NASPGHAN joins challenge to end hunger, funds ‘bold’ innovations for health equity

The White House has accepted a $25,000 commitment from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, which will help advance the administration’s goal to end hunger and nutrition disparities by 2030.

According to a NASPGHAN press release, the commitment will fund up to five grants to support “bold” ideas for community-based interventions to improve nutrition-based child health equity and reduce diet-related diseases. The organization submitted its pledge as part of the White House Challenge to End Hunger and Build Healthy Communities.

“Food insecurity is highly prevalent in the United States, with around 10% of all the population impacted,” Jennifer A. Woo Baidal, MD, MPH, director of pediatric weight management in the division of pediatric gastroenterology, hepatology and nutrition at Columbia University Irving Medical Center and vice chair of the NASPGHAN Research Committee, told Healio. “But food insecurity prevalence is among families with children, particularly after COVID and its related economic issues and inflation. We’re seeing that it’s more common in certain communities where structural and systemic inequities exist.”

Through the challenge, the administration accepted 141 commitments from U.S. health systems, insurers, companies, nonprofits, philanthropic groups, academia and local elected officials, a White House press release stated. The commitments add $1.7 billion to the already $8 billion in funding announced in September 2022 during the White House Conference on Hunger, Nutrition and Health.

Jennifer A. Woo Baidal

In an interview with Healio, Woo Baidal discusses NASPGHAN’s commitment and explains how health disparities and food insecurity affect the pediatric population.

Healio: How is NASPGHAN participating in the White House challenge?

Woo Baidal: We will be funding small pilot grants for new community interventions, which is a new area for our society. Most of our existing funding initiatives focus more on research or practitioner educational initiatives. This new program will fund new initiatives.

We are hoping these seed grants will spark longer term partnerships between NASPGHAN members and community organizations to develop hyper-local interventions that could be expanded over time through other funding sources to really address priorities specific to individual communities.

Healio: What are some examples of diet-related diseases affected by food insecurity?

Woo Baidal: All health is related to nutrition. That is why we’re not being too prescriptive on specific disease states or diagnoses.

Evidence of high prevalence of food insecurity or nutrition-related diseases such as obesity, metabolic dysfunction-associated steatotic liver disease, type 2 diabetes, hypertension or dyslipidemia could serve as basis for an application.

We’re leaving it up to our members and their community partners to determine what disease state or topic to focus on. For example, in some communities, celiac disease may be highly prevalent and some gluten-free foods can be quite costly. In other communities, there could be a high prevalence of chronic disease or metabolic-related diseases that could lead to steatotic liver disease, so they may focus more on increasing access to healthy, affordable foods or lifestyle initiatives for prevention.

We are hoping that this will spark creativity and allow flexibility for each member and community stakeholder to determine the priorities for their patients and community members. It’s really going to be up to the applicant and their community partners to work together to help address matters related to nutrition and health inequities.

Healio: How do health disparities, food insecurity and social determinants of health affect patient care?

Woo Baidal: As pediatric practitioners, we’ve realized that determinants that are not medical, such as social risk factors and health-related social needs, impact our patient’s health and health care. A lot of these determinants are based on the context of where people live. For example, food insecurity creates difficulty accessing care and medication and also impacts well-being and stress.

This new program is NASPGHAN’s way of trying to have a broader influence that is not just prescribing a medication but thinking about all of the assets and resources a family might need to help them take care of the whole patient. We hear so often that families are having to choose between paying for food, rent, or healthcare. We want to find new ways to increase access to healthy, affordable food so that barriers to nutrition are not impeding the treatment of pediatric diseases. We also want to motivate families to make healthy food choices so they can prevent chronic disease. Together, these efforts can help prevent increased disease severity, reduce barriers to healthcare access, and mitigate unnecessary hospitalizations in the future.

This is a newer area for us, and there are a lot of opportunities to make clinical-community linkages that could have very large impacts. When we make small changes during early life, we have the potential to move the needle for long-term health outcomes.

Healio: How can health care providers help address issues that affect diet–related diseases?

Woo Baidal: Nutrition education and counseling are a mainstay of chronic disease risk reduction. However, barriers to healthy affordable nutrition also need to be overcome.

For example, the American Academy of Pediatrics (AAP) recommends universal screening for food insecurity in pediatric clinical settings, and there are ways of operationalizing that through electronic health records and patient portals. The AAP also has a toolkit and resources on nutrition and food insecurity on their website. It’s also important to train staff on social determinants of health, how to think about social needs in non-stigmatizing ways, and how to use sensitive, empathetic communication techniques to talk about these determinants with patients.

Providers also can refer patients to local community-based services, organizations, or existing nutrition programs such as the Supplemental Nutrition Assistance Program or Special Supplemental Nutrition Program for Women, Infants, and Children. Providers can develop relationships with food partners who can help connect families to food and other benefits.

More and more, states are picking up Medicaid 1115 waivers for demonstration projects related to “food as medicine” or other types of benefits where community-based organizations might be able to get reimbursement for services. A practice may have a certain payer that covers most of the patients in that practice, so talking to payers may help expand reimbursement for screening and referrals for nutrition and food security interventions.

Ultimately, our hope is that we can find better ways to address not just medical determinants of health, but also social and environmental determinants through novel clinical-community partnerships between NASPGHAN members and community organizations.

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