Comer Children’s Hospital Tackles Food Insecurity through In-House Food Pantry Programs

The Origins of Our Upstream Work

When Julia Auerbach’s family found themselves in the hospital for an extended period of time caring for her brother, they had the support of their friends, family and community to help them get through their long days (and nights). “Friends and neighbors came over every day and stocked our fridge so we didn’t have to think about where dinner was coming from,” she recalls. “We could focus on getting better.” But, as Julia soon realized, not everyone who came to the hospital was as lucky as she. “Some people don’t have anyone they can count on, and they don’t have anyone bringing them something to eat. If their child is really sick they can’t even leave the hospital to go home to get it [food]. And guest trays are $6 per meal. For some people, $48 per day is just too much money.”

Luckily, Julia was not alone in this realization. In 2009, Reverend Karen Hutt, a Comer Children’s Hospital chaplain, shared with physician leaders of the University of Chicago Medicine Urban Health Initiative that some caregivers of hospitalized children were struggling to feed themselves during their child’s hospital stay. While hospital policy does permit social workers to provide one food voucher per family request per admission, this is often not enough.

Comer Children’s Hospital, located on Chicago’s South Side, serves a largely African- American, low-income community. About 60% of patients seen at Comer are publicly insured or without insurance. “Among other issues, food insecurity is a concern for many Comer families,” said Gillian Feldmeth, (former) Special Projects Team Manager within the Lindau Lab. “From Reverend Hutt, we learned that there were parents who didn’t have enough money to purchase food within the hospital, and they were asking nurses and other staff for help buying food.” Aside from the long-term consequences of food insecurity including poor physical and mental health, impaired ability to self-manage chronic illness, and, for children, suboptimal growth and development, in the short-term food insecurity threatened caregiver dignity and child recovery.

So in 2010, the Feed1st program was founded by the Lindau Lab in partnership with the Urban Health Initiative, Greater Chicago Food Depository, volunteer medical students and other community stakeholders. The Lindau Lab opted for a “feed first, ask questions later”* approach that was aligned with the ethical principle of beneficence in research by launching an in-house food pantry program that provides free food to all families of Comer Children’s Hospital patients, regardless of their financial need or length of hospital stay. With five locations throughout the hospital, food is never too far away from those who need it.

“One significant challenge we have had to tackle,” describes Feldmeth, “is measuring program use while ensuring the pantries remain as accessible as possible. We don’t want to discourage anyone from using the pantry by requiring clinician referral or proof of identification to receive access. All five pantries are open 365 days per year, 24 hours per day, 7 days per week and there’s no requirement to sign in or leave any personal information in order to obtain food. While this makes it more difficult to track pantry use – to determine which and how many caregivers are using the pantries – it was important to us that no one felt stigmatized accessing food.” In collaboration with researchers at the Massachusetts Institute of Technology and the School of the Art Institute of Chicago, the Lindau Lab is piloting the use of various sensor technologies to evaluate use patterns and optimize the pantry experience without needing to collect sensitive information from patients’ families.

There are several key elements critical to the success of Feed1st.

• Community Advocates: This includes hospital staff, caregivers who have used the pantries and caregivers who have donated to the pantries. Comment boxes are available in each pantry to elicit user feedback. “We regularly request feedback from the people we are trying to serve to ensure that we’re meeting the needs of the hospital community,” Feldmeth said. “We formed the Feed1st Advisory Board which meets on a quarterly basis and provides a space for institutional stakeholders and caregivers to provide insight and ensure relevance for Comer families.” Caregivers (both food secure and food insecure) have contributed food, dollars and personal stories to raise awareness. Hospital staff across many departments have hosted food drives to collect and contribute thousands of pounds of food.
• Space & Hospital Support: Space is not easy to come by in a hospital, so hospital leadership buy-in was essential to ensure that the food pantries received the square footage and visibility needed. Hospital administration provided Feed1st with its first inpatient pantry and storage space and helped to facilitate expansion to additional inpatient floors and the emergency department.  Hospital staff are critical to ensuring that families are aware of the pantries– at Comer this meant including information about the food pantry within the admission packet provided to all families. Future work will involve screening for food insecurity at the point of admission.
• Volunteers: Our volunteers are critical for ensuring pantry shelves remain well stocked.  First year medical students from the Pritzker School of Medicine and volunteers from the University of Chicago Medicine Volunteer Services Department monitor and re-stock the pantries Monday-Friday.

“It’s really thanks to our incredible volunteers and dedicated hospital stakeholders that Feed1st has been as successful as it has,” says Feldmeth. Auerbauch agrees with her. “Your community is a support system in times of good health and times of need,” she said. “ I spent a lot of time thinking about this when my brother was in the hospital and I realized how important it was and that people in my community really need help more than I do.” At just 13 years old, Auerbauch continues to serve as an advocate for Feed1st and is an active member of the Advisory Board “It just didn’t seem fair that my family had so many resources when so many people in my community don’t have anything. I can be a part of changing that and that’s really inspiring.”

*Makelarski JA, Thorngren D, Lindau ST. Feed First, Ask Questions Later: Alleviating and Understanding Caregiver Food Insecurity in an Urban Children’s Hospital. AJPH. 2015;105(8): pp. e98-e104

Lessons Learned

Community advocates are critical. We have formed an advisory board that meets on a quarterly basis and provides a space for institutional stakeholders and caregivers to provide insight and ensure continued relevance of the Feed First Pantries.

Find your supporters: We rely on the generosity of caring volunteers to ensure that the shelves remain well stocked

Solicit feedback: We regularly request feedback from the people we are trying to serve to ensure that we’re meeting the needs of the hospital community.

Secure buy-in from the important decision makers: Hospital leadership buy-in was critical for us because space is at a premium in the hospital. The administration was essential for finding our first space and facilitating the expansion to other areas in the hospital.

Partners

Partners for our upstream work include:

• The Feed1st Advisory Board (including caregivers, a Comer patient-turned-volunteer, University of Chicago Medicine care providers, staff and other institutional stakeholders)
• Pritzker School of Medicine students and University of Chicago Medicine Volunteer Services volunteers
• The Greater Chicago Food Depository
• An interdisciplinary research team
• Countless members of the community who have donated their time, money and efforts to support Feed1st

More Information on Our Work

Feed1st Overview and Advisory Board
Feed1st Newsletter
CommunityRx Overview