When it comes to childhood hunger, looks can be deceiving

• Copyright © 2014 by the American Academy of Pediatrics

Photos courtesy of Karen Ande

Looks can be deceiving, which is why AAP California Chapter 1 is working to raise awareness among pediatricians and the public in Northern California about this serious social health issue.

Each night, one in four San Francisco Bay Area children goes to bed hungry. But you cannot tell just by looking at a child if he or she is hungry or food insecure, said Lucy S. Crain, M.D., M.P.H., FAAP, a member of the California Chapter 1 Child Advocacy Committee.

“Food insecure children in the U.S. do not generally appear severely malnourished or starving and may even be obese due to excess junk food intake,” Dr. Crain said.

Dr. Crain

The Child Advocacy Committee partnered with local photographer Karen Ande on a photo exhibit that illustrates the diversity of children and families affected by hunger. Called “Who’s Hungry? You Can’t Tell By Looking,” the project was designed to raise awareness among pediatricians and the public about the prevalence of childhood hunger in Northern California and promote resources to address this issue.

The children featured in the exhibit screened positive for food insecurity at a local health and safety fair, and their parents consented to have them photographed. A multilingual team, including a pediatric resident, conducted the screenings and were surprised to find 10 of the first 20 families screened positive for food insecurity.

The photos have been exhibited at a variety of local venues, including a reception at San Francisco City Hall attended by pediatricians, representatives from public health departments, school districts and faith-based organizations, and the public.

“These photos encourage us all to think more broadly about who can be impacted by hunger or be food insecure,” Dr. Crain said.

Hunger and poor nutrition pose major threats to children’s health and development, increasing the risk for illness, growth and developmental problems, hospitalizations, nutrition deficits, and educational difficulties.

The Who’s Hungry? project encourages pediatricians to identify food insecure families using two screening questions from the U.S. Department of Agriculture Household Food Security Scale:

1. Within the past 12 months, we worried whether our food would run out before we got money to buy more.

2. Within the past 12 months, the food we bought just didn’t last, and we didn’t have money to get more.

The screening questions have been found to be valid, sensitive and specific (Pediatrics. 2010;126:e26-e32OpenUrlAbstract/FREE Full Text).

Dr. Lewis

When families screen positive for food insecurity, pediatric practices can refer them to community food assistance resources and public benefit programs.

“We know that pediatricians can’t do this work alone and encourage practices to partner with other fields that are concerned with child hunger such as advocacy groups, faith-based organizations, schools and community organizations,” said chapter President Gena L. Lewis, M.D., FAAP.