Earlier this week, the Urban Institute released a report on an exploratory study meant to gauge the impact of hunger and food insecurity on children. The study is available on their website and is titled Impossible Choices: Teens and Food Insecurity in America. The study was conducted in partnership with the food bank Feeding America, which released a report titled Bringing Teens to the Table: A Focus on Food Insecurity in America.

Over the course of 2014 and 2015, the researchers held 20 focus groups in 10 diverse communities across the country. Teenagers were asked to describe food insecurity in their community. Some participants shared first-hand experiences, though they were not asked to relate personal experiences. A lot of the behaviors participants discussed were well known to researchers who are familiar with the dynamic of poverty in America. This included strategies like saving school lunches to eat later during the day, sharing food with siblings or relatives, hanging out at the homes of friends or neighbors hoping their families would invite them to dinner.

But there was one finding that came as a surprise to the study’s authors, particularly since they were focused on teenagers who were in stable housing (i.e. not homeless):

Teens in all 10 communities and in 13 of the 20 focus groups talked about some youth selling sex for money to pay for food. These themes arose most strongly in high-poverty communities where teens also described sexually coercive environments. Sexual exploitation most commonly took the form of transactional dating relationships with older adults. [Impossible Choices]

There are several other findings that are very distressing, including a pattern of children going without food to help feed younger siblings or relatives. The focus groups had a total of 193 participants ranging in age from 13 to 18 years of age. The groups were convened in ten varied communities that represented urban, rural, small urban centers with a mix of public and market-rate housing. The ten communities were Chicago (IL), Eastern Illinois, Champaign (IL), Los Angeles (CA), Greensboro (NC), Rural North Carolina, Eastern Oregon, Portland (OR), San Diego (CA) and Washington DC.

Girls and boys participated in different groups. Most of the communities chosen for the study had higher than average levels of food insecurity, higher poverty rates, and high rates of SNAP participation. The study is considered exploratory and the authors relate that studies of teen food insecurity are new, with most organizations focused on younger children. The focus group participants relayed many difficult stories and it is a painful, troubling read:

“She [my friend] always beg for other people's stuff, but everybody push her away because like when I got chips, they like, ‘Oh, here she go.’ But I be feeling like she… always seems like she hungry because she don't ever have enough to eat.”

— Girl, Chicago [Impossible Choices]

Such stigma and shame had numerous negative effects. Teens reported being concerned that word would get around in their communities if they asked for food. Participants were also aware of children who hid their hunger, fearful that child welfare agencies would become involved. Many were unaware of food banks/pantries, or afraid of the stigma attached to visiting food pantries serving the broader public. Only one focus group was aware of a food pantry focused on serving teens specifically.

Feeding America’s report does highlight that teens are active participants in family food acquisition and management, and acutely aware of food insecurity. Participants expressed many opinions on how to improve existing programs and how important school programs in particular were for children in their communities. However, many teens were unaware of summer feeding options or believed other programs were meant for younger children.

The long term effects of malnutrition and food insecurity on children can be severe. Here’s USA Today’s article on the two studies:

Teens usually require the most food in their families, said Neville Golden, chief of adolescent medicine at Stanford and a member of the American Academy of Pediatrics' nutrition committee. However, the studies show they often go without a meal in order to let others eat.

“The teenage years are the years during which most growth and development occur outside of the first year of life. It’s a critical window of time,” he said. “Depriving a teenager of critical nutrients during that time can have long-lasting implications.”

The study’s authors caution readers from generalizing some of the risky behaviors that participants described. Not all focus groups described the same behaviors, and the authors note it’s difficult to disentangle the exact impact poverty, low income and food insecurity have. There is a concern that risky behaviors (stealing, shoplifting, selling drugs, sex work) will get “sensationalized”. That said, the findings are troubling and these patterns demand attention from both policy makers and citizens concerned about the impact of food insecurity on children.

Identifying sex as a coping strategy for teen hunger may be particularly difficult because the great majority of teens talk about it in terms of ongoing, transactional dating relationships. As a teen boy in rural North Carolina explained, “When you’re selling your body, it’s more in disguise. Like if I had sex with you, you have to buy me dinner tonight... that’s how girls deal with the struggle... That’s better than taking money because if they take money, they will be labeled a prostitute.” Despite the outward appearance of a dating relationship, youth in Portland were quick to point out, “You’re not even dating… They’ll be like... ‘I don’t really love him, but I’m going to do what I have to do.’” These kinds of relationships become a key survival strategy for some young women, particularly ones who already have kids of their own. As one girl in eastern Oregon explained, “[This girl I know] doesn’t have a lot of money... so she goes out and mingles with the guys and that’s how she feeds her family, by doing that.” [...]

Beyond these transactional dating relationships, in 7 of the 10 focus group communities, teens also related stories about girls exchanging sexual favors with strangers or stripping for money. They said these incidents occurred outside schools, in abandoned houses, at flea markets, and on the street. A girl in San Diego talked sadly about what happened to a friend from school, “Someone I knew dropped out of high school to make money for the family, she felt the need to step up, she started selling herself.” And another girl in Chicago told a similar story, referring to an even younger girl who was only 11 when she dropped out of sixth grade to work in the sex trade. Boys in Los Angeles confirmed that this behavior may start at an early age in their community, with middle school girls putting up flyers in public places advertising their services. [Impossible Choices: pg 25/26]

The Guardian covered the study and interviewed the authors:

“I’ve been doing research in low-income communities for a long time, and I’ve written extensively about the experiences of women in high poverty communities and the risk of sexual exploitation, but this was new,” said Susan Popkin, a senior fellow at the Urban Institute and lead author of the report, Impossible Choices.

“Even for me, who has been paying attention to this and has heard women tell their stories for a long time, the extent to which we were hearing about food being related to this vulnerability was new and shocking to me, and the level of desperation that it implies was really shocking to me. It’s a situation I think is just getting worse over time.” [...]

The consistency of the findings across gender, race and geography was a surprise. “I wasn’t sure we would see it,” Popkin said. “Kids knew about all these strategies: hanging around your friend’s house and see if they’ll feed you, going hungry so that their younger brothers and sisters could eat, saving their school lunch so they could eat it at night so they could sleep at night.

The Guardian article refers to policy “reforms” that curtailed New Deal and Great Society welfare programs in the 80s and 90s.

Popkin also discussed how law enforcement policies exacerbate these problems:

Popkin said: “I think one of the things we see, particularly around girls, is that if they get caught up in the criminal justice system, they get treated as status offenders, so they get arrested and they get put in the system instead of receiving the help and support they should be having for being exploited. One of the policy changes we advocate for in the report is a real shift in the perspective and getting kids help and support instead of a criminal record.”