Sick of Crunching Gears? How can you restructure your organization around your evolved mission

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.

Feed Gear stick copy

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.

tiananmen-square-1989-tank-man-china-close-up-one-tank

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):

Inspired?
Don’t you feel like you could die in one of these little boxes and it would take them months, maybe years to find your body?

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:

I am the chosen sun and you will revolve around me.
Hark! I am the chosen sun and you lesser celestial bodies must revolve around me.

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:

Upstream Downstream1

Upstream Downstream4

Upstream 3

Upstream 4

Upstream Downstream copy

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

Potiphar was proud of his three-tier pallet racks
Potiphar was proud of his three-tier pallet racks

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!)

SB Postcard

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

'The Remodel'
‘The Remodel’

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

How did they afford a facility like that? Must have been selling all the poppies from the community gardens...
How did they afford a facility like that? Must have been selling all those poppies from their community gardens...

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

catalyst

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.

The Vision Thing
The Vision Thing

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.

B19d copy

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:

This is what we are increasingly doing. How can we find an org structure that allows this to flourish?
This is what we are providing to agencies and clients in Santa Barbara. How can we find an org structure that allows these varied opportunities to flourish together?

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…

Photo of Don Draper in the final season of Mad Men. His transformation complete...
Photo of Don Draper in the final season of Mad Men. His transformation complete…

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.

rebuild22

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

3. Development

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.

aha logo

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.

THRIVE_Carpinteria_Logo_-_UnofficialOur 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.

Feed the Future Program Cycle
Feed the Future Program Cycle

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.

"The war on hunger is within sight of victory."
“The war on hunger is within sight of achievable victory.”

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.

Flip Logo Small
We can give you a bin of pears, but we can’t give you a small bag for you and your family to try.

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.

Nutrition Advocates Logo

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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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


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

Waking the Sleeping Dragon: A pathway for food banks to create an equitable food system – A Dialogue with Jan Poppendieck

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.

Jan Poppendieck

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.

Free for All: Fixing School Food in America, University of California Press, 2011

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.

Thanks Jan, for your work and your vision.

Welcome

Here I am, the self-styled “King O’ The Yams.’ Standing on the prow of the Titanic, Leo was “King of the World.” Well I’m sitting on a pile of boxes of yams in a drafty warehouse, and so I’m ‘King O’ The Yams.’ Hopefully I can keep my head above the ice water at least…

“From Hunger to Health” is the blog of Erik Talkin, CEO of the Foodbank of Santa Barbara County. We distributed over 11 million lbs of food last year (of which half was fresh produce) to Santa Barbara County through our own programs and through our network of 290 member agencies and programs. We are proud members of Feeding America, the nationwide network of food banks.

Our Foodbank is one of 202 food banks around the country who are members of Feeding America

This blog serves  both as a call to action and a clearing house of information, but most of all it is the story of how one organization on the inside of the ‘hunger business’ is trying to redefine what a food bank can achieve in transforming the health of our communities through good nutrition. At the top of the page are drag down menus providing access to a number of pages of content on key topics of interest.

For too long, food banks have been looked at as a band aid on a problem that will never go away, or worse, as organizations that unwittingly serve to disempower those individuals that they seek to help.

Maybe it’s time we got out of the hunger business and into the health business. Hopefully this blog will help others to navigate a similar journey. It’s fun, it’s exciting – and just ask my friend below – we can’t be stopped!