Rural Health and Hunger: Why Should We Be Concerned?
According to the Center for Disease Control and Prevention, more than 46 million Americans reside in rural communities, yet there is a significant gap in the provision of health care services between those who live in urban versus rural areas. The Association of American Medical Colleges found that in 2013 and 2014, the death rate in rural regions was 830.5 per 100,000 people versus 704.3 per 100,000 people in urban regions. This report also found that the average per capita income in rural areas was $45,482 in comparison to $53,657 in urban areas. Rural health equity research from The National Rural Health Association shows that rural communities face challenges of hunger, access to medical treatment, transportation and more.
Rural areas are known to have higher rates of poverty and are less likely than urban areas to have healthcare coverage. There is a myriad of reasons why these communities have fallen victim to the adverse impacts of health inequity. Overall, those living in rural areas are more susceptible to poorer health outcomes due to aspects of their environment that puts residents at greater risk, such as poor road conditions, fewer and less accessible medical clinics, exposure to environmental hazards, fewer job opportunities, and more.
According to Feeding America, 2.4 million rural households are combating hunger and three-quarters of the counties with the highest rates of food and child food insecurity can be found in rural regions. The top contributing factors to food insecurity in these areas align with the challenges of living in remote environments such as the increased presence of food deserts, lower income, and higher unemployment rates. Based on research conducted by Food Research and Access Center, 13.3% of rural households faced food insecurity in 2017 compared to 11.5% of households in urban areas.
Great Plains Food Bank
The Great Plains Food Bank (GPFB) is one of many organizations that is dedicated to the fight of closing the hunger gap. As the largest, and sole, hunger-relief organization in North Dakota, GPFB plays a prominent role in addressing rural hunger. With a mission to end hunger in North Dakota and western Minnesota through community engagement and partnerships, GPFB distributes all donated surplus food to a network of food pantries, soup kitchens, shelters, and more where grocery items are distributed to those suffering from hunger and homelessness in the geographic area. 96% of each charitable dollar that is received goes towards programs and services to combat these systemic issues. As a result of the work of GPFB and their community partners, thousands of families are able to access food and live without fear of starvation.
Melissa Sobolik, president of GPFB, believes food banks and soup kitchens are just one piece of the puzzle when looking to address the hunger crisis in rural areas. It’s also important to consider nutrition and overall health. “We came to the hard realization that food is sometimes just a band aid for things that are going on with people…Proper nutrition really is important to a person’s health and we need to make sure that we’re providing them with the right food and healthy and nutritious food so we don’t exacerbate their condition,” she said. “The health equity piece that we’re looking at is reaching people where they are and also providing them with healthier food, because what they have been traditionally getting from their food pantry may not meet their nutritional and medically-tailored dietary needs.”
According to their 2018 Health in North Dakota Report, of all the GPFB clients, 75% have reported living with a chronic disease, with 84% living with more than one. Additionally, clients are forced to make tough decisions about their health due to financial strains. “We know that all of those are interconnected because if they’re making the choice to save up for gas, they may not have enough food, or be able to pay for medicine,” Sobolik said.
Location, access and other financial stressors reinforce how the social determinants of health are all interconnected and impact healthy lives. One of the unique barriers that North Dakotans face as a result of the rural terrain is a short growing season. Many families rely on their gardens for fresh produce, but due to a long winter season, these gardens are unable to be used for extensive periods of time. Housing is another primary issue, as the quality of life in rural areas can be inconsistent and homes may not be as structurally sound as those in other areas. “There are old farmsteads that may not have running water or heating, but people are living there. They are very proud that they have a roof over their head, but it’s not the quality that they should be living in,” Sobolik said.
Transportation is also a challenge. Due to the vast and rural expanse of North Dakota, residents are accustomed to driving 30, 60, and even 100 miles to reach the nearest clinic, grocery store, food pantry, etc. Poor road conditions in the winter months and the inability of the aging population to drive only serves to further reinforce the inaccessibility and isolation of rural life.
In order to combat such inequities, the GPFB partners with the community. While food banks are an essential stakeholder in closing the gap in rural hunger, cross-sector collaboration amongst housing organizations and healthcare agencies is key to best serving the population. The geographic layout of North Dakota makes it difficult to reach all populations that are in need. As a result, GPFB utilized an innovative approach to bring food closer to the community by implementing mobile food pantries and imperishable food distribution services in underserved areas.
A program that grew from GPFB’s effort to engage more community partners and assess other systemic issues faced by rural communities was the Ending Hunger 2.0 Program. This program is focused on assessing the root causes of hunger. By viewing hunger beyond its immediate effects, strategies are considered to address food accessibility and health inequity. “We really work with the community to find something that they get excited about, to let them have a stake in designing a solution and piloting it because it really means a lot when you tell them that they get to pick how this looks and how it rolls out, and really giving them personal ownership of it,” Sobolik said.
Through advocacy, research and community involvement, GPFB has enacted greater change to support and uplift rural communities and bring awareness to other root causes of hunger. Residents and partner organizations alike praise GPFB’s efforts to combat hunger and serve such a vast population of underserved people and communities.
“Our mission is to end hunger through community partnerships because we recognize that a food bank alone will not end hunger – it takes all of us working together…If we really want to help them (clients) we need to look holistically and connect them to all of the other services than can help them as well.” Through cross-sector collaboration and continuous assessment of clients’ needs and challenges, stakeholders are better prepared to eliminate this health inequity.
Interested in supporting Great Plains Food Bank? Visit the link below to see ways in which you can help through serving as a financial donor, volunteer, advocate, or participating in their food and funds drive: https://www.greatplainsfoodbank.org/get-involved