Craving to Make a Difference in a Rural Community

With a population of 27,000 residents, Ashe County is a Tier 1 county located in the northwest corner of North Carolina. Tier 1 is a designation assigned by the North Carolina Department of Commerce for the most economically distressed counties in the state [1]. According to Feeding America's study, Map the Meal Gap 2015, 1 in 5 children and 1 in 6 adults in Ashe County were identified as food insecure [2], meaning that the person does not have the existing means to have enough food at any given time. Additionally, 72.1% of the households utilizing emergency feeding programs in Ashe County reported having to choose between food and medicine/medical care either every month or some months during the last 12 months [3].

The Ashe County Sharing Center was started in 1983, a time when many county residents were struggling with hunger and making sacrifices to make ends meet [4]. The Sharing Center serves the outermost areas of the county with 2 mobile pantries once a month, 2 additional pantries, and 1 children's program. In December 2015, after a stagnated high unemployment rate, the Sharing Center realized they were not reaching everyone in need. Michael Sexton, executive director for Ashe Sharing Center, and Kelly Vannoy, a board member, began exploring ways to reach more people. Michael and Kelly met with Laura Lambeth, Ashe Memorial Hospital (AMH) CEO, and Melissa Lewis, director of Community Outreach at AMH, to discuss their idea of starting a food pantry at the hospital. Ms. Lambeth did not hesitate in her willingness to help in any way possible. “We are committed to the well-being of the residents of Ashe County and offer numerous community outreach events throughout the year,” stated Ms. Lambeth. Since beginning this relationship, AMH, the Sharing Center, and Second Harvest Food Bank of Northwest North Carolina have worked together by sponsoring food drives, grant proposals, community health events such as giving free influenza vaccines to residents that participate in the food box program (described below), and Cooking Matters Class, a 6 week program that helps individuals learn to cook on a budget.

One of AMH's largest efforts to combat food insecurity in Ashe County is through the Food Pantry Project, a screening and distribution program for patients when they are seen at the hospital. Every patient that is admitted to or receives services at our facility is asked the following questions: “Within the past 12 months were you worried whether your food would run out before you received money to buy more?” and “Within the past 12 months did the food you bought not last and did you not have money to buy more?” This population includes those admitted to the emergency department—approximately 13,000 patients per year. If the patient answers “yes” to either question, they receive a food box, which contains enough food for 4 days. This prompts an email to our Social Work Department as well as many other departments. The Social Work Department will then see the patient, speak to them about their needs, and assist them from there. The department is able to make referrals to the Ashe Medication Assistance Program, Supplemental Nutrition Assistance Program, and Special Supplemental Nutrition Program for Women, Infants, and Children and to assist patients in the application process for SNAP, WIC, and Medicaid. This process is completed before the patient is discharged.

Since December of 2015, AMH has distributed over 450 food boxes to patients, serving over 1500 family members. All patients that receive a food box are tracked by name, age group, and geographical location. In tracking these factors, AMH can see where the needs in our community are, and work to address them. We feel that if AMH has a strong presence in the community, then the overall health in our area is going to improve through education and awareness.

The idea behind the Food Pantry Project was that access to appropriate nutrition and medications required to support healing will improve health outcomes and lower readmission rates for ambulatory care sensitive conditions. By providing this service at a critical time in a person's health, AMH is better positioned to positively impact the long-term health of the patient. AMH has become a leader within the North Carolina health care sector by being the first hospital in the 18 county service area of Second Harvest Food Bank of Northwest North Carolina to house and manage a food pantry for patients. AMH continues to work with the Sharing Center on continuously improving ways to eradicate the food insecurity in Ashe County.

• ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.