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Hannah Redford March 13, 2019 Anthropology& 206D (W) Section A Assignment 3 Cynthia Clarke Literature Review In the United States one in eight Americans were considered food insecure in 2017. That equals 40 million Americans, children being 12 million of those or 30 percent (Hunger and Health: Feeding America, n.d.). Research has shown being food insecure can potentially impact people in many ways. For example, studies have found that it can have negative effects on their overall mental and physical health. It was also discovered that food insecurity varies among communities. An area of concern for health was a correlation between childhood asthma and food insecurity. [1 supplemental source] Researchers have discovered an association between household food insecurity and children experiencing asthma symptoms. Mangini, Hayward, Dong, and Forman (2015) analyzed data from the third grade year of the Early Childhood Longitudinal Study—Kindergarten Cohort. They evaluated how food insecurity and other factors related to the likelihood of childhood asthma. In grade 3, they interviewed the parents of children asking if a medical professional had diagnosed their child with asthma. They found that childhood asthma was strongly correlated with food insecurity and living in poverty. When accounting for ethnicity the correlation remained positive. The study showed that a child’s health could be negatively affected when living in poverty (Mangini et al., 2015). Looking at the correlation between food insecurity and childhood asthma across all school years studied, Mangini, Hayward, Zhu, Dong, and Forman (2018) looked at four sets of data from the Early Childhood Longitudinal Study-Kindergarten cohort study on the exposure to food insecurity to determine the strength of the correlation. The

COMBINED PAPER 2 study followed US children from kindergarten to eighth grade, starting in the fall of 1998 to the spring of 2007. Results showed that children were 29% more likely to have childhood asthma if they had been exposed to food insecurity. Their results also revealed that when low-income families used assistance programs, there was a lower likelihood of childhood asthma. These results indicated how food insecurity during a child’s school years could play a part in childhood asthma (Mangini et al., 2018). Both articles found that children exposed to food insecurity were more likely to experience asthma or asthma symptoms. Other health issues, such as anemia and inflammation, can arise from being food insecure. [2 sources] Studies have discovered that food insecurity could play a role in both your mental and physical health. Gowda, Hadley, and Aiello (2012) surveyed 12,192 people on their health and nutritional status between 1999 and 2006. They also asked about their food security and took blood samples that were measured with clinical biomarkers. The results showed that 21.5% of the population was food insecure. And that there was higher levels of C-protein and white blood cells in those who were food insecure. These higher levels seem to correlate with inflammation and chronic diseases which is a health concern according to the researchers (Gowda et al., 2012). While also investigating negative health effects, but looking at data from three age groups, Gunderson and Ziliak (2015) examined research on the correlation between food insecurity and health outcomes. They found that there was poor health reported across all age groups (children, non-senior adults, and senior adults) surveyed. They found that children had a higher chance of health problems (such as anemia), behavioral difficulties (such as aggression), and cognitive issues. In addition, mental health problems were reported to be twice as likely among non-senior adult mothers. Lastly, it was noticed that senior adults had a higher chance of being depressed if they were food insecure. The results showed how a variety of health problems occurred among

COMBINED PAPER 3 the age groups that were food insecure (Gunderson & Ziliak, 2015). To determine if having children within a household affected the chances of being food insecure, Adams, Hargunani, Hoffmann, Blaschke, and Helm (2017) screened for food insecurity in pediatric patients that came in for their routine appointment by giving the parents a questionnaire. Results showed that households with children were nearly twice as likely to be food insecure (19.2% vs. 11.7%). The authors stated this was an area of concern since food insecurity can negatively influence a child’s health (Adams et al., 2017). Food insecurity has shown a correlation with impacting overall health. Being food insecure could also impact the health of elderly people. [3 sources] Elderly people who are food insecure could have both mental and physical health issues. Kim and Frongillo (2007) examined two longitudinal studies to look closer into the relation of weight and depression to food insecure elders. They also looked at participation in food assistance programs and how that affects the same variables. They discovered a positive correlation between weight and depression to being food insecure. They also found that the correlation became weaker when they participated in food assistance programs. Getting assistance had a positive impact on the overall health of the elders by reducing the negative outcomes of being food insecure. In addition to researching the health outcomes of food insecure older adults, Hessol, Zepf, Zobell, Weiser, and John (2017) performed a cross-sectional study of HIV infected adults who were age 50 and over. Those who were food secure were less likely to experience anxiety, depression, falls, and other health issues. While food insecure participants had a higher chance of experiencing these problems and an increased likelihood of using drugs and alcohol. The researchers discussed the importance of promoting good health and implementing targeted food assistance programs. This study shows how being food insecure can affect geriatric health and is associated with the probability of them using drugs and alcohol.

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COMBINED PAPER 4 Being food insecure can impact populations in many different ways. [2 sources] Food insecurity can vary among many ethnic groups and potentially impact health. Jernigan, Wetherill, Hearod, Jacob, and Salvatore (2017) surveyed a group of 513 American Indians in rural Oklahoma. They did this to try and estimate the relationship between certain health problems and food insecurity factors. The research found a correlation between insufficient food quantity and the risk of diabetes, obesity, and hypertension. They also discovered a strong relationship between food quality and health problems. These results suggested that food quality could have more of a negative health impact than food quantity. The authors suggested there should be an improvement to tribal food environments. For example, lessening the obstacles to obtain healthy foods and raising the living wages to lessen the effects of food insecurity (Jernigan et al., 2017). While examining food insecurity prevalence among numerous ethnicities, Denney, Kimbro, Heck, & Cubbin (2017) used data from the GROW study to see how the occurrence of food insecurity varied among ethnicities. The research showed that black and Latina mothers were more likely to be food insecure vs white mothers. Results also showed that Latina mothers were twice as likely as white mothers to be food insecure in a neighborhood where they felt disconnectedness. The GROW study suggested that food insecurity among minorities needs to be addressed (Denney et al., 2017). Looking more closely at food insecurity among several ethnicities, Balistreri (2016) looked for patterns in a survey on food insecurity at 3 different time periods. They found that food insecurity was more common in black households whether they had children or not. The largest increase of being food insecure over time was in white households compared to Hispanic and black households. The survey revealed that food insecurity is still a large issue, since it is increasing in all ethnicities across the U.S. (Balistreri, 2016). Food insecurity can impact anybody, but there seems to be more of a

COMBINED PAPER 5 prevalence of it among minority populations. [3 sources] In 2017 it was reported that one in eight Americans were food insecure. As several studies have shown, food insecurity affects people in many ways. One study demonstrated that asthma was more likely to occur in children who were exposed to food insecurity. Other studies showed that families of black and Hispanic households had a higher rate of being food insecure vs white households. Though white households had a larger increase of food insecurity over time. Being food insecure was also found to be a potential factor in poor health, such as inflammation or mental health.' Entering the field Food banks help several families who are food insecure. According to the food bank director, [)eierling (2019], the Marysville Community Food Bank serves roughly 300 families a week. I started to volunteer at the food bank during the beginning of January. On my first day there was not an orientation, they just found me a job to do and let me figure it out on my own. The other volunteers were friendly and showed me how to do certain tasks. A lot of the tasks include organizing fruit and eggs into containers. Also, stacking cans of food into plastic crates and double bagging bags so they are strong enough to hold food items. The first time I volunteered I felt very awkward and out of place at first. After getting into a rhythm, the feeling went away and it got less awkward every time I volunteered. Saturday is the only day of the week that I am available to volunteer, so I have not gotten to work with any food bank clients. The food bank wants to help individuals and families who are food insecure by providing them a variety of foods to meet their needs. They want to make an impact by hopefully alleviating the stress of not having enough food to feed yourself and/or your family. [)eierlin] [2019] stated that they want their clients to feel welcomed and unjudged when they come to the ' Word count (Literature review) = 1,355

COMBINED PAPER 6 food bank and to provide a good experience for them. He also mentioned potentially creating to go bags or doing home deliveries for those who don’t want to risk seeing people they may know at the food bank.? Findings The Marysville Community Food Bank [MCFB] had been at its current location, located behind St. Mary Catholic Church off of 88" street in Marysville since 2007. They have been located at three prior locations in the past. The building had a client entrance and a volunteer entrance as well as an exit for clients and 2 upward sliding doors. One of the sliding doors is located at the back corner of the building and is mainly used for when they receive deliveries of food. At the volunteer entrance, there is a table with a sign in sheet for volunteers to check in and out, if they don’t sign out, the hours they volunteered will not be documented _ _ On the wall behind the table they have a variety of posters and advertisements on the wall. They have an office and break room next to each other and located near it is 2 bathrooms, one of which is for volunteers only. They have freezers located on the back side of the building and pantries located in several areas around the building. They use these storage areas for the donations of food they receive. D. Deierling stated that a majority of the food donated to the food bank comes from local grocery stores in Marysville [Deierling, 2019]. Anybody can donate as long as the food is unopened and not homemade _ The few donation requirements they have decreases health risks from the food being homemade or opened and going bad before its expiration date. Deierling mentioned that non-acidic canned foods can last three and a half years past there written expiration date. Acidic canned foods, such > Word Count (Entering the field): 280

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COMBINED PAPER 7 as pineapple, lasts up to a year after the expiration date. Canned baby food has to be thrown out by its expiration date because it starts to lose its nutritional value. MCEFB delivered food to around 600 children who are food insecure on the weekends . Volunteer, personal communication, January 250 5, 2019)! They also serve a couple hundred B 200 S families a week. Figure 1 represents weekly % 150 data collected on the number of families that E 100 were served at the food bank in 2018. .“-é 50 Tuesdays seem to have the highest number of 2 o WLARRRRARARLLRRRARANL ALRRRRARARARARIALARANARRALAN Winter Spring Summer Fall clients served compared to the other days. Months (Weekly Intervals) According to D. Deierling - B Mon W Tue m Fri m Sat _the Figure 1: Families Served at Marysville . ) Community Food Bank numbers of families served is lower at the beginning of the month. [CG1] Deierling and JoAnn mentioned trying to get through the lines faster and boost customer experience as a few ways to improve the food bank. The numbers of families served includes those who visit the food bank and those who are home bound and receive deliveries from the food bank. Someone who also volunteered on distribution days, told me about the color card system the food bank has in place to determine how much of certain foods they receive . _ The colors are separated by family size: yellow being less than four, red being four to six people, blue is seven to ten, and green is more than ten. JoAnn stated that yellow was the most common color assigned to the families that they serve (SHNaMENperSonal Communication, Februay 2 2049)! Richard said that she helped a

COMBINED PAPER 8 majority of clients with yellow cards (Richard, 2019). [CG2] Seeing as the food bank serves many families, there is more than likely highly wanted foods. A fellow volunteer mentioned that the most wanted foods are canned tuna and chicken, as well as peanut butter and milk. It was said that milk is almost bought weekly with donated money _ These seem to be in high demand since peanut butter is a source of protein and milk provides calcium. Tuna provides omega-3s and chicken can also provide protein and is a “lean” meat. This provides a quality food for families, since many who are food insecure also experience low food quality along with quantity. Good quality food is especially important for growing kids who need to meet their nutritional needs to stay healthy. Deierling stated that they mainly spread awareness of the food bank through word of mouth and their website. He also stated that they will post ads in the newspaper looking for volunteers and donations, but it is difficult to reach out to people who are food insecure (Deierling, 2019). Deierling (2019) also mentioned it’s difficult to advertise with signs because of where they are located near a residential area. It seems that they get just enough awareness out to the public, but would like to be more known so food insecure families who aren’t getting help know that they can. When people dump food or unwanted items at the food bank, Deierling said that they just clean it up and that it doesn’t happen too often [Deierling, 2019)] Somebody observed JoAnn® putting together around five or six large paper bags filled with a mix of foods so that it could be delivered to people who are home bound and have no one to pick up food for them. She stated that one of the bags was diabetic so it had slightly different foods to accommodate that person’s needs (JHSEWellNPersonal communication FeDruar 2! - Food bags contained eggs, bread, fruits, canned foods, etcetera that met the essentials for 3The use of 1st names is a cultural norm at this field site.

COMBINED PAPER 9 the person receiving it. She put these bags together on her own since she knows the specifics on what to put inside. Anyone can volunteer at the food bank as long as they don’t have a felony. Driver volunteers help the food bank with picking up and bringing food in with a large vehicle of their own or with a delivery truck that was donated by Walmart. Sorters help organize the food donated and sorting through what is okay and what needs to be tossed or composted. Sorters are required to wash their hands before hand and wear gloves while sorting fruits, vegetables, and eggs. They also help clients walk through the food bank to get what they need and walking them out to their cars to unload their groceries for them. Distributers help by delivering food to children and those who are home bound. While working with fellow volunteers they started discussing why they were there. Some were volunteering because it was court ordered while others were volunteering to meet graduation requirements or they had a class that required it . Ollinteers; personal communication, January 19 2019)! An observation made was that a majority of new volunteers got tasks of sorting, stacking, bagging, and sweeping. Volunteers who seem to have been there awhile had other tasks that they did. This difference may be because of experience and “seniority” or just the amount of volunteers needed for specific tasks. There are only three paid staff members at the food bank and there are no openings for a paid position as they mainly run off of volunteers _ -. These staff have computers to keep track of volunteers and their hours and also to keep track of clients and the number of people they serve on distribution days. Deierling mentioned that he is kind of a nerd when it comes to organizing and creating excel files for the food bank (DiDeiling personal communication Febriar 202019)! Those who are food insecure and live in the city of Marysville, Tulalip, and Lakewood qualify as potential clients for the food bank.

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COMBINED PAPER 10 They can find the food bank online and get directions to locate it. They use the food bank so they can provide for themselves and their family. They are required to bring proof of residency for themselves and family members when signing up for food bank services (Marysville community food bank, [MCFB], 2019).Every time they visit the food bank they must bring proof of identification and every July first clients are asked to update their application or fill out a new one. The hours on Saturdays are business hours with no distribution, so volunteering mainly consisted of sorting foods and double bagging the plastic bags. Every Saturday they sorted canned foods, such as tuna and mixed fruit into crates. Once that was done we sorted eggs looking for cracks and those that were went into a “bad” pile of egg cartons and are given to a farmer to feed to his animals or put into compost. The last thing they did was putting bags inside of bags to make them stronger for holding heavy groceries, this project never seemed to end as there is an abundant supply of plastic bags. The break room has a refrigerator that has water for the volunteers, as well as other things people brought and placed in the fridge for later. There is coffee and often donuts or other snacks available when you go to take your break. An unspoken rule is the 5-10 minute time limits, though a few people have broken that rule to get out of participating in a certain task. One volunteer said that they have had people who are on drugs, usually court ordered volunteers, come in to volunteer and that they usually just tell them to leave _ The Marysville Community food bank is set up in a way that helps make it be as efficient as possible for clients and volunteers. Figure 2 is a rough sketch of how the food bank is organized. They have an entrance for volunteers and staff and a designated entrance and exit for

COMBINED PAPER 11 clients. They have a large sliding door located in the back side of the building that is used for when they receive deliveries of food from local groceries. They have several pantries and sorting tables located around the building, as well as freezers and refrigerators. They have a cart storage area between the client entrance and exit. [V1] The way they have the food bank organized helps make sure that the clients can get through the building to get what they need in a timely manner and provide a good experience. The sorting tables help provide room for going through donated products and making sure that they are of quality and consumable. They have a check in area where clients enter that has a computer to check if they are a current client or need to apply. The cart storage area is located where it is easily accessible. [V2] Richard mentioned that when she volunteered on distribution days for clients, she helped an average of five to six people an hour (Richard, 2019) and that it took on average 10 to 15 minutes to walk through the building with each client (Richard, 2019). She also stated that there were no specific items asked for often by the clients, because it was more of a first come first serve set up, though the clients were grateful for everything they received (Richard, 2019). The food bank has a covered area that is located on the client entrance side of the building. This area has benches and picnic tables for people to use while they are waiting in line. To make the experience less awkward Richard mentioned that she had small talk with clients about how they liked the food bank and often learned a little about their families. These conversations help the time go by and promote an enjoyable experience for clients coming in.* *Word Count (Findings): 1908

COMBINED PAPER 12

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COMBINED PAPER Term Business Hours Client Distribution Days Sorting Sponsors 13 Appendix A: Glossary of terms Definition Hours that the food bank is open for volunteers and paid staff to come in and usually occurs during distribution days. Someone who is food insecure and uses the food bank to obtain food necessities for themselves and their family Days that the food bank is open for clients to come in and get what they need. Going through donated food products to make sure that they are within quality standards. People or communities that provide the food bank with money that helps with buying food that isn’t donated, obtaining equipment, etc.

COMBINED PAPER 14 References Adams, E., Hargunani, D., Hoffmann, L., Blaschke, G., & Helm, J. (2017). Screening for food insecurity in pediatric primary care: A clinics positive implementation experiences. Journal of Health Care for the Poor and Underserved, 28(1), 24-29 Balistreri, K. (2016). A decade of change: Measuring the extent, depth and severity of food insecurity. Journal of Family and Economic Issues, 37(3), 373-382. Deierling, D. (2019, February 1). Marysville community food bank impact. (H. Redford, T. Lewis, C. Martinez, J. Name, S. Name 1, S. Name 2, ... S. Name 4, Interviewers). Marysville Community Food Bank, Marysville, WA. *Note: we discussed the student names and some signatures not being ledgable.* Denney, J. T., Kimbro, R. T., Heck, K., & Cubbin, C. (2017). Social cohesion and food insecurity: Insights from the geographic research on wellbeing (GROW) study. Maternal and Child Health Journal, 21(2), 343-350. Gunderson, C., & Ziliak, J. P. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830-1839. Gowda, C., Hadley, C., & Aiello, A. E. (2012). The association between food insecurity and inflammation in the US adult population. American Journal of Public Health, 102(8), 1579-1586. Hessol, N. A., Zepf, R., Zobell, E., Weiser, S. D., & John, M. D. (2017). Food insecurity and aging outcomes in older adults living with HIV. AIDS and Behavior, 21(12), 3506-3514

COMBINED PAPER 15 Jernigan, V., Wetherill, M. S., Hearod, J., Jacob, T., & Salvatore, A. L. (2017). Food insecurity and chronic diseases among American Indians in rural Oklahoma: The THRIVE study. American Journal of Health, 107(3), 441-446. Kim, K., & Frongillo, E. A. (2007). Participation in food assistance programs modifies the relation of food insecurity with weight and depression in elders. The Journal of Nutrition: Nutritional Epidemiology, 137(4), 1005-1010. Mangini, L. D., Hayward, M. D., Zhu, Y., & Forman, M. R. (2018). Timing of household food insecurity exposures and asthma in a cohort of US school-aged children. BMJ Open, 8(11), 1-9. Mangini, L. D., Hayward, M. D., Dong, Y. Q., & Forman, M. R. (2015). Household food insecurity is associated with childhood asthma. The Journal of Nutrition, 145(12), 2756~ 2764. Marysville Community Food Bank (2019). Marysville Community Food Bank: Feeding the hungry in the community since 1974. Retrieved from http://www.marysvillefoodbank.org/ Richard, T. (2019, March 2). Helping food bank clients. (H. Redford, Interviewer). Canvas Student E-mail, Marysville, WA.

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