Feeding Health: The Fight Against Childhood Food Insecurity

00:00:00:02 - 00:00:20:08
Tom Haederle
Welcome to Advancing Health. Food insecurity is more than the lack of enough to wheat. The lack of healthy, quality food is just as big a problem as Dr. Stormee Williams, senior vice president and chief health equity officer at Children's Health, explains in this Community Health Improvement Week podcast.

00:00:20:10 - 00:00:34:00
Nancy Myers
I'm Nancy Meyers from the American Hospital Association. Welcome to today's conversation. I want to start by saying welcome and thank you to Dr. Williams for sharing the work that you and your team are leading at Children's Health.

00:00:34:01 - 00:00:35:25
Stormee Williams, M.D.
Thank you so much for having me.

00:00:35:27 - 00:01:00:22
Nancy Myers
Today's topic, which is supporting health by identifying and tackling food insecurity for patients and community members, is one that I think is especially important as we think about how to better support children and their families. So, Dr. Williams, can you start off by telling us a little bit about Children's Health and how you came to focus on food insecurity in your community?

00:01:00:25 - 00:01:34:14
Stormee Williams, M.D.
Yes. So Children's Health is a leading pediatric health center in North Texas, and we're one of the largest pediatric health care providers in the nation. And with our academic partner at UT Southwestern, we're one of the leading pediatric care providers in the nation. Our mission is to make life better for children and we take that very seriously. So it's only natural that we decide to take care of the whole child, which is also including their families,

00:01:34:14 - 00:01:52:26
Stormee Williams, M.D.
right? So we can't do that by only considering their health care needs. We have to consider all of the needs that allows us to take care of both their health, as well as other needs and non-medical needs that impact their health outcomes, which includes food access and food quality.

00:01:53:00 - 00:02:04:16
Nancy Myers
So talk a little bit more about that. As a pediatrician yourself, can you tell us about how being food insecure impacts health, especially in children?

00:02:04:19 - 00:02:29:04
Stormee Williams, M.D.
Yeah. So let's talk a little bit about what is food insecurity. When we hear that term food insecurity, we think just having access to food, meaning you know, you just don't have enough food to last one day to the next. And that is definitely a part of it. But also food insecurity also looks at the quality of food that you have access to.

00:02:29:04 - 00:03:06:15
Stormee Williams, M.D.
And if you look at under resourced areas, sometimes some of our highest rates of obesity are in under-resourced areas. And so as a pediatrician, my early career started in an under-resourced area. And in fact, I worked in a federally qualified health center right in the Dallas-Fort Worth area. I saw firsthand what that looked like. A lot of my patients were overweight or obese in that very area, right, very close to downtown Dallas, actually, and they just didn't have access to healthy foods.

00:03:06:16 - 00:03:37:24
Stormee Williams, M.D.
I saw it for myself because if I forgot to bring my lunch, what was close by, and I had very limited time to run out and grab something to eat. My options were fried chicken, fried fish, you know, something that was not necessarily healthy. It was calorie dense, but not necessarily nutrient dense. And that's what we see for our patient families, is that they might have access to food, but is that necessarily healthy food?

00:03:37:24 - 00:03:47:04
Stormee Williams, M.D.
So we have a twofold approach to food insecurity. It is access to food, just purely food, but also access to healthy food.

00:03:47:04 - 00:04:08:20
Nancy Myers
And I would think that in addition to impacting our physical health outcomes, just being food insecure, especially in terms of access to just enough calories, has an impact on kids in terms of their mental health, too, and their sense of well-being. Do you see that in the work that you're leading?

00:04:08:22 - 00:04:33:14
Stormee Williams, M.D.
Oh, absolutely. There's been some studies out there that shows that kids who are food insecure, they're more likely to have mental and behavioral health issues. In fact, we've seen it firsthand. I have a very dear mentor of mine who's a pediatric emergency medicine physician, who told me about a story of a patient who came into our emergency room.

00:04:33:14 - 00:04:53:13
Stormee Williams, M.D.
She was seen, unfortunately, for trying to take her life, and she was only ten years old. And when she spoke to one of our counselors who asked her, did you really want to take your life? She said, no, but if I'm not here, they'll have enough food to feed my baby brother. And so that just is an extreme case.

00:04:53:13 - 00:05:23:09
Stormee Williams, M.D.
But when you think about children and the toll of what, you know, inadequate access to food and just financial resources and what that does to a family, we think as parents that we are keeping those needs away from the kids, but they hear it and they feel it. And also, food insecurity impacts kids ability to learn. We've all heard the term and we've used the term "hangry," right, when we're hungry.

00:05:23:10 - 00:05:44:26
Stormee Williams, M.D.
Remember that those ads like you need a snicker. But we've heard those terms. And we felt those terms to get a little irritable. Before a child that could look like behavioral issues, that could look like hyperactivity. But imagine trying to perform on a standardized test or to sit still. And so these are the types of things that children experience.

00:05:45:01 - 00:06:13:21
Stormee Williams, M.D.
But we see it in so many different forms in the health care system as well. So, it makes so much sense for health care providers, for hospitals to not necessarily say we want to take this on and tackle or solve food insecurity, but how can we partner with those organizations who are tackling these issues and say, we want to partner with you to see how we can stand in the gap for our patients and their families.

00:06:13:24 - 00:06:23:28
Nancy Myers
So you said that you have a two pronged approach within Children's Health. Tell us about what is the approach that you're taking to support children?

00:06:24:01 - 00:06:53:24
Stormee Williams, M.D.
Yeah. So first it all started with screening our patients for their non-medical drivers of health. We call it our social drivers of health screening. We started that back in 2022 as systematic digital screening for those needs where when they have a patient that's coming in for an appointment and if they're being seen in our emergency department or even as an inpatient, they received a digital screening tool through our electronic health record.

00:06:53:24 - 00:07:17:15
Stormee Williams, M.D.
And they can, within the privacy of their own device, just answer a few questions about those needs, whether or not they worry about food running out or food has actually run out. And of course, we ask them about other needs, including housing insecurity, financial strain as it relates to paying their utility bills or transportation issues, getting to and from appointments and things like that.

00:07:17:15 - 00:07:39:04
Stormee Williams, M.D.
And then if they do have a need, we can either just give them a list of resources or if they ask to speak to someone, we can connect them with one of our members of our care management team, which includes our social work team or our social work extenders. We call them our family resource coordinators. Based on that information,

00:07:39:06 - 00:08:10:04
Stormee Williams, M.D.
we've had the fortunate opportunity to screen over 250,000 families over the last few years, and we have access to a lot of information. And food insecurity remains in the top three needs of our patient families. And what do we do with that? We can't, you know, just sit on that information. And we're so thankful and grateful because our executive leaders of our hospital system, along with our board of directors, said that they want to do something about this.

00:08:10:04 - 00:08:40:04
Stormee Williams, M.D.
And so we have partnered with the community and said, like, there are some organizations out there who are already doing some really great work. So we partnered with a food bank here in the area and said, how can we support you to meet the needs of some of our patients? And so that's really the approach of screening families and then connecting them with resources that are already doing the great work and helping our families to get connected with those resources.

00:08:40:07 - 00:09:03:28
Nancy Myers
So I want to kind of dwell for a moment or two on that concept of partnership and collaboration. You know, health care and health is a team sport. And I think you said earlier hospitals can't do it all themselves. How has the act of partnering to better support the children and families in your community made your program stronger and more effective?

00:09:04:00 - 00:09:08:07
Nancy Myers
Talk about kind of the benefits of partnered approaches.

00:09:08:14 - 00:09:37:00
Stormee Williams, M.D.
Yes, I, I can't stress that enough. We pride ourselves on the work we do, of course, within the hospital, the walls of the hospital. But we pride ourselves as much on the work we do outside of the walls of the hospital as well. We are fortunate to have led a program known as our school based telemedicine program, that has been in existence since 2013, and what that is, is a program in schools.

00:09:37:00 - 00:10:11:10
Stormee Williams, M.D.
We're in over 260 schools in the Dallas-Fort worth area, in more than 30 school districts, actually in the area. And so we leverage that partnership with schools to say that we want to make sure that kids are benefiting from the partnership with the food bank. So we went and were able to leverage that relationship that we've already had and that we've built over a decade and had the food bank go to one of those schools and say, how can we leverage this relationship and put a food pantry right in one of these existing schools?

00:10:11:10 - 00:10:56:16
Stormee Williams, M.D.
So again, leveraging the data that we had, we knew exactly where some of the most needy areas were. So we looked at zip code data from our social needs screening or our non-medical driver screening, and could really drill into the top zip code that that was needed and put a food pantry right in one of the schools that we already had an existing partnership with. That relationship that we've built, like I said, for over a decade with schools, is really what helped us to get the ball rolling so quickly is because we already have that relationship, and because we've had these trusting relationships and collaborations with the North Texas Food Bank, it was really

00:10:56:18 - 00:11:30:03
Stormee Williams, M.D.
easy. But, you know, to be able to pick up a phone or send an email to someone you already have a relationship with, and to say that we want to expand, it was really not even difficult to do. Again, there's so many community based organizations who - that is their sole purpose - is to close those gaps. So to let them know that we want to right in line with what they're doing to help them expand their mission, it really just it's really like a no brainer for both of us to do that.

00:11:30:04 - 00:12:04:09
Nancy Myers
And, you know, the power of the data that you have, you've screened a quarter of a million children so that you can identify where those needs are highest. And that is then allowing those community partners to be more effective in targeting their delivery of services. I love that you've been able to use your data to bring food to where the children are, to make it easier for children and their families to access that food, and to probably decrease stigma too, I would imagine.

00:12:04:12 - 00:12:30:28
Stormee Williams, M.D.
Yeah. And, you know, and it's so great because we've been so intentional with all of our programing, right? One of the reasons we were in that particular school for the school based telemedicine program is because that is an under resourced area that needed access to primary care and acute care visits for kids. And that is why we were in that school for school based telemedicine

00:12:30:28 - 00:12:57:12
Stormee Williams, M.D.
so it made sense that that would also be an area that needed additional support for food, right? And again, it's kind of this this feedback loop of putting resources where those resources are needed. And the more we can kind of wrap our hands around that particular neighborhood, they kind of expect to see us. And what we've also seen is that now they look to us for so many other things.

00:12:57:12 - 00:13:15:03
Stormee Williams, M.D.
So we've done, you know, expanded career days in that school. And they now they know to pick up the phone for us and say, hey Dr. Williams, can you come? We're having this day and we're having that. We want you to come and read to the kids, because again, it's just expanding on an already fruitful relationship in that community.

00:13:15:06 - 00:13:31:27
Nancy Myers
Well, and that kind of reach back to you from the community certainly is a measure of success. What other ways are you looking at outcomes to understand what impact you're having with the food insecurity programing?

00:13:32:00 - 00:13:56:25
Stormee Williams, M.D.
Yeah. So that's the beauty of data. And this is actually the first year that we've had that particular program. So we're looking to see kind of what the impact of that work will be. We have another pilot that we've started inside the walls of the hospital, where we are connecting families who are food insecure with meal support, while their children are inpatient, where they are admitted into the hospital.

00:13:56:26 - 00:14:25:03
Stormee Williams, M.D.
So that'll be a little easier to track. With the data that we have is a little harder in the community, obviously, to track that information, but we're hoping to do that with the North Texas Food Bank. Another initiative that we do is with helping families to get enrolled with SNAP benefits. Once they're, you know, outside of our patient care, it's a little harder to track success and impact, but we hope to be able to do that.

00:14:25:06 - 00:14:41:07
Stormee Williams, M.D.
You know, there's so many different factors that are involved with food and financial security currently. We're tracking all of this. We see these numbers actually increasing over the last 2 or 3 years, so it's kind of hard to tell. But we definitely are looking at the data.

00:14:41:09 - 00:15:01:14
Nancy Myers
Dr. Williams, thanks so much for that insight and for all that you've shared today and for the work that you and your team are leading at Children's Health every day. To our audience, I want to say thank you for joining the conversation and for your commitment to improving health in the communities that you serve. Be well.

00:15:01:16 - 00:15:10:12
Tom Haederle
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