Booklet-Mon

LET’S USE OUR STRENGTHS TO ENSURE Photo Exhibition of Food Insecurity byChildren and Seniors in Monongalia County February 20th, 2016, 2:00-4:00pm St John University Parish 1481 University Ave, Morgantown, WV 26505 


West Virginia University’s School of Public Health and CatholicCharities West Virginia conducted this project to understand the socialand environmental conditions that impact the availability and quality offood available and to understand the experiences of individuals thatutilize food pantries in Preston and Monongalia counties. In October-November 2015, we engaged adults (older than 54 yearsold) and children (9-13 years old) to use cameras to document theirevery day realities of living in persistent hunger. The project was funded through the generosity of:• The West Virginia Clinical and Translational Science Institute through the National Institute of General Medical Sciences (U54GM104942)• The R. Dean and Charlene Hartley Fund for Community Engagement• The Department of Social and Behavioral Health Sciences• The West Virginia University School of Public Health• Catholic Charities West Virginia Any opinions, findings, and conclusions or recommendations expressed inthis material are those of the researcher(s)/author(s) and do not necessarilyreflect the views of any of the above names individuals/organizations.


Table of ContentsIntroduction………….….…………………………………… 1 Five A's of Food Security Accessibility ……………………….………..….……… 2 Accessibility, Transportation…………………………. 3 Accessibility, Cost of Food…………….………..…….4 Acceptability and Adequacy…….……….………….. 5 Adequacy………………………………………………. 6 Availability ………………………………………….….. 7 Action/Agency ……………………………..…………. 8Tradeoffs ……………………………………..……………… 9Discussion…………………………………………………… 10What you can do……………..…………………….……….. 10Community Resources……..…………………….………… 11What is Photovoice?..………………………………………. 13

Voices of Hunger in West Virginia Photovoice ProjectFood insecurity is often defined as a condition in which individuals lackphysical and economic access to sufficient, safe and nutritious food tomeet their dietary needs and food preferences for an active and healthylifestyle. In some West Virginia counties, 1 in 4 children and 1 in 5 adults areconsidered to be food insecure. Not only do the food insecure go withoutfood, they often are forced to make tradeoffs between food and essentialslike needed medical care.Through discussions of the photographs taken by our participants,common themes emerged across all of the photographs. This bookletserves as a guide of these themes and includes some of the picturestaken by the participants in Monongalia County. We present the photosand some of the discussion of how the participants gain access tofood with regards to: • Accessibility - Can they get to the food?  Is it affordable? • Acceptability - Is the food appropriate? • Adequacy - Is the food safe, adequately healthy and nutritious?  • Availability - Is there enough food?  For everyone?  • Agency/Action - If any of the previous four elements are not being met, is there a policy and procedure in place for you to take steps to change that situation?This exhibition provides an exceptional opportunity to interact with adiverse group of individuals, learn about the challenges facing those whoare persistently hungry and hopefully gain some insights about how we asindividuals and as a community, may face the challenge of ensuring that nomountaineers go hungry.On behalf of all of the participants that tirelessly devoted their time, energyand willingness to tell their story, thank you for attending.Yours in appreciation and celebration,Haslyn Hunte and Kandi Shafer
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Accessibility- Missed OpportunityAccess to food, in termsof distance/time, is oftena barrier for low-incomeindividuals. In WestVirginia in particular(shown in the graphicdeveloped by WVFoodlink), it is wellrecognized that a majorityof communities havelimited access to grocerystores with fresh, healthy,nutritious and relativelylow cost food. As such,residents often shop atgas stations andconvenient stores toavoid commuting overlong distances to accessfood. Individuals like ourparticipants deal withpoor access to food in avariety of ways.The lack of access to low cost quality food was a theme that surfaced in the Monongalia sessions.access food.” [female, adult] “As eloquently noted by one of the participants, these closed businesses are just a “a missed opportunity,” for community members to Page 2

Accessibility- TransportationTransportation to get food, either form the food pantries or grocerystores is difficult for many in Morgantown. From parking issues, to theprice of gasoline, to not being able to afford vehicle maintenance, fewpeople relied on their personal vehicle if they had one. Furthermore,most rarely relied on public transportation either due to hassle fromschedule issues or placement of bus stops. Instead, most rely onothers (friends and neighbors) for a ride or walk, often on sidewalks/roadways that is in disrepair. “Even though the bus runs by my house I don’t want to catch it in the winter because it’s hard to walk to the stop and back home. The sidewalks have an incline or are broken down, let alone the ice.” [male, adult] The cost of transportation, in terms ofmoney and time, is an important factor when seeking food.“Transportation takes a big bite out of our money. I go between acab, the bus and my friend’s car but sometimes… But a bus is justas expensive if you have to go to places in different areas of town.But by the time you wait and pay for the bus to go all around, youmight as well try to take a cab or pay for gas.” [female, adult]“Bus time is limited, they have a schedule. So people have to wait.Plus it doesn’t run in the evening. So if people have to getsomewhere in the evening, what to do?” [female, adult] Page 3

Accessibility- Cost of FoodIn addition to distance/time, the cost of healthy foods must also beconsidered when considering the accessibility of food. As noted byone of the adult participants, food shopping often results in tradeoffsbetween bargain hunting for lower prices, time and cost of gas.The participants, in general, shared the sentiment that the cheapestfoods were usually the most unhealthy foods.“I took this picture, because [the bacon] is so so expensive. Itdoes seem to be a lot leaner meat than the other cheaper packages around it too. And this is at [notoriously cheaper chain grocery store]! It would be crazy expensive in another store. I would hate to see how much something like this would be elsewhere.” [female, adult] Worry about the cost of food was very widespread among the participants. In particular, some suggest that the continueddevelopment and perceived expansion of WVU campus is driving upthe cost of food by causing smaller affordable stores to go out ofbusiness. “The town is getting so expensive. They get rid of low-incomehousing and put up fancy buildings in their places. Where are allthose people supposed to go? It’s just too expensive to move intothose places.” [female, adult] Page 4

Acceptability and Adequacy The acceptability (Is the food appropriate?) and adequacy (Is the foodsafe, adequately healthy and nutritious?) were also of concern. It isvery evident that the ability to maintain a healthy diet is challenging,which is particularly troubling given that low income individuals alsotend to struggle from chronic health issues such as diabetes,hypertension, high cholesterol and obesity. Budgetary constraints limitthe food insecure to eat more high sodium foods, canned foods,pastas and meats with higher fat content due to the lower cost. ““Grandma’s house is the best place to eat. And she has a back yard, and a pool, and chickens and lots of Italian food.” [female, child] Many of our participants relied on friends and family for support to meet their food needs. Most children were cared for and provided in such a positive way, that the concept of food insecuritywas not as persistent to them as it was for our adult participants.Although many themes discussed were focused on change forindividuals, families and the community,many people voiced a sense ofcamaraderie with others dealing withstruggles of persistent hunger. Offering avoice for this population is the first stepin making a difference for members ofour community. Without major societal changes, childrenwho are food insecure, and hence futuregenerations of Mountaineers, willcontinue to develop health conditionscharacteristic of adults (e.g. high blood pressure, diabetes, etc.) as aresult of growing up in a food insecure household. 
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AdequacyEating healthy foods is a concern and challenge for the food insecure,both adult and children alike. “We have chicken like in this picture afew days a week. It’s alwaysfried.” [female, child]“When we are home mom always tellsus to eat the leftovers. But usually thereisn’t stuff in the fridge. When thathappens we just eat soup like Ramennoodles.” [male, child] “The [CCWV] food pantry provides access to items that are low sodium and low sugar. They offer much better choices for people.” [female, adult] Most participants including the children knew what they are eating is not the healthiest option, butthey also knew it is the cheapest. Everyonetalked about how their diets were high insodium and sugar, because that is what theycan afford to purchase or receive fromassistance services. Some of the participantswith hypertension and diabetes mentioned thatthey will give away the food items at times thatthey know is not good for them but they willalso use the same foods when they do not haveany other food. The latter seems to be the rule rather than theexception. CCWV is a unique resource for this population becausethey take health needs into consideration when helping clients choosethe foods they will take home. Availability Page 6

The lack of businesses in Westover that would provide a low cost alternative to the current sources of food stores in the area was a major focus of discussions. Presently, no grocery storesoperate in Westover, thereby forcing all Westover residents to travel toMorgantown, which at times can be very difficult despite its seeminglyclose proximity. As such, many participants shop at the local gasstations and small convenient stores. All of which are very limited withregards to fresh, nutritious meals.“This is a closed door. A closed door for accessibility for food thatis a necessity for the city. You drive around and see empty parkinglots with no people where it could be filled. There is a need in thiscity but places are still empty.” [male, adult] “…it is really a shame because it not only is a lack of food and a store but it’s a loss of jobs in Westover too.” [female, adult] As eloquently noted by one of the participants, these closed businesses are just a “a missed opportunity,” for community members to access food. Action/AgencyIt’s also very evident that some of the participants recognize Page 7

and appreciate the services provided by the various social serviceagencies. Most of the participants noted that the food pantries make a huge difference in the lives of those who utilize it’s services. “This [picture] represents receiving help and food pantry services to help fulfill our needs. It fills a void for people.” [male, adult] “Myfridge is full like this most of the time. Wealways have a lot of juice. You can see on thebottom. I’m not sure if the fridge would lookthis full without the food bank.” [female, child]The participants also spoke very highly of theefforts certain agencies take to make suredonated items and financial assistance get tothe people that are really in need. In addition tofederal assistance services, some of ourparticipants visit multiple food pantries to fulfilltheir food needs. Many discussed issues withjob loss, single parent incomes, medical billsand trying to help provide for extended family or friends. Allparticipants were extremely grateful that local food pantries were thereto help in their times of need. Page 8

TradeoffsNot only do the food insecure go without food, they often are forced tomake tradeoffs between food and life essentials. “[Taking prescription medication] is something you have to scrimp on sometimes or make choices. Taking lower doses, every other day or not at all. Once your doctor finds out they say it’s not effective that way and in the long run it can really hurt you. Some of mine are for the heart. If you don’t take those you could wind up in the hospital like Idid. I can’t make this sacrifice anymore. Now, food is the first togo” [male, adult]And also utilities…“sometimes I sacrificeutilities. Once I went a year without heat.It’s kinda crazy, I make $10 over theincome limit for utility assistance. I don’tknow what to do because I need the $10but I also need the help.” [female, adult]Such trade-offs were common for most ofour participants, including the children. Medication seemed to be thebiggest struggle, but many were worried about paying utilities throughthe winter. Gasoline and vehicle maintenance was another sacrificepeople are choosing to make, providing yet another barrier to foodaccess. The children were also keenly aware of the family’s situationand also had to make scarifies. The children talked about having to relyonly on leftovers to get by, eating plain cereal with water instead ofgetting to have milk, not always being able to get school supplies and“new” clothes for school and worrying about having things to fit in withthe other other children at school. Page 9

Discussion Although there is a cadre of social service agencies available to the foodinsecure in Monongalia county that address the need for adequate, qualityand nutritious food, the food “safety net system” (action/agency) for thefood insecure, consisting of these various agencies, in Monongalia Countycan be best characterized as fragile but intact.The food safety net system is a patchwork of agencies that is supportedwith a variety of non-secure financing options. As such, the quality andavailability of food gained through this patchwork of agencies are notuniformly available. Similar to the other services available to the foodinsecure, the structure and strength of the food safety net system oftenvary and heavily depends upon the general political environment of thestate or local community, which often puts the providers that make up thefood safety net system at risk.What you can do…. to ensure that no mountaineer goes hungry!• Make a financial donation to help a local pantry/program put food on the shelves.• Purchase and donate healthy groceries to a local food pantry, such as low sodium and low sugar items.• Sponsor a local food drive and donate proceeds to a local food pantry.• Hold a fundraiser and donate the proceeds to a local food pantry.• Work with your elected officials to ensure programs for the vulnerable are not reduce or eliminated.Also, please consider supporting Catholic Charities and their valuable worksupporting the food insecure in Monongalia, Preston, Barbour, Taylor,Marion, Harrison and Doddridge Counties. Contact Kandi Shafer Catholic Charities’ Central Region Director 827 Fairmont Road, Suite 203, Morgantown, WV 26501 304-292-6597 [email protected] www.catholiccharitieswv.org Community Resources Page 10

Catholic Charities WV- Central Region- provides the followingservices in Monongalia, Preston, Marion, Taylor, Barbour, Harrisonand Doddridge Counties.WV Birth to Three- A system of services and supports for childrenages birth to three who have delay in their development, or whomay be at risk for delay. The services and supports are providedunder Part C of the Individuals with Disabilities Education Act.(304) 296-3660Child Care Food Program- Supports family child care providers’choice to serve healthy meals to children in their care. Theprogram educates and assists care givers in meal planning andapplication for meal reimbursements through the USDA’s Child andAdult Food Program. (304) 203-3711 or (304) 614-2492Child Care Resource Center- Assists families, providers and thecommunity with information on child development, financialresources, training and technical assistance. This state fundedprogram assists families who are working or going to school withthe cost of child care. (304) 292-7357Homemaker & Case Management- Provides comprehensiveservices to the elderly and people with disabilities in their homesthrough private-pay or income eligible Medicaid Waiver. (304)623-1765Migration & Refugee Services- Provide resettlement services tonewly arrived refugees with a goal to help them attain early self-sufficiency. (304) 343-1036Immigration Services- Focusing on the reunification of familiesthrough immigration, we provide legal assistance to Page 11

individuals eligible to apply for immigration benefits. We alsohandle humanitarian relief in cases involving refugee and asyleebenefits. (304) 267-3071Disaster Recovery Services- We are active in long term recovery.We work with people throughout the state in response towidespread and personal emergency and disaster situations. (304)292-6597Basic Needs and Emergency Assistance- Helps low-incomeindividuals and families meet their most basic humanneeds(utilities, rent, prescription medications). We extend help andhope in times of crisis. (304) 292-6597WellnessWorks Food Pantries- Our response to health andwellness issues encountered among our at-risk neighbors andpromotes healthy nutrition through education, direct serve andadvocacy. (304) 292-6597Volunteer Income Tax Assistance Program- Certified communityvolunteers are trained to help clients prepare and electronicallysubmit their tax returns at no cost to the client. (304) 292-6597Case Management- Working with clients to identify areas ofimprovement, set goals and provide the support to meet thosegoals. (304) 292-6597 For more community resources, visit www.wv211.orgWhat is PhotovoicePhotovoice is an innovative participatory action research strategy thatengages participants in the research process by Page 12

allowing them to use cameras to document their lived realities. Thismethod creates the opportunity for reflection, critical dialogue, andknowledge production. Photovoice projects allow individuals who are typically underservedand/or reluctant to participate in research to “tell their own story”, andto influence the national, state, and local policy dialogue.It is ideal because pictures can be used to capture an individuals’experience regardless of their age, sex, race/ethnicity and literacylevel.The process typically occurs in four main stages: 1) Training; 2) Picturetaking; 3) Debriefing/dialogue among the participants; 4) Publicpresentation/exhibition.This project was a part of the Community Assessment graduatecourse (SBHS 611) at WVU School of Public Health. Every springsemester, graduate students enrolled in the course partner with one ormore community agencies to complete a community assessment onbehalf of the community agency. To find out about the course and/or tobecome a partnering community agency, please contact- Haslyn Hunte, PhD, MPH West Virginia University Department of Social and Behavioral Health Sciences Office: 304-293-0756 Email: [email protected]