Hunger is silently sweeping the United States, and few of us feel it. Yet 42 million people, including 13.1 million children, struggle to find their next meal.
As a registered dietitian with more than 15 years of public health experience under my belt, I initially made two catastrophic assumptions that I believe are aiding hunger in America. Most public health educators and healthcare professionals promote the impractical consumption of fresh produce to prevent and manage chronic disease, and I, too, jumped directly into nutrition education and health promotion without asking an important question. Blinded by my own privilege, I never asked my clients if they had access to or could afford fresh produce. My second assumption was thinking that those on Medicaid were the only patients at high risk for food insecurity and utilized food assistance programs.
In health promotion, we must first ensure that our clients have access to healthy foods before we preach about how important it is to eat our vegetables. 
For example, teaching someone that broccoli helps prevent chronic disease means very little to a person who cannot afford to buy broccoli, even at a discount grocery store. Imagine living with the chronic stress of hunger and feeling powerless over food choices. Until the basic need for food is met, healthy eating tips are not a priority for most people.
Healthcare professionals also tend to look at Medicaid status as an indicator of food insecurity. As I now know, it is not the only one. Shockingly, since 2007, food insecurity has grown at a faster rate in suburban America than in cities. Yet, according to a nationwide survey, Americans believe hunger is an urban issue, even though more poor people live in suburbs than in cities.
Because the middle class is not immune to hunger, we need to realize those who are food insecure can be anywhere. Unfortunately, food insecure families tend to hide their struggle from family, friends and neighbors. Pride in a world where food assistance is surrounded by shame prevents people from reaching out for the help they need.
If we are going to end childhood hunger, public health officials and healthcare providers need to transform their approach to nutrition education by assessing for food access using tools such as The Hunger Vital Sign at every patient visit. If a family is found to be at risk for food insecurity, they are referred to food assistance programs such as the SNAP, the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children, or WIC, school nutrition programs and other emergency food resources.
Because hunger is an invisible health epidemic hitting new and unexpected neighborhoods, hunger relief is everyone’s job. It is time to evaluate how worksites, schools and healthcare providers play a role in the fight against hunger. Every organization has the power to influence and improve food access.
How is your organization screening for potential food insecurity and working to improve food access?
