regional Feeding America meetings last year, and then I have not heard a lot more since about it being integral to their upcoming new strategic plan.

No, that’s not the case. The discovery and research phases are now over, and we are at the point where we are deciding what things we want to do, from policy down to technology and food sourcing strategies, and with incentivizing certain sorts of foods. The structure and foundation is there. These issues were brought up in strategic planning sessions, especially in the ‘Evolution of the Network’, and the recommendations coming out of our group are piloting strategies to help the network move in this direction.

Let’s talk a little bit about the challenges of rolling out the task force recommendations and the nutrition agenda in general across a diverse network. It feels like there is a lot more direct pressure from the Feeding America National Office on an area like food safety, whereas it can feel like nutrition is still a ‘would be nice, but we’re not going to push it too hard’ type thing.

As to the network, the overall interest has gone way past those you might predict would be interested.

What, us hippy Californians? You can say it Michelle.

No, you said it, Erik. We find many food banks across the country, large and small who want to take a more holistic approach. In the 18 months we have worked on this, the conversations we have had with the network have really evolved due to increased public awareness countrywide. People know about the diet-related disease crisis, and things like HBO’s Weight of the Nation will only increase awareness.

From the National Office perspective we want to make sure that nutrition is not a stand alone initiative and that we have a cross-functional charge – with our food sourcing team, our policy team, our philanthropy team, communications and research all acting in concert. That way it becomes less likely to drop off the agenda. We also have strong leadership support, which is vital for success.

What other challenges are there?

Lack of information about the food in our system. We all face descriptions of foods that can vary wildly, dependent on how the information is entered by someone receiving in the warehouse. It is often inconsistent, and more detailed information will need to be an key evolution. The same is true with the way that we measure nutritious pounds. We are looking at ways to do this, within our existing system constraints (31 categories) and trying to limit these to be more consistent with the ‘My Plate’ system, so we can use this as a platform. Down the line we want to look at long-term solutions to incentivize the sourcing and distribution of foods that are more in line with the dietary guidelines.

Will this be based on CHOP? (The Choose Healthy Options Program – a system first developed by Pittsburgh, which we use our own version of, which ranks the food in our warehouse as red (for low nutritional value) through amber and green (high nutritional value). It helps encourage us to tracking our abilities to source more nutritious food and also helps provide a guide to our 290 member agencies and programs about selecting the best items for their clients. Lots of green and maybe one red item).

No, CHOP is more of a nutrient analysis approach, which makes sense if you are looking at similar types of the same food, but the advisory team wanted us to move in a direction that was aligning more with the external environment. We want to promote foods that are in line with the dietary guidelines, so whole grains, fruits and vegetables, lean proteins and low-fat dairy. We also want to think about the negative nutrients that we want to limit – sodium, sugar, saturated fats. So the difference with CHOP is that we want to focus on food groups first.

What other perceptions in the network challenge the adoption of a nutrition-based approach?

One concern is that if we focus too much on nutrition and nutritious food, we simply won’t be able to meet the need (i.e. quantity vs. quality). This mentality is deeply tied to how we currently measure our success – in pounds. At the same time, what’s exciting is that as many members move in the direction of moving more produce and supporting efforts to not just move food but provide education, benefit assistance and community food security efforts, we start to see a significant shift in how we all think about our collective impact and our definition of success. At this year’s network summit, “measuring something in addition to pounds” came up countless times—now it’s time for all of us to determine what those other measures can and should be.

And then of course there is the argument that we are just emergency food providers, which has been debunked by Feeding America’s own recent report. We are providing a significant contribution to clients diets, so our previous role as Calorie Banks could actually have been making clients less healthy and more hungry.

One of my colleagues challenged that ‘we’re only an emergency response’ theory by turning it around—perhaps because we have limited resources and very few chances to have an impact on our clients health and well-being, that this in fact justifies why maximizing those opportunities is so critical. In that sense the question becomes not ‘why us?’, but ‘who else but us?’

CSI: Junkfood – All new Next Season.

What about the issue of choice? When I first put forward some of my ideas when Santa Barbara was holding the Western Region Conference back in 2010, some ordinarily pussy cat food bankers became rabid dogs when they discovered that in Santa Barbara ditch the candy and soda that comes to us rather than distribute it. My argument was that this choice already exists. It is very easy to get candy, but much harder to get nutrient dense food.

The ‘food police’ argument, yes. Within our network we talk about choices a lot, choice pantries, client choice, the choice system etc. I always find quite perplexing that when we bring up nutrition the opponents of this shift immediately use “client choice” as a reason not to focus on healthy food. I just have never understood this. Given the data and research surrounding food deserts, food access and the inequities that exist in so many communities (many of which are served by our network) it seems to me that by focusing and securing more healthy foods within our network, we are in actuality increasing the choices available for our clients, not decreasing them.

To me, the highlight of the work of the Nutrition Task Force has been the focus on ‘foods to encourage.’ Taking a positive approach is a wonderful way to nullify the ‘food police’ and other areas of concern.

I’m glad you think that. The framework of “Foods to Encourage” outlines the food groups promoted in the 2010 Dietary Guidelines and serves as a general philosophy to help guide everything from food sourcing to communication and education. Furthermore and most importantly it allows us to continue to talk about food as food, while still allowing for food banks to adopt more detailed nutrient based evaluation systems to make decisions within food categories should they so choose.

Food is a powerful modifier in our life, it can bring us down a pathway to good health or one that leads to poor health.

Exactly. Every person on the planet has a relationship and personal experience with, (and subsequently an opinion about) food, it’s a struggle to have an objective dialogue about the issues. In some ways that is what makes these issues so challenging to tackle. Food has power, is often emotionally charged, deeply rooted in one’s culture and community, and provides much more than just energy and nutrients. When we attempt to make black and white decisions, it doesn’t take long before we realize when it comes to food and nutrition there will always be a lot of gray.

Foods with all the colors in the rainbow…and some that aren’t.
Forget about the food, they have way better hats.

Perhaps key to all of this is unlocking the power of the communities themselves, to fight for an environment that allows all people to make the choices that allow them to nourish their families and live healthy, productive lives. As the food bank network we need to see our work as part of the solution today and in the long-term, our core work of hunger-relief does not need to be mutually exclusive of health promotion or vice versa. Everyone brings something to the table and I tend to believe food banks know food better than any other group.

Where would you like Feeding America and the Network to be in 5 years from now?

I would like to see nutrition fully integrated into how we see ourselves as an organization. Currently, you might go to our website and we talk about food security and hunger and then you have to go to different page to find out about nutrition. The earlier disconnect that I talked about with public health is also there to some extent within our own organizations. To truly bring together the goals of better nutrition and building food secure communities requires full integration. It needs to become engrained in how we do business, talk about ourselves and envision our future.

Thanks Michelle for all your great work.

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BRISTOL MYERS-SQUIBB/FEEDING AMERICA DIABETES PROJECT

The Need: Individuals who have immediate food needs may be at risk for nutrition-related problems such as type 2 diabetes. For all diabetics, diet is a critical part of managing their disease type. For diabetics who are also facing food insecurity, maintaining a healthy diet can be nearly impossible, however. A research study conducted by the University of California at San Francisco found that adults living with the most severe levels of food insecurity had more than twice the risk of diabetes than adults who have ready access to healthy foods. By providing nutrient-dense food and nutrition and disease education, food banks can help their own clients with type 2 diabetes and those referred by health centers adhere to the diet and lifestyle changes that are prescribed, but are impractical due to lack of access and affordability.

The Project: Feeding America and 3 member food banks in Texas, Ohio and California will collaborate with health care providers to improve the health outcomes of individuals who are food insecure or at risk for food insecurity and also affected by type 2 diabetes. They will create and pilot bi-directional food bank-health center partnerships that will provide diabetes screening, care coordination, nutrition and disease education, and healthy foods. Feeding America will evaluate how well the project improves diagnosis of diabetes, adherence to diabetes treatment, increases self-care skills, maintains or increases mental wellness, lowers risk or presence of depressive symptoms, and improves specific physical outcomes related to type 2 diabetes such as Ha1c.

Foodbanks participating include:

Food Bank of Corpus Christi www.foodbankcc.com

Food Bank of Redwood Empire www.refb.org/html/innovative_programs.html

Mid Ohio Food Bank www.midohiofoodbank.org/pdfs/EHhd/BMS-MOF-Release-Together-on-Diabetes.pdf

Feeding America CEO’s message to network: Adapt or Die?

Adaptation is a rare thing. For one thing, it is the title of that rarest of things, a good Nicholas Cage movie, but rare also when it comes to nonprofit organizations who see that their own continued success is dependent on a major change in its approach or operating model. Adaptation was the main theme of the keynote address to the Unity 2012 summit by Feeding America CEO, Vicki Escarra.

She told the audience of several hundred food bankers from around the country that getting food and distributing it was no longer enough. Building bigger and bigger food banks was no longer enough. That it was the role of the network of food banks to lay the groundwork for change so fewer people need assistance, and to improve the wellness of clients so that they are healthy enough to move toward self-sufficiency.

Yes!

If this blog and the work we are doing in Santa Barbara is about anything, it is about this. Amazing amounts of innovation come out of the network, but  to hear the CEO of Feeding America say something like this in a keynote to a group of food bankers (comprising a good number of people who have been perfectly happy pushing more and more food through the system, and who would view looking at their mission as anything else as heretical )- it was still sweet music.

As I sat in one of the sessions, I was inspired to doodle a physical representation of this adaptation and what it would mean for Feeding America. This graphic comprises my view of what should happen – I don’t think Feeding America are going to drop another $20 million on a rebranding to adopt my new version of the logo, but nevertheless…

Evolution: Time to pull ourselves up out of the dreaded pink slime…

As Escarra related it, this concern about getting stuck and becoming a dinosaur came to her when she was literarily surrounded by dinosaur bones at a Boston Consulting Group conference that was being held in NYC’s natural history museum. The report to this conference indicated that the world was facing a period of prolonged turbulence with some fundamental shifts occurring for companies to be aware of. The gaps between winners and losers is growing. The link between profitability and industry share has virtually vanished. The traditional ways of planning and building competitive advantage have changed too. Instead of being good at one thing, companies need to be good at learning to do new things, and quick to read and act on signals of change.

Non-profit leaders taking the risk to leave their conference hotel and hit the streets.

Escarra admitted that this openness to change was also linked to the realization by her organization that increases in awareness of the issue of hunger in America were not being met by a commensurate level of response of people taking action to do something about it. Three years ago, everyone got the issue of emergency food. Everyone knew someone who lost their job and was suffering. After three years of banging away at the level of ‘Emergency, Emergency, Emergency’, people are not viewing it as an emergency anymore and want to move on.

Escarra related that great companies were fostering a culture of innovation generated by unlocking the resources of the people who work for them, and that the network of food banks would also have to rely on innovation to remain relevant. This would mean that rapid testing of new ideas and scaling those that were successful had to be the cornerstone of the way the organization moved forward, whether it was new ways of sourcing the next billion pounds of food or new ways of fighting chronic diseases like diabetes through the activities of food banks. As the world evolved, so Feeding America would have to evolve with it.

It sounds like the movement from Hunger to Health now has a powerful ally, and I for one will work to ensure that this change in the conversation becomes something more lasting – a network-wide evolution of food banks to move beyond emergency treatment and into preventative treatment.

Feeding America National Summit

Trying to get to Detroit, creator of both techno music and the ice cream soda, to attend the Feeding America National Summit.

I believe this will be a significant conference for how the network moves forward. Feeding America has been charging hard for the last few years to develop its national brand, introduce new technology and food safety standards. Sometimes it has been a struggle for them to take all of the 202 network food banks in the direction they have advocated. Food bankers are an independent, eccentric bunch (I know, I am one) and sometimes it is like herding cats to get them to want to follow any national direction.

Feeding America has taken its own knocks in the last year, with some attrition of staff, and a reappraisal of priorities in a situation where they are working hard to avoid a budget deficit. It will be interesting to see what effect this has on the dynamics of the dialogue between national office and the membership.

There has already been considerable collaboration by various teams of staff and members tasked with exploring different priority areas as part of the strategic plan refresh. This has produced a large number of potential activities in each area. This summit will still be about obtaining membership input into the process, so we have yet to see how these priorities can be finally agreed on and acted upon.

I hope to be interviewing a range of people at the conference for this blog. I encourage you to check out the pages in the drop down menus at the top of this page, which contains a lot of information about the approach of this blog.