Hidden Hunger

POCKETS OF POVERTY REVEAL WIDESPREAD FOOD INSECURITY HIDING IN PLAIN SIGHT IN LAND OF PLENTY

This is a region of farm-fresh abundance and dining excellence. It’s also a place of scarcity for people like fixed-income seniors living in subsidized housing in Tiburon. Or the two-income Sausalito couple who hit hard times when the husband, coping with an expensive, chronic health condition, lost his business. Or students in Marin, Sonoma and Napa counties who struggle to pay the cost of going to college while keeping up with classwork. Or young immigrant families in San Rafael’s Canal District, whose adults often hold down multiple jobs. Or the soon-to-graduate single mom on a limited budget living in low-income housing in Marin City. Or the motley crew of West Marin individualists with limited financial resources in San Geronimo. Or farm laborers in Napa. Or residents displaced by fire or flood in Sonoma.

There is need in every nook and cranny here.

A lot of people—including those who don’t have to give much thought to what they spend on groceries or eating out—assume food pantries are mostly frequented by the hungry homeless. And, it’s true: Food banks in the community do feed this population, whose highly visible manifestation of hunger—digging through trash cans, asking for food—is widespread throughout the area. But just 14% of San Francisco-Marin Food Bank (SFMFB) clients are homeless. One out of every five residents in Marin simply don’t have the resources to fill their refrigerators and pantries and put a meal on the table, according to the food bank, which assists around 17,000 Marin County individuals a week. Marin residents miss 10.5 million meals a year, according to the SFMFB’s latest Missing Meals Report from January 2019.

Nonprofit organizations such as food banks, and government assistance programs such as nutrition services for older adults and school lunch programs, feed children, seniors, rural residents and isolated farmworkers, the working poor, the newly arrived, the recently displaced and the unexpectedly unemployed. And in an area with a housing affordability crisis (the flip side of the economic boom), their numbers are rising. There’s been a 23% increase in meals needed between 2009 and 2017, according to 2019 SFMFB data.

“Even in a county as wealthy as Marin, there are pockets of poverty,” says Edith Cadena, senior program coordinator for the SFMFB. “There’s a huge misconception that everyone here has access to everything and there is no hunger, no need. But I see it every single day.”

It’s not just Marin. In Sonoma County, 50,100 people or 10% of residents are food insecure, meaning they have limited or uncertain access to nutritious food and can’t reliably count on three meals a day, according to Feeding America, a nationwide nonprofit that tracks food insecurity rates based on federal data and other economic factors. In Napa County 11,320 residents (8%) are food insecure; in Marin County 24,840 residents (9.5%) have limited access to food, based on 2017 numbers. In a double whammy for Bay Area low-income earners, many don’t make enough to make ends meet in the expensive region but make too much to be eligible for federal food assistance programs. In Marin about half of all food insecure residents don’t qualify for public assistance; around one-third of Sonoma and Napa residents who are food insecure aren’t eligible for federal aid either, according to Feeding America.

These individuals, couples and families, many of them working or retired, make do on tight budgets or do without in a region that has become the country’s most expensive to live in. In the Bay Area, 41.2% of household income goes toward housing, compared to 33.0% nationally. With soaring housing costs, skyrocketing health insurance and climbing transportation expenses (a hefty $4 gallon at the gas pump and big toll hikes) there isn’t always much—or any— money left over to buy food. In 2019, households with an income at or below twice the federal poverty level, or $51,500 for a family of four, are considered most at risk of food insecurity.

“So many people are paddling upstream in this area, trying to live on an income that just won’t stretch to cover basic needs,” says Paul Ash, executive director of the SFMFB, who notes the irony of hungry residents in a region with the best agricultural bounty in the country. “This isn’t about a lack of available food. This is a food distribution and access problem.”

Ash has worked at the food bank for 30 years. When he started, the organization distributed around 3 million pounds of food annually; today that figure has climbed to 48 million pounds. Since the San Francisco Food Bank merged with the Marin Food Bank back in 2011, the agency has tripled the amount of food distributed in Marin, from 2.1 million pounds a year to 6.1 million pounds. It has upped the number of food pantries in the county from 18 to 52. The program includes nine school pantries, two college pantries, a food pharmacy (a partnership with a medical clinic that “prescribes” healthy food in Marin City) and a mobile food pantry that delivers bagged groceries to isolated West Marin residents working on ranches and dairies.

In 2018, the food bank expanded its warehouse operations in Marin. The nonprofit tripled in size, moving from a leased facility in Novato to a 38,000-square-foot building the organization bought in San Rafael. Ash calls the move “a game-changer,” which will greatly increase food distribution in the area, add more hunger-prevention services and, beginning later this year after renovation of the warehouse is complete, engage more Marin residents who want to volunteer their time.

“Hunger is a solvable problem,” says Ash. “To solve it on a systemic level, we need multiple strategies, from nonprofit organizations, like the food bank, and government agencies.”

He notes California has one of the lowest rates of participation in the nation in the federal food program SNAP (Supplemental Nutrition Assistance Program, known as CalFresh in California, and formerly known as food stamps). SNAP, the largest domestic program in the hunger safety net, is distributed via electronic benefits transfer (EBT) on a plastic card for use at grocery stores and farmers’ markets. Eligibility is based on household size, income, assets, participation in other public assistance programs and immigration status (undocumented individuals are not eligible). About 4.1 million Californians, or 70% of those eligible, are enrolled in CalFresh. The national average is 83% enrollment. Within California, Marin County has one of the lowest rates of enrollment, with around 45–50% of eligible low-income residents receiving aid.

The reasons for that are complex. More education and outreach could help decrease fear and stigma and increase enrollment. The bureaucracy around applying for and maintaining SNAP can feel daunting. But that’s only part of the problem. Californian residents with an annual income of less than $50,208 (or $4,184 a month) for a household of four are usually eligible for the benefit. But these eligibility standards are set at the federal level and don’t take into account that the local cost of living is considerably higher than the national average. Many lower-income residents in Marin find they earn too much to receive benefits, but not enough to get by without assistance. The current maximum monthly CalFresh allotment for a family of four is $642.

Run the numbers: According to the most recent data from the Insight Center for Community Economic Development in Oakland, a family of two adults and two school-age children in Marin needs $9,518 a month in income to cover basic needs, with $1,129 going towards food. The family-needs calculation (formerly known as a self-sufficiency standard) measures the minimum income needed to cover a family’s basic expenses without private or public assistance. In Napa, the minimum monthly income needed is $6,255 a month, with $1,092 going towards food; in Sonoma it’s $6,513 a month, with $1,016 for food. Of course, many low-income families in these counties make nowhere near $80,000 to $120,00 in annual incomes.

Little wonder then that many people simply don’t have enough money for three meals a day.

SENIORS STRUGGLE IN TIBURON

Even neighborhoods with million-dollar water views, rolling green hills and multimillion-dollar properties rely on food pantries. Two mornings a week at the Hilarita Apartments in Tiburon, the computer learning center—which doubles as a community meeting space—is converted into a makeshift market. Mondays, the local food recovery service ExtraFood (see story, page 22) drops off grocery store surplus from Woodlands Market in Tiburon and Nugget Market in Corte Madera. The bounty can vary, but on the day this reporter stopped by, there was ample: artisan pesto bread loaves (sticker price: six bucks a pop) and flaky apple turnovers, cold-pressed watermelon juice, plus chocolate milk, organic eggs, cream, yogurt and baby food, prepared meals and packaged salads, and an assortment of fruits and vegetables, including staples like carrots, potatoes and apples and fancier fare such as microgreens. The vast majority of the food quickly finds a home with a group of about a dozen residents waiting patiently for the dropoff, which arrives later than normal due to volunteer driver availability.

On Tuesdays, the San Francisco-Marin Food Bank drops off food for a farmers’-market-style pantry. Spread out appealingly across four long tables, there’s fresh produce, proteins and whole grains. This week’s delivery includes boxes of salad vegetables, thin asparagus and frozen chickens. About 60% of SFMFB’s distribution consists of fresh produce, much of it California grown. The pantry, now open to the public as well, serves about 35 to 40 families each week, according to Gustav Helzberg, resource coordinator for EAH Housing, which manages the government-subsidized apartment complex. Helzberg runs the pantry with volunteers who live on site; it serves mostly low-income seniors and young families.

“We try to create a welcoming, friendly environment,” says Helzberg, who knows most visitors by name and greets them with a smile and a chat. “We set up the room so it’s easy for residents to navigate. Typically, there is plenty of food to go around and most people are good about taking only what they need.”

Residents requested a food pantry for a couple of years before it began in 2018, the first in Tiburon. Thess Cortez, who lives in the complex, visits the pantry and picks up groceries for other seniors and disabled residents. Cortez keeps lists in her head of what different folks like to eat—she says it helps to be blessed with a photographic memory—and runs food up the hill to their apartments.

“This has been invaluable to residents, there are so many people in need who really benefit from this help,” says Cortez, a 68-year-old former bookkeeper who moved to the U.S. from the Philippines in 1980. “It’s all healthy food and I save more than $40 a week shopping here.” A third of all seniors in Marin County live on a fixed income below the elder self-sufficiency standard of $27,000 per year to cover basic costs of living, according to SFMFB.

Jacque Wade, who enjoys cooking, says she’s been pleasantly surprised by the quality of the food she’s able to pick up on Mondays and Tuesdays. On food pantry days she’s sourced expensive proteins, including frozen Alaskan salmon one week, along with staples such as rice, pasta and beans. She finds her favorite potatoes—Yukon Golds—on some occasions and an unexpected benefit of the pantry: She’s learned to cook, and enjoy, unfamiliar produce such as eggplant and kale.

“The Bay Area is a very expensive place to live,” says Wade, a 63-year-old African American grandmother who works part-time as a home health aide and who declined to discuss details of her financial situation, which was the case with many clients interviewed for this story. “This makes a significant difference in my budget. I’m grateful we have it.”

Adds another senior resident, who asked that her name not be used: “Look at the food here today. It’s really gourmet,” she says, of the offerings on the ExtraFood delivery day. “I pick up items here to supplement what I buy from the grocery store. But for many of the residents who come to the pantry this is life-saving and makes all the difference.”

On Fridays, there’s another opportunity for elderly residents to access nutritious food via a hot lunch for seniors, provided by the Marin County Health and Human Services Department. The weekday lunch program is offered on rotating days elsewhere in the county, including in Corte Madera, San Rafael, Novato, San Geronimo and Point Reyes Station.

A typical menu might include quiche, lasagna, meatloaf or chili; a salad; whole-wheat bread and a seasonal fruit salad. The organic lunch at Tiburon is prepared by Good Earth Natural Foods. There’s a $3 suggested donation, though no senior is turned away for lack of funds.

Helzberg, volunteers and the residents who frequent the food pantry and senior lunch say that these services not only nourish people, they foster a sense of community and social engagement as well. Pantry participants encourage those in need to overcome any sense of pride or stigma about such programs.

“Nobody should feel embarrassed about coming to a food pantry,” says Cortez. “Everybody needs to eat.”

FOOD PHARMACY PRESCRIBES FRESH PRODUCE

On a Tuesday afternoon a pop-up farmers’ market finds a temporary home next to the low-slung, wood-shingled Marin City Health & Wellness Center, which provides affordable health care to residents in a historically African American community living in public housing. A pair of Dominican University of California nursing students check residents’ blood pressure and glucose levels. Michaela Moss, a health educator for the clinic, walks residents through a recipe for a simple but tasty zucchini salad as she hands out samples.

“I’ve never cared for the texture of cooked zucchini,” says Moss, to a smattering of affirmative nods from a small group of residents sitting in on a brief nutrition session. “But it’s quite good when eaten raw.” Agreed. And with that, participants in this 12-week course are invited to “shop.”

Welcome to the Marin City Food Pharmacy, a partnership between the health and wellness center and the San Francisco-Marin Food Bank, which stocks the food pantry during these “prescribed” sessions. Moss says around 10 people are able to attend the afternoon class; the pharmacy serves around 30 individuals a week. “We’re the little food pantry that could.”

Angela Nielsen, who runs her own paralegal service, comes early with her husband, a former Sausalito gallery owner, who recently lost his business. The Caucasian couple pay $2,000 a month in rent and $2,000 in health insurance. Bill, who has a rare, chronic disease that requires expensive weekly infusions, pays an additional $7,500 out of pocket a year for medical care.

“When you have to pay $4,000 a month for basic needs, and one of you has lost a job, it’s hard. Everything helps,” says Nielsen, 50, who stocks up on produce and proteins at the pantry. “We’re caught in the middle here,” says the Cal graduate. “We’re not eligible for aid, we make too much, but not enough to make it.” The food pantry has made a big difference. “We save $50 a week here. Maybe more,” she say. “We can make eight to 10 meals from what we pick up at the pantry: We sauté vegetables, bake squash, make a ton of salads,” says Nielsen, who says she was diagnosed as borderline diabetic before she started going to the pharmacy each week. “I definitely think being more conscious about nutrition and what we’re eating has helped. We ate pretty healthily beforehand but we definitely eat more vegetables since shopping the pharmacy.”

The food pharmacy works differently than a typical food pantry. Patients are referred by their physicians to this 12-week program, conveniently located right next to the clinic where they receive medical care. It’s not just about picking up groceries for dinner. The goal is that participants will improve their vital signs by choosing nutritious food, pick up cooking ideas through demos, receive nutrition tips, undergo health screenings and find referrals to other food assistance programs. (In between food pharmacy sessions participants are referred to permanent weekly pantries in the area.)

One impetus for the pharmacy: Several relatively young men (all in their 50s) in the community died recently of heart attacks, says Moss. The first 12-week food pharmacy session focused on heart health. The pharmacy offers a holistic approach to health care: It strives to teach people to use food as medicine. Patients at the food pharmacy are “prescribed” produce such as spinach and carrots instead of medications. The pharmacy/farmers’ market model is designed to foster community, choice and dignity, which may help lessen participant reluctance about receiving food aid. The pharmacy also promotes exercise: Moss leads weekly nature walks through the surrounding hills with clinic patients.

Hunger is a personal and societal issue; it’s also a public health concern. People who are food insecure may skip meals or purchase unhealthy foods because they often cost less or are more accessible than nutritious ones, putting the food insecure at greater risk of diabetes, high blood pressure, obesity and other health problems. In Marin City, 53% of residents are considered poor, according to data from the Marin County Health and Human Services Department and 75% of adults are overweight or obese. For decades—up until a Target selling groceries opened in 2017—there were no large supermarkets, grocery stores or farmers’ markets in the area, just a couple of convenience stores and a few fast-food outlets.