Clinical social worker Cheryl Champion sees the toll of hunger on children every day. And it extends far beyond tummy aches.
"It's huge. Kids who are hungry can't concentrate, and they're irritable, they're unhappy," she said. "In homes where there's everyone on edge, there's more domestic violence. Food is basic to everyone's survival, and without it, it snowballs into a million other problems."
A new campaign launched Monday in Minnesota aims to show how hunger can spiral into larger problems that burden all of society. Growing research suggests it can lead to depression, diabetes, and even obesity, resulting in medical and educational costs paid by the public sector.
Champion counsels clients at the People's Center, a community health clinic in Minneapolis that serves largely low-income people and immigrants. About half of her clients struggle with putting food on the table.
The U.S. Department of Agriculture estimates about 10 percent of Minnesotans are often hungry and don't know where their next meal is coming from. That's below the national average, but relief groups are worried because statewide hunger is on the rise. A recent study suggests that hunger in Minnesota has doubled over five years.
Champion said the face of hunger is changing -- from chronically mentally ill or chemically dependent individuals to entire families wounded by an unrelenting economy.
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Research shows hungry teens are more likely to suffer from depression. Hungry adults are two-and-a-half times more likely to be obese. That's a correlation that Champion acknowledges might seem ironic.
"That always confuses people. Why are people who are poor so overweight? How can they be hungry? Well, they're hungry because they're not getting nutritional foods, and diabetes is rampant in this culture," she said.
Health care professionals say poor people are more likely to buy food that's cheap. That usually means food high in calories and fat.
According to a new report prepared by the University of Minnesota Food Industry Center, the cost of hunger is rising, and public programs such as Medicaid are, in part, footing the bill. Co-author Jean Kinsey estimates that Minnesotans pay more than $1.6 billion every year in medical and educational costs.
"It's costing not only them, but us, a lot of money every year," Kinsey said. "It's a solvable problem. With the help of a lot of individuals, corporations and food companies, this could be taken care of."
"Food is basic to everyone's survival, and without it, it snowballs into a million other problems."
Minnesota nonprofits and corporations are working to end hunger in the state. A new partnership called Hunger-Free Minnesota has the backing of Target, Greater Twin Cities United Way, Hunger Solutions Minnesota, Minnesota Public Radio and six food banks that serve the state.
Early conversations have focused on increasing food in the emergency food supply, and encouraging more participation in Minnesota's food-stamp program and childhood nutrition programs.
Some schools around the state are already making changes to end hunger among their students.
As soon as sleepy-eyed children walk through the front doors of the Paul and Sheila Wellstone Elementary School in St. Paul, they're greeted by Jamal Abdur-Salaaam. He works with kids on their behavior.
The kids know the routine. Just about every one, no matter the family's income, lines up and fills a sack with cereal, milk and fruit, and carries them to their class.
School officials started this portable breakfast program, called Breakfast to Go, hoping to remove the stigma of free school meals and make it the norm.
Ninety-seven percent of the students at Wellstone qualify for free and reduced-priced meals, an indicator of family poverty levels. But until the schools made the breakfasts portable, fewer than half of the students participated. The program has since expanded to several other schools across the district.
Research shows hungry children are more likely to misbehave, see a psychologist, have lower math scores and even repeat a grade. Abdur-Salaam said kids on empty stomachs are just thinking about one thing.
"Their whole mindset is about survival. They're not thinking about what it is we're trying to do in the classroom, because their mind is where they're going to get their next meal," he said. "And that was kind of true to me. When I was a kid, being in school, I was a welfare baby, and I wanted to eat every chance I possibly could at school. It was like my couple of guaranteed meals a day."
Principal Christine Osorio said the school nurse also noticed how hunger affected kids' health, even if they didn't know the root of the problem.
"They feel like they're tired, they have a headache, or they have a stomachache. They don't often say it's because, 'I didn't eat breakfast.' They don't make that connection," Osorio said. "When students don't feel well or don't have the energy to focus, it could be for a variety of reasons. But we definitely know hunger will cause that, too."
Osorio said visits to the school nurse have gone down since the breakfast program began, and officials are glad the school is doing one small thing to thwart the larger repercussions of a child's empty stomach.
Editor's note: Minnesota Public Radio is a partner in the Hunger-Free Minnesota project. The partnership includes funding for MPR News to report on hunger and related issues for the next year.