Friedman Policy Corner: A Call to Action for Aspiring Food Activists

by Ayten Salahi (MS/RD-FPAN) and Marielle Hampton (MS-AFE)

On February 5, the Friedman Food Policy Action Council (FFPAC) convened its inaugural meeting. Massachusetts Congressman Jim McGovern stopped by to offer words of wisdom, encouragement, and a call to action.

Congressman Jim McGovern offers words of wisdom at the inaugural meeting of new Tufts advocacy group, Friedman Food Policy Action Council.

Congressman Jim McGovern offers words of wisdom at the inaugural meeting of new Tufts advocacy group, Friedman Food Policy Action Council.

Congressman Jim McGovern surprised Tufts students with an impromptu visit at the first meeting of the newly formed Friedman Food Policy Action Council (FFPAC) on February 5, one week before the Trump administration announced its budget request for fiscal year 2019. Congressman McGovern, champion of anti-hunger causes and ranking member of the House Subcommittee on Nutrition, was visiting the school to discuss his recently launched bipartisan Food is Medicine Working Group in the House Hunger Caucus.

During the meeting, Congressman McGovern expressed his appreciation for the student initiative to get involved in advocacy, since “academia doesn’t always translate into activism.” When FFPAC founding member Ayten Salahi requested words of wisdom for students looking to get involved in political action, McGovern chuckled. “This is the toughest year you could have picked to get started, but that’s why it’s so incredibly important.”

He urged students to remember that people in government are supposed to be working for them. Even in the current political climate, he said, “pressure works.”

So how can students and citizens help? “Every elected official has one thing in common: they want to get re-elected. These issues are important enough that these people need to know if they’re not with you, you’re not with them. There has to be consequences… Nobody would tell you they’re pro-hunger, but judgment should be based on actions.

The Congressman then offered a crucial piece of advice that he adopts in his professional and personal life: Correct misinformation and provide facts.

Even in Congress, falsehoods are repeated regularly. He makes a point to correct the record, whether at a family dinner or among colleagues. “The average SNAP benefit is only about $1.40 per person per meal and the majority of people on SNAP are kids and senior citizens or disabled,” he explained. “The majority of beneficiaries who can work, work. The majority of people on SNAP are white, despite misconceptions. The USDA has been very effective at cracking down on SNAP fraud.”

Congressman McGovern’s guidance to hold our elected officials accountable may prove especially important for food and nutrition advocates this year, with changes to the Farm Bill slotted for congressional review in March.

On Monday, February 12th, the Trump administration announced its budget request for fiscal year 2019, which included a plan to cut 30% – $214 billion – from the SNAP budget over the course of 10 years. The proposed “cost-savings” would result from a major shake-up in the program’s benefit structure. Among the proposed changes, one has received significant publicity: Instead of receiving monthly funds loaded into EBT cards as is currently done, SNAP beneficiaries receiving $90 or more per month would receive half of their benefits in the form of a “USDA Foods Package,” packed with predetermined food items specifically chosen for their long shelf life. The package would include cereals, pastas, canned foods, peanut butter, and shelf-stable milk. Notably, no fresh fruits and vegetables would be included. No one has seen if or how these changes would be reflected in the 2018 Farm Bill.

While the administration calls the proposal a “cost-effective, Blue-Apron-style approach” with “no loss in food benefits to participants,” stakeholders are skeptical that the proposed “Harvest Box” is anything more than a distraction from work underway behind the scenes to slash federal funding for food assistance programs. Stacy Dean, vice president for food assistance policy at the Center on Budget and Policy Priorities says, “I don’t think there’s really any support for their box plan. And, I worry that it’s a distraction from the budget’s proposal to cut SNAP by some 30 percent. That’s the real battle. But all anyone is talking about today are the boxes.” Ranking democrat on the agricultural committee Senator Debbie Stabenow also cautions that this “isn’t a serious proposal and is clearly meant to be a distraction.” Shortly following the release of the budget proposal, administration officials admitted that the food box plan had “virtually no chance of being implemented anytime soon,” rousing further suspicion around the administration’s motives in publicizing it so widely.

During his visit with FFPAC, Congressman McGovern expressed similar concerns, and emphasized how important it is that food policy activists and SNAP beneficiaries alike demand transparency from members of the House Committee on Agriculture on the drafting of the 2018 Farm Bill. Despite his role as Democratic ranking member of the House Subcommittee on Nutrition, Congressman McGovern shared that neither he nor his Republican counterpart has seen a single sentence of the updated Farm Bill, now under review with the Congressional Budget Office (CBO). He cautioned this lack of transparency around the latest draft as “a sign that someone is hiding something.”

Though it remains to be seen, the bill is anticipated to reflect significant reductions in the federal SNAP budget, which will have a direct and jarring impact on the sustenance and economic freedom of nearly 46 million low-income Americans who depend on the program to nourish both themselves and their families.

In his closing remarks, Congressman McGovern issued a call to action for us at Friedman – and for all those invested in the protection of health equity, food security, and social welfare – to call our representatives, and to demand transparency around the content of the latest Farm Bill, and when it will be made available for review. In the coming months, FFPAC pledges to maintain a finger on the pulse of the upcoming Farm Bill and rally advocates to hold representatives accountable for votes that jeopardize SNAP program benefits.

Friedman Food Policy Action Council (FFPAC) is a student-run organization of the Friedman School of Nutrition Science and Policy at Tufts University. Our mission is to advance evidence-based nutrition and agricultural policies in support of public and environmental health, by equipping students with the skills and relationships necessary to impact policy through advocacy. For more information, or to join FFPAC, please contact friedmanfpac@gmail.com

Ayten Salahi is a first-year FPAN MS/RD candidate, co-founder of FFPAC, and is dedicated to the future of policy, programming, and clinical practice in sustainable diets and nutrition equity. Ayten came to Friedman after working as a molecular and clinical researcher in neuropharmacology and diabetes management for nearly 8 years.

Marielle Hampton is a first-year MS candidate in the Agriculture, Food, and Environment program and a co-founder of FFPAC. Marielle began her studies at Friedman after spending five years working with small farmers on Hawai‘i Island.

WIC at the Crossroads of the Opioid Epidemic

by Danièle Todorov

The complexity and pervasiveness of the opioid epidemic has forced government agencies to be innovative with their resources. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in a prime position to care for pregnant women affected by the epidemic and has stepped up to the plate.

In January of 2016, then Secretary of Agriculture Tom Vilsack was appointed by President Obama to lead an interagency taskforce to address the opioid epidemic in rural America. Secretary Vilsack, who’s been outspoken about his own mother’s struggle with prescription drug addiction, knew that compassion and collaboration would be vital. His agency, the USDA, has unique resources and relationships in rural areas, putting it in a prime position to address the epidemic.

Addressing the epidemic is no simple task. According to the CDC, 91 Americans died daily from opioid overdose in 2015. Nearly half of these deaths involved a prescription opioid, used in the treatment of pain. In a town hall meeting in Missouri last July, Secretary Vilsack stated that due to “the devastating toll that opioid misuse has taken on our communities, and particularly rural areas, I have tasked USDA with creatively using all of the resources at our disposal to stem the tide of this epidemic” [1]. Interestingly, Secretary Vilsack highlighted WIC as a resource that could be creatively used. “For many women”, he stated, “WIC is their first point of entry into the healthcare system, and we have an opportunity to intercept and potentially prevent dangerous health outcomes for both the mother and the child” [1].

Pain management is an important part of pregnancy care. The prescription of opioids for pain in pregnancy is increasingly common; 1 in 5 Medicaid-enrolled women were prescribed an opioid at some point during their pregnancy in 2014 [2]. However, the effect of opioids on birth outcomes is understudied. In utero opioid exposure may be associated with preterm delivery and low birth weight [3]. Exposed neonates may develop withdrawal symptoms, a condition known as neonatal abstinence syndrome, which is associated with increased risk of seizures and breathing difficulties [3]. Similarly understudied are the rates of opioid abuse during pregnancy. We do know that pregnant women with substance abuse problems are particularly vulnerable to food and job insecurities and unstable housing, which exacerbate potential health complications [4].

The healthcare system often stigmatizes and underserves pregnant women with substance abuse problems. However, WIC is increasing its ability to engage them in care. WIC’s mission is to promote the health of low-income women and their children by providing nutritious food, health education, and referrals. Starting in 2014, WIC agencies have increased staff training surrounding substance abuse [1]. Staff are better equipped to notice potential substance abuse, to educate WIC participants about the dangers of substance abuse during pregnancy and breastfeeding, and to connect them with local resources. These expanded roles align with WIC’s mission, not only because they aim to protect the health of the women they serve, but because WIC “acknowledges that substance use is incompatible with good nutrition” [5].

WIC is forming relationships with women at a promising point in time in their lives. In their staff training guide, WIC cites a study showing that women are “more motivated to improve their lifestyle and health habits during periods when they make the transition from one life situation or role to another… WIC participants are a natural target audience for substance use information because they are, by definition, in the life transition stage of pregnancy and new motherhood” [5].

WIC is playing an important part in the collaborative response to the epidemic. As the director of the USDA, Secretary Vilsack understood that a holistic response was the only effective solution and embraced President Obama’s mandate. “This disease isn’t a personal choice,” says Secretary Vilsack, “and it can’t be cured by willpower alone. It requires responses from whole communities, access to medical treatment, and an incredible amount of support. To me, our mandate is clear: don’t judge, just help” [6]. Secretary Vilsack’s endorsement of his replacement as Secretary of Agriculture, nominee Sonny Perdue, gives hope that the USDA will continue this vital endeavor.

Sources

  1. Agriculture Secretary Vilsack Announces Substance Misuse Prevention Resources for Low Income Pregnant Women and Mothers In Order to Battle the Opioid Epidemic, U. Office of Communications, Editor. 2016.
  2. Desai, R.J., et al., Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstetrics and gynecology, 2014. 123(5): p. 997.
  3. Patrick, S.W., et al., Prescription opioid epidemic and infant outcomes. Pediatrics, 2015. 135(5): p. 842-850.
  4. Sutter, M.B., S. Gopman, and L. Leeman, Patient-centered Care to Address Barriers for Pregnant Women with Opioid Dependence. Obstetrics and Gynecology Clinics of North America, 2017. 44(1): p. 95-107.
  5. Substance Use Prevention: Screening, Education, and Referral Resource Guide for Local WIC Agencies, F.a.N.S. U.S. Department of Agriculture, Editor. 2013.
  6. USDA. Addressing the Heroin and Prescription Opioid Epidemic. 2016 02/17/17].

Danièle Todorov is a first-year nutritional epidemiology student with a focus on pregnancy nutrition and birth outcomes.