Building Public and Political Will
The world has made dramatic progress against hunger and poverty in recent decades, and it is possible to virtually end hunger worldwide – certainly in the United States – in our time. The binding constraint on progress is lack of political will. Charitable efforts are important, but we need to get government to do its part. The mission of the Alliance to End Hunger is to engage diverse organizations in building the public and political will to end hunger.
In order to learn from experience and help the Alliance make its case for membership and support, I have written up case studies of four inspiring Alliance members – Islamic Relief, the Indy Hunger Network, Auburn University, and ProMedica. They have worked in different parts of U.S. society to build public and political will to end hunger, with far-reaching impacts for hungry and food-insecure people.
This post is longer than most, but worth reading. It closes with data on how Alliance members generally are growing in their capacity to speak up for hungry people and shape public policies to provide help and opportunity on a large scale.
Islamic Relief USA joined the Alliance in 2008. The organization’s main function then was to raise money among American Muslims for the international assistance (mainly hunger programs) of Islamic Relief Global. Conversations with Bread for the World at Alliance meetings convinced Islamic Relief USA to focus their growing domestic assistance program on hunger too – partly because hunger is an important theme in the Quran as well as the Bible. They now assist 1.3 million people across the United States, mainly with problems of hunger and livelihood.
Islamic Relief’s participation in the Alliance also convinced them to get involved in advocacy. Jihad Saleh Williams, their manager of advocacy, now visits about 120 congressional offices every year, often with coalition partners and sometimes in the legislator’s home office together with Muslim constituents. Their advocacy focuses mainly on the national nutrition programs, and they were part of the broad coalition that succeeded in fending of $2 billion in cuts to SNAP food assistance in 2018. If they can claim one-tenth of one percent of the credit for that legislative achievement, it was worth $2 million in food assistance to food-insecure people. Islamic Relief also educates the 70,000 American Muslims in their network about hunger, advocacy, and connections to the Quran.
“When we first joined the Alliance,” says Jihad, “we felt afraid about what other Americans were thinking about Muslims and uncertain of ourselves.” But Islamic Relief has now moved into leadership roles in Washington’s international development and interfaith community coalitions and has relationships with many members of Congress.
“Our advocacy for hungry people is a way to communicate Muslim values,” adds Jihad. “Our presence in congressional offices helps members of Congress know who Muslims are and what their concerns are. We are not all that different from other constituents.”
Islamic Relief has brought to the U.S. Muslim community into an active and important role in U.S. civic affairs, helping to forge U.S. policies to provide help and opportunity to hungry people.
Indy Hunger Network
Dave Miner led the process of organizing the Indy Hunger Network (IHN) in 2009. He had long been a leader in Bread for the World, in Indianapolis and on Bread’s board. IHN joined the Alliance in 2011.
“We learned a ton,” Dave says. “The Alliance helped to birth, nurture, and encourage IHN.” They shared experience with leaders in other communities through the Alliance-led Hunger-Free Communities Coalition.
IHN has set up methods to foster coordination among the many programs – public and private – that provide food assistance in Indianapolis, improve the effectiveness of the system, and monitor food security. Thanks to IHN, Indianapolis may well have done more over the last decade than any other community in the country to increase food assistance to hungry and food-insecure people.
The gap between food assistance and need was equivalent to 30 million meals in 2009. Despite the Great Recession, they eliminated this gap by 2013. But they then suffered a huge setback. In late 2013 Congress cut SNAP by 6 percent, opening a new gap of 10 million meals for Indianapolis. Since then declining unemployment and continued efforts by local charities have again reduced the gap – now less than 5 million meals.
A key to this exceptional impact was IHN’s success in developing community awareness that the federal food programs fund 83% of the food assistance in Indianapolis. Dave Miner illustrates this point with six grocery bags or cans, noting that five-sixths of the food assistance in Indianapolis comes from the federal food programs. Food banks and food pantries worked together to improve their coordination and effectiveness, and they also joined forces to help the federal food programs (SNAP, WIC, school and summer meals) reach more eligible people.
Community understanding of the federal government’s role in ending hunger has also led to stronger anti-hunger advocacy in Indianapolis and across Indiana. IHN does some advocacy itself, and they have also partnered, formally and informally, with Bread for the World. As a result, Bread’s network in Indiana is now stronger than in any other state, and Hoosiers have played leadership roles on far-reaching advocacy achievements in Congress – Senator Todd Young’s leadership on humanitarian needs in Yemen, an extra $1 billion for near-famine countries in 2017, passage of the $2 billion Global Food Security Act in 2018, and Congress’ repeated rejection (by narrow votes) of powerful efforts to make deep cuts in SNAP and other safety net programs.
The Indy Hunger Network has directly benefited millions of hungry and food-insecure people in Indianapolis, and its support for advocacy has benefited tens of millions of hungry and food-insecure people across the country and around the world. Other U.S. communities, especially hunger-free community coalitions, are likely to draw lessons from what Indianapolis has done. And according to Dave Miner, “It is clear the Alliance to End Hunger has made an important contribution to the development of the Indy Hunger Network.”
The Alliance to End Hunger was just getting started when Dean June Henton and Dr. Harriet Giles from Auburn’s College of Human Sciences first became involved in 2005. Following a campus visit from the executive director of the World Food Program, Auburn agreed to partner with the WFP in the fight against world hunger. The first follow-up activity was a fundraising campaign in the Auburn community for the WFP. The Alliance helped June and Harriet focus on the broader contribution that a university could make toward ending hunger and the idea that Auburn could provide leadership on this issue among universities. Auburn has successfully pursued these goals ever since, now leading the four anti-hunger coalitions described below.
They established a Hunger Solutions Institute to manage this work. It is now led by Dean Susan Hubbard and Dr. Alicia Powers. Susan and Alicia continue Auburn’s participation in the Alliance and its committees. They find this helpful in staying up to date on public-policy issues and on the work of other organizations working to reduce hunger.
In 2006, Auburn launched Universities Fighting World Hunger (UFWH) to educate a generation of global leaders who are committed to ending hunger and to assume a leadership role in creating innovative solutions to hunger. UFWH convenes an annual summit, bringing together hundreds of student leaders from around the world to share best practices and experiences. The Alliance has helped them identify speakers and organizational partners for their summits. The UFWH network now includes 300 campuses, with a student organization on each campus focused on awareness, action, and advocacy.
UFWH encourages student chapters to lead regional, state, local, or campus hunger dialogues as an annual activity. For example, the Maine Hunger Dialogue brings hundreds of faculty and students together from 20 campuses to learn about hunger and ways to reduce it. Campus teams are awarded small grants for hunger alleviation projects (campus food pantries and gardens, food recovery networks, and hunger awareness and engagement activities). Some campus teams have become advocates with administrators for programs of food assistance in response to hunger among students.
For the last five years, Auburn has led a companion organization for university presidents, Presidents United to Solve Hunger (PUSH). To date, 111 college and university presidents have signed the PUSH commitment. PUSH meets annually near the time of the UFWH Summit. The PUSH presidents work to develop curricular, research, outreach, and student engagement initiatives on the causes and solutions to hunger locally, domestically, and globally.
Education is the main thrust of UFWU and PUSH, and building the public and political will to end hunger is also a priority. A survey of 15 PUSH universities found that seven are involved in advocacy related to campus hunger, five for local change, five for state-based change, four for federal-level change, and two for global change. Right now, PUSH and UFWH are promoting a new program of the Congressional Hunger Center, a 30-day challenge to devote 30 minutes a day to learning about hunger, its causes, solutions, and advocacy. Both also are involved in bringing Vote to End Hunger, an Alliance led advocacy effort, to universities.
In 2013, the Hunger Solutions Institute convened the End Child Hunger in Alabama (ECHA). Remarkably, its quarterly meetings bring together all the agencies of the state government, food-related business associations, and numerous charities and state-level advocacy groups. Working together, they have achieved an impressive series of advocacy successes:
They have driven a public campaign that nearly doubled the state’s Summer Feeding Services Program – from 1.65 million meals in 2013 to 3 million meals in 2018.
The state’s education and agriculture agencies convinced the state legislature to double funding in just two years for locally grown food for school meals.
The state’s department of human resources convinced the legislature to increase funding for infant and toddler care providers by $40.7 million.
Most recently, the Hunger Solutions Institute established the Alabama Campus Coalition for Basic Needs. It currently includes 10 Alabama universities committed to making sure that their 150,000 students can meet their basic needs. The Hunger Institute secured a $500,000 foundation grant to support this work.
Clearly, Auburn University has contributed to the public and political will needed to end hunger. Its leadership among universities is building a new generation’s commitment to ending hunger and understanding of what it will take.
ProMedica is a large health system headquartered in Toledo, Ohio. Its CEO, Randy Oostra, believes deeply that hospitals should, as 501-(c)3 organizations, serve the public good. A great deal of research has shown that food security and other social determinants account for about 80% of health outcomes, while what happens in the medical system accounts for about 20%. In the rust belt area that ProMedica serves, obesity is an obvious cause of disease. Thus, in 2010 ProMedica set up community education programs to promote good nutrition and exercise.
Tony Hall, with his strong Ohio connections, invited ProMedica to join the Alliance. Barb Petee, ProMedica’s chief advocacy and government relations officer, explained what they were doing to an Alliance meeting. She and Randy quickly re-focused on hunger as a prime cause of obesity and of other health problems. She remembers a dinner meeting that brought her, Randy, Tony, and David Beckmann together. That meeting – in 2012 -- hatched the plan for a Capitol Hill forum on hunger and health. ProMedica and the Alliance organized the event together. It included members of Congress, health-care organizations, and hunger- and poverty-focused organizations.
Barb remembers that David Beckmann spoke during the closing panel and urged an effort to mobilize health-sector organizations to push for changes in public policy to end hunger in America. Lisa Marsh-Ryerson, head of the AARP Foundation, attended the forum. That day, Lisa, Randy, and Barb laid plans to organize a health-sector organization to push for action to address hunger and other social determinants of health.
Kevin Concannon, Undersecretary for Food, Nutrition, and Consumer Services, Department of Agriculture, spoke at the forum. He offered USDA’s help in organizing similar forums in different regions of the country. ProMedica (with help from the Alliance) organized six regional forums over the next two years, bringing health-care providers together with anti-hunger organizations and political leaders to discuss the impact of hunger on health and how this problem could be addressed.
ProMedica has been developing innovative programs in its own facilities:
ProMedica hospitals added two questions to their patient admission process to let medical staff know whether a patient is food insecure. Doctors were encouraged to prescribe food if necessary, and ProMedica opened food pantries in its hospitals. They later instituted a set of 10 questions, including questions about other basic needs and employment status. ProMedica added offices to help unemployed patients search for jobs to its food pantries.
ProMedica responded to a congressional attack on funding for SNAP with an email to their 14,000 employees, explaining that hunger causes disease and urging calls to Congress in opposition to a proposed cut to SNAP.
Over time, they have developed a comprehensive approach to socioeconomic health issues, using data analytics and focusing on specific populations – a clinic and 10-year revitalization program in the Ebeid neighborhood of Toledo, for example. This program is now led by a senior officer at ProMedica; Kate Sommerfield is President of Social Determinants of Health.
The Alliance to End Hunger and Bread for the World have learned from their connections with ProMedica. Bread for the World Institute focused its major annual report for 2014 on nutrition. The Institute commissioned university researchers to estimate the health-care cost of widespread food insecurity in the United States. They documented connections between food insecurity and various diseases through studies in peer-reviewed journals. They estimated that food insecurity in the United States increases annual health-care costs by $160 billion. The report noted that our country could virtually end food insecurity by increasing SNAP benefits by enough to cover a family’s food expenses for the entire month. The cost would be much less than the government would save in Medicare and Medicaid expenses.
From 2011-2018, Bread for the World helped lead the faith community in opposition to a powerful political push for cuts of roughly $2 trillion over ten years for poverty-focused programs. As the President and Congress focused on health care in 2018, Bread for the World provided leadership within the faith community to resist a proposed cut to Medicaid of $1 trillion over ten years. It was the first time Bread had been so deeply involved on a health-care issue. But if families in poverty don’t have health insurance, they will sometimes be forced to incur emergency health care expenses even though it will leave them without money for groceries.
The coalition that ProMedica and the AARP Foundation envisioned got underway in 2015. The initial membership of the Root Cause Coalition included 75 health systems, hospital associations, foundations, businesses, nonprofits, health insurers, academic institutions, and policy centers. The Coalition’s mission is to achieve health equity through cross-sector collaboration in advocacy, education, and research. Its five-person staff is headed by Barb Petee. So far, the Root Cause Coalition has focused mainly on learning and education in the health sector about ways that health providers can address socioeconomic determinants of health on their own or in collaboration with social service organizations. A monthly webinar typically attracts about 300 people from across the country.
In early 2020, the Root Cause Coalition released a “Status of Health Equity Report” at the National Press Club and on Capitol Hill. It makes the case for increased effort to deal with the social determinants of health. It reports on a survey of health-care providers which found that most doctors and nurses recognize the importance of socioeconomic determinants of health but feel like they can’t do much about a problem like periodic hunger. It highlights strategies that some health providers are pursuing now – targeted efforts in communities of concentrated poverty, for example, and developing evidence to demonstrate the health-care impact of socioeconomic interventions. The report also includes a call to action toward longer-term goals, some of which would require support from the federal government – payment reform to cover the cost of proven socioeconomic interventions, for example, and setting a target for the cost of health care as a percentage of the nation’s GDP.
In the January 2019 issue of Modern Healthcare, Randy Oostra called for a congressionally mandated commission to develop recommendations to address the social issues that are causing health problems, reduce the growth of health-care costs, and result in a healthier population.
Health-care reform is the leading political issue in our country. Everybody agrees that the system is not working well. The political debate is mainly about the role of government in financing health care for people who can’t otherwise afford it. ProMedica and now the Root Cause Coalition are leaders of a growing movement to address hunger and other social problems as a strategy to improve health outcomes and reduce health-care costs. If the United States would get serious about reducing hunger and poverty, lower-income families would be healthier, and the government and taxpayers would save money.
Ladders of Impact
These case studies report on how four very different Alliance members have increased their impact – partly through effective action to build public and political will – and on how the Alliance has helped in this process.
It’s noteworthy that the Alliance helps organizations concerned about hunger partly by giving them opportunities to meet each other. In all four of these case studies, one benefit of participating in the Alliance was the development of collaborations with other member organizations. Collaborations are almost always necessary to achieve changes in public policy.
The Alliance has developed a system that all the Alliance’s 90 members and 75 Hunger Free Community coalitions can use to assess the extent to which they are building public and political will to end hunger. The system for the Alliance’s organizational members is shown below.
Some Alliance members are just beginning to think along these lines; they may come to Alliance meetings mainly to learn from and develop partnerships with other organizations who can help them with their ongoing programs. Other Alliance members are promoting awareness of the importance of government programs and policies, and yet others are participating in or leading advocacy coalitions.
Late in 2019, 45 of the Alliance’s 63 organizational members assessed their own place on the ladder of engagement when they joined the Alliance and at the end of 2019. On average, Alliance members have all moved one step up the six-step scale ladder of impact. The step-by-step movement of many organizations is further evidence of the Alliance’s efficacy in engaging diverse organizations in building the public and political that we need to move toward the end of hunger in the United States and around the world.