The Philadelphia GROW Project

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The Philadelphia GROW Project

• Addressing child nutrition in the context of
  poverty

College of Physicians The Crisis of Childhood
Obesity Is It Reversible? With Surgeon General
Rear Admiral Steven K. Galson, MD, MPH
Mariana Chilton, PhD, MPH Drexel University
School of Public Health
www.growproject.org
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Food Insecurity Definitions

• Food Insecurity
• Lack of access to enough food for an active and
  healthy life
• Without hunger Low food security
• Poor food access
• Worry/anxiety
• With hunger Very low food security
• Reduction of quality quantity
• Disrupted eating patterns

Terminology changed Nov. 2006
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Food Insecurity Disparities By Household
Composition (2004)
Household Composition
Race Ethnicity
Nord, Andrews, and Carlson 2007
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Children in Philadelphia

• 35 of all children
• 39 of children under age five in poverty
• 7,600 infants and toddlers are at risk for hunger
  (2004) (PHMC 2004)
• 1 in 3 already behind in reading preparedness by
  kindergarten

Annie E Kasey Foundation, Kids count/census
data, 2006 Blue Ribbon Commission on Behavioral
Health, 2007
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www.growproject.org
GROW Clinic A multi-disciplinary approach to
care for children with Failure to Thrive at St.
Christophers Hospital for Children.
Multi-site network of pediatricians and child
health professionals conducting research to
inform policy.
Childrens Sentinel Nutrition Assessment Program
(C-SNAP)
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GROW Clinic Failure to Thrive
A multi-disciplinary team approach to care at St.
Christophers Hospital for Children.
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Childrens Sentinel Nutrition Assessment Program
(C-SNAP)

• Tracking the impact of social policies on young,
  low-income childrens nutrition and health

• Multi-site Research Study
• Boston, MA
• Philadelphia, PA
• Minneapolis, MN
• Baltimore, MD
• Little Rock, AR
• Los Angeles, CA
• Washington, DC

30,000 children their families(3,000 in
Philadelphia)
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Food Insecurity Health OutcomesAdjusted Odds
Ratios
Controlled for site, race, child age, caregiver
age, marital status, education, birth weight,
child breastfed
All differences p value 9
The Cost of Tolerating Hunger

• US Hunger costs 90 Billion
• Health care
• Low educational attainment
• Low productivity
• Charity
• Pennsylvania ranks in top 5
• Cost to Philadelphia
• 375.7 Million per Year

Larry Brown, et al, 2007
Dr. Larry Brown, et al, 2007
Cost of obesity 92.6 Billion (2002)
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Double Burden of MalnutritionObesity Food
insecurity ( or underweight)

• Malnutrition (over undernutrition)
• Relationship -- obesity food insecurity
• Relying on cheap calories
• Access to markets / fruits and vegetables
• Parental coping mechanisms -- eating patterns
• Poverty early in life associated with
  overweight/obesity in adulthood

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Cost of Thrifty Food Plan in Four Philadelphia
Neighborhoods
(121.93)
(212.56)
(241.76)
(204.48)
542 maximum monthly food stamps benefit
allotment for a family of four
Annual Deficit (1,463) (2,550)
(2,900) (2,454)
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Community CollaborationsSocial and Environmental
Determinants
www.growproject.org