AILSA CHANG, HOST:
Many of the children in this country are not getting enough to eat. Now, child hunger is not new, but the pandemic, food inflation and the end of aid programs are making it much worse - so much worse that caseloads at Boston Medical Center's Grow Clinic are up 40% since the start of the pandemic. Dr. Megan Sandel is the co-director of that clinic, where she helps malnourished and underfed children. She joins us now. Welcome.
MEGAN SANDEL: Thanks, Ailsa.
CHANG: So can you just start out by telling us about, you know, just a typical patient that you're seeing right now?
SANDEL: Yeah. I think one of the things that when we talk about malnutrition in the United States, people often have this sense of what malnutrition looks like in the developing world - right? - kids with bulging eyes and bulging bellies. And what we see actually in the United States looks different. We'll see what you think of is a really cute 1-year-old. And when you start talking to their mother, you realize the child's 2 years old and hasn't outgrown their 12-month-old clothes. And what is happening there is not just is that child not getting enough to eat, not gaining weight, but they're actually starting to stunt their height and potentially stunt their brain growth during a really critical period.
CHANG: Wow. Well, I mean, access to enough nutritious food - it was already a problem before the pandemic in lots of places. But can you explain how this pandemic especially has made things worse?
SANDEL: Yeah. I think that what we're seeing is a bunch of different factors. And honestly, this is the result of economic forces that predated the pandemic, right? We don't have enough affordable food, and so a lot of times, what happens is families are really struggling to afford food and making really toxic choices. We also often don't have enough affordable housing. And so Matt Desmond in his book, "Evicted," often talked about how rent eats first in a lot of low-income families. And so what we end up seeing is families oftentimes living in places where even if they can afford food, they're not necessarily able to afford healthier food options. And then they're oftentimes struggling where they may have, say, benefits at the beginning of the month, but by the end of the month, they're stretching, and they're not able to feed their children on a consistent basis.
CHANG: Yeah. You've already mentioned some of the more immediate consequences when a child is malnourished or underfed, but can you walk us through some of the long-term effects when there is a high rate of malnutrition?
SANDEL: Yeah. I think one of the critical things to realize is that during the first three years of life is when you really grow the brain that you need for the rest of your life. And when you're not able to grow well, you're actually starting to see those developmental delays. What parents will often report to me is once their children start eating more, once we're able to connect them with food resources and get them back on track, they'll report that their child is hyper. And what actually is going on is their child was actually pretty docile before because they were literally conserving energy. And now that they have enough calories, they're exploring their environment. They're being a normal 2-year-old. And those can be really impressive changes that result in kids, say, not growing up well, not being able to show up to kindergarten ready to learn, and we pay those consequences over a lifetime.
CHANG: Absolutely. Well, you know, we mentioned the pandemic aid programs and how they have helped, but are there other things that come to mind that policymakers could be doing right now, could be thinking about but don't seem to be? Anything?
SANDEL: Yeah. I really have to call out the child tax credit. We have seen in the last six months families starting to get back on their feet. We have started to graduate kids from our Grow Clinic finally. And a lot of that has to do with being able to have that consistent check every month that they know they're getting. And so I really have to call out that with the "Build Back Better" bill not being passed, that we are seeing now families really losing hope. And one thing that I'll just say is we have a saying in medicine that time is brain, and that's the same whether you have a heart attack or whether or not you're a kid missing out on meals. And so time is of the essence. We need to really make sure that families don't fall off the cliff, especially in this time with such high food inflation.
CHANG: Beyond the expanded child tax credit, is there any other particular policy change that you would like to see from the federal government to help address malnourished kids?
SANDEL: Yeah. I think that one of the biggest things that we know is that local communities are doing everything they can. Food banks are incredible. We run a food pantry at Boston Medical Center. We are really stepping up. I think that what becomes really important is that, honestly, we need to invest in housing and other affordable options so that families don't have to make toxic trade-offs.
CHANG: That is Dr. Megan Sandel. She is the co-director of the Grow Clinic at Boston Medical Center. Thank you very much for joining us today.
SANDEL: Thanks for having me, Ailsa. Stay safe. Happy holidays.
CHANG: You, too.
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