Friday, June 25, 2021

Now a professor of pediatric medicine at George Washington University, Dr. Kofi Essel uses the analogy of a deadly snake to explain the toxic stress of food insecurity to his students.

He asked his students to imagine the shock of seeing that snake outside of your home, a healthy fear response, but then he described repeatedly seeing the snake and being unable to make it go away.

The healthy and self-preserving fear of the snake becomes permanent and starts wearing on you.

“We all experience stressors,” he explained. “But when it’s unrelenting, it overwhelms the system; it becomes a toxic stress. Food insecurity is a toxic stress that permanently rewires the brains of children.”

The latest installment of the Food Justice Series held hosted by Share Our Strength —the organization behind the No Kid Hungry campaign and Food & Society at the Aspen Institute — focused on the devastating impacts of food insecurity and mental health.

Doctor Cindy Leung, nutrition epidemiologist at the University of Michigan, shared that this conversation was long overdue, while she described some of the many consequences food insecurity can have on kids.

The non-exhaustive list included, lower psycho-social function, lower cognitive development, hyperactivity, aggression and anxiety and difficulty getting along with peers.

Susana Martinez witnesses all of these consequences in her role as chief strategy officer and national director at the Latin American Youth Center in Washington, D.C. Her organization offers comprehensive services to immigrants and other vulnerable families.

“Food insecurity,” Martinez shared, “is something that will take a little bit of time to expose. The stigma around food insecurity reveals itself in the fact that families don’t want to disclose.”

Martinez shared stories of kids who rejected food because they were embarrassed to say they were hungry and parents who would call feeling offended whenever their kids received free food. She emphasized the importance of looking for behavioral signs in kids and building relationships to meet and understand their needs.

Dr. Essel has encountered the same experience with his patients. He expressed the importance of creating environments in which the stigma doesn’t exist.

“Kids just want to be accepted,” he shared. “One thing we did in D.C. was to offer school breakfast across the board. The idea of allowing all kids to access healthy meals reduces stigma.”

Dr. Leung, Martinez and Dr. Essel wrapped up the conversation discussing practical solutions like the universal breakfast in Washington, DC.

Martinez focused on additional strategies to reduce stigma, addressing food access and changing the conversation around mental health, normalizing the fact that these challenges can affect anybody. She said understanding the cultural background of families was essential to achieving this.

Dr. Essel focused on solutions at the federal level.

“The most important policy by far is SNAP,” he shared, explaining that – according to a USDA report – 90% of families in the U.S. don’t have enough funds to purchase food for their families all month.

The speakers agreed that the pandemic magnified already underlying inequalities that are the root cause of food insecurity and its devastating effects on the mental health of kids.

“The first thing we can do is acknowledge that food insecurity has structural drivers in our communities, like poverty, racism and unequal food distribution,” Leung explained. “Addressing how we can make food more equitable is a good starting point, recognizing that food insecurity correlates with other insecurities.”

Stay tuned for more Conversations on Food Justice. Please email to share any feedback and ideas of what topics you would like to see.


  • Kofi Essel

    Dr. Kofi Essel Community Pediatrician and Assistant Professor of Pediatrics at Children’s National and The George Washington University School of Medicine and Health Sciences

    Dr. Kofi Essel is a board-certified community pediatrician at Children’s National Hospital in Washington, DC. He also serves as Assistant Professor of Pediatrics, the Director of the George Washington University School of Medicine’s Community/Urban Health Scholarly Concentration, and the Director of the Clinical Public Health Summit on Obesity. Dr. Essel has dedicated his career to advocacy and research around healthcare training, health disparities, and community engagement, with expertise and national recognition in the areas of addressing obesity and food insecurity in families. He is Principal Investigator of a multidisciplinary population health initiative
    that aims to strengthen community-clinical ties to address diet related chronic diseases in marginalized settings in DC. He earned a BS from Emory University, and his Medical Degree and MPH in Epidemiology from GWU. He completed pediatric residency and General Academic Pediatric fellowship training at Children’s National. Follow Dr. Essel on Twitter @DrKofiEssel

  • Susana Martinez Chief Strategy Officer and National Director of the Latin American Youth Center (LAYC)

    Susana Martinez became LAYC’s national director of the Promotor Pathway® in 2016 and chief strategy officer in 2017. She is responsible for the national expansion of Promotor Pathway, an intensive case management model for disconnected and disengaged youth. Susana was a key member of the LAYC team that first developed the Pathway, and served as director during the model’s external evaluation as part of the Social Innovation Fund investment. Susana is a licensed independent clinical social worker (LICSW) who has worked with Latino communities in Texas and DC, and has expertise in providing clinical and case management services to immigrant families, victims of domestic violence, and youth and families within the child abuse and neglect system. Susana has over 15 years of experience in the fields of youth development and program management. She received her BS in psychology from Georgetown University and her MSW from the University of Texas at Austin. Follow the Latin American Youth Center on Twitter @THELAYC

  • Dr. Cindy Leung Nutrition Epidemiologist and Assistant Professor, Department of Nutritional Sciences, University of Michigan

    Dr. Cindy Leung is an Assistant Professor of Nutritional Sciences at the University of Michigan School of Public Health. Trained as a nutrition epidemiologist, her research focuses on the experience of food insecurity and its negative influence on health across the life course. In particular, her research combines qualitative and quantitative research methods to investigate the role of chronic stress as a novel mechanism underlying food insecurity and diet-related health outcomes in children, adolescents, college students, adults, and older adults. She is especially interested in using this research to inform the development of federal programs and policies to help alleviate food insecurity and promote good health for vulnerable populations. Dr. Leung holds an adjunct appointment at the UC Berkeley School of Public Health. She earned her BA and MPH from UC Berkeley and her ScD in Nutrition and Epidemiology from Harvard University.

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