"Eating Like A Foster Kid"
Hunger, Food Insecurity, Foster Care, and America’s Children
I have an intimate familiarity with hunger. I know what it's like to have a nap for dinner, and I know the feeling of not knowing when my next meal would be. I am not alone in this respect. According to Feeding America — an advocacy organization — more than 13 million children experienced hunger in 2022. The USDA puts this figure a little lower, at about 7.3 million kids. To put this latter number in perspective, there are more hungry children in the United States than the combined populations of both Dakotas, Montana, Idaho, Nebraska, and Wyoming. No need to sugarcoat it: there’s a ton of hungry kids in America.
My familiarity with this hunger, I believe, bred a rather peculiar relationship with food. For example, I have long experienced an almost physiological revulsion to wasting food. Leslie is often amazed by how much peanut butter I’m able to eke out of a jar that many would’ve long ago abandoned. I am not ashamed to say that I’m known to spend fifteen minutes diligently scraping out every last bit of peanut butter in order to feel satisfied that not a single molecule went to waste. This specific behavior, in my opinion, is quirky. Harmless. But during my decade in the system, my foster parents liked to point out specific behaviors that they deemed problematic.
A frequent topic of conversation was the pace at which I ate. Apparently, I was a fast eater. A few of my foster parents would compare me to Major Payne. Some even commented that I “eat like a foster kid.” More specifically, they said “stop eating like a foster kid.”
This comment was meant as a joke and I truly do not believe the two people who said it meant any harm. But such a strange observation is hard to forget, and so, I never forgot it. Periodically I’d think about this comment and ruminate on what it might mean. It never occurred to me to look it up, to see if the internet had something to say about what, exactly, “eating like a foster kid” entailed. With all the recent news about feeding children, I thought I’d give it a google search to see what I could find.
This search yielded an interesting result: there exists something called “food maintenance syndrome,” which is a common eating disorder for children in foster care. According to the few resources I found on the subject, this is a condition that often goes undetected or misdiagnosed, but essentially, children with food maintenance syndrome have a “survivalist response to food.” I’ll discuss this syndrome more in-depth in a bit, but apparently it consists of behaviors that would comport with what my foster parents observed: eating quickly and refusal to throw away any leftover food, among other behaviors. I doubt the folks in my foster home were up-to-date on the academic literature on this subject, but it's interesting that their comments intersected with an actual phenomenon.
Like it so often does, this nugget of information only prompted further questions. How does hunger, food insecurity, and eating disorders intersect with the child welfare system and system-involved youth? How does persistent hunger shape these kids? Most importantly, how do we help these children? In this newsletter, I attempt to answer these questions and explore a relatively under-discussed aspect of the child welfare system.
The Long-Lasting Impact of Hunger
Our inability to feed all of America’s children is one of our most self-defeating and immoral policy failures. A cursory glance at the statistics would show that when kids don’t get enough to eat, they struggle in school and have poor long-term health outcomes, in addition to a diminished quality of life.
Let’s just start in the classroom. It doesn’t take a litany of studies to determine that hungry kids will find it difficult to focus and to stay on task, but if you need to see some studies, I have ‘em for you. To cite one example of many, one group of researchers found that transitory periods of food insecurity decreases a child’s short-term memory, math skills, and self-regulation. Longer, more persistent periods of food insecurity reduces a child’s literacy scores.
Early childhood education and preschool programs have a range of benefits — including providing young children with critical math, reading, and self-control capacities — but these benefits are eroded if kids enrolled in these programs aren’t getting enough to eat. They will struggle to stay awake, struggle to focus, and struggle to learn. If this hunger occurs even earlier in life, the consequences compound. Research has found, for example, that iron deficiency — which is associated with food insecurity — during the first 1,000 days of a child’s life can adversely impact their cognitive, socio-emotional, motor, and physiological health.
One report from this side of the pond found — by interviewing 700 teachers in England and Wales — that kids lose one hour of learning time a day when they arrive at school hungry. Should this occur once a week, this amounts to approximately 8.4 weeks of lost learning time over the course of their primary school life. This is also an issue in the United States, and was the subject of an Associated Press article last year.
If you needed even more evidence, a study from Duke University found that a child’s academic performance is significantly affected by the timing of when their family receives SNAP benefits (colloquially known as food stamps). Specifically, this research revealed that reading and math scores tend to dip to their lowest levels at the end of the benefit month, when SNAP benefits are likely to have already been expended.
I could keep it going, but I think you get the picture: hungry kids are likely to do poorly in school. But the harms of hunger aren't restricted to the classroom; there are lifelong consequences of not getting enough to eat as a kid.
Food insecurity puts children at an increased risk of developing asthma, obesity, and generalized anxiety disorder. A failure to to get enough to eat during pregnancy is associated with an increased risk of gestational diabetes, maternal depression, and low birth weight, all of which can harm an infant’s development and physical health. Due to nutritional deprivation, childhood hunger might be connected to depression later in life. Finally, studies have found that hunger during childhood is linked to an increased risk of developing diabetes and osteoporosis during adulthood, a higher likelihood of experiencing impulse control problems and engaging in violence, and a 2.5 greater chance of poor overall health 10 to 15 years later.
Now, with this brief context in place, let’s talk about what happens when all of the above is layered atop all the other issues that contribute to entry into the foster care system.
The Intersection of Food Insecurity and Foster Care
Let’s start off by discussing the aforementioned Food Maintenance Syndrome (FMS). Interestingly enough, it is not recognized as a mental health disorder. However, it occurs frequently enough to warrant its own label. As I said in the introduction, FMS is a “survivalist reaction” to food, and is linked to human’s innate “fight or flight” instinct. How does this survivalist relationship arise? Put simply, trauma.
Acute stress — a phenomenon all-too-familiar to children in foster care — is connected to incidences of FMS, particularly food related stress. Typically, children who have experienced prolonged periods where they lacked access to adequate amounts of food develop a “heightened survival instinct” related to food. This survival instinct manifests itself in some of the following behaviors:
Hoarding or hiding food in order to eat later
Stealing food from stores or homes
Eating very quickly
Refusal to throw away any leftover food
Overeating to the point of feeling nauseous or uncomfortable
Purposely not eating enough
Given that it is rarely diagnosed, it is difficult to ascertain how prevalent FMS is amongst foster youth. However, a paper out of New South Wales, Australia sheds at least a little light on the issue. The author tracked 347 pre-adolescent children in court-ordered foster and kinship care placements and found that at least a quarter of these children exhibit “clinically significant aberrant eating problems.” These problems included excessive eating and maintenance (hoarding, storing, and stealing), which the author collectively grouped under the FMS umbrella. Importantly, the study notes that this maintenance of food is not always done with the express intention of later consumption, but rather as a psychological balm; the very knowledge of having food hidden away provides a bit of comfort to a kid experiencing FMS.
Ultimately, though, it might be impossible to estimate how many children in foster care experience FMS. Absent some large-scale study, the only way we have to measure it is observations made by foster parents. Heck, some might be seeing their foster child engage in the above behavior and chalk it up, playfully, as “eating like a foster kid.” Worse yet, they might punish the kid in their care for symptoms associated with FMS — such as stealing or hoarding food — which might both exacerbate food trauma and complicate efforts to address it.
I’ve focused a bit too much on FMS and not so much on the factors that contribute to this condition: hunger and trauma. Studies have found that kids entering foster care have higher prevalence of stunting and being underweight, both of which are associated with exposure to “chronic adversity” and from just not getting enough food to eat. In addition, children who have multiple adverse childhood experiences (ACEs) are significantly more likely to be in a “high eating disorder risk group” than those who haven’t — specifically, adolescents with four or more ACEs were 5.7 times likelier to develop an eating disorder.
Now, it is important to mention that while under-nutrition is indeed common among children entering the foster care system, obesity is “the most common medical condition noted among foster children 2-19 years of age.” For children 2 years of age or older, between 35% to 44% were overweight and 17-37% were obese at their time of entry into the child welfare system. This isn’t exactly surprising: several studies have found that there is a paradoxical relationship between food insecurity and obesity. As a matter of fact, one study found that the odds of being obese were 5 times higher for children from food insecure households compared to children from food secure households.
I’ll conclude this section with an interesting tidbit of information I found in a 2011 article from the American Bar Association. Citing a 2002 study, this article stated that “51% of children in kinship foster care compared to only 24% of children in non-kin foster care experienced food insecurity.” Now, this finding should be taken with a grain of salt; a lot has changed in 22 years.
But what I found fascinating about this study was that it found a quarter of children in foster care experienced food insecurity. That is, kids already in the system are not getting enough to eat. I did some digging and I wasn’t able to find an up-to-date statistic, so if you’re reading this and are familiar with the issue, send me any study you might have. Specifically, I’m interested in knowing the following: how many kids in the foster care system aren’t getting enough to eat? I have some of my own personal stories to tell on this front, but I shall save them for another time.
Let’s Not Complicate Things: Just Feed Kids
Folks, let’s just feed children. In addition to being the right thing to do, it is a damn good public policy, providing a much needed bang for the taxpayer’s buck.
One low-hanging fruit is universal free school meals, a policy that several states have already implemented. The availability of free meals at school means children — particularly those from low-income families — have access to significantly healthier diets than children who do not. If you need further convincing, there’s evidence that students who participate in school meal programs eat more fruits and veggies, have higher attendance rates, and score better on tests than kids who do not have access to these programs.
These meals should be free to all kids, and there are significant financial reasons to advocate for this universality. For example, according to the Center for American Progress, there are 1.54 million students across the United States whose families “pay for full-price meals that they cannot afford, resulting in an average yearly meal debt of $170.13 per child.” Rather than relying on GoFundMe’s and the charitable efforts of fifth graders, we should just make meals free for any kid going to school. If you needed an added motivation to abolish school lunch debt and the practices that create it, in 2019 one school district in Pennsylvania warned parents that if they didn’t pay their outstanding lunch debts, their kids will go into foster care. Scary stuff.
One very fascinating study found universal free lunch programs have a cascading series of benefits: they lead to a 10% decline in grocery sales at large retail chains in the surrounding area, which in turn lower prices by 2.5%, which corresponds with reduced grocery costs for the median household by roughly 4.5%. In short, consumers save cash when we feed kids before class.
Instead of complicated means testing, let’s keep it simple: if a kid shows up at school, they should be fed, free of charge. But we can do more. We can also, for example, expand SNAP benefit eligibility and generosity, which can help directly contribute to a reduction in food insecurity for low-income families. We can offer tax incentives to grocery stores willing to operate within low-income communities and strengthen food production in areas lacking access to healthy meals, reducing the “food desert” problem. All told: let’s feed kids.
As for the Food Maintenance Syndrome for foster youth, there are certain therapeutic treatments that can help foster children develop healthier relationships with food. Locking food up — a common tactic, from what I’ve read and from my conversations with other foster youth — can actually reinforce “the idea that food is inaccessible to the child and he/she should thus hoard it when available.” Rather, experts suggest a range of behavioral therapy methods that can be effective, such as the following:
Establishing set, routine meal times
Allowing children to keep stores of food, so they have a sense of security
Reinforce to children that food will always be available should they need it
Hopefully, by addressing food insecurity, the prevalence of FMS would be reduced considerably, but in the event that it doesn’t, we should just be kind to kids, especially to ones in the foster care system.
The world is full of complex problems requiring complicated solutions; childhood hunger in the richest nation in the history of the world shouldn’t be one of these problems. Let’s do the necessary work — voting, donating, volunteering, and talking about the issue — so that no child falls asleep to the sound of a growling stomach.
Thank you, as always, for reading. I’ll see you in a few weeks!
Current Read(s):
This week, I am working way through The Unbearable Lightness of Being by Milan Kundera. I’ve heard much about Kundera and his works, and over the years I have collected four of his novels. This is the first one I’m reading though, and thus far, I am enjoying it considerably!
What’s going on in the world of child welfare?:
Harris’ VP Pick Has Kept Kids and Families Front and Center (The Imprint) — I wanted to write a newsletter on this, but The Imprint beat me to the punch. Minnesota has churned out a ton of great child welfare policies over the last couple of years, and naturally, Walz signed most of these bills. Give it a read!
Desperate for Child Social Workers, Michigan Tries A New Tack: $20K for College (Bridge Michigan) — Michigan is putting money where its mouth is by paying tuition for aspiring child social workers in order to address a shortage of social workers. Seems pretty smart!
State Should Confront Indigenous Foster Care and Prison Numbers (South Dakota Searchlight) — This article highlights a pernicious issue in the US: “In South Dakota, Native American children account for 13% of the child population but represent 74% of the foster care population.”
Older Young People in Foster Care Were an Afterthought. A Politician and a Child Welfare Expert Teamed Up to Reform the Safety Net (Chronicle of Philanthropy) — An article that highlights the work of an organization near and dear to my heart: John Burton Advocates for Youth
My Life as a Foster Youth Includes Dreams of College (EdSource) — Read this article if you want to learn a bit more about the aspirations for foster children, written by a former foster child.
One of the Original Plaintiffs Against Texas Says It Has More to Fix in Foster Care (Texas Public Radio) — What an article. Texas is going through it at the moment, with its child welfare system, and this piece contains the perspective of one kid who had to live through this system.
A Foster Youth ‘Bill of Rights’ Now Being Drafted in Minnesota (The Imprint) — I eventually want to get around to writing about Foster Youth Bills of Rights, but in the meantime, you can read this article about one being crafted in Minnesota.
Conservative AGs Hope to Upend 70 Years of Law Going Back to Brown v. Board of Education with Texas Case (Texas Standard) — The long-running legal battle between Texas and a federal judge has implications far beyond the child welfare system.
California Announces Significant Investment to Support Foster Youth (Yuba Net) — Some news coming out of my beloved home state of California: foster care payment rates are now going to be linked to individual children rather than placement type.
Racial Gaps Persist for Montana’s Indigenous Foster Care Youth (El Observador) — More evidence on the disproportionate representation of Indigenous children in child welfare systems across the United States.