By David K. Shipler
Dr.
Megan Sandel, a pediatrician, experiences a troubling revelation whenever she
sees a patient in the Boston Medical Center’s Grow Clinic. The clinic seems
like a normal health-care facility in an advanced country, she notes: a waiting
room, a medical assistant taking a child to be weighed and measured and then
into an examining room.
“But that’s where, in some ways,
the picture changes,” said Dr. Sandel, the clinic’s co-director, “because when
you walk into the room you see this really cute, what you think is a
twelve-month old, but it turns out it’s a two-year old. It’s a two-year old who
hasn’t outgrown their twelve-month-old clothes yet.” [Listen to Sandel here.]
Even more serious than what you see
is what you do not see: the brain of the child during a critical window of
cognitive development. And in that largely invisible universe of neurons and
synapses, of myelin sheaths and the neurological connections that are supposed
to be generating the abundant future of every small person, lifelong damage is
being done. The medical diagnoses are “stunting” and “failure to thrive.”
That is malnutrition in America, which is
chronic among the poor and has soared during the pandemic. Its long-term harm will
be one of the most severe legacies of Covid-19.
The usual incidence
of what the government calls “food insecurity” ranges from 13 to 21 percent of American
households with children, varying with the state of the economy. Most of them are
white, although Black and Hispanic families suffer at higher
rates. As school meals ended and vulnerable parents lost jobs during
the Covid-19 outbreak, the Grow Clinic’s caseload jumped 40 percent. Nationwide,
the rate of food insecurity in families with children rose
to 29.3 percent last spring and summer from 13.6 percent in 2019, before the pandemic. With the return of some
jobs and bursts of government assistance, the level has gradually declined to
17.8 percent, according to a large sample of adults with children in their households,
surveyed
by the Census Bureau in April. Seven out of ten who reported that
they “sometimes” or “often” did not have enough to eat said they simply couldn’t
afford to buy more food.
The recent $1.9-trillion American
Rescue Plan will help, but not sufficiently or indefinitely. It raises grants
by what used to be called food stamps--the Supplemental Nutrition Assistance
Program (SNAP)—by up to $100
a month per family. More significantly, the plan’s
$3000 to $3600-per-child stipend for one year would re-conceptualize
governmental aid if made permanent, evading bureaucratic red tape by providing
direct cash payments. Medical professionals say that getting money into
parents’ pockets is the best way to treat children’s malnutrition.
Without broader policy overhauls, though, food insecurity seems likely to remain both a result and a cause of hardship, a key link in the middle of a complex chain reaction. For poor families without government housing subsidies, for example, rent on the private market can soak up 40 to 60 percent of income. Paying rent is not optional. The bills for electricity, water, heat, phone, and car loans cannot be ignored. The part of the budget that can be squeezed is the part for food. And that’s what happens.
