Hungry kids are hospitalized more often. They're at a higher risk for developmental problems and their moms are more likely to be depressed. Yet, hunger rarely comes up when those kids and their families see a doctor.
"We are blind to (hunger) as clinicians," said Dr. Diana Cutts, a pediatrician at Hennepin County Medical Center who's been researching the ties between food and health for more than 15 years. At any given time at least a quarter of her patients don't have enough food, she said.
Cutts is part of a small but growing movement in Minnesota to get better food into the hands of patients as a way to keep them healthy and out of the hospital.
Some clinics operate their own food banks or offer mobile food deliveries to patients. But programs that use food to try to improve patient health are still a relatively new idea. This summer, Lakewood Health System in Staples, Minn., will offer free community supported agriculture shares to low-income families with children. The families will also receive nutritional counseling and cooking tips from hospital staff.
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It seems like a simple prescription. A poor diet can worsen heart disease and diabetes and reduce the effectiveness of drugs and other treatments, Cutts said, but physicians may not know what hunger looks like or how to talk about it with patients.
Cutts doubts she would have realized the extent of the problem if she hadn't started screening her patients for signs of hunger. The signs aren't necessarily obvious. Medical school, she said, didn't prepare her to identify patients who don't have enough food.
In 2010, she launched a food bank at HCMC to support her patients' diets with healthy food that isn't always available at community food shelves. The program has grown considerably in four years, and now supplies the equivalent of 7,000 to 8,000 meals a week to clinic and hospital patients.
HCMC recently began tailoring the contents of its food bags to meet the specific nutritional needs of elderly and diabetic patients.
That includes patients like 69-year-old Fannie Mae Anderson of Minneapolis, who got a bag of groceries during a recent routine clinic visit.
Without it, Anderson would be eating a lot more potatoes and hot dogs because that's what she can afford. Those high-calorie foods make it harder for her to lose weight, which she needs to do to get her diabetes under control.
There are patients who run out of food and skip meals periodically, and that's dangerous if they are taking insulin to lower their blood sugar levels, said diabetes nurse specialist Carmelita Nelson. It can cause people to pass out or suffer brain damage from low blood sugar, she added.
Enlisting the health care system as an ally in the fight against hunger and related health problems is an idea that's gaining traction. But even supporters still view the effort as an experiment. That's because most efforts, so far, still rely heavily on grant funding, volunteers and significant organizational commitments to make the projects happen.
The community supported agriculture project in Staples found a partner in HungerFree Minnesota, which is contributing $25,000.
David Dayhoff, director of partnership engagement and advocacy for HungerFree Minnesota, said his group could have used the money to give participants more food than they will likely get from their CSA share but that the Staples project was appealing because it's trying to make people healthier.
"I'm more than willing to give that a shot," he said. "If it helps be a pilot example that proves this case that the healthcare setting has this special role to play in helping food insecure Minnesotans, then that's something we want to build out a little more."
Identifying hunger should be a priority for any physician who serves at-risk populations, Cutts said. Those patients include children, seniors and families undergoing major life changes that could affect their finances, such as birth, death or divorce.
Health care providers, she said, need to "admit that this might be something important that you're not thinking about."