Nourish Families Beyond Poverty

Lance Chilton, MD, FAAP

March 14, 2018

Walking with my grandchildren around a lovely farmer’s market in an upscale U.S. suburb, we delighted in stand after stand brimming with fresh-picked vegetables and a bounty of other wholesome delicacies. As a pediatrician, I know how important it is for kids to eat plenty of healthy foods like these. But a glance at the prices reminded me that what children need to eat isn’t always what families can afford.

I thought of families struggling with poverty, lacking the money not just to purchase those beautiful vegetables at the farmer’s market, but even to buy something other than the cheapest thing that will fill a hungry child’s stomach. Often, these are foods that are too low in nutrients and too high in calories, contributing to health problems such as obesity and diabetes.

Research shows us that children who live in households where food is limited by lack of money or other resources get sick more often and recover more slowly. They have poorer overall health and are hospitalized more frequently. Hunger also impairs a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems.

Worldwide, natural disasters and armed political conflicts are among chief causes of hunger. Our hearts break with ongoing accounts of African refugees, many of them children, dying from starvation and dehydration as they travel on small, overcrowded ships across the Mediterranean to flee violence. With nothing else available to sustain them, some drink sea water, which satisfies briefly but ends up killing them by hastening dehydration.

The number one cause of hunger throughout the world, though, is poverty. In the United States, outright starvation is relatively uncommon. But because of poverty, many families are unable to get the food they need while surrounded by a sea of unhealthy options.

In my state, New Mexico, the rate of poverty is high. So is the rate of children living in food insecure households, where access to good nutrition is limited by a lack of money or other resources (27 percent in New Mexico, compared with the national rate of 12 percent). Because hunger can affect families in any community, however, American Academy of Pediatrics policy encourages pediatricians to screen all children for food insecurity. It also recommends becoming familiar with local resources such as food pantries where we can refer families, and advocating for state and federal nutrition support initiatives that make a big difference in many children’s lives.

"Research shows us that children who live in households where food is limited by lack of money or other resources get sick more often and recover more slowly. They have poorer overall health and are hospitalized more frequently. Hunger also impairs a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems.”

Nationwide, more than 40 million Americans utilize the Supplemental Nutrition Assistance Program (SNAP) each month, with 2 million children lifted above the poverty line through the program. Many families also benefit from Women, Infants, and Children (WIC), and school lunch, breakfast and summer feeding programs. For the past 2 years, the American Academy of Pediatrics has been at the forefront of efforts to reauthorize these important programs, which now limp along without needed legislation. Efforts continue and can use all of our help.

Here in New Mexico, we passed a law last year to help end “hunger-shaming.” The law prohibits the practice of branding children who are behind in paying for school lunches. (Quite literally, some schools scrawled that they owed school lunch debts on their forearms, and gave them a very simple, obviously identifiable and less adequate school lunch.) We haven’t yet passed a recent bill to require school districts to educate teachers and other school people on the effects of poverty on learning and social development, but we should.

March is National Nutrition Month, a great time for pediatricians to commit to helping families access the food children need. This year’s theme is “Go Further with Food,” but in fact, we should all remember that you can’t go anywhere without food.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author

Lance Chilton, MD, FAAP


Lance Chilton, MD, FAAP, is currently chair of the American Academy of Pediatrics Council on Community Pediatrics, and a former New Mexico Pediatric Society president and District VIII vice chair.