Hunger in US: as soup lines lengthen, debate intensifies on how to shorten them

There is hunger and malnutrition in the United States. On this there is little disagreement among medical and other researchers interviewed by this newspaper who have studied the question nationally or locally.

How much exists? And what should be done about it? On these questions there are a wide variety of opinions, and research findings.

But recent studies provide much more than just anecdotal indications that some people are not getting enough to eat or the right kind of food.

Meanwhile, soup kitchens and other emergency food programs continue to report increases in demand. And the number of homeless Americans is apparently continuing to rise, according to two estimates.

Malnutrition and poverty are closely linked in the recent studies. Poverty is the highest in 17 years, at 15 percent of the population in 1982, latest year available. (Poverty is defined by the Census Bureau as yearly cash income of less than $9,862 for a family of four.)

Two periodic federal studies show no increase in malnutrition during the 1970 s, but one study ends in 1978 and the other in 1980. There are plans to make one and possibly both of the surveys annual.

But there are a number of more recent indicators of malnutrition and hunger in the US.

Malnutrition: Recent studies in Massachusetts, Chicago, and, to a very slight degree, New York, found that some children in low-income families are showing physical signs that may be related to malnutrition.

As many as 10 percent of the low-income, preschool children in Massachusetts may be suffering from chronic malnutrition, according to the Massachusetts Department of Public Health. Poor whites showed more indicators of malnutrition than poor blacks; Asian refugee children showed the most of all.

But the study examined only children brought into low-income health clinics this summer (for nonnutritional problems). If more children were examined, the estimate of those in the state suffering from malnutrition might be even higher, says Janet Savage, a nutritionist with the department.

The study found that ''the lower the income (of the child's family), the worse the nutrition,'' she says.

Massachusetts responded in December by approving a $2.4 million package to beef up feeding programs and health care for malnutrition.

Findings by Boston City Hospital pediatrician Deborah Frank helped spark the larger state study. She noted a serious loss of weight in five children about four months after their families experienced cutbacks in food stamps or another federal nutritional program. The children were hospitalized. Abnormally low weight can be ''an early warning sign'' for malnutrition, she says. A number of other Boston-area doctors have made similar findings, she adds.

The state study could make no finding relating food program cuts to increased signs of malnutrition because it did not examine earlier records of the children.

The Chicago study found a 25 percent increase since 1981 in conditions in children under age two that may be related to malnutrition. Among several hundred children examined who were admitted to the Cook County hospital emergency room, the number showing signs that may be related to malnutrition rose from about 80 in summer 1981 to 99 last summer.

''Hunger and malnutrition are increasingly serious health problems,'' says Dr. Agnes Lattimer, the pediatrician who made the Chicago study. Cook County Hospital serves primarily the poor and near poor.

Neither the New York City nor the Massachusetts studies could tell whether signs of malnutrition are increasing or not as there was no earlier, comparable data.

In the New York City study, more than 2,000 children of low-income families living in ''welfare hotels'' were examined. A ''very very small number'' were referred to clinics for showing signs of being undernourished, says a doctor who participated in the study.

But data from the study regarding at least one additional major indicator of malnutrition have not been completed. George Rutherford, MD, who also participated in the study, doubts that many cases of apparent malnutrition will show up when the analysis is completed.

But New York City Council President Carol Bellamy is not convinced the study is the final word on malnutrition in New York, says her aide on food issues, Michael Sandifer.

Meanwhile, the city plans to begin a better malnutrition monitoring program in February, he said.

And others doubt the efficiency of the study. ''I'd be happy to hear it (that there are barely any cases of malnutrition in New York), but I don't believe it, '' says Gretchen Buchenholz, who runs a day-care center and a soup kitchen in New York.

''There is some malnutrition,'' says Catherine Woteki, of the National Center on Health Statistics, who is familiar with both periodic federal studies of nutrition. But, she adds, ''We are, by and large, well nourished.''

On the other hand, she says, some 22 percent of the males and 24 percent of the females in the US are obese. Malnutrition can be due to overnutrition as well as undernutrition, she says.

Hunger: A number of studies show a rapid increase in the demand for food at soup kitchens and food pantries, especially at the end of each month, when some people have exhausted their food stamps, welfare payments, or social security.

A 72-year-old women told interviewers of Hunger Watch, a survey funded by the State of New York and five private foundations, that the last 10 days of the month she does not have enough to eat.

A 65-year-old man told the interviewers that practically the only food he ate was at a soup kitchen. His food stamps had been cut from $40 a month to $10 a month.

''There is a great feeling of hopelessness'' among the hungry, says Jo-Ann Lamphere, a public health specialist who directed the Hunger Watch project, which is about to publish its findings.

The findings, based on interviews with 446 low-income people in affluent Suffolk County, Albany County, and New York City, will include the following, she told the Monitor:

* Many of those interviewed daily eat food with far less than the number of calories recommended by the National Academy of Science, often 50 percent less. Many cited a recent drop in income of food stamps as the reason.

* Twenty-five percent said they sometimes could not get food when they were hungry; and about 20 percent said their children sometimes go to bed hungry.

Gretchen Buchenholz's study for New York's Coalition for the Homeless cited examples of hunger, said feeding centers were turning people away in some cases, and suggested using schools near homeless shelters to feed the homeless and others needing emergency help.

A General Accounting Office study earlier this year of 33 feeding centers found their demands for food had increased ''many fold,'' says Jerry Killian, a GAO official. Some programs had seen increases of 40 to 100 percent or more in food provided, he said.

And as it did in 1978, the GAO again pointed out the need for a more up-to-date survey of malnutrition.

Mr. Killian noted that a 1977 GAO report found that Americans that year wasted some 137 million tons of food, which end up as personal or commercial garbage.

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