by Kim Krisberg

Hunger in America can be hard to see. It doesn’t look like the image of hunger we usually see on our TVs: the wrenching impoverishment and emaciation. Talking about American hunger is hard because, well, there’s food all around us. Everywhere you look, there’s food — people eating food, people selling food, people advertising food, people wasting food, people dying of eating too much food. The obesity epidemic alone is getting so big that it’s slowly swallowing the health care system in billions of dollars of care.

We have a food problem.

But food cost money. So for some people, the problem is access to enough food. And in the aftermath of a recession, the foreclosure crisis and high unemployment, many more Americans need help putting food on the table. Specifically, many more families are seeking help through the Supplemental Nutrition Assistance Program, commonly known as SNAP and previously referred to as the food stamp program.

The food assistance program has found itself in the middle of the frenzy to reduce government spending, with a whirlwind of votes on ways to cut food assistance. Last month, the Senate passed a spending bill that would cut SNAP funds by $4.5 billion over the next 10 years. And yesterday, the House Agriculture Committee went further, passing a proposal with cuts of $16 billion. According to the Food Research and Action Center, the House cut would mean up to 3 million people could lose food assistance and about 280,000 school-age children would no longer be eligible for free school meals.

The proposed cuts come at a time when the need for food assistance has been on the rise. SNAP enrollment went up by more than 1.5 million from April 2011 to April 2012; the program has grown by more than 29 million since July 2000, when it reached its lowest point in the previous decade. Among the people who need food assistance are older adults — about 3 million older adults are currently enrolled in SNAP, and 80 percent of them live alone, reports the National Council on Aging. Only one in three seniors who qualify for SNAP receives the benefit.

“People who think they know what it’s like (to be hungry), should try it themselves,” said Lura Barber, senior policy analyst at the National Council on Aging. “They should put their money where their mouth is. Walk a mile in their neighbor’s shoes. It opened my eyes and it would do that for other people as well.”

Barber speaks from experience. She took the official SNAP/Food Stamp Challenge, limiting herself to $5 of food per day for a week.

“You kind of start to get it at a gut level, literally,” she told me. “It was hard…I felt very hungry the first day. I was consuming enough calories but the balance of calories was a bit off. If I was a kid running around all day or if I had a hard, physical labor job, I would have really felt it.”

Barber’s co-worker Marci Phillips, the council’s director of public policy and advocacy, also took the challenge. She said it was pretty difficult to afford fresh produce and it took a lot planning to make sure the food didn’t run out.

“It really made it very personal as to how difficult it is to make it through the day with a limited calorie count,” Phillips said. “I’d be sitting in an afternoon meeting and wouldn’t be able to focus because all I could think of was ‘I can’t wait for dinner.’ It made a lot of what you hear much more personal.”

Phillips said that while the debate on Capitol Hill is about spending, what the issue really reflects is that more and more Americans have incomes so low that they now qualify for food assistance. Phillips added that cutting off seniors from food assistance will likely only shift costs to the health care system instead.

“Older adults by far are dealing with multiple chronic conditions…so nutrition is really an essential component to keeping them healthy,” she said.

Rev. Michael Livingston also lived on a SNAP budget for a week. Livingston, who serves as director of the National Council of Churches’ Poverty Initiative, took the SNAP challenge as part of the council’s Fighting Poverty with Faith effort, which last year focused on hunger. The council challenged members of Congress to take the challenge as well — “we wanted to demonstrate what it means for a person to live off of $31.50 a week,” he said.

“We have to look at more than just the struggle of individuals, but also at the structural deficits that make it necessary for people to ask for help,” Livingston told me. “There aren’t visible, vocal and powerful advocates giving voice to opposing (these cuts). The poor are easy targets. It’s just a big political circus, to be kind. And lost in that is the devastating effects this has on the people who are most vulnerable.”

State(s) of hunger

Minnesota: In 2010, more than 608,000 residents faced food insecurity, including more than 212,000 children.

During the last few years, Diana Cutts has watched more and more of her patients fall into food insecurity, which the U.S. Department of Agriculture defines as reduced food intake and disrupted eating patterns due to a lack of money or other resources for food. Cutts, who is assistant chief of pediatrics at Hennepin County Medical Center in Minneapolis, said she’s watched the stress on families increase during the recession — a lot of jobs have been lost and work hours cut. Along with that trend, she’s seen hunger grow as well.

She and her colleagues have been surveying families who visit the center’s pediatric clinic. Using USDA’s food insecurity scale, they’ve recorded food insecurity rates from a low of 22 percent to a high of 39 percent.

“One of the hard things for physicians to wrap their heads around is that there aren’t obvious physical signs of food insecurity — the way we see food insecurity in health can be pretty subtle,” Cutts told me. “This is a very invisible condition and yet it’s very prevalent.”

Cutts and her colleagues regularly helped connect food-insecure families to resources such as SNAP, but there were few ways to help patients with immediate needs. So a couple years ago, Cutts launched a food pantry inside the hospital — it was one of the nation’s very first hospital-based food pantries.

“Because we’re based in a hospital, we really wanted to stress the connection between food and health, so we often call it a food pharmacy,” she said.

At first, the food pharmacy efforts were directed at the pediatric clinic, but it’s now expanded to include the obstetrics clinic and many others. Families must be making less than 200 percent of the federal poverty level to qualify for food help. In addition to the food pharmacy, which helped nearly 1,400 households in June alone, the hospital also participates in a summer food program for children and teens, providing free breakfast and lunch to kids Monday through Friday. Cutts said they’re helping about 40 kids every day with the summer program.

“I don’t think anybody who believes in evidence and science could see…how (cuts to SNAP) are going to result in anything but increased costs for health care, increased costs for education and really a very poor investment strategy for all of our futures,” she said. “This idea that adversity makes us stronger is really at odds with science, which shows that this is not true. If (policymakers) want to see the impact of adversity on kids they only have to walk into a hospital like mine to see that children really do pay a price and I think we can do far better.”

Missouri: In 2010, more than 1 million residents faced food insecurity, including more than 316,000 children.

In 2010, the Missouri Food Bank Association helped distribute about 85 million pounds of food. In 2011, the demand jumped to 95 million pounds and “we’re barely scratching the surface in terms of addressing the need,” said Scott Baker, state director at the association, which consists of a coalition of six food banks that serve households throughout Missouri.

“What we’re seeing is that not only are more and more people coming through, but they’re relying on food pantries longer,” Baker told me. “We’re seeing people who in the past may have needed help for a month or two, who now need help for six months or longer. It’s not uncommon to hear stories about former donors to pantries who are now coming because they need help. Because of the unemployment situation, people are finding themselves in a very different position.”

Baker said hunger is especially growing in Missouri’s rural communities, where securing accessibility to a food pantry is a real challenge. He said that if federal cuts to SNAP are enacted and people are cut off from assistance, there’s no way Missouri’s food pantries can fill the resulting gap.

He noted that even though SNAP usage has gone up around the country, that overpayments, underpayments and payments to ineligible families reached a record low in 2011. He said it’s a “sham to say that deep (SNAP) cuts are a way to go after fraud and abuse…right now, hundreds of thousands of kids would be cut from school meal programs. So we’re not talking about fraud and abuse, we’re talking about literally taking food out of the mouths of children.”

“The poor and the most vulnerable don’t have a lot of voice in Washington, D.C.,” Baker said. “We understand that the budget needs to be balanced but it needs to be a shared responsibility. Right now, the most vulnerable are bearing the burden and that’s not right.”

Texas: In 2010, more than 4.6 million residents faced food insecurity, including more than 1.8 million children.

The North Texas Food Bank provides access to more than 90,000 meals a day through its partnering food pantries. Unfortunately, the bank would need to triple that number to meet the growing food needs in its 13-county service area, said Kim Aaron, the bank’s vice president of policy, programs and research.

Similar to the experience in Missouri, Aaron said that demand for food help is steadily increasing. She also hears stories of people who used to volunteer at the pantries who now need the assistance themselves. She said there’s just as much need in North Texas’ rural communities as there is in its urban areas, though accessibility in rural areas can be difficult to navigate.

“The face of hunger is changing,” Aaron told me. “I used to say that hunger looks like the people next door to you, but now they may actually be the people next door to you.”

Providing food assistance, she said, takes the “burden of food off the list of things people have to do and provides them with some relief so they can attack the other issues in their lives.”

“What we believe is that if someone is struggling for food, there’s a lot of other things they’re probably struggling with as well,” Aaron said. “This is a problem that we can at least solve for a period of time so they can spend their time on other problems. If you’re hungry, there’s no substitute for food. This is a fundamental need that we’re meeting.”

According to Celia Cole, CEO of the Texas Food Bank Network, one in six Texas families struggle with having enough food, and one in four Texas children live in a family that struggles with food security. At this point, she said, hunger in Texas is at an unprecedented high and it isn’t showing signs of slowing down. Today, about 3.5 million Texans receive SNAP assistance, the majority of whom are children, elderly and people with disabilities.

Cole said the network’s partner agencies distribute about 300 million pounds of food every year and serve about 3 million Texans, but there’s no way food banks in Texas could fill the gap that SNAP cuts would create.

“We recognize the need to reduce the deficit, but SNAP is not causing the deficit and cutting it won’t solve the deficit,” she said. “We’re talking about taking food off the table of working families, families trying to get back in the work force. The (SNAP) problem is being invented in order to justify cutting a program that is wildly invaluable to helping Americans.”

To learn more about cuts to SNAP or hunger where you live, visit www.frac.org or www.feedingamerica.org.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for a decade.