This Rural Mission
Welcome to Season Four of This Rural Mission. We're excited to connect with you again and talk more about the wonderful things that rural communities have to offer and the impact our leadership and rural medicine students and graduates are making for these communities. I'm your host, Julia Terhune and let's get started. Last season, we highlighted how COVID-19 affected residency, and I thought it might be time to talk about residency and what we as a college have been doing to impact the rural workforce. Now residency, well medical education as a whole, was a totally foreign concept to me...
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info_outlineThis week we are staying in Clare, Michigan to discuss how people living in rural communities access food. Food insecurity is 5% higher in rural communities across the country and rural Michigan is no exception. We speak to experts who are trying to make a difference and alleviate this disparity. Kara Lynch is a Registered Dietitian who teachings vulnerable and low-income families about healthy eating and food safety through Michigan State University Extension. Justin Rumenapp provides an overview of the hard work that the Greater Lansing Food Bank puts forth to feed thousands of food insecure and hungry people across the state. Finally, we get a unique look at how the Amish in Clare County feed and cook for their families and impact that has on health and wellbeing.
- [Julia] This Rural Mission is brought to you by Michigan State University, College of Human Medicine, Leadership in Rural Medicine programs. The podcast is funded in part by a generous grant provided by the Herbert H. and Grace A. Dow Foundation. To learn more about the Leadership in Rural Medicine programs, please visit www.msururalhealth.chm.msu.edu. I'm your host, Julia Terhune, and stay tuned for more from this Rural Mission.
(spirited violin music)
(overlapping group chatter)
-[Julia] The sounds you are hearing are coming from a mobile food pantry hosted in Harrison, Michigan. These food distributions are organized almost every month in Clare County by the Community Nutrition Network, a group coordinated by Veronica Romanov and community volunteers.
- [Veronica] Good morning, everybody.
- [Man] Good afternoon.
- [Veronica] I hear we have watermelons coming today, so everybody's gonna get some watermelon.
- [Julia] Veronica and her team spend weeks making sure that the distribution is supplied with as much fresh produce as they can get, low-fat dairy options, lean protein, and lots of healthy non-perishables like whole wheat pasta, bread, and low sodium canned food. The task of making sure that people living in Clare County, one of the most underserved counties in the state, is a community effort. It takes weeks of Veronica and her team's planning to get the mobile food pantry up and running and then it takes the labor of 10s of volunteers to just get the food to the people. Even Dr. Bremer, who we have highlighted before on this podcast, comes out to help load up baskets of bread. It really is a community effort and it has to be to make these distributions a reality.
- [Justin] It's really a community coming together to solve a problem that does affect the whole community. We are so happy for people that want to volunteer, that want to get involved, that want to help out, that if people come up and say, "We wanna work," we're gonna put 'em to work because we're happy to do that.
- [Julia] That was Justin Rumenapp, the communications manager for the Greater Lansing Food Bank the food bank that provides food to the mobile food pantries in seven counties, four of which are designated as rural counties by the state of Michigan. We will hear more from Justin in a bit, but I want to make something very clear about the coordination and implementation of these mobile food pantries, they are hard work. Food needs to be shipped from the greater Lansing area, distributed at a local site, distributed in a food-safe manner and sent home with hundreds, yes I said hundreds of people.
- [Woman] Does everyone have a number?
- [Woman] Yes.
- [Woman] Number, number, number?
- [Woman] I got mine.
- [Woman] All right, perfect. Number, number?
- [Julia] Getting food from mobile food pantries and food pantries alike is a reality for so many people living in a state of food insecurity.
- [Justin] Even if you've never been food insecure, which means that you've either had to eat less food or lower quality food as a result of financial issues, people understand hunger as a state of mind. Other community issues, while equally important, sometimes are harder to grasp your mind around. And when we say we feed people, we mean exactly that, we ship food. If you volunteer here and you move a hundred pounds of produce, that translates directly into a number of meals that you help serve the community.
- [Julia] Food insecurity is something that perils so many people living in poverty. The ALICE population, which stands for Asset Limited Income Constrained Employed, or what used to be called the working poor, and it even plagues certain demographics at higher rates than others, specifically older adults and children. In rural communities, especially across the country, we see food insecure households in greater number than in any other geography. While there are many reasons for this discrepancy, there was one reason that resounded with all my interviewees.
- [Justin] Transportation, transportation, transportation. Getting the food out there, getting families to the distribution site, trying to make it centrally located. With a sparse population, it becomes much more difficult to try to get food out there in a cost effective manner.
- [Kara] I think Missaukee County is a great example. There's no big box supermarket or anything there, so there's a couple of grocery stores and communities, but people might still have to drive 20 or 30 minutes there and then they're paying more for fruits and vegetables and food in general.
- [Julia] Kara Lynch is a registered dietician and an educator with Michigan State University Extension. Kara oversees nutrition education and food safety in Isabella, Clare, Gladwin, Mecosta, Osceola, Wexford, and Missaukee counties, all of which are rural, and she had this to say about nutrition and food insecurity in rural communities.
- [Kara] There are more and more food distributions and food pantries popping up in communities. A lot of 'em are faith-based, so the food banks that provide food to these distributions and food pantries are trying to get more healthy foods, more produce, more fresh foods, but there's also some education that has to take place with the pantries themselves. The people that are ordering the foods because maybe they can order in bulk some Little Debbies or some candy or cookies or things like that, and maybe it's even free through the food bank, so they bulk up their order with that kind of stuff and then they don't get some of the nutritious food that they could. Part of what we're doing as well is our effort is trying to teach them how to plan their meals so that they can make lists and maybe get a week or two weeks of groceries at a time, so when they do travel 30, 40 plus minutes to the grocery store, they can get the food that they need.
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The government is actually taking some steps to try to get more food to these areas where they might be considered like a food desert, where they don't have the fruits and vegetables accessible to them. In the past, in order to accept or to be a SNAP retailer, meaning that in order to accept what we used to call food stamps, they had to essentially only offer like 12 items. But now it's moving to where the retailers have to have at least like 84 items. I mean there's a little bit more, there's more to it than just that, so it's making it so that basically stores that accept benefits have to also provide a variety, like fruits, and a variety of vegetables, and a variety of grains. Hopefully that will b helpful and not hurtful.
- [Julia] Equitable food policies do make a difference in where and what people can buy on food subsidies, but understanding how to cook can really help bridge financial and social gaps. It can also help to empower persons of all backgrounds to choose healthy options.
- [Kara] And just recently with this new organization that's trying to happen within our community, anyways there was a food pantry involved with it and they received from the food bank and a food distribution a bunch of, I think it was eggplant that they said and people didn't know what it was. And then they're like, okay, if I take this, what am I going to do with it? And there's some really, really good recipes that are easy and healthy to make eggplant with, but people don't know. It's helpful to have things that people can taste as well, so that they can say wow, this is really good. So that's nice when we're able to do that. Like yesterday I was actually at an event and we had some celery with hummus. This one child came along and he didn't wanna try it at first. And finally we did encourage him enough that he did try it and he came back, he was so excited. He said, "I really like it." So if he hadn't tried that he would never probably, 'cause his parents were there and said, "Go ahead, try it," and they were encouraging him to do it, they said, "We don't like it, but you might." And sometimes we hear feedback from parents, not sometimes, but quite often, our instructors will get stopped in the grocery store by a parent, or maybe they'll be in the school and see the parent and they'll say, wow, I had to start buying cilantro, or jicama, or something like that that my child tried in the classroom. I never really tasted it before, so I didn't really know how to prepare it and they came home with a recipe and said that they liked it and they're really wanting to eat more fruits and vegetables and so we get responses like that from the people, so that's encouraging to know that it does happen.
(lively music)
- [Julia] With the efforts that MSU Extension makes to educate people in almost county of Michigan, organizations like the Greater Lansing Food Bank help to make that job easier by providing healthy options that not only feed, but nourish the people who receive these items.
- [Justin] This is the main side of our warehouse where we store a lot of the stuff. You can see there's stacks and stacks and stacks. These are all donated to us. Other things are donated to us directly from the stores because they get too much that they're not gonna be able to sell everything, so instead of letting that go to waste, give it to us, we get it out to folks, and occasionally we do have to buy some product with monetary donations that people give us. We get a great cost, it's below even wholesale 'cause we don't pay for any brand names, and so if there's something we don't have a lot in, like cereal, again, is a big one, we'll buy a pallet of that to make sure that cupboards are full across Michigan.
- [Julia] Because that's a big one that people buy?
- [Justin] Cereal's a big one. And another thing that people have told us that is really important is fresh produce. So over the last year, we've really tried to make an effort to work with some of our retail partners, some of our agriculture partners, to make sure we have fresh produce in stock to be able to get out to folks.
(lively guitar music)
- [Julia] Katie Lindauer, whom you've also heard on our podcasts before, was part of the Rural Community Health Program and spent two years of her clinical medical education in Clare County. She has seen firsthand what people in underserved rural communities have to do to feed their families, but she also had personal experience with the Amish population in Clare County. Through those experiences, she saw how an understanding of food, cooking, food preservation, and nutrition, had an overall positive effect on this population's health. Just a little background, students who complete the Rural Community Health Program in Clare, have a unique opportunity to go into the homes of the Amish and provide immunizations and other public health outreach.
- [Katie] So Clare's really interesting. So actually my answer now is different after having hung out with some Amish folks last week. Than it would have been before last Friday, before doing the Amish immunization rounds with the public health folks. I know that a lot of my patients who have kids get their food from WIC in Clare. I've seen that in the family practice clinic, and so actually that's something I learned this week. We were talking to a couple moms about food and what they're feeding their kids, and they're like, well, I just feed 'em whatever WIC gives me. So Women, Infants, and Children, right, it's a food supplementation program. So I didn't know very much about Amish people at all. It's interesting 'cause I expected like really simple lives and really simple people, but like people are people, and when you have a bunch of kids, so you have 10 people living in a house, like there is really nothing simple about that (laughs) like you may not have a telephone in your house or you may not have electricity, but there's nothing simple about raising eight kids (laughs) especially when you're cooking for eight kids with no electricity. So it was canning week when I was there, like three or four of the houses we had visited had harvested tomatoes. So like one woman had actually 20 pint jars of tomato sauce on her counter. And she did all that without a blender. She chopped all this by hand. There's no food processor. But also Amish people do go to the grocery store and buy groceries, which I didn't realize. I thought it was all like the fruits of the earth, but no, we saw it. The kids eat cereal for breakfast. And I don't know where they get their milk from, but like one family their child had a lot of food allergies, so like their family only drank almond milk. And the kids, we, the nurses give out cookies after they vaccinate the kids, so they like are known more for the cookies than the vaccinations actually, as they go around. And they're store-bought cookies and the kids can have those too, so it's not, I mean there's like definitely a preference for the simple, but it's not only what they've grown on their farms that their family is consuming, so that's cool. But they're definitely healthier. Like the Amish kids compared to the non-Amish kids, like already in seven year olds I can see a difference. Like they chart different on a growth curve. They listen better. Like all the non-Amish kids I've seen so far, have been on some sort of ADHD medication. And all of the Amish kids sit and focus and have no problems focusing, and it's not a question, they just do it. And so I don't know how much of that is nutritional, like the Amish kids aren't having as many processed foods and sugars and things that we're starting to think now may lead to those sorts of attention issues, and how much of that is that like Amish family community value really preference well-behaved kids, whereas some of the non-Amish families, their lives are so busy and complicated because of their jobs and whatever social issues they have going on that sometimes they maybe spend, I don't want to say spend less time with their kids, but have different priorities with their kids, or their lives have forced them to sort of spend their time with their kids differently than maybe an Amish family would. So that's been really interesting to see too.
- [Julia] Nutrition and food insecurity is a complex animal. Coming from a dietetics and nutrition education background myself, I know that trying to change habits and outlooks on the food we eat can be a deeply emotional and personal experience. But I also know this: food is not optional an hunger does not discriminate.
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Yet there's a real disparity in rural America. 15.4% of rural households are food insecure compared to 12.2% of all metropolitan homes. Rural communities see 5.1% more people receiving WIC benefits and 3.9% more people on supplemental nutrition assistance than in urban areas. Looking to Michigan, we see that 50% of all children, both urban and rural, are receiving free and reduced lunch. But what that 50% looks like in rural Michigan is a little different. When we say 50% are receiving free and reduced lunch, that means in Beaverton School District, 603 students out of 1,101. And in Clare School District, 664 out of 1,542 students are receiving free and reduced lunch every school day. And yes, I said district, which means there are whole classrooms in Clare and Beaverton where a majority of the students are living in a level of varied poverty. And while I don't have time to get into that now, we're talking about free and reduced lunch during the school year, we haven't even spoken about what that looks like for those children during the summer and on holidays. We don't have an answer to this issue, but we do have efforts. Organizations like the Clare County Community Nutrition Network, the Greater Lansing Food Bank, and MSU Extension, are doing what they can to reach people where they are. While there will always be more room for access and education, we can continue to support these programs and organizations, providing avenues for exposure in nutrition education in medical school can also make future medical leaders into advocates and volunteers for nutrition security. If the theory of equity is to take care of the least, so even the greatest is provided for, then if we can make sure that the most remote and isolated person in rural Michigan has adequate food, then everyone will have food.
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Thank you for listening to this Rural Mission. This podcast is produced by me, Julia Terhune. Thank you Justin Rumenapp, from the Greater Lansing Food Bank, for agreeing to be interviewed and for touring me around your amazing establishment. The work that the Greater Lansing Food Bank does in our state is outstanding and makes a difference in so many lives. Thank you also to Veronica Romanov for letting me be part of the Clare County Mobile Food Pantry. And Kara Lynch and Katie Lindauer for agreeing to be interviewed for this podcast. As always, a huge thank-you goes out to Dr. Andrea Wendling for making this podcast a part of the Leadership in Rural Medicine programs. I want to encourage you to make rural your mission and until next time, I'm Julia.
♫ Well, I guess I've got
to see that silver lining
♫ I don't mind a little rain
♫ Truth be told, I can't complain
♫ 'Cause life is full of give and take
♫ And there ain't no rainbows without rain
♫ I heard the wind start picking up
♫ Just when I thought I'd had enough
♫ But it was rough and it was coarse
♫ And took the trees with all its force
♫ It blew a left, then blew a right
♫ It rushed the land with all its might
♫ But when the wind had finally ceased
♫ Well we'll cleaned up all the leaves
♫ So I guess I've got to
see that silver lining
♫ I don't mind a little rain
♫ Truth be told, I can't complain
♫ 'Cause life is full of give and take
♫ And there ain't no rainbows without rain
♫ I don't mind a little rain
♫ Truth be told, I can't complain
♫ 'Cause life is full of give and take
♫ And there ain't no rainbows without rain
- [Julia] To learn more about the Rural Community Health Program, please visit our website at www.msururalhealth.chm.msu.edu. By joining our website, you can connect to us on Facebook, Instagram, and Twitter. You can also find out more about our musician. Music today was provided by Horton Creek and Bryan Eggers, a local musician and Michigan native. We hope you tune in next time to hear more from this Rural Mission.