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Food Insecurity and Assistance — Making Ends Meet
By Suzanne McDevitt, PhD
Social Work Today
Vol. 18 No. 6 P. 20

Hunger remains a critical issue in this country. For many Americans, receiving some form of food assistance is a regular part of their household management.

Larry Breitenstein, PhD, chair of the social work department at Slippery Rock University and former director of the Office of Children and Youth in Westmoreland County, PA, remembers child protection work in Kentucky in the early '70s. "I used to carry extra canned food in my car, just in case. Almost half my families needed help with food. Food stamps were new and food banks were scarce. We had petty cash for food, but it was never enough. I almost always bought food because I never knew when I was going to find a starving kid."

Today, hunger is still a prominent issue. Ads with a picture of a sad-looking child appear on billboards, the internet, and television saying, "No school means no school lunch. Donate now [to] Feeding America." Summer or winter, a line forms on a country road at a door that will not open for another hour at the local food pantry. Food distributed through the Feeding America system comprises part of the food distributed to those clients (or customers) that day.

Feeding America, a national organization, monitors and sets food handling standards and business practices for its member regional food banks, and routes food to that system. For many low-income Americans, using some form of food assistance is a regular part of their household management. For many Americans of any income level, taking canned food to a concert or other entertainment event or putting a bag out by the post box on a Saturday in May allows many people to feel that they are "taking care of hunger."

Mandy Fauble, PhD, executive director of Safe Harbor Behavioral Health UPMC in Erie, PA, reflects on the importance of food assistance to the clients her agency serves. "In our population, we see how not having basic needs met, such as nourishment, can trigger mental illness," she says. "Likewise, people whose illness interrupts their education or employment struggle to meet their basic needs. We very regularly refer to food banks, agencies that serve meals, and more formal programs like supplemental nutrition. It's especially concerning for two reasons: children can't learn if they are hungry; people also have a really tough time coping with their illness and practicing good coping skills when they are unable to meet their basic needs."

Hunger, though not the focus of many social service agencies, is a factor in the lives of many clients. Food insecurity is defined by the US Department of Agriculture as "multiple indications of disrupted eating patterns and reduced food intake."

The Intersection, located in a former church surrounded by a boat yard close to the river in the aging former steel town of McKeesport, PA, has been providing an on-site meal and other services for 46 years. Founded by the Sisters of Mercy, it provides lunch three days a week and has food pantry clubs at two different locations. Karen Supansic, who manages the day-to-day services, says, "When no one else will do anything for you, people come here."

The food pantry club on-site provided 5,000 food orders to 500 families in 2017. After the food pantry near the public housing community closed, the Intersection opened a branch that quickly grew to 127 families a month.

"One of our biggest problems," Supansic says, "is predicting need. One day we will have 40 people here for lunch and the next day 75."

The Intersection receives referrals from the public assistance office, the Office of Children and Youth, local parenting programs, and local behavioral health agencies. In the early months of 2018, the number of people with problems increased and food orders grew by 18%. Orders to large families with more than five members increased by 28%.

The Intersection gives each recipient a dry bag of canned goods, pasta, and cereal; a cold bag with milk, eggs, and various foods such as cheese, yogurt, and frozen food; and a walk-through bag where the food pantry member chooses from fresh fruit and a variety of other foods than can vary from visit to visit.

Food pantry members receive food once per month. Pantries vary as to how often clients can receive. Once per month is typical, but some allow people to receive once a week and others once a quarter. Food supplied by the federal government can only be distributed monthly, but many pantries accept food from a range of sources.

Major Food Assistance Programs
Today, SNAP, often referred to as food stamps, is the most prevalent of the 16 food assistance programs provided by the federal government. It maintains a client's purchasing power by allowing recipients choice in their food shopping.

The federal government also provides 15 other food assistance programs. While the number is surprising to many people, the names are not. Enacted at different times for different reasons, they have diverse and exclusionary eligibility criteria and many are provided in kind. Some provide support to children, some to young families, and some to older adults. For example, school breakfast and lunch programs that serve low-income children on a sliding scale of 185% of the poverty level and under are common across the country, as are the lunches offered in older adult centers and from Meals on Wheels.

The Women, Infants, and Children program, to which social workers working with families routinely make referrals, provides pregnant and nursing mothers and their children up to age 5 with incomes 185% of the poverty level and under food and nutritional education. Meals on Wheels serves homebound older adults with incomes 185% of the poverty level and under.

Other targeted programs, such as the Commodity Supplemental Food Program, provide a box of stable foods to older adults. Less well-known programs such as the Child and Adult Care Feeding Program and The Emergency Food Assistance Program (TEFAP) provide commodities for after-school and day care programs and for distribution through food pantries and on-site meal programs also known as soup kitchens, respectively.

SNAP benefits can be used for food and seeds but not prepared foods, alcohol, or tobacco. In 2000, about 17 million people received the program, but, during the recession, the numbers soared in response to need and changes in the program that made it more flexible to about 47 million. By 2016, when the waiver of work requirements enacted as part of the American Recovery and Reinvestment Act stimulus program had been reinstated, the numbers had decreased to only 45.5 million; they have never returned to the prerecession numbers.

Alex Majchrowicz, of USDA's Economic Research Service (2016), says the number of enrollees and the composition of the SNAP caseload has shifted over the last decade. In 2007, children under the age of 5 comprised 16.8% of the caseload, but by 2016, due to a declining birth rate, their share had fallen to 13.4%.

During the recession, more working adults entered the program, increasing their share of the caseload to 46.5%, though after reimposition of work requirements, the percentage declined to 44.1% of the caseload. Those 60 and older were 11.8% of the caseload, rising from 9.3%.

The need for food assistance, which is the result of inadequate income, interfaces with the need for other programs. During the recession, the rate of early retirements (at age 62) increased when older adults lost jobs and could not locate other employment. This group is likely to be affected by low income for some time and continues to need SNAP—thus, the proportion of those older than 60 receiving SNAP is likely to rise, even above the rate of retirements.

Special Populations
Adolescents, college students, and older adults all experience particular issues with food insecurity.

Teens will conceal hunger, and, though they overwhelmingly prefer employment, faced with acute food insecurity and no employment prospects, they may resort to criminal behavior.

Hunger continues into college. The number of campus pantries has grown to 400 nationwide in response to the number of hungry college students.

As for older adults, Weber says, "Some of our women only have incomes of $5,000 per year."

SNAP Recipients and Work
Many SNAP participants work. According to Keith-Jennings & Chaudry (2018), "Most low-income, nondisabled adults work, but often with interruptions, and they are more likely to participate in SNAP when they are not working."

A recent analysis by the Pennsylvania Department of Human Services, published by the Pittsburgh Post-Gazette, found that in excess of half a million Pennsylvanians—one in every 12 workers—is living in a household that receives SNAP.

Where do these folks work? Dollar General stores had the highest percentage at 19.7%, followed by Dollar Tree at 16%. Significant numbers of employees at major retailers such as Amazon (12.7%) and Walmart/Sam's Club (10%) also depend on SNAP to supplement their wages.

Employers are similar for rural food pantry clients. Mary Weber, who runs a food pantry in rural Erie County, says. "I see our people in Country Fair [a convenience store], Walmart, sometimes Sheetz [another convenience store], and the dollar stores."

Significance of SNAP Dollars to Local Communities
SNAP brings in significant dollars to local economies. During fiscal year 2017, the US spent $70 billion on SNAP, down from $79.5 billion in 2013. In small rural counties, SNAP can be an especially important resource for local groceries. For example, in May 2018, Pennsylvania's 67 counties received more than $217 million in SNAP dollars.

A rural county such as Fayette, south of Pittsburgh on the Maryland border, with a population of 130,000 and a poverty rate of 18.4%, had 29,625 recipients. SNAP provided the county with approximately $3.5 million to support local nutrition and grocery stores.

50 States/50 Programs
The 1996 welfare reform legislation and other legislative and regulatory changes gave states broad authorities in the administration and eligibility criteria for SNAP, including the ability to simplify program requirements and even change the name of the program. In California, the program is known as CalFresh; in Wisconsin, FoodShare; and, in Vermont, 3SquaresVt. Most states use the name SNAP; only three—Utah, Missouri, and Alaska—retain the old name of food stamps.

States can set the income eligibility limit, the amount of assets applicants can own, how the benefit is delivered (primarily by EBT [electronic benefit transfer] cards, similar to ATM cards), etc. Between 2002 and 2014, the Economic Research Service found state SNAP policies had become more accommodative of SNAP enrollment. However, a major change introduced by the 1996 legislation created a work requirement for so-called ABAWDs—Able Bodied Adults Without Dependents—wherein they can receive SNAP for only three months out of 36 unless they work 20 hours per week. While the work requirement was waived during the recession, it was reimposed in 2014. However, states can seek waivers for high-unemployment cities and counties.

The Informal Food Assistance System
The number of people receiving food assistance from a food pantry or onsite meal center (often known as a soup kitchen)—46 million according to Feeding America—is nearly equal to those receiving SNAP. In fact, it may be the case that Americans are more familiar with informal food assistance programs—food banks and food pantries—than the formal federally based program.

Who uses food pantries and for how long? Food pantries may be the only universal food assistance available in the United States. The only requirement is income eligibility; there are no work requirements. Each pantry may set its own criteria as far as income and range of services. Many have a service area such as municipal boundaries or school district boundaries. In some instances, recipients self-report income.

Weber says, "We have the same people for years. Sometimes a new family comes when something happens (for example, someone loses a job). Eventually, when they get their act together, they quit coming. But by and large it is the same people."

"A person we are helping today first came here as a child," Supansic adds.

Low income, chronic unemployment, and modest benefit amounts in programs such as Supplemental Security Income and Social Security can encourage reliance on the informal system.

Farm Bill
SNAP, TEFAP, and other smaller programs are reauthorized every eight years as part of the Farm Bill. (As of this writing, they are up for renewal.)

The proposed House bill, seen as onerous and impractical by advocates, passed on June 21 after an initial failure. In part, it proposes that part of the benefit be delivered as "Blue Apron for Food Stamps," or food boxes of staples. However, the bill, which lacks funding for related shipping and handling, has proven highly controversial. By introducing new work requirements and removing flexibility for state administrations, analysts found that it would likely result in some 2 million recipients losing SNAP.

Though unlikely to produce a noteworthy increase in employment, implementing the proposed new work requirements would require the development of significant state bureaucracies and would be a step away from decreasing food insecurity. It also has the potential to increase the burden on the food bank/food pantry system as former SNAP recipients turn to that system.

The bipartisan Senate bill, passed June 28, would improve the program's integrity and expand a promising job training pilot program. In addition, it would provide increased support to help older adults, people with disabilities, and indigenous tribes.

Given the current difficulties in congressional dialogue, reconciling the two bills in Conference Committee may be a protracted process with the potential to continue past the midterm elections, though as of mid-September there was pressure to pass the bill to enable agricultural subsidies to continue to flow. Some Senate staffers, according to The New York Times, believed that the pressure to pass the bill made it less likely that the House cuts would survive.

The Grand Challenge of Hunger
The Social Work Grand Challenges established by the American Academy of Social Welfare do not directly refer to hunger or food insecurity, but at least one-half of the challenges may indirectly relate to the condition. And existing food assistance programs, despite ongoing shortfalls, may be having more of an impact than we sometimes realize.

Breitenstein comments on the decline of failure-to-thrive cases in the child welfare caseload: "I found that failure to thrive as a type of child abuse/neglect was almost nonexistent. When the politicians talk about reducing food stamps or limiting them to two years, I wonder how long it will be before we start getting more failure-to-thrive reports at children and youth agencies?"

Social workers, grounded in the impact of the environment in their clients' lives, must be mindful of the effect of such concrete issues in the midst of competing demands. Fauble says, "Hunger continues to thwart development and success for people, and working to address that is important in any setting. If people aren't struggling themselves, it can be easy to miss how much poverty is really out there."

— Suzanne McDevitt, PhD, is an associate professor at the Edinboro University of Pennsylvania School of Social Work.

Keith-Jennings, B., & Chaudhry, R. (2018) Most working-age participants work, but often in unstable jobs. Center on Budget and Policy Priorities. Retrieved from https://www.cbpp.org/research/food-assistance/most-working-age-snap-participants-work-but-often-in-unstable-jobs.