Who's hungry? You can't tell by looking, pediatricians say

When Lisa Chamberlain, MD, began seeing patients in East Palo Alto more than 10 years ago, she never thought one of her top concerns would be whether they had enough food to eat.

It was during the 2010 recession that Chamberlain, a pediatrician with Stanford Children’s Health, learned from families at the Ravenswood Family Health Center that 50 to 60 percent of them were struggling to pay rent and buy food.

“We are trained to ask these questions because it’s not always obvious that families aren’t eating adequately. Most of the kids look normal and healthy,” said Chamberlain, an associate professor of pediatrics at the School of Medicine.

Some children are even obese because low-income families tend to shop and eat at places that don’t have many healthy options, she said. They may be hungry or experiencing “food insecurity,” meaning their families don’t always have the means to buy food.

“There are some children who have real hunger, but more commonly we see children who live in families where there is a lot of stress around making ends meet,” she said.

Food for the needy

After seeing many families in need, Chamberlain decided to start a hunger program with her colleague Janine Bruce, MPH, director of the pediatric advocacy program at the School of Medicine. Begun as a collaboration in 2012 with the Ravenswood City School District and Revolution Foods Inc., the project has grown to include the YMCA of Silicon Valley, Second Harvest Food Bank and the San Mateo County Library System, working together as the East Palo Alto Food Security Collaborative. The collaborative has provided more than 33,000 meals to families and children since it started. The program is funded by Lucile Packard Children’s Hospital Stanford and the School of Medicine, among others.

Chamberlain, medical director of the pediatric advocacy program, also works with Bruce to mobilize pediatric residents, medical students and undergraduates to address community needs through education, service and research.

Raising awareness

That advocacy has taken Chamberlain to Sacramento, where she works closely with state Sen. Richard Pan, MD, to raise awareness about children’s health-care needs. This year, they attracted the attention of state legislators with the installation of a photo exhibition, titled Who’s Hungry? You Can’t Tell by Looking, in the state capitol. The exhibition, spearheaded by the American Academy of Pediatrics of California and created by San Francisco-based documentary photographer Karen Ande, was designed to illustrate the problem of child hunger in Northern California, where one in four children lacks adequate food and may suffer the ache of hunger. With permission from their parents, Ande took photos of 20 children at a health fair in the Tenderloin district in San Francisco. The children then were screened to determine which were from families with food insecurities.

“It was impossible to tell which 10 of the 20 children in the photos had food insecurity,” Chamberlain said. “They didn’t look any different. These families live in and among us, and we are unaware of their struggle. That’s why pediatricians have a key opportunity, and even a responsibility, to break the cycle by asking questions, because it’s really the only way to find out if there is a problem. And then we need to do something about it.”

Although the situation has improved somewhat with the economic recovery of the last few years, Chamberlain said, increased rents have created a noticeable uptick in families needing help. So she, Bruce and their community partners continue to address the issue and raise public awareness.

“We need more public and private partnerships to think about solutions to these problems,” she said. “There is a lot of innovation and wealth around us, and I think if we come together, we can eradicate hunger and food insecurity for our neighbors. I welcome anyone who wants to work with us and alongside our many dedicated and inspirational community partners.”