Institute Insights August 2018

Schoolchildren in India. Photo by Jim Stipe

From the Director

We recently learned that this October, the 2018 World Food Prize will be awarded to two leaders in global nutrition: Dr. David Nabarro and Dr. Lawrence Haddad. The award recognizes their lifelong commitment to improving maternal and child nutrition.

I first got to know David and Lawrence about 10 years ago. It was a difficult time for the world’s hungry and poor people, and for global efforts to end hunger and malnutrition, because of what was soon named the “global food price crisis.” Starting in 2007, with perhaps the worst impacts in 2008, the prices of staple grains such as rice, wheat, and maize/corn spiked rapidly. In some countries, prices doubled or even tripled. Prices remained high and volatile for many months. This was devastating for low-income families, who spend up to 80 percent of their entire incomes on food. The food price crisis forced an additional 100 million people into poverty. It worsened malnutrition, particularly among the most vulnerable people in the poorest areas.  

Also in 2008, the respected British medical journal The Lancet published its seminal series of articles on maternal and child undernutrition. The series made clear that the evidence strongly supports a set of specific nutrition actions as the most effective ways of reducing malnutrition. In addition, a panel of leading economists has identified nutrition as one of the top cost-effective and productive sectors to direct development investments. Both the medical and the economic experts also emphasized that nutrition has significant and lasting impacts on other important aspects of development, such as education, maternal/child mortality, and the cost of health care.

The stage was set for experts and advocates to move this evidence into action. When I think back on how much has happened since then to build global political support and commitment for nutrition, I think it is safe to say that we would not have made as much progress without David’s and Lawrence’s ingenuity, passion, energy, and persistence.

David Nabarro led the team that conceptualized and established the Scaling Up Nutrition Movement (SUN) and served until 2014 as SUN’s first coordinator. SUN’s goal is to expand the reach of the highly effective nutrition interventions endorsed in The Lancet series. SUN countries are working to reach more people with such high-impact actions, which range from promoting exclusive breastfeeding, to providing supplementation for iron, Vitamin A, and zinc deficiencies, to ensuring universal salt iodization. The governments of countries with high burdens of malnutrition lead SUN, in partnership with donors, UN agencies, and local civil society and private sector actors. The movement is now 60 countries strong.

Throughout Lawrence Haddad’s career, his research has focused on building the evidence base that good nutrition is crucial—to individuals, communities, and entire countries. He is also an effective advocate who takes his research and analysis directly to policy makers. Lawrence pushed for greater accountability in the nutrition field, developing various tools to ensure that all stakeholders do their part. These tools, which include the Hunger and Nutrition Commitment Index and the Global Nutrition Report, provide global and national civil society advocates with the detailed information that is essential to their work.

We at Bread for the World congratulate Drs. Nabarro and Haddad and thank them for their hard work and unwavering commitment. We are excited about the momentum that the World Food Prize will add to their critical efforts.

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

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Exclusive breastfeeding provides the best nutrition for babies younger than 6 months. Photo: UNICEF

U.S. Global Nutrition Commitments Include Support for Breastfeeding

By Jordan Teague

Researchers have established that exclusive breastfeeding—meaning no other food or water—provides the best nutrition for babies younger than 6 months. Breast milk is also an important supplementary food until a child’s second birthday. Not only does breast milk provide essential nutrients for growth, but it also supplies antibodies that help babies fight off infections. Infections are a leading cause of child mortality around the world.

Breastfeeding saves lives every day. In 2016, The Lancet, a renowned British medical journal, released an analysis showing that increasing breastfeeding rates could save the lives of more than 820,000 children every year. The calculation was made using data from the 75 countries where 95 percent of child deaths occur. It assumes that 95 percent of infants younger than one month are breastfed exclusively, 90 percent of infants ages one month to 6 months are breastfed exclusively, and 90 percent of children 6 to 23 months are partially breastfed.

There is some evidence that breastfeeding mothers are healthier as well—for example, breastfeeding has been associated with lower cancer rates. The Lancet analysis estimates that increasing breastfeeding could also save the lives of 20,000 mothers annually.

In addition to improved survival and health for babies and mothers, there is also evidence that breastfeeding is associated with cognitive development. Children who are in better health and better equipped to learn can contribute more to the development of their countries’ economies. In fact, the 2016 Lancet breastfeeding analysis calculated the economic losses associated with not breastfeeding at about $302 billion every year.

At Bread for the World Institute, we recognize that not every mother is able to breastfeed. For example, some women have medical conditions that would make breastfeeding too risky for their babies or themselves. Some are able to breastfeed for only a short time before they must return to jobs that do not permit the necessary work breaks. Certainly, infant formula is critical to the nutrition of babies who cannot be breastfed. On the other hand, we should encourage and support policies that enable women to breastfeed as they are able.

A significant amount of evidence shows, unfortunately, that problems with the marketing of breast-milk substitutes and infant formulas undermine breastfeeding. Product labels are frequently confusing, leading to children being fed breast-milk substitutes and formulas that are meant for other age groups.

This is not a new concern. In 1981, the World Health Assembly (WHA) – the governing body of the World Health Organization – adopted the International Code of Marketing of Breast-Milk Substitutes to help countries better regulate the marketing of breast-milk substitutes as part of their efforts to promote breastfeeding.

Every two years, breastfeeding is on the agenda at WHA’s annual meeting. In 2016, the WHA endorsed the recent World Health Organization Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children.

This year, events unfolded differently. As has now been widely reported by Malnutrition Deeply, The New York Times, and other news media, WHA considered a resolution promoting breastfeeding, but the United States, led by the U.S. Department of Health and Human Services (HHS), attempted to block the resolution entirely. In the end, the resolution was adopted, but with final wording on breast-milk substitutes that is weaker than in the original. The changes include deleting references to the 2016 World Health Organization Guidance.

Particularly in the wake of these actions, it is important to understand that none of the documents we have mentioned—this year’s WHA resolution on infant and young child feeding, the 2016 World Health Organization Guidance, or the 1981 International Code—ban or propose banning the sale or use of breast-milk substitutes or infant formulas. The purpose is to ensure that the products are not marketed to women and families inappropriately and that when breastfeeding is a viable option, it is promoted as the best choice.

In 2016, the U.S. government developed and launched the U.S. Government Global Nutrition Coordination Plan. The plan provides for better coordination on nutrition among federal departments and agencies with nutrition responsibilities, with the goal of progressing as far as possible toward the 2025 WHA global nutrition targets. The agencies that agreed to participate in the coordination plan include HHS. The United States has endorsed the global nutrition targets, one of which is to increase the rate of exclusive breastfeeding in babies younger than 6 months to at least 50 percent by 2025.

It is disheartening that HHS disregarded these commitments to the point of leading the U.S. delegation’s opposition to this year’s WHA resolution on infant and young child feeding.

Bread for the World Institute calls on the U.S. government agencies that signed on to the federal Global Nutrition Coordination Plan to prioritize coordination that advances U.S. support for the WHA nutrition targets and, more broadly, our country’s support for saving infant lives by promoting evidence-based policies that ensure that babies get the best available nutrition.

Jordan Teague is international policy analyst with Bread for the World Institute.

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Meeting the repair and renovation needs of the country’s aging infrastructure—roads, bridges, and many other structures essential to our modern economy—will require filling millions of jobs. Photo: Bread for the World

The High Road to Ending Hunger

By Todd Post

As readers of Institute Insights know, global climate change has already devastated many areas where hungry and poor people live. People who rely on rain-fed agriculture to feed their families have been hit hardest.

The United States is not immune to the destruction caused by climate change. The economy must absorb billions of dollars’ worth of storm damage, farmers and consumers face the consequences of crop failure due to drought, and low-income communities struggle to regain basic services and jobs in the aftermath of floods.

Yet climate change could also be the catalyst for the United States to make significant progress against hunger and poverty. On the surface, this may not sound likely—but there is a powerful connection between what is needed to reduce hunger, and what is needed to slow the harmful impacts of climate change. This connection is good jobs to upgrade national infrastructure. Meeting the repair and renovation needs of the country’s aging infrastructure—roads, bridges, and many other structures essential to our modern economy—will require filling millions of jobs that do not require a college education. The manufacturing and construction work needed pays well.

Of course, whether infrastructure upgrades do in fact contribute to the well-being of struggling families depends completely on where the investments are targeted and who is hired for the jobs. Areas where the infrastructure is in very poor condition are often areas with high and persistent poverty rates. The weak or nonexistent infrastructure is one of many signs that the country has turned its back on these communities. But economists widely agree that infrastructure is one of the best investments to spur job creation. Done right, a national infrastructure rehabilitation initiative could enable large numbers of low-income families to free themselves from food insecurity and poverty.

Even setting aside climate change for a moment, improving U.S. infrastructure is essential. The economy’s productivity growth has been anemic since the turn of the century, due partly to our infrastructure’s growing inadequacies. Higher productivity growth is essential to improving national living standards. The decrepit state of the nation’s infrastructure is apparent to many Americans—not just economists and civil engineers. Then-president-elect Trump mentioned the topic soon after his election: “We're going to rebuild our infrastructure, which will become, by the way, second to none, and we will put millions of our people to work as we rebuild it.”

Two-thirds of the flooding during Hurricane Katrina could have been averted if the levees in New Orleans had held. In its most recent review of infrastructure conditions in each state, the American Society of Civil Engineering (ASCE) gave Florida’s infrastructure an overall grade of C. While this is better than the national average of D+, hurricanes strike Florida every year, and cities along the coast are already having to deal with sea-level rise. So-called nuisance flooding, which occurs on sunny days, is common in coastal areas across the Southeast.

Although improving the nation’s infrastructure will not help slow the impacts of climate change automatically, it is not difficult or costly to ensure that it does, and it makes little sense not to. An energy infrastructure, for example, that produces enormous amounts of carbon dioxide is one of the main causes of climate change. At the same time, it is unrealistic to expect people in the United States to give up the conveniences and comforts that these energy sources have made possible. The solution that has emerged in recent years—driven by business interests rather than climate activists—is climate-smart energy. Energy efficiency is the fastest and easiest way to reduce carbon emissions, and the transition to renewable energy sources, such as solar and wind, is well under way. In the past few years, according to the International Energy Agency, solar power has attracted more investment than all other energy sources, with China, India, and the United States leading the way.

For every $1 million invested, the renewable or “clean” energy sector produces more than three times as many jobs as the fossil fuel sector. Solar installers and wind turbine service technicians are the two fastest-growing occupational categories, according to the Bureau of Labor Statistics, and these jobs pay decent wages. Because commercial and residential buildings create 28 percent of energy-related emissions, the United States needs significant numbers of workers to weatherize buildings and homes to prevent energy leakage. Already, more than a quarter of all construction workers are employed with energy-efficiency firms. There is still much room for growth since consumers are driving demand so that they can immediately begin saving on their electric bills.

The federal government could be doing much more to meet three important goals in one main initiative: improving the national infrastructure, creating many more jobs that pay enough for workers to meet their basic needs, and slowing climate change. Concern about the state of the nation’s infrastructure is a bipartisan issue, although the parties have yet to resolve their differences as to how to finance infrastructure development. Congress needs to make a key decision: to elevate infrastructure, jobs, and climate change as higher priorities, and to lower the importance lawmakers attach to serving the interests of the fossil fuel industry. Advocates and ordinary citizens need to press for this change, using our power as voters and consumers.

Todd Post is senior researcher, writer, and editor with Bread for the World Institute.

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Photo by Joseph Molieri/Bread for the World

Black August: Criminal Justice Reform Is Essential to Ending Hunger

By Marlysa D. Gamblin

Black August originated and has been observed since the 1970s with a decision by African-American prisoners to protest unjust incarceration and police killings of black people.

In papers such as Mass Incarceration: A Major Cause of Hunger, Bread for the World Institute has explored the connection between the unjust over-incarceration of black bodies and the disproportionately higher rates of hunger and poverty in the black community to which this inequity contributes.

In last year’s blog, I wrote about some good first steps in addressing mass incarceration, specifically to reduce the over-incarceration and unjust treatment of African Americans in our criminal justice system. These steps included eliminating racial inequality and bias, prioritizing investments to support communities most affected by hunger and mass incarceration, and implementing plans to release individuals currently incarcerated (particularly those who have been over-policed, over-sentenced, and/or given an unjust mandatory minimum sentence).

Over-policing and unjust sentencing must be addressed to end mass incarceration and ensure comprehensive prison reform. Congress and several state legislatures have demonstrated bipartisan agreement on sentencing and prison reform, so enacting applicable policy provisions would be a good first step.

Since both long prison sentences and a lack of rehabilitative programs for incarcerated people impact individuals’ and families’ ability to put food on the table, we believe that a combination of sentencing and prison reform is critical to achieving real change in the criminal justice system. This change, which Black August participants demanded through protests, would not only yield more racially equitable results, but also dramatically reduce hunger in the United States.

The evidence shows that African Americans are sentenced at higher rates than whites. For example, African-American defendants are disproportionately convicted of offenses that carry a federal mandatory minimum penalty (31.5 percent for African Americans compared to 27.4 percent for the general population). In addition, according to the Sentencing Project, African Americans are incarcerated at up to 10 times the rate of whites due to over-policing and disproportionate convictions.

African Americans are also given longer sentences than whites for the same crime. In 2000, Professor Cassia Spohn released a comprehensive survey of 40 studies of sentencing outcomes over the course of 30 years. The survey concluded that black offenders were both more likely to be convicted and more likely to receive harsh sentences than white offenders.

These are a few examples of the conditions that black prisoners protested when they originated Black August. Harsher, longer sentences not only are unfair, but also disproportionately hurt black children and families. We know from research that being incarcerated results in less income and wealth post-incarceration, leaving families with few resources to fight hunger. And since African Americans are racially profiled, policed, arrested, and convicted at higher rates than their white counterparts, mass incarceration means that African-American households are more likely to earn lower incomes. This explains, in part, why African-American households with children experience hunger at twice the rate of white households with children (26.0 percent v. 12.7 percent).

As August approaches, we should be bold as a country; bold in our research and analysis; bold in our advocacy; and bold in our expectations from our policymakers. Part of honoring Black August is being truthful about the real reforms we need to see in our criminal justice system, which should include both sentencing and prison reform as a first step. We must also fully acknowledge and address the system’s racial inequities in order to complete the needed reforms.
 
Marlysa D. Gamblin is domestic advisor, policy and programs, specific populations, with Bread for the World Institute.

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Photo by Joseph Molieri/Bread for the World

Promoting Dignity and Nutrition in Schools

By Christian Brooks

In Bread for the World Institute’s 2018 Hunger Report, The Jobs Challenge, we emphasized the importance of dignity for workers. Every job should be a dignified job, meaning that employees are paid a livable wage, given essential benefits such as paid sick leave, and treated with respect. According to Monique Valcour in the Harvard Business Review, “Dignity is fundamental to well-being and to human and organizational thriving.”

The reasons that dignity is so important for adults in the workplace make dignity even more vital for students in school. As people who are still developing, students are in an excellent position to benefit from dignified educational settings and practices. Unfortunately, this also makes them particularly vulnerable to harmful policies and practices when schools do not prioritize dignity.

With 50.7 million students returning to public schools this fall, now is the time to explore what is needed to establish greater dignity in schools and how schools can begin to do this. Dignity in school requires a safe and supportive environment where students are treated with honor and respect. Incorporating dignity into schools is vital to successfully educating our youngest generation. In turn, graduates of dignified schools are vital to developing workplaces that treat workers with dignity and prioritize creating jobs that enable families to meet their basic needs.

A few years ago, when I worked in an elementary school, I saw a first-grade student arrive at school 30 minutes late. As a result, he was refused breakfast in the cafeteria. He went to class hungry and was unable to pay attention. Withholding the resources that students need to be successful is a failure to respect their dignity.

It is important for government decision makers at all levels, as well as school officials themselves, to realize that many students have difficult lives outside school. Dignity begins with acknowledging the existence of obstacles and working to help students get what they need. Here are three ways to overcome barriers that keep students from doing well in school:

  1. Ensure that every student has access to nutritious meals. This is fundamental to a child’s learning process. According to a recent report from the U.S. Department of Agriculture (USDA), 13 million households with children do not have regular access to sufficient nutritious food. Of these households, 26 percent are Black and approximately 22 percent are Latino.

    Hunger impacts a child’s ability to perform in school. Food insecure children have a harder time focusing in class, are more likely to miss school due to illness and are more likely to repeat grades. Schools should ensure that they are participating in school breakfast and lunch programs and potentially in after-school snack programs. Whenever possible, they should also help students identify options for meals during summer vacation.
  2. Adopt flexible, responsive policies. The little boy in my example could not have breakfast because according to school policy, breakfast ended at 8 a.m. But first-graders have no control over what time they get to school. The school policy essentially punished students for factors beyond their control.

    A common reason for school policies and procedures to impact students adversely is that they were not designed to take into account relevant external factors. Policies that are more responsive to students’ circumstances offer more respect for dignity. In this case, perhaps the breakfast policy could be amended to provide for wrapped food to be available for students who arrive late.
  3. Empower students to find their voices—to express their own opinions and embrace who they are as individuals. When students can see that adults believe they are important and valued, they feel more supported and encouraged in their efforts to learn and contribute.

All students deserve to be in a safe environment where they are treated with respect. As the new school year gets under way, anti-hunger advocates and others concerned about children will have new opportunities to look for policy changes or enhancements that will reduce hunger among students—and uphold other principles of dignity in the process.

Christian Brooks is a racial equity policy fellow with Bread for the World Institute.

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Tools
from our Resource Library

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For Faith

  • Unity Declaration on Racism and Poverty

    A diverse body of Christian leaders calls on the churches and Congress to focus on the integral connection.

    Dear Members of Congress,

    As the president and Congress are preparing their plans for this year, almost 100 church leaders—from all the families of U.S. Christianity—are...

  • In Times Like These … A Pan-African Christian Devotional for Public Policy Engagement

    This devotional guide invites deepened relationship with and among Pan-Af­rican people and elected leaders in the mission to end hunger and poverty.

  • Sermon by David Beckmann at Duke University Chapel

    Remarks delivered October 1, 2017 at Duke University Chapel in Chapel Hill in North Carolina.

    Thank you for inviting me to preach here at Duke University Chapel. And I especially want to thank the Bread for the World members who have come this morning.

    Bruce Puckett urged...

For Advocacy

  • U.S. Hunger and Poverty State Fact Sheets

    These fact sheets provide a snapshot of hunger and poverty in the United States and in each state plus Washington, D.C. 

  • Fact Sheet: Hunger by the Numbers

    In 2017, 11.8 percent of households in the U.S.—40 million people—were food-insecure, meaning that they were unsure at some point during the year about how they would provide for their next meal.

  • Sentencing Reform and Corrections Act of 2017

    Unnecessarily long prison sentences, combined with the lack of rehabilitative programs for people in prison, exacerbate hunger, poverty, and existing inequalities.

    Overly harsh mandatory minimum prison sentences have contributed to the rapid increase of our country’s prison population. The...

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