( P7 ). A participant explained they began accessing food pantries because “ I got on disability . I was unable to work ” ( P36 ). Another stated , “ I got laid off from work and my husband became disabled ” ( P4 ).
Changes in Household Structure Participants explained how fluctuations in the number of individuals in a household affected the financial burden associated with food costs . Changes in household structure , with individuals leaving or joining the household , and its impact on household food costs were often exacerbated by changes in income . One participant remarked , “ I lost my job , baby momma left , less income from help from her , so therefore it put me in a bind feeding my children and stuff , so I started coming here ” ( P17 ). Another participant described his experiences after his son was born : “ Well I just moved , and my little boy was born , and I couldn ’ t find a job nowhere , and times are just hard . We just didn ’ t have nothing . We found out about the food pantry and that we could go there about once a week . They took care of us ” ( P29 ).
One participant stated , “ Well my son got killed last month so we ’ ve been having to have a little help because food and stuff ” ( P33 ). Another participant discussed the burden associated with the addition of family members , particularly children , when asked about why they started going to the food pantry : “ My husband lost his job . My daughter moved back in with us . She had a child and I got custody of four of my grandchildren ” ( P59 ).
Discussion
This qualitative study explored food pantry clients ’ experiences that led to food pantry utilization in their own words in individual interviews . Awareness about events that precipitate utilization of food pantries will allow health care providers , policymakers , and community members to both identify high-risk community members and begin to better respond to acute and chronic food needs . This study provides evidence that events that precipitate utilization of Arkansas food pantries include unexpected changes in income , costs associated with acute and chronic illness , and changes in household structure .
SNAP participation rates in Arkansas continue to be low . Compared to other U . S . states , Arkansas has implemented particularly strict eligibility requirements , including household asset limits . 12 These requirements result in either lack of eligibility or a significant gap between onset of food insecurity and receipt of benefits . There is opportunity for collaboration between state authorities and the charitable food system to institute a referral program that would serve as a stop gap for the time between benefit application and receipt . This programming could also serve as a measure for better meeting the needs of individuals who would not immediately qualify for benefits but would still consider their households food insecure .
The interplay between illness and food pantry use is complex . Food insecurity and chronic illness is correlated and there is little known about the temporal nature of the association . 2-4 Participants discussed the costs associated with acute and chronic illnesses as a main contributor to food pantry utilization . Other research has demonstrated that food insecurity and a lack of nutritious food can negatively affect the development and management of chronic illness . 2 As food pantries continue to implement programs aimed at improving dietary outcomes , there will be increased need for collaboration between primary care providers and food pantries to improve food insecurity and health outcomes for patients , particularly those with chronic illnesses . Primary care providers can have an impact on screening and referral to resources to combat food insecurity . 13 One study found that patients had higher enrollment rates in SNAP at follow-up after primary care referrals to charitable food resources compared to other non-referred food insecure patients . 13
Unpredictability characterizes the three primary drivers for participants in this study to access food pantries . Individuals who face such events should be connected to coordinated resources that address their acute food needs as well as provide access to additional services important for overcoming unexpected challenges . Most Arkansas pantry clients who participate in this study and other studies have been accessing food pantries for at least two years . 10 Clients ’ need for longterm food pantry access demonstrates how difficult it is for families to manage the events that led them to seek out food pantries . Programs implemented in pantries should include coordination of services for families who have encountered unexpected life events that precipitate food insecurity .
References
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2 . Gucciardi E , Vahabi M , Norris N , Del Monte JP , Farnum C . The Intersection between Food Insecurity and Diabetes : A Review . Curr Nutr Rep . 2014 ; 3 ( 4 ): 324-332 . doi : 10.1007 / s13668-014-0104-4
3 . Seligman HK , Laraia BA , Kushel MB . Food Insecurity is Associated with Chronic Disease Among Low-Income NHANES Participants . J Nutr . 2010 ; 140 ( 2 ): 304-10 . doi : 10.3945 / jn . 109.112573
4 . Laraia BA . Food insecurity and chronic disease . Adv Nutr . 2013 ; 4 ( 2 ): 203- 12 . doi : 10.3945 / an . 112.003277
5 . Gregory CA , Coleman-Jensen A . Food Insecurity , Chronic Disease , and Health Among Working-Age Adults . 2017 . ERR-235 . Accessed January 10 , 2022 . https :// www . ers . usda . gov / webdocs / publications / 84467 / err-235 . pdf
6 . Berkowitz SA , Seligman HK , Choudhry NK . Treat or eat : food insecurity , cost-related medication underuse , and unmet needs . Am J Med . 2014 ; 127 ( 4 ): 303-310 . e3 . doi : 10.1016 / j . amjmed . 2014.01.002
174 • The Journal of the Arkansas Medical Society www . ArkMed . org