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Volunteers fill bags with food for part of their backpack school lunch program at the Cleveland Foodbank in Cleveland on Tuesday, Nov. 22, 2011. (AP Photo/Amy Sancetta) Ad Policy

There were over 46 million Americans on food stamps (SNAP) last year, and in 2010 the program kept 3.9 million people from falling into poverty. Nearly half of all recipients are children, and 76 percent of participating families have at least one employed person.

That’s a good sign that SNAP expanded exactly as it was designed to during the Great Recession and as the economy continues to struggle. But if we actually want to end hunger in the wealthiest nation in the history of forever, we have a long way to go. Three studies released this week tell us a lot about where we are and where we need to be.

Consider the Food Research and Action Center’s (FRAC) report, Food Hardship in America 2011. Since January 2008, 1,000 different households have been asked every day by Gallup, “Have there been times in the past twelve months when you did not have enough money to buy food that you or your family needed?”

More people answered “Yes” in the third and fourth quarters of 2011 (19.2 percent and 19.4 percent) than in any period since the fourth quarter of 2008. The national rate for the entire year was 18.6 percent, up from 18 percent in 2010 and the highest annual rate in the four years FRAC has tracked the data. Every region had higher food hardship rates than in 2010 except for the Mountain Plains, with the range varying between a low of 16.2 percent in the Mid-Atlantic and nearly 22 percent in the Southeast. Mississippi had the worst rate of any state, with one in four households suffering food hardship, while “the best” state was North Dakota, which still had one in ten households struggling with hunger.

So why is food hardship still on the rise even with recent economic growth?

“Rising food prices, continuing high unemployment and underemployment, and flat food stamp benefit allotments all contributed to the high food hardship rate in 2011,” said FRAC president Jim Weill.

The flat SNAP benefit allotments are particularly conspicuous. The report notes that the cost of the Thrifty Food Plan—which is what the government views as the cheapest nutritionally adequate diet and is the basis for setting benefit levels—increased by 6.2 percent between December 2010 and December 2011, while benefit levels remained the same.

That’s a significant loss of purchasing power for program participants who in most states must have incomes at or below 130 percent of the poverty line—about $24,100 a year for a family of three—and receive an average benefit of $4.40 a day per person. In essence, the government defined the minimum need but hasn’t raised benefit levels so people can afford it. FRAC therefore recommends increasing benefits so that households can indeed purchase a nutritionally adequate diet.

The good news is that SNAP is up for reauthorization every five years under the Farm Bill and 2012 is the lucky year. But rather than use this opportunity to strengthen and support the program, there are proposals in Congress to cap spending (think TANF block grants, and see how well that turned out), reduce benefits, and restrict eligibility. With 269 of 463 Congressional districts now having more than one in six households experiencing food hardship, now’s a good moment for legislators to look homeward. Within Republican leadership alone, Speaker Boehner’s district has a food hardship rate of over 21 percent; conference chairman Jeb Hensarling’s district has the thirty-eighth highest rate at nearly 26 percent; majority whip Kevin McCarthy’s district comes in at 20 percent; and Senate minority leader Mitch McConnell’s Bluegrass State has over 22 percent of its residents struggling with food hardship, fourth-most of any state in the nation.

For congressmen and senators who might follow the lead of those who would make SNAP benefits harder to access, The Snap Vaccine by Children’s HealthWatch (CHW)—a research group bringing evidence and analysis from the frontlines in pediatric emergency rooms and clinics to policy-makers—should give them pause.

“These accelerating food insecurity numbers are not just ‘oh what a shame’ but really are really scary in terms of the nation’s health,” says CHW founder and principal investigator, Dr. Deborah Frank. “Food insecurity is associated with stunted growth, decreased bone mass, slower learning in childhood, obesity, pregnancy complications, out of control diabetes in adults, and decreased ability to fight infections at any age. The SNAP Vaccine is about treatment—good treatment that’s even better at higher doses.”

CHW analyzed data on more than 17,000 young children whose parents sought care for them in an emergency room or pediatric clinic between 2004 and 2010. It compared children whose families received SNAP benefits with those who didn’t but were likely eligible (based on their participation in at least one other means-tested program.) The children who received benefits were less likely to be at risk of being underweight or having developmental delays, and more likely to be living in food secure families.

The results were even more telling in young children of immigrants.

Compared to children of US-born mothers, children of immigrants are more likely to live in a two-parent family, be born at a healthy weight and breastfed, and have a mother who isn’t depressed. But CHW notes that despite this healthy start, young children of poor immigrants are also more likely to be in poor health and food insecure. Part of that might be explained by SNAP participation rates.

Ninety-three percent of children under six with immigrant parents are American citizens but their families have lower participation rates than their contemporaries with US-born parents. There are regulatory barriers—like documented immigrants who have been in the United States for less than five years being ineligible—and there are misconceptions that receiving government assistance will hurt someone’s chances to obtain citizenship in the future.

However, CHW found that young children of immigrants in families that receive SNAP benefits are more likely to be in good or excellent health and in food secure households than those who are eligible but not receiving benefits.

“The bottom line is that SNAP is a health program and it works like medicine for children in these families, working to counteract their heightened vulnerability,” said Stephanie Ettinger de Cuba, research and policy director at CHW. “There are potentially huge implications for cost savings here—if children can avoid the need for special services or special education in school, and are healthier and not needing to utilize the health care system as much, these are some of the ways the investments pay for themselves in the long-run.” (Not to mention every $5 in SNAP benefits generates as much as $9 of economic activity, helping families and local economies.)

Like FRAC, CHW advocates for raising benefit levels so that people can actually afford what is considered a minimally adequate diet. Previous CHW studies have found that the cost of the Thrifty Food Plan was 39 percent higher than the maximum monthly SNAP benefit for a family of four in Boston, and 49 percent higher than the maximum benefit in Philadelphia. Benefits were raised as part of the American Recovery and Reinvestment Act (ARRA), and child recipients were then more likely to be well—healthy, good height and weight, not hospitalized, and no developmental delays—than similar children not on SNAP. The Thrifty Food Plan was still 29 percent higher in Philadelphia than the maximum SNAP benefit, but it was a step in the right direction. However, legislation passed in 2010 would end the increased benefits in October 2013.

At a minimum, the ARRA benefit boost needs to be preserved, outreach to immigrant families needs to be increased so that all eligible children receive nutritional support, and the structure of SNAP needs to be maintained so that it can expand during economic downturns rather than being locked into arbitrary block grant limits. Implementing these policy changes would have a real impact on the health and well being of children and their opportunities for success.

But if we truly aspire to end hunger and help people rise out of poverty, a new study by Dr. Mariana Chilton and Jenny Rabinowich of Drexel University School of Public Health—Toxic Stress and Child Hunger Over the Life Course: Three Case Studies—suggests a more holistic approach to food insecurity is needed.

Chilton is a co-principal investigator for Children’s HealthWatch and founder of Witnesses to Hunger, a project which facilitates the participation of mothers who know poverty first-hand in the national dialogue on hunger. She and Rabinowich argue that food insecurity among children—more severe and far less reported than food insecurity at the household level—is related to the traumatic childhood experiences of their adult caregivers, and that it’s not enough to only provide nutritional support in the present, we need to tend to the damage done in the past as well. The authors view the lifelong consequences of early toxic stress as key to intergenerational poverty and food insecurity, impacting adult health and earnings outcomes, and consequent ability to nourish children.

Chilton and Rabinowich interviewed twenty-nine women involved in Witnesses to Hunger. What began as conversations about food stamps and accessing food quickly transformed—at the initiative of the interviewees—into discussions about past traumas that were making it difficult for women to secure meaningful employment with a living wage as adults.

“They women would say, ‘Look, if you really want to talk about hunger let’s talk about what happened to me when I was a kid. I have a really hard time now functioning because of what happened to me back then,’ ” Chilton told me.

Chilton and Rabinowich relate the stories of three women (changing their names) whose accounts are similar to twenty-five of the twenty-nine people they have interviewed thus far for this ongoing study on toxic stress. Lacey, Irene and Silvia were all raped at an early age, had unsupportive or negligent caregivers who suffered from depression and/or substance abuse and experienced homelessness or the risk of homelessness as children.

The women in Witnesses to Hunger take photographs to document their lives and use them to educate policymakers about their experiences with food insecurity. Many took pictures of their current bruises stemming from violent relationships they were now involved in. They would then speak of exposure to severe violence as children, including “rape, abuse, and neglect that had [a] life-changing impact affecting their mental health, their ability to successfully complete school, and their ability to find and maintain employment.”

“Now many of these women are so depressed, or can’t sleep, or they have anxiety attacks, or self-medicate with marijuana laced with PCP,” says Chilton.

Despite the fact that Silvia works a full-time and part-time job, and Irene is in college part-time, they both struggle with food insecurity like Lacey who receives Social Security Income (SSI) due to debilitating anxiety and depression. They are also representative of people who would not likely report their children’s struggles with food security. For one, there is a feeling of shame if they are struggling to feed their children, even though Chilton notes that these parents all make extreme sacrifices including going without food. But there is another deep-seated fear as well.

“If you tell someone who is an authority or a professional they will not only look down on you as incapable or incompetent but they may take away your children too,” says Chilton. “That’s sort of a myth but it gets spread throughout the deeply poor community because so many of them are impacted by the foster system and Department of Human Services.”

So when we read that for children under age 6, “very low food security”—defined as multiple indications of disrupted eating patterns and reduced food intake—increased 250 percent from 2006 to 2010, from 147,000 children to 533,000 children, the picture is likely markedly worse. Further, the authors suggest that “exposure to violence and neglect as a young child and adolescent are what distinguishes the caregivers who report child food insecurity from those who do not.”

Ultimately, the authors advocate for a “life course approach,” expanding an understanding of traumatic life experiences to all levels of agencies administering income support programs and social services, and coordinating their efforts to address food insecurity; and involving the people who are personally impacted in the planning and implementation of these new policies.

“We’ve got to stop looking at people as if they are a snapshot in time without a past,” says Chilton.

Get Involved

Food Research and Action Center

Children’s HealthWatch

Witnesses to Hunger/Center for Hunger-Free Communities

Vital Statistics

US poverty (less than $22,314 for a family of four): 46 million people, 15.1 percent.

SNAP recipients, 2011: 46 million people.

Percentage of SNAP recipient households below half the poverty line, 2010: 43 percent.

Percentage of SNAP recipients who are children: 47 percent.

Percentage of families receiving SNAP with at least one employed member: 76 percent.

Average SNAP participant’s per meal benefit, 2011: $1.63

Cost of SNAP, 2011: $78 billion

Percentage of total cost going to households for purchasing food: 92 percent.

Quotes of the Week

“If I don’t do anything right, I want [raising my children] to be the one thing that I’ve done right in my life…. I want to show them what life is. What a real life is, with the things that they’re supposed to feel.”

—Silvia, from Toxic Stress and Child Hunger Over the Life Course

“I have a lot of issues that, had I not gone through the stuff that I went through, I feel I would have been a better person… I know if I was able to hold my concentration or my thoughts or my emotions or anything, I would be able to work and concentrate and do the things like other people can do.”

—Lacey, from Toxic Stress and Child Hunger Over the Life Course

“I ate out of trashcans; I ate scraps from people… I would go in the supermarket and eat grapes and leave. You know, eat a pear down an aisle, then leave. You know, it was all about survival… Until you’re in our shoes, you will never understand. Never.

—Irene, from Toxic Stress and Child Hunger Over the Life Course

This Week in Poverty posts every Friday morning. Please comment below, e-mail me at WeekInPoverty@me.com and follow me on Twitter.