Food Insecurity Social Determinants of Health

Food Insecurity and Health


A week ago, I spent several days in Maine filming a series of videos about community partnerships that are designed to address the social determinants of health including substandard housing and homelessness, food insecurity, substance use disorder, violence (domestic violence, rape, and human trafficking), and more. All of these are prevalent in the State of Maine and, most likely, wherever you live.

For three days, we were shooting videos that focused on the local hospital’s partnerships with local non-profit organizations and public health groups to improve community health by addressing those upstream causes of poor health. The community hospital, St. Joseph Hospital in Bangor, Maine, has a focus that extends well beyond the walls of its hospital and clinics. Its work to reduce food insecurity in the area is a great example of this.


For the team at St. Joseph Hospital, addressing food insecurity is an effort that is fought on many fronts with many different community partners. They work to encourage healthy eating both inside the hospital and out in the community. That means it is important to help people access healthy options such as fruits and vegetables. One program, St. Joseph Hospital’s Community Vegetable Exchange, was started by a local Eagle Scout. The scout built the vegetable cart that now sits in front of the hospital’s main entrance. All community members are welcome to help themselves. Local farmers and the Good Shepard Food Bank help stock the cart with fresh fruit and vegetables.

One thing hospital leadership noticed, once the cart was in place, was that late at night many of the hospital’s employees would visit the cart (when very few people were around) and help themselves to the produce. They were always welcome to the food but some felt ashamed or embarrassed to avail themselves of the produce. Many hospital employees make low wages and struggle to make ends meet; so the food cart was an important resource. This revelation led the hospital’s leadership to start an employee food pantry within the hospital. Employees are encouraged to help themselves to the food in the pantry for themselves and their neighbors or family members who may be in need.

St. Joseph Hospital has an incredible partnership with Food Shepard Food bank, the largest organization of its type in the State of Maine. As patients visit the hospital and its primary care clinics, they are assessed for food insecurity (a few simple questions). If they are believed to be food insecure, they leave with a bag of non-perishable food provided through the partnership with the food bank. In addition to providing food, St. Joseph’s Hospital offers counseling to all food-insecure patients to help them stretch their income, find food resources in the community, and secure assistance with their home heating oil purchases.

The team at St. Joseph Hospital also secured a grant so they could purchase frozen meals from the Eastern Area Agency on Aging that could be given to post-surgical patients. Thanks to this program, these patients are sent home with five frozen meals to make their transition easier. Often hospitalizations are not planned, so being sent home with easy-to-prepare frozen meals is a great option while a patients recovers from surgery or some acute illness. This is particularly helpful for elderly patients.

St. Joseph also does food promotions in partnership with the Good Shepard Food Bank, USDA Organic Farms, and the Family Food Box Program (part of the Coronavirus Food Assistance Program). These food events have been incredibly important during the pandemic. On October 6th, they held a “Drive Through Produce Pick Up Event” where they gave out 500 healthy food kits to members of the community. Community members did not have to demonstrate need or show any documentation to receive the food. The food was there for anyone who showed up. And food boxes were delivered to those who did not have transportation or who did not feel safe leaving their home during the pandemic.

St. Joseph has also recognized that hospitals should model healthy eating and should provide healthy, nutritious options to their staff, patients, and visitors. With that in mind, St. Joseph Hospital launched an initiative to improve its food offerings and to make healthy options more accessible within its cafeteria. Their chefs have worked to make their recipes more nutritious by reducing salt content and integrating more fresh ingredients. As an employee or visitor walks through the cafe, the healthier options are right at eye level and within easy reach. The less healthy options take a little more work to access. The impact of these changes is far reaching. St. Joseph’s cafe has become a dinner spot for many members of the community, particularly seniors, because the meals are affordable and tasty, and the staff is very welcoming. Of course, the pandemic has curtailed this for the most part.

That is the story of one community hospital’s efforts to reduce the prevalence of food insecurity within its service area. What I didn’t include are the partnerships and programs that St. Joseph leads to address and reduce the impact of violence, addiction, homelessness, substandard housing, and transportation (a huge barrier to care). From the perspective of St. Joseph Hospital, this is the role of the community hospital. This is about addressing the needs of the community. And this is why it is so important that we support our community hospitals and make sure they emerge from this pandemic on a solid footing.

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