The Right Questions

en Español

Dana West sat in the pediatrician’s office, her two young children by her side, and felt her I-can-do-it-all façade slowly crumble. All it took was a simple question.

“I didn’t want to admit that I couldn’t provide my kids with everything they needed. I was too proud as a mom,” says West, a single mother from Portland, Ore. “When their doctor asked me if my kids get all the food they need, I just broke down.

“And that’s actually when things started to get better.”

Equipped with new knowledge from a free course offered online by Oregon State University’s Extended Campus (Ecampus) – and developed by a slew of medical experts – health-care providers statewide and beyond are able to better identify cases of food insecurity and hunger in children. It stems from an increased effort to ask screening questions and provide patients with proper resources.

Anne Hoisington

Anne Hoisington helped create screening techniques for physicians to identify food insecurity in children

And although it’s too early to declare hunger issues are on the decline, some physicians are taking solace in the fact that the discovery of more cases is a good thing because, as was the case with West and her children, it’s still a widely overlooked topic in the clinic and at home.

“A lot of people in the medical field aren’t aware of how prevalent childhood food insecurity is and that it has real medical and psychological consequences for a developing child,” says Charlotte Navarre, a registered nurse and a faculty member in Providence Milwaukie Hospital’s Family Medicine Residency Program. “The course raises awareness and addresses the medical issues so doctors can feel educated and direct those at-risk families to valuable community resources.”

The five-module course – Childhood Food Insecurity: Health Impacts, Screening and Intervention – was developed in 2008 by Oregon’s Childhood Hunger Initiative, with representatives from the Oregon Food Bank, Kaiser Permanente, Oregon Health & Science University, OSU Extension Service, the Oregon Hunger Relief Task Force and the state’s Public Health Division.

Health professionals learn how to ask sensitive questions related to food insecurity in order to supply their patients with adequate interventions and access to food resources and qualified outreach workers. Navarre was one of the many experts who reviewed the online course in its development phase, and she instantly made it a requirement for all first-year residents in Providence Milwaukie’s three-year specialty training in family medicine.

Since then, she says, childhood hunger has been addressed in a far more effective manner after “years of it not being on anyone’s radar.”

“We see kids that get sent to the clinic by their schools because they have behavioral problems, and there are questions about learning disabilities,” Navarre says. “Asking a standard (food insecurity) screening question is one piece of the puzzle because children that are hungry don’t tend to do very well in school. It’s hard to concentrate and pay attention if you’re hungry. We have to fight that.”

The fight has never been more relevant, either. In late August, Feeding America – a national food bank organization based in Chicago – released its “Map the Meal Gap” study, which showed Oregon to have the highest rate of childhood food insecurity in the nation. The study revealed that a staggering 29.2 percent of the state’s children have inconsistent access to nutritionally adequate or safe foods.

That’s disconcerting news to Anne Hoisington, an OSU nutrition education specialist and one of the creators of the Childhood Food Insecurity course. But she sees reason for optimism: Registrants from nearly 40 states have taken the course since its inception, putting the issue front and center and supplying practitioners with the necessary knowledge to improve food security among children.

“Once people complete the course, they feel inspired to make changes in their practices. That’s evident from the feedback we’ve received,” Hoisington says. “And based on the volume of interest in the course, we’ve received bonus funds from the governor’s office to create tool-kits so providers have more materials in hand.”

“In the end, it helps our patients live healthier lives.”

And West and her two children are proof that it’s working.

“It’s my responsibility to care for my kids, but I didn’t know what other options I had,” West says. “I needed help, and they pointed me in the right direction. I can’t say thank you enough.”

-Story by Tyler Hansen

The OSU Ecampus course is funded by the Oregon Department of Human Services, OHSU, OSU Extension, Oregon Food Bank and Providence Health Systems.


Food insecurity resources

Oregon Food Bank

Feeding America

Partners for a Hunger-Free Oregon

Supplemental Nutrition Assistance Program (SNAP)






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