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This case study is from “Food Insecurity and the Role of Hospitals,” which offers strategies and case examples to help hospitals and health systems address food insecurity issues in their communities. For more information and to access the full guide, .

Introduction 

In 2013, Arkansas Children’s Hospital (ACH), based in Little Rock and the only pediatric medical center in Arkansas, recognized the need to address food insecurity as its community was ranked the highest in childhood hunger and second highest in overall population rate of food insecurity. As part of a research project, ACH, along with faculty from the University of Arkansas for Medical Sciences, surveyed families in the ACH emergency department for a number of years and discovered that 20 percent of families reported some level of difficulty in accessing food. Because food insecurity can risk the well-being and development of a child, ACH has developed strategies to assist children and families suffering from food insecurity. 

Approach 

Key Partnerships 

A partnership with the hospital, Arkansas Children’s Research Institute, and the National Park Service–Central High site helps maintain an on-campus garden with fresh vegetables that are provided to a neighborhood food pantry, Helping Hand of Greater Little Rock. A GardenCorps service member oversees the garden with volunteer help from neighborhood residents and hospital employees, creating a true spirit of community for the project. 

ACH collaborates with the U.S. Department of Agriculture to serve free lunches to children in both hospital and clinical care settings. One young patient visits ACH often for MRIs and multiple doctors’ appointments. At every visit, he receives a healthy lunch bag from the hospital, as part of ACH’s free lunch program. Long days at the clinic are tiring, and he says being able to pick up a healthy lunch during his visits makes them endurable. One of his parents says, “If you spend a lot of time at the hospital or at clinic appointments, you know how costly food away from home can be, no matter what your financial situation. Costs add up quickly. This meal has always been the highlight of [his] MRI/ clinic days because he loves the chocolate milk and fruit cup.” It is not only the young patient who is benefiting from this program; his parents benefit as well by saving time and money while dealing with the stress of their child being hospitalized.

In partnership with the Arkansas Hunger Relief Alliance and the local Children’s Library, the hospital offers the Share Our Strength’s Cooking Matters classes/tours to patients, families, employees and the community to educate attendees about preparing affordable and healthier meals. Staffed by local chefs and nutritionists, these classes teach how to plan, budget, shop and cook with health in mind. This initiative has encouraged many participants to cook and eat healthy. One participant said, “This tour was very informative. The tips for buying produce and what’s in season gave me great ideas for meals.” 

Arkansas Children’s Hospital’s Initiatives 

More than two-thirds of the hospital’s served community is under Medicaid, so ACH has worked with the state’s health department to establish an onsite Women, Infants and Children (WIC) office to encourage families to apply for benefits like federal nutrition programs during their hospital stay or office visits. The Helping Hand bus comes to the hospital one day each week to provide groceries for patients and families. These visits not only have improved the health of patients but also have influenced the life of an employee who runs the bus. The employee now has built a deep connection with her clients from Circle of Friends Clinic. “The young people treat me like their grandmother — maybe it’s the gray hair. They tell me everything — like the nurse told them no more pizza or the nurse encouraged them to walk more. Sometimes the child and I just walk around the bus area to get in those extra steps,” says the employee. 

ACH implemented a social determinants of health screening tool in one of its busiest clinics to help determine the food insecurity status of individuals and families in the community. This screening tool gives an opportunity for physicians and staff to recognize foodinsecure individuals and families instantly at a health visit. Clinical nurses provide additional information about resources at the hospital along with a grocery bag filled with food once a patient is identified as food insecure. One clinical nurse at the clinic observed, “When I returned with a grocery bag of food as well as information about emergency housing assistance including a shelter list, the patient’s mother started to cry. She was concerned about where she was going to get food for her children. She expressed relief and gratitude for the resources and information.” 

Impact 

Results and Data 

The on-campus garden provided 1,791 pounds of fresh produce to Helping Hand food pantry in 2016. Through its partnership with the USDA, Arkansas Children’s Hospital offered 21,165 free lunches in 2016 and more than 60,000 since the program began in 2013, making it the first hospital in the nation to take this initiative of serving free meals year-round. In 2016, the Cooking Matters classes/tours were attended by 102 people and the WIC clinic had 299 visits. The mobile food pantry bus visits at the hospital provided groceries to 488 families in 2016. The impact this program has made on the community is larger than just numbers. A community has been built because of this as patients and families regularly visit the bus with smiles and updates on their health and well-being. In 2016, 7,048 screening forms for the pilot social determinants of health screening program were completed with the tool identifying 29.4 percent (2,074) of respondents as food insecure. 

Lessons Learned 

Arkansas Children’s Hospital is constantly evaluating and tracking its programs to measure their effects on food insecurity in the community. The hospital measures its success by: 
•    Implementing evidence-based interventions 
•    Surveying participants in clinical settings 
•    Integrating local data to drive 

Next Steps 

•    Expanding the social determinants of health screening tool and grocery bags distribution to a new hospital clinic in southwest Little Rock 
•    Expanding the community garden to produce more for the Helping Hand food pantry 
•    Offering pop-up Cooking Matters presentations in schools across the state 
•    Adding a second day that the WIC office is open on campus. 

Contact Information 
Anna Strong 
Executive Director 
Child Advocacy and Public Health 
(501) 364-1413 
strongac@archildrens.org

Patrick H. Casey, M.D. 
Vice Chairman, Faculty Affairs 
(501) 364-6591 
caseypatrickh@uams.edu