Institute Insights: May 2017


UN Photo / Tobin Jones

From the Director

It’s not surprising that we have a lot of contenders for “top priority” at Bread for the World Institute. Hunger is interconnected with so many other human issues — poverty, health, gender, climate change, conflict, social structures…

Then there are the sheer numbers. Food and nutrition are, of course, essential to everyone. With almost 800 million people who continue to experience daily hunger, 156 million stunted children, more than 60 million people displaced from their homes — 20 million of them refugees, and 15,000 babies born every hour, the world needs to find effective solutions and scale them up.

In this issue of Institute Insights, we are heading in several directions. Ensuring that people at imminent risk of starvation receive assistance is obviously urgent. The famine in South Sudan and near-famine conditions in Somalia, Yemen, and parts of Nigeria — coinciding with the deep cuts to humanitarian assistance that the U.S. administration advocates — is a top priority. We report on senior foreign assistance policy advisor Faustine Wabwire’s testimony on Capitol Hill, updating lawmakers on what is at stake.

Climate change is a related urgent priority. It is a contributing factor to current humanitarian crises. Climate change also poses the greatest challenge to continued progress against hunger. It is therefore one of the main subjects of our 2017 Hunger Report, Fragile Environments, Resilient Communities.

We are excited to announce that the Institute has just launched a new effort to communicate the Hunger Report’s key points and recommendations to new audiences — audiences that we believe are receptive because they are active on related problems. The first subject chosen for this campaign, The Hunger Reports, is climate change, the “Climate Fragile” chapter of Fragile Environments, Resilient Communities. We have a new video featuring an interview with pioneering climate change activist Bill McKibben, founder of If you are new to Institute Insights, perhaps brought here because you saw the video with Bill explaining why climate change and hunger are closely interwoven, welcome!

The new campaign also features a blog series, memes, infographics, and web resources that break a complex topic like “climate fragile” into shorter pieces and show you how to explain it to your friends, families, neighbors, community organizations, and so on.

Female-headed households are disproportionately affected by poverty in the United States. In this issue, we also consider ways of supporting single mothers struggling to provide the best for their children, and discuss a new program to identify effective ways to help low-income families connect with social safety net programs that will enable them to become more food secure and healthier. 

As always, we would love to hear from you! Are we touching on the right issues, should we focus each newsletter around one issue or theme? Please email your ideas to me at

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

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Dabora Nyibol, a returned refugee in South Sudan, prepares sorghum. Photo: Stephen Padre for Bread for the World

Pioneering Climate Activist Bill McKibben Connects Climate Change and Hunger

By Michele Learner

Editor's note: Watch the companion video, featuring an interview with Bill McKibben on the links between climate change and global hunger.

It may not be common knowledge in the United States, but the world has been making enormous progress against hunger. Since 1990, the rate of chronic hunger has been cut nearly in half. The hard work of hungry people themselves deserves most of the credit, but U.S. advocates’ calls for better policies and funding have helped. 

In 1989, as progress against hunger was gaining momentum, Bill McKibben wrote the first book that warned of the threat of climate change. Since then, U.S. climate activists have been unwavering in their efforts to persuade and pressure government to reduce CO2 emissions — before it’s too late.

Until recently, though, climate change activists and anti-hunger activists didn’t necessarily think of the two problems as connected — not even people working on both issues.

McKibben is an exception, explaining, “Climate change is a sort of amplifier of [the world’s] weaknesses and fractures. It makes it much, much harder to cope with what are already very difficult problems.”

He’s right, of course. Climate change is now a leading cause of hunger. It could undo all the progress of the past decades.

McKibben points out, “If you worry about injustice… [there’s no better example] than changing the very basic fundamentals of where everybody lives and makes their living.” Poor communities, whose livelihoods are already precarious, are the most vulnerable.

Bread for the World Institute works toward policies that will end hunger and malnutrition. That is why our 2017 Hunger Report, Fragile Environments, Resilient Communities, includes a chapter on how climate change worsens hunger. The effects on agricultural production, access to water, conflict over resources, and more mean that the two problems must be solved together.

When we talked with McKibben recently, he mentioned the hundreds of thousands of farm animals that suffered fatal burns during the March 2017 wildfires in Kansas and Oklahoma. “Now imagine those same kinds of conditions happening in places where people lack all resources,” he said. In Somaliland in the Horn of Africa, “we’ve seen losses to livestock herds of 40, 50, 60, 70 percent as record drought descends.”                 

Fragile Environments, Resilient Communities also illustrates how people already deeply affected by climate change can build resilience. Of course, the industrialized countries that are causing climate change have a responsibility to stop it and to mitigate the damage that’s been done. But while we’re pressing our elected leaders to do the right things, it’s good to know that strategies such as reforestation, improved livestock grazing practices, and fuel-efficient cooking methods are accessible to poor communities.

Michele Learner is associate editor at Bread for the World Institute. 

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North Darfur. Photo by Albert González Farran - UNAMID

Famine: The Reason I Testified Before Congress

By Faustine Wabwire

Editor’s Note: This piece originally appeared in The Hill of April 14, 2017. It is reprinted here with minor adaptations.   

I was recently asked to testify before the Africa Subcommittee of the House Foreign Affairs Committee about the famine gripping parts of East Africa. I urged members of Congress to reject the administration’s proposed cuts to foreign assistance, especially to programs that help countries deal with humanitarian crises and other emergencies.

The world is experiencing its worst humanitarian crisis since the end of World War II. More than 20 million people in four countries — Somalia, northeastern Nigeria, Yemen, and South Sudan—face starvation.

Our existing emergency funds are already stretched and the crisis is expected to worsen. If we do not act quickly and decisively — now, not tomorrow — more people will die, a preventable tragedy that will greatly erode the global progress against hunger and poverty.

As I testified before Congress, a Somali girl named Shida was very much in my mind. Shida is a two-year-old living in a famine-stricken village in southwest Somalia. Mohamed, a young man working to counter extremism in Somalia by empowering fellow youth, narrated to me how Shida’s mother, Fatima, tearfully pleaded for lifesaving assistance for her only remaining child.

Fatima’s two sons, Juma, 6, and Suraji, 8, had succumbed to starvation three weeks previously. She knew too well that Shida could follow if she doesn’t get immediate food and medical help. But where can she turn? Severe drought and conflict have depleted their livestock. Crops and water sources have dried up. For Shida, like 5 million others in Somalia, time is running out.

U.S. international development assistance is critical for people like Fatima and her daughter Shida. It is also critical to our national security. We cannot simply out-gun our way out of famines and humanitarian crises.

Countries experiencing extreme hunger and poverty can provide fertile ground for extremism, just as we have seen in Shida’s home country, Somalia.

As the world’s largest foreign aid donor, the United States spends less than 1 percent of our budget on foreign aid. Yet, the return on our investments in agriculture, health, and the nutrition of women and children are incalculable. Not only do we save lives abroad, we also create robust local economies and strengthen democratic institutions.

These are two critical bulwarks against terrorism and extremism. Unchecked by our investments in foreign aid, terrorism could easily spread further, as we have already seen it spread and reach our shores.

In the past 15 years, bipartisan efforts in Congress and various administrations have considerably increased the effectiveness of U.S. foreign assistance. U.S. assistance has become more transparent and its progress tracked by the public. It has leveraged the commitment of all actors in development efforts — low-income countries themselves, donors, and the private sector. Evidence from around the world shows clearer accountability for how U.S dollars are spent.

Foreign assistance has also created markets overseas for American exports. This approach has paid off dramatically. One example is Feed the Future, the U.S. initiative that works with U.S. businesses to combat global hunger and poverty. The program has boosted food supplies through agricultural development. Markets are functioning efficiently and we have reduced the number of hungry people around the world.

National security experts, Republicans and Democrats alike, emphasize the importance of foreign assistance as an indispensable tool for diplomacy, national security, and economic prosperity. International development assistance is not a partisan issue — it is an American issue. We know from experience that it is better and cheaper to prevent emergencies than to react to them or put U.S. soldiers in harm’s way. U.S. civilian tools of diplomacy and development are critical in our increasingly interconnected world.

We also know that the responsibility of funding emergency responses and development overseas is not borne by the United States alone. Across all four countries experiencing famine, our partners, including regional bodies, the World Bank, other donor countries, and the World Food Program, are engaged in large-scale, coordinated humanitarian operations.

The administration’s proposed foreign assistance cuts ignore the ongoing and impending famines. The cuts will undermine progress we’ve made collectively on global hunger, health, and national security.

U.S. foreign aid is an investment, not a giveaway. Instead of these unprecedented cuts, the administration and Congress should ensure that the budget protects and improves foreign assistance to promote a better, safer world.

Faustine Wabwire is senior foreign assistance policy adviser at Bread for the World Institute.

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Heather Rude-Turner, reading to her son Isaac, depends on the Earned Income Tax Credit to help support her family. Laura Elizabeth Pohl/Bread for the World.

Honoring Mother’s Day by Eliminating Gender and Racial Inequality

By Marlysa D. Gamblin

Mother’s Day is one time when we stop and acknowledge mothers for their hard work to provide for their families. This responsibility is a lot for any mother, but especially mothers with limited support. Mothers in female-headed households arguably face some of the most trying scenarios and continue to fight to feed and clothe their children. What can we do to honor this hard work and tenacity?

Female-headed households are more than twice as likely to experience food-insecurity than other U.S. households. A recently published briefing paper from Bread for the World Institute, “Ending U.S. Hunger and Poverty By Focusing on Communities Where It’s Most Likely,” describes some of the hardships that single mothers face. Two main factors that hurt a woman’s ability to provide for her family are gender discrimination and racial discrimination. The majority of those working in the 10 lowest-paid jobs in the United States are women. They are also the majority of those in “tipped-based” jobs. A single mother with three children in a minimum wage job would need to work more than 130 hours a week just to make ends meet. There are only 168 hours in a week — and she must take care of her children and sleep. Tipped-based jobs can legally pay as low as $2.13 an hour. There are literally not enough hours in the week to enable many tipped-based workers to support themselves and their children.

Households headed by single mothers of color face the added stress of racial discrimination. Currently, white women are paid about 76 cents for every dollar that white men are paid. But women of color are paid only 55 cents to 60 cents for every dollar white men are paid. That difference means that a woman of color would need to work an additional eight to 10 months every year to take home the same paycheck as a white male—which, of course, is impossible. Each of us has the same number of hours, days, and weeks in a year.

Ending gender pay discrimination would lift almost 5 million low-income families, many with children, out of poverty. Ending racial discrimination would do the same for millions more.

To honor mothers for their hard work, too often done with little reward, the United States should eliminate gender and racial pay gaps, workforce segregation, and disparities such as those in access to health care, safe and affordable housing, credit, and employment benefits such as paid sick leave. That would truly make this year’s Mother’s Day something to celebrate.

Read more about policies that support women and female-headed households in fighting hunger and poverty.

Marlysa D. Gamblin is domestic policy advisor for policy and programs, specific populations at Bread for the World Institute.

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Finding Ways to Connect Hunger and Health

By Cynthia Woodside

As Bread for the World Institute explored in detail in our 2016 Hunger Report, The Nourishing Effect, social factors have major impacts on health. As it turns out, social, environmental, and behavioral factors determine 60 percent of a person’s overall health, while health care and genetics determine only 20 percent each.

Thus, it is not surprising that inattention to ensuring that the social determinants of good health are in place can have devastating and long-term consequences for mothers and children. Food security or insecurity is one of these social determinants. Food insecurity is associated with higher rates of hospitalization, developmental delays, asthma, depression, cardiovascular disease, high blood pressure, and diabetes.

Ensuring that pregnant women are food secure reduces their risk of having low birth weight babies. Even those who are not premature have more long-term health problems than babies born at a healthy weight. Ensuring that babies receive food and nutritional support into their early childhood reduces their likelihood of obesity, heart disease, and diabetes in adulthood. It even increases their likelihood of graduating from high school.

A study by the Boston Medical Center and Children’s Health Watch, included in the 2016 Hunger Report (Appendix 2), found that in addition to its significant human costs, food insecurity adds at least $160 billion in additional, unnecessary costs to the nation’s healthcare bill.1

Last year, the Centers for Medicare & Medicaid Services (CMS) in the U.S. Department of Health and Human Services announced an Accountable Health Communities (AHC) grant program. The grants will enable organizations to test whether systematically identifying and responding to the needs of Medicare and Medicaid participants on certain social determinants of health will improve their health while reducing unnecessary medical visits and the cost of their medical care.2

CMS awarded the first five-year grants to 32 organizations in April 2017. These grantee organizations will serve as local “hubs” to enable Medicaid and Medicare beneficiaries to bridge the gap between health care and the social services needed to help resolve food insecurity, housing instability, utility needs, interpersonal violence, and transportation needs. The grant’s goals are to reduce avoidable health care utilization, lower the cost of health care, and improve the health and quality of care for participants.3

There are two tracks. The 12 grantees in the Assistance Track will help beneficiaries access the services they need, while 20 grantees in the Alignment Track will coach community service providers in coordinating services and supports with beneficiaries’ needs. The 32 grantees represent 193 rural and urban communities in 23 states. They include county governments, hospitals, universities, and health departments.

CMS gave two examples of how this will work:

  • In the AHC Assistance Track, Community Health Network Foundation in Indianapolis will partner with the Eastside Redevelopment Committee, an organization whose members include 50 businesses and community-based organizations, all of whom focus on improving health through high-quality support services, educational programs, and workforce development. Together, the partners will serve residents of East Indianapolis, a community where 40 percent of the population received Indiana Medicaid services in 2015 and whose rate of emergency room visits was higher than the national average.
  • In the AHC Alignment Track, the Oregon Health & Science University (OHSU) will work with more than 50 clinical sites, community service providers, and local health departments in nine rural counties. The AHC model plans to reach more than 300,000 Medicare and Medicaid beneficiaries in Oregon. OHSU will coordinate activities through the Oregon Rural Practice-based Research Network, a statewide network of primary care clinicians, community partners, and academicians dedicated to identifying ways of improving healthcare delivery to people in rural areas and reducing rural health disparities.

View a list of the Assistance and Alignment Tracks bridge organizations in the Accountable Health Communities Model.

Cynthia Woodside is senior domestic policy analyst at Bread for the World Institute.

1. J. Michael McGinnis, Pamela Williams Russo and James R. Knickman (March 2002), “The Case for More Active Policy Attention to Health Promotion,” Health Affairs, Vol. No.2.
2. Children’s HealthWatch Data, 1998-2005.
3. Council on Economic Advisors, “Long Term Benefits of SNAP,” December 2015,

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Global poverty rate 1996 - 2030. Graphic by Derek Schwabe / Bread for the World Institute

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