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When reporting new aspects of a familiar story, location can be everything

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Topics in Health: Lessons From The Field

When reporting new aspects of a familiar story, location can be everything

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Orange County isn't the first place you'd expect to find child malnutrition.
Orange County isn't the first place you'd expect to find child malnutrition.

“Try West Virginia.” That was a common suggestion when I told people I was producing a report for the on the long-term impacts of childhood malnutrition last year.

If not there, they said, then Mississippi or Alabama would be good. Or maybe an American Indian reservation out west.

Fair points. These are places with some of the highest rates of chronic childhood malnutrition in the country — places where poverty and adversity run so deep it’s easy to find children skipping meals or exclusively eating low-cost junk food. Both of those things can lead to a whole slate of chronic diseases later in life, and that’s part of what I wanted to convey.

But you’d be hard-pressed to find someone in the United States who doesn’t already know that many West Virginians are poor. And having grown up there, I can tell you that most people in West Virginia are tired of these stories, too. Besides that, going for such an obvious choice wasn’t necessary in this case. In fact, there are very few counties in the U.S. where childhood hunger isn’t a major problem. See on the subject by the nonprofit group Feeding America.

Of great interest to me was this paradox: America’s junk-food culture means a growing number of children from all economic backgrounds are becoming both obese and malnourished.

That trend is especially true for low-income children who often don’t have access to healthy foods. On top of that, new research coming from the National Institutes of Health suggests that the chronic stress of poverty causes the body to metabolize food more slowly – often leading to rapid weight gain for low-income kids.  

Feeding America also each year and . So I started there. Within the report is a ranking of the places in the country where child hunger rates is most severe. Los Angeles, New York, Houston and Chicago top the list – not particularly surprising given the large number of low-income children living in those cities. But the bottom of the list caught my eye.

Orange County, California. More than 20 percent of children there – roughly 153,490 kids – were living in households considered “food insecure.” That’s the government’s definition for people who don’t always have enough nutritious food available to lead healthy and productive lives. It struck me as the perfect spot for this story.

Granted, most Californians know that many parts of Orange County are poor – some neighborhoods desperately so. But thanks in large part to the television drama “The O.C.” and reality shows like “The Real Housewives of Orange County” and “Laguna Beach: The Real Orange County,” it has a reputation as a playground for the rich.

I tested the theory on several friends – including some who live in Orange County itself – and across the board, the reaction was the same. Shock and outrage. They wanted to know how a community overflowing with resorts and yacht clubs could also be home to so many hungry children. Even food insecurity experts I interviewed were curious to learn more. Bottom line: I knew this was a location that would grab attention.

But the PBS NewsHour rarely highlights a problem – even such a compelling one – without also looking toward a solution. To make this story work, I needed someone within the county who was aware of the scope of the problem and was taking action, preferably from a health perspective.

That’s when I stumbled upon on the website of Physicians News Network which included a picture of Orange County Health Officer Dr. Eric Handler addressing a coalition meeting in Irvine. I had never heard of the coalition but a quote from Handler near the top of the post stood out.

“You cannot address health without addressing the issue of food insecurity,” he said. “Doctors should be asking their patients if they struggle with access to food. And now, thanks to the new coalition, we have easy tools that physicians can offer to their patients.”

I called Handler that same afternoon. He spoke passionately about his ideas of wiping out hunger in Orange County through simple initiatives, like an interactive map that can help doctors point low-income patients toward food pantries in their neighborhoods, and a program to gather excess food from the county’s many resorts and restaurants and redistribute it to food banks.

It’s unclear whether any of this will work. A lot plays into Orange County’s steep food insecurity numbers. Most significantly, the high cost of living –- driven by the county’s luxury economy –makes it difficult for the people waiting tables and buffing yachts to pay rent. Even more so, it makes it difficult for low-income parents to feed their kids much besides junk food. Handler’s initiative would be a piece of the story but not the primary focus.

In the end, we picked “The O.C.” because it tells the story of food insecurity in the broader U.S. context so well. The idea that 17 million children are considered “food insecure” in the United States – one of the richest nations on earth – is just as puzzling and complex a problem as Orange County’s presence on the “Top 10” list for food insecure children. And while many are excited by small-scale initiatives to reverse the trend – like community gardens, new grocery stores in food deserts or efforts to collect leftover food for the hungry from restaurants – there are just as many people who say that very little will change until the federal, state and local governments undertake more widespread reform.

We found compelling “characters” in Orange County . And as planned, one of those characters was the place itself. There’s something about the contrast between the county’s mansion-lined beaches and the utter poverty several miles away in the Tina Pacific neighborhood of Anaheim – not far from the gates of Disneyland, the so-called “happiest place on Earth” – that gives reason for pause and reflection.

And judging from the dialogue the segment provoked, the tactic worked. On our website, viewers debated the sources of American inequality, the links between obesity and poverty, and what should be done about both issues from a policy perspective. In Orange County itself, the local chapter of the American Academy of Pediatrics used the segment to publicize the depths of the problem, mobilize a series of town hall meetings on solutions, and secure a substantial grant to help area pediatricians better connect hungry families with local resources like food pantries and national programs like SNAP and WIC. “It is our intention to create a replicable model of this project for use in other communities both within and outside of Orange County,” the local chapter of pediatricians wrote in the successful grant application.

Several months after the NewsHour piece aired, Orange County government officials wrote in a newsletter that the segment provoked so much interest throughout the world that “other counties and municipalities have begun to emulate aspects of Waste Not OC’s program. The website, , is drawing visitors from as far away as India and Slovakia.”

In the end, choosing Orange County achieved that “pause” we were hoping to inspire. It lasted just long enough to get many viewers, medical experts and policymakers thinking about – and charting – a better way forward.

Photo by via Flickr.

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