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Child Nutrition Hearing - Senate Ag Committee - March 4, 2009 - Part 2

by: Jill Richardson

Wed Mar 18, 2009 at 18:53:59 PM PDT

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Earlier I posted about the first half of the Senate Ag Committee hearing on child nutrition. The first half had to do with school food. This is about the second half, which is on food outside of school.

Panel II:  Improving Nutrition for Children When They're Not in School

Dr. David Paige, Professor
Johns Hopkins Medical School, Baltimore, MD

Mr. Kenneth Hecht, Executive Director
California Food Policy Advocates, Oakland, CA

Ms. Lucy Nolan, Executive Director
End Hunger Connecticut, Hartford, CT

Jill Richardson :: Child Nutrition Hearing - Senate Ag Committee - March 4, 2009 - Part 2
David Paige
Dr. David Paige began. He spoke about the "critical role" of the WIC program of improving the health and wellbeing of women, infants, and children living in poverty. He said today 18% of the population of children is living below the poverty line - and that number rises to 21% when you look at children under 5 - and higher if you look at Hispanics, African Americans, and children in female-headed households. He said over 12 million children are food insecure and the number will escalate in the current economy.

He said 75% of WIC enrollees are below poverty level, so WIC is very good at reaching this population. In general, poverty results in poor health. He said 60% of pregnant women who enter the WIC program have nutritional problem and these affect the well-being of the baby. WIC has been successful at increasing birthrate and decreasing pre-term birth. He said a review by GAO that WIC is cost effective. He said that even 1 less day of a hospital stay or 1 or 2 less nights in the NICU for babies will more than pay back the cost of the WIC program.

He said the U.S. has bad infant mortality numbers for an industrialized country, and reducing pre-term birth and underweight babies will reduce this. Then he said we need to increase enrollment in WIC. Next he addressed obesity. We need to think of obesity as poverty-induced. Not that obesity is limited to that group but this is an important population to look at because poor communities have bad availability of supermarkets and low income people choose calorie dense foods.

Then he spoke about the benefits of breastfeeding. WIC is dedicated to trying to improve the number of individuals who elect to breastfeed. However, in lower economic tiers, breastfeeding is very difficult.

He recommended that we enroll all infants, women, and children below 185% of the poverty level. He wants to enroll all Medicaid recipients. He wants to establish linkages with the social services community, and expand WIC for electronic benefits (EBT). Also military families with someone serving in a combat zone get extra pay but that can kick them off the WIC program and he asks that this practice is ended.

Kenneth Hecht
Next, Hecht spoke. He said by the time kids come to school, it may be too late to stop them from becoming obese. He brought up 2 studies. One was in LA, where he looked at childcare homes and centers. A 2nd was done by mail to 500 randomly sampled centered and homes in CA. The results were the same in each case.

1 in 4 children in the 2 to 5 age bracket is obese or overweight, before reaching kindergarten. This is exceedingly difficult to reverse. At the same time, we have concern for hunger and food insecurity. Almost 1 in 5 in that age bracket is living in a household that is food insecure or hungry.

The childcare food program he spoke of occurred about 1/3 in homes and 2/3 in centers. He said the food given to the children isn't responsive to obesity. USDA has commissioned a study from IOM to start next year, and he believes that the results will not be implemented for another 4-5 years.

His 2 studies found that the childcare facilities that participated in the food program had better nutrition than those that did not. Head Start was best, food brought from home was worst. Even in the childcare food program, there are problems - 50% of the sites serve whole milk, and he thinks that from the age of 2 on children shouldn't receive whole milk. Only 1/4 were serving any whole wheat at all.

His recommendations wanted to be consistent with the WIC program. Second, he wants to make recommendations simple. In the homes in particular there isn't much time to fuss with complicated requirements. Third, he wants to make it inexpensive.

Recommendations on nutrition - first, increase the reimbursements. With that, he's asking that nutrition improvements be linked. Low fat milk, more fresh fruits and veg, more whole grains, less fat, sugar, sodium. He also proposes changes in the health environment in the facilities - every program oughta have water easily accessible to kids, limit screen time, get the kids outside and moving. He wants to import the idea of "foods of minimal nutritional value" into this program - keep the kids from getting soda and candy.

He also asks to grow the programs. He calls for categorical eligibility for kids who have already been means tested. Also, there are areas where no sponsoring organizations and therefore there can't be childcare homes. He asks that the state then become the sponsoring organization. He also said when a program operates on a school campus it should operate under school lunch rules. Last, he wants money for training of sponsors and providers, so they can provide nutrition education to kids and families.

Lucy Nolan
Nolan spoke last. She spoke about after school and summer nutrition programs. She said that kids who participate in school nutrition programs they do well and they gain weight when they are out of school. Therefore, these programs that serve meals and snacks outside of school are important. She recommended a financial incentive for schools to reach "certified healthy" nutrition standards. She also said the programs should stay activity based because the kids will come to the program for a meal and then go swimming or play sports while they are there.

She also noted poor participation rates and made some recommendations on this. She wants to create partnerships with farmers and farms. In Middletown there was a partnership with a CSA that came in and taught the kids where their food came from, brought foods to try, showed them how to plant things.

She said outreach is necessary. She said they give out 5 grants to communities as a way to buy things that are not food related. An example she gave was a raffle to win a bike where kids would get a raffle ticket each time they showed up.

Also, she asked for commodity support for these programs or in rural areas cash instead. Last, she said she wants to see this as a year-round seamless program. It gets complicated when one sponsor does the summer program and someone else does after school programs. She wants to see streamlining.

Question and Answer
Harkin asked Nolan to clarify if she's asking for several programs to be combined into one. She said yes, to make administration easier. Hecht said that in CA there's a program where summer sponsors can continue to provide after school snacks during the year, and it has helped a lot.

He asked Nolan about how in the summer, activities and games attract kids more than the food. If that's so, what are her suggestions to draw kids in to the programs? She brought up a grant program, and said in one community they had police officer and firefighters come and read to the kids. They had a trunk and said it was a mystery what was in the trunk and on the last day they opened it and all the kids got T-shirts. They also got art supplies. She said these things got the kids to come because they were excited about it and told their friends. She said the food is a pull but the other stuff helps build community and it works.

Harkin asked if somehow the money for the food should then be linked to the community providing those activities that draw the kids in. He wants to encourage the local communities to think about how they can attract the kids. Hecht said that kids in summer who get food in the summer get it via summer school. Now that schools are broke there will be less summer school and less kids anchored to a summer food program. Nolan suggested a pilot of some sort but thought Harkin's idea would be helpful. He also wants to know how YMCAs could help. Nolan mentioned Boys and Girls Clubs.

Chambliss spoke next. He likes Nolan's idea of creating one "umbrella" program. He said it's obvious that Nolan is letting the kids have fun and if they have fun they will show up. He asked Dr. Paige about his statement that everyone under 185% of the poverty level oughta be enrolled in WIC. He said those folks are already eligible, they just aren't enrolled, so Paige is talking about increased participation.

Paige said currently the WIC funds will not cover all of the eligible women, infants, and children. He talked about integrating the programs together with regards to qualifying and reducing the burden on the participants. He also said we could locate these programs together with health programs.

Chambliss asked about child obesity and the 1 in 4 statistic. He asked if there's a correlation between the statistic and the economic strata the children come out of. Hecht answered that good food costs more money, so low income families struggle. However, obesity exists at every income level.

Chambliss asked about the paperwork in the program and how it's a problem. He asked if there was a way for them to do it online and how we could eliminate the paperwork. Hecht replied that it can be done online. However, some families don't own or know how to use computers. He said there has been a paperwork reduction taskforce meeting, but their work needs to be carried on. He said some paperwork is intended to catch fraud but it's burdensome and also not adept at catching any fraud.

Casey spoke next. He was blown away about the high percent of children in poverty but happy about the good data on WIC. He asked Paige about WIC, to rank his recommendations in terms of the 3 most urgent in light of "budget realities." Paige replied that he wants to get women into the program very early and increase education. Casey ended by bringing up the challenge of the summer food program in rural areas.

Klobuchar came next. She asked Hecht about the high percentage of small children who were obese and overweight. She asked him why. He answered "Calories in and calories out." Lack of movement, too much screen time, and on the food side, healthier food is more expensive and in some cases, less accessible. Hecht said, on the other hand, families that paid more for childcare got less in terms of nutrition because they weren't going to places that got the childcare food program.

Harkin became an absolute hero to me by bringing up breastfeeding. He said years ago he was part of a group protesting Nestle for giving mothers formula in the hospital. He asked what the barriers are to getting low income women to breastfeed. Paige said in the 1960's and 1970's the instance of breastfeeding was high among low income folks. He said the formula given out in hospitals contributes to this.

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