Nearly one-quarter of St. Louis city residents have trouble putting food on the table — and for some, it’s a source of secret shame.
Embarrassment and fear can keep parents from asking for help, according to research from St. Louis University. Based on a series of in-depth interviews with parents and caregivers, researchers have pinpointed ways pediatricians can connect with families experiencing food insecurity.
The idea for the research grew from a disturbing pattern SLU professor Ellen Barnidge and her colleagues observed in 2015.
When surveyed anonymously at a St. Louis clinic, almost 60% of parents reported food insecurity in their homes — but if asked directly by their child’s doctor, less than 5% said they had trouble feeding their families.
“Clearly there’s something going on,” said Barnidge, a coauthor on the study. “We’re losing a good number of families who might need connection with resources but are uncomfortable talking about it.”
Interviews with parents revealed that social stigma and shame keep them from talking to doctors about their struggles with hunger. As one parent explained: “People look down on you, like you’re poor, you’re needy … it’s not that, I just have bills.”
More than 40% of parents interviewed felt uncomfortable talking about food insecurity in front of their children. One parent said she prefers not to discuss it when her son is in the room “because he doesn’t need to know ... he’s only 13, and he’s been through so much.”
Others stay silent about their food needs, Barnidge said, because they fear repercussions.
“‘If I talk about not being able to afford the food we need, how is the health care system going to respond? Are they going to take my children away?”’ Barnidge explained.
Based on these interviews, the research team created a program in July 2017 that connects families with a variety of community resources.
Katrina Brown, who leads the Promoting Health and Social Equity program at Danis Pediatrics in Cardinal Glennon Children’s Hospital, said the pediatric clinic is an ideal place to establish relationships with parents.
“Pediatricians are often the gatekeepers,” Brown said. “[Parents] trust their medical staff, so it’s a really big deal for them to understand a family’s needs outside of just health. Really looking at, what is a family experiencing in their community that is affecting their health?”
The program — which has enrolled more than 150 families from the greater St. Louis area — takes a comprehensive view of the factors that can contribute to health, including food security, transportation and financial planning.
The goal, Brown said, is to help destigmatize poverty and help families feel empowered.
“A lot of people are concerned about, ‘What are people going to think about me?’” Brown said. “It helps to see that resource insecurities don’t discriminate; they’re affecting middle-class people, students on college campuses, families in suburban areas. It’s across the board.”
Program organizers also are looking to the future, by training first-year SLU medical students in how to talk to families about challenging issues like food insecurity.
“We tell the students, ‘You all are the next leaders,'” Brown said. “‘Hopefully you will take these things you’re learning and change the way things are done.’”
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