Strengthening Food Systems Resilience Before, During and After Disasters and Other Crises

1 Introduction

Food system resilience can help mitigate the health, societal and economic consequences of disasters and other crisis situations (Boyacι-Gündüz et al. 2021). The COVID-19 pandemic demonstrated how food systems can be impacted, especially for vulnerable populations such as children. School closures were used to help mitigate the spread of COVID-19, and progressively expanded across the United States from March 2020. Many schools were recommended or ordered to close for the academic year, affecting approximately 124,000 U.S. public and private schools, and 55 million students (Education Week 2021). This removed a much-needed safety net for students as schools provide essential services beyond education, including meals, health promotion, and other activities (O’Neill et al. 2020). Closed schools compromised essential meals for the 15 million students involved in the School Breakfast Program (SBP) and the 30 million children in the National School Lunch Program (NSLP), resulting in significant increases in food insecurity (Dunn et al. 2020; McLoughlin et al. 2020).

To address this food security crisis, the federal government put a range of programs in-place across the United States. This included congress expanding nutrition assistance to families impacted through the Pandemic Electronic Benefits Transfer (P-EBT), which allowed food benefits to be loaded onto EBT cards, and administration flexibilities created for the United States Department of Agriculture (USDA) school-based nutrition programs (McLoughlin et al. 2020; USDA 2022). However, in low population densities and rural areas many could not access these food programs, which are suited to condensed urban areas (Ryan et al. 2022). This gap in services was identified prior to the COVID-19 pandemic by the Baylor Collaborative on Hunger and Poverty (BCHP), which created the Meals-to-You (MTY) pilot in partnership with the USDA. This program provided summer meals (when schools were closed) to students in rural areas who could not access traditional congregate feeding sites. This three-year pilot was in the second summer with plans to expand from Texas to New Mexico and Alaska when the COVID-19 pandemic emerged.

The USDA, BCHP, McLane Hunger Solutions, PepsiCo’s Food for Good, and Chartwell’s K–12 used this nontraditional MTY model to create Emergency Meals-to-You (eMTY) (BCHP 2021). This was a public/private partnership to deliver meals to students in rural areas affected by COVID-19 school closures (BCHP 2021). The initial aim was to provide one million meals per week for children affected by nationwide school closures, however, this rapidly increased from April to May 2020 to five million meals per week (Baylor University 2022; USDA 2021). Actions included delivering directly to the student home what would normally be received at school over a two-week period using boxes containing 20 meals (10 breakfasts and 10 lunches) (USDA 2021). This program provided 38.7 million meals to approximately 270,000 children in rural communities across 43 states and Puerto Rico between April and August 2020 (Dunwoody 2020; Norman 2020).

By leveraging the knowledge and experiences of eMTY, we conducted workshops to identify strategies for strengthening food system access and resilience before, during, and after disasters and crisis situations. This included exploring what strategies could be used to mitigate the health, societal, and economic consequences of food related emergencies in the short, medium, and long-term. Due to the interdisciplinary nature of this study and the geographical areas covered, the findings could be translated into existing multidisciplinary emergency management structures and systems, and potentially applied in low, middle, and high-income settings. Ultimately, the goal of this study was to develop and advance strategies for strengthening food system resilience for school-age children after the COVID-19 pandemic and beyond.

2 Methodology

The study was conducted using workshops to identify, rank and prioritize strategies for strengthening food system resilience (Figure 1). Individual workshops were conducted to collect data using a scorecard approach. This was followed by data interpretation and analysis. A consensus-based discussion process was used to develop and rank priority actions. After individual workshops, the data were combined, aggregated, and interpreted to remove duplicates and develop priority actions representative of all locations.

Figure 1:

Project methodology employed in this study.

The workshops methodology was selected because it provides a platform to explore and identify factors for understanding complex work and knowledge processes such as eMTY (Ørngreen and Levinsen 2017). The interactive and participatory nature of workshops is particularly helpful when the aim of data collection is to influence future processes (Ørngreen and Levinsen 2017; Shamsuddin et al. 2021). Workshops also support the identification of factors which are not obvious to the researchers or the participants prior to commencing the process (Ørngreen and Levinsen 2017). The facilitators applied a scorecard during the workshops to identify, rank and prioritize areas for action. This is a process that offers an opportunity to unlock community-based knowledge and is conducive to new understandings around local challenges and possibilities (Sanchez-Betancourt and Vivier 2019). An overview of the scorecard approach, data collection, data analysis and interpretation, and the sampling strategy is provided below.

2.3 Data Interpretation and Analysis

The scorecard results from each participant were aggregated and then a mean for each indicator was calculated. The results were presented to the workshop participants as a table with the lowest ranking four to five indicators highlighted for group discussion. The decision on removal, clarification, and ranking of an indicator for discussion was determined by workshop participants through a consensus approach (Hsu and Sandford 2007). Once consensus was reached on the indicators to be discussed, workshop participants began developing priority actions for each selected indicator. When finalized, the priority actions were applied to a ranking grid (Figure 2). This impact versus difficulty process allowed workshop participants to discuss and visualize the priority actions in terms of which should be addressed initially according to the impact on food systems and difficulty to solve (Simon and Canacari 2012). When complete, the priority actions were presented to the participants for input and finalization.

Figure 2:

Ranking grid used at workshops to examine priority indicators. Used with permission from (Williams 2020). Please note, grids of this type predate Williams’ adaptation.

Following the individual workshops, data were collated, interpreted, and analysed by the research team. The mean scores for each indicator from the workshops were combined and then averaged. This was conducted to aid interpretation and identify priority actions from all five workshops. All priority actions were collated and grouped into different themes. We then identified where there was duplication and interpreted the data to develop consolidated priority actions. At this point no ranking for the priority actions across all workshops was applied because the goal was to provide representative recommendations.

The interpretation and analysis of the data from all workshops was initially performed by one researcher. This person helped develop the Food Scorecard, had applied different versions of this tool, and previously published research papers in this area. This initial analysis was then preliminary reviewed by two researchers before being presented to all authors for review and input. This specific process was thus designed to ensure reliability of the findings and recommendations (for example, confirming/reviewing results) (McDonald, Schoenebeck, and Forte 2019).

3 Results

There were 69 participants across the five workshops (Table 1). The workshop in Montgomery, AL, had the most participants with 20 (16 in-person and 4 virtual). This was followed by Waco, TX, with 15 participants (10 in-person and 5 virtual), Fargo, ND, 14 (11 in-person and 3 virtual) and 10 in-person participants at both the St. Louis, MO, and Charleston, SC, workshops. All participants were over 21 years old. Participants included school administrators and regional managers, emergency preparedness representatives, child nutrition specialists, companies and organizations involved in supplying and coordinating food delivery, and government officials familiar with the eMTY program, transportation experts, and environmental health professionals. The others included public health professionals, registered dieticians, human resources, facilities and operations managers, and academics. Results from the workshops and the priority actions developed from this study are provided in the following.

4 Discussion

Strengthening food system resilience is vital to help mitigate the health, societal and economic consequences of disasters and other crises in the short, medium, and long-term (Ryan et al. 2020). Achieving such resiliency is increasingly urgent because an estimated fifty million people are food insecure in the United States, making this one of the leading public health and nutrition issues for the nation (Gundersen and Ziliak 2015; Ziliak and Gundersen 2016). For example, inadequate access to nutritious food is associated with higher healthcare costs and poor health outcomes for both adults and children, suggesting it may be an important driver of health disparities (Gundersen et al. 2017). Poor nutrition is also related to serious adverse health effects such as suppressed body growth, accelerated ageing, reduced muscle mass and strength, reduced bone density, reduced heart contractility, lower lung capacity, limited cognitive performance, and reduced immune response to infective agents (Wells et al. 2021). Therefore, a new path towards strengthening food system resilience could be built on existing and previous programs, including eMTY.

Efforts have been made to address the food insecurity challenge through various programs. For example, the Supplemental Nutrition Assistance Program (SNAP) allows eligible people to buy food in authorized retail food outlets. However, many do not participate for the following reasons: transaction costs such as time and cost spent travelling to a SNAP office, the benefit level can be quite small, for example, for one or two person households this could be as low as $16 per month, and receiving SNAP may carry a negative stigma (Gundersen and Ziliak 2018). Complementary to this effort are the SBP and NSLP, which are supported and funded by the USDA. The unprecedented nature of COVID-19, school closures and eMTY provided an opportunity to reflect on these programs and consider alternatives for underserved populations. For example, the Urban Institute found the Meals-to-You program, including eMTY, is as effective as the NSLP in providing food to people in need and also provides a useful tool for reducing food insecurity among hard-to-reach households (Waxman et al. 2021).

The eMTY could provide another template for addressing food insecurity for older adults. The particularly vulnerable are older adults with caregiving responsibilities aged 50–59 years (Waxman 2021). Older seniors are less likely to be food insecure compared to younger seniors (Gundersen and Ziliak 2018). Among elderly food insecurity and nutrient deficiency often result in low level of vitamins E, C, D, B2, B12, zinc, phosphorus, and calcium. These findings could serve to policy makers to build food security more oriented to risk groups (Zarei et al. 2021). Also, people struggling with food insecurity often experience limitations in their daily activities, which are equivalent to those of food-secure seniors who are 14 years older (Gundersen and Ziliak 2015). Waxman (2021) recommended five actions to address this challenge: 1. Strengthen the power of SNAP for older adults; 2. Help federal nutrition programs and charitable food providers meet older adults where they are; 3. Support grand families with additional resources; 4. Prioritize racial and ethnic equity in all public and private responses to food insecurity; 5. Resolve to not reach 2030 in the same place we are now. A modified eMTY could help achieve recommendations 2, 3 and 4 by providing nutritious, safe, and brand-named food directly to older adults.

There is a need to integrate the food sector and schools with emergency management systems. This was a common theme identified in the current study and by Ryan et al. (2022). Addressing this need could allow food related emergency scenarios to be better considered and promulgate coordination of community networks such pantries, food banks, warehouses, and retail outlets that can pivot quickly to emergency production and distribution. Also, the agency administrating the SBP and NSLP varies by jurisdiction, however, each works directly with local educational bodies (McLoughlin et al. 2020). Decentralized food supply chain management with applied blockchain technology could provide another advantage for storage, transport and distribution on local levels with less possibilities of failure due to better monitoring of the food supply chain (Abdullah, Rahardja, and Oganda 2021). Emergency management systems are local, designed to coordinate complicated tasks in crises, multidisciplinary, and are in-place around the country and many parts of the world. These decentralized systems provide a ready-made framework for locally driven initiatives to strengthen food systems.

The Food Scorecard was effective in unpacking the requirements of the Ten Essentials and how they relate to the food system resilience. Linking to the “Ten Essentials” helped ensure a holistic coverage of the disaster resilience field, including factors indirectly influencing food systems (Williams 2016). Other versions of the scorecard have been used around the world and the popularity is demonstrated by the Health Scorecard now being available in over ten languages. The Food Scorecard also supported the perspective that resilience is a “system-of systems” issue that affects multiple physical and social systems, and therefore needs to be addressed in each of these systems (Williams 2016). Overall, this approach is translatable to different settings and scenarios because of the level of granularity used to identify areas needing improvement to strengthen resilience (Jones et al. 2021).

The App version of the Food Scorecard was effective in facilitating input from both in-person and online participants. However, there was a challenge on the user interface with ExPo Go © 2022. This system worked well to test the methodology, but some participants were unable to download the App. The feedback from participants who were able to use the App found this to be very useful. It is recommended the Food Scorecard and others with the format be transitioned and upgraded into a more user-friendly App (for example, easily downloadable and accessible).

Further research is recommended to rank and prioritize actions and needs across the United States and beyond. The networks and connections made through the eMTY program could be leveraged to examine underserved areas across broader spatial scales. Exploring environmental public health systems and characteristics in the survey areas would be beneficial, given the inherent linkages between poverty, hunger and public health service delivery. Providing an insight into what systems exist to address and monitor risks relating to drinking water, food safety, hazardous materials, healthy homes and schools, infectious diseases, vector-borne diseases, and other issues that compromise community and individual well-being across the urban to periurban to rural gradient (Brooks and Ryan 2021). This process could also be applied to other sectors, beyond schools, to examine how closures due to disasters impact nutrition of families in poverty, and elders living alone. In addition, establishing advanced knowledge of regulatory processes and what needs to be addressed to facilitate distribution from farm to local food stores in these locations would provide another step towards strengthening food systems (Gundersen and Ziliak 2018).

To translate the priority actions identified into practice, capacity building activities should commence at the local level. This could include, for example, socializing the concept with local officials, parent teacher associations and school boards. Local emergency managers and their teams could facilitate this process with support provided as needed from state and federal agencies. The activities could include mapping local food sector capacities and surge needs, working with schools to receive de-identified data about nutritional and allergy needs, developing disaster plans for sustaining food supply and access at the school district level (including farm-to-table), and maintaining ecosystem services and the integrity of agricultural areas that provide food sector benefits. A focus on protecting ecosystem services and agricultural areas would be consistent with priorities identified by the Food and Agriculture Organization of the United Nations (FAO 2021). One approach is ecological intensification, which is based on organisms that make direct or indirect contribution to agricultural production where yield is maximized while environmental impacts minimized (Bommarco, Kleijn, and Potts 2013).

We expect this scorecard approach and actions identified in the current study can be transferred to different income settings and locations to understand and prioritize needs. This process helped create awareness of the importance of food security and brought together stakeholders that may not interact under usual circumstances. The next step would be to develop detailed action plans to address the gaps, with roles, responsibilities, and timelines articulated. Ultimately, implementing the priority actions identified here would provide benefits for underserved communities by demonstrating a whole-of-society-needs approach to strengthening food systems.

5 Limitations

The authors’ work, research and teaching influenced this study. To minimize the impact of this limitation, a transdisciplinary research team was used to complete this research. The team had experience, for example, in food systems, emergency management, environmental health science, resilience, and the education sectors.

A limitation to this study was self-selection bias. For example, participants who attended the workshops were available, interested in the research area and willing to participate during the COVID-19 pandemic. There was no focus on a specific age (other than being over 21), ethnicity and race for the workshops. Therefore, this data was not collected during the workshops. The goal was to maximize participation. The researchers asked those interested if anyone else should be invited. Although a limitation, this approach was consistent with snowball sampling. Also, the focus of this study was to leverage the knowledge and experiences of eMTY to identify strategies for strengthening food system access and resilience. To minimize this bias, workshops were made available online and in-person in different geographical areas to prevent COVID-19 concerns from being a participation barrier. Also, many participants coordinated meal delivery to schools and other locations before the pandemic.

The research was conducted during the COVID-19 pandemic and many lessons were identified based on this experience. This was a unique situation when compared to other emergencies due to the simultaneous impacts across the country. However, due to the knowledge and experience of the researchers, authors, and participants in working and studying various disaster situations the findings could be transferable to other events such as floods and hurricanes. Caution should be applied when applying the results to these events as areas of priority and needs could vary.

Geographical location of the workshops was a limitation. However, a vital component of this study was leveraging existing knowledge and experiences with eMTY. BCHP was consulted about workshop locations along with the co-authors. The goal was to identify locations with the ability to host workshops, knowledge of eMTY and food systems, and ensuring timely completion of this project as plans to strengthen resilience post pandemic were being developed.

6 Conclusions

Food system resilience is vital to mitigate the consequences of disasters and other crises on community and individual well-being. The COVID-19 pandemic demonstrated how food systems can be impacted, especially for vulnerable populations such as children. School closures compromised essential meals for many children across the United States. To help address this food security crisis, a nontraditional public/private partnership model, eMTY, was set up and implemented to deliver meals to students in rural areas affected. By leveraging the knowledge and experiences of this program, we were able to identify, rank and prioritize actions for strengthening food system resilience. These include integrating the food sector and schools within emergency management, mapping local food sector capacities, working with schools to receive de-identified data about nutritional, allergy and other health needs, developing disaster plans for sustaining food access at the school district level, and protecting ecosystem services and agricultural areas. Addressing this timely need would promulgate coordination of community networks that can pivot quickly to emergency production and distribution. Emergency management systems are local, designed to coordinate complicated tasks in crises, multidisciplinary, and are in-place around the country and world. Providing a ready-made framework for locally driven initiatives to strengthen food systems now and into the future.