Gleaners Food Bank of Indiana

IBJ Hunger and Health - Transcript


                                                                        1

            1              GREG MORRIS:  Okay, so good morning and
            2      welcome to our Hunger and Health Time for Creative
            3      Intervention Inaugural Event presented by Gleaners
            4      and Indianapolis Business Journal.  I'm Greg Morris,
            5      Publisher of IBJ.  Thanks for coming out.  I hope you
            6      all didn't have too tough a time parking, I know it's
            7      a challenge at this time, but it looks like the room
            8      is pretty full here, so most of you made it.  I want
            9      to sincerely thank John Elliott and the entire
           10      Gleaners organization for your partnership, thank
           11      you, it's an honor to be a part of this immensely
           12      important effort to educate all of us about the
           13      complexity and myriad of factors that contribute to
           14      hunger and the related health issues we have right
           15      here just outside our doors at home and at work.
           16      This morning will cover a lot of content, but attempt
           17      to focus on three overarching questions, as well as
           18      perhaps to begin to decide where we go from here as
           19      community leaders who control the resources to
           20      resolve daunting interconnected challenges.  First,
           21      hunger impacts crime, education, health, and the
           22      economy.  Is food insecurity Indy's most urgent
           23      issue?  Second, how are hunger, obesity and chronic
           24      illness hurting Hoosier taxpayers, employers, and our
           25      shared future?  And, third, are we doing enough about
                                                                        2

            1      the state of hunger and health from federal programs
            2      to local food pantries?  Well, let's get to it.  I'll
            3      defer any extra time I have to our speakers.  Please
            4      give a warm welcome to the President and CEO of
            5      Gleaners Food Bank of Indiana and our convening host
            6      for this morning's event, John Elliott.
            7              (Applause.)
            8              ELLIOTT:  Well, thank you, Greg, both for the
            9      introduction but also for what's been a genuine and
           10      dedicated partnership with the Indianapolis Business
           11      Journal.  Gleaners would not have a loud enough voice
           12      alone, so your partnership has been very helpful, and
           13      thanks to all of you for joining us this morning as
           14      we share the urgency of hunger and health but also
           15      the complexity of the interconnected issues that Greg
           16      referred to related to hunger, education, worker
           17      productivity, and the diminished economic success
           18      that comes with that lower productivity, crime and
           19      other challenges.  It's hard work and even
           20      overwhelming at times to be poor, especially when the
           21      community's attention and resources seem to jump from
           22      one priority and concentration to yet another
           23      priority.  I also want to say the Indy Hunger Network
           24      is a genuine collaborative partnership that's the
           25      envy of peer cities across this country.  We truly
                                                                        3

            1      make a difference working together measured by both
            2      the quality and the quantity of meals provided to our
            3      hungry Hoosier neighbors every day, so it's my
            4      pleasure to acknowledge the extraordinary efforts of
            5      Jennifer Vigran from Second Helpings, Dave Miner from
            6      Bread for the World, John Whitaker from Midwest Food
            7      Bank, John Ryan from St. Vincent de Paul, Kate Howe
            8      from Indy Hunger Network, Ann Hartman from
            9      Connect2Help 211, and Emily Weikert Bryant who's
           10      representing the Statewide Food Bank Association, all
           11      are partners in solving hunger issues together.  Now,
           12      however daunting our jobs, as Indy Hunger Network
           13      partners, are, our special guest this morning, Jim
           14      Morris, of Pacers Sports & Entertainment, who
           15      formally led the UN World Food Program and a team
           16      that fed over a billion people today, faced much
           17      greater challenges than we face here in Indianapolis.
           18      If he can do it, and he did, we can do it as well.
           19      He improved the lives of hundreds of millions of
           20      people every day and, Jim, you are an inspiration and
           21      a mentor to the entire hunger relief community and in
           22      many ways I would say a mentor to those who choose to
           23      serve this community together.  So we'd love to have
           24      you share some brief remarks and set the framework
           25      for the discussion this morning.
                                                                        4

            1              (Applause.)
            2              JIM MORRIS:  It's always important to listen
            3      to your introduction when the introducer says "We're
            4      looking forward to hearing brief remarks."
            5              (Laughter.)
            6              ELLIOTT:  That came from Jackie.
            7              JIM MORRIS:  Yeah, yeah.  It's my pleasure
            8      this morning to bring you greetings from your first-
            9      place, league-leading, undefeated Indiana Pacers.
           10              (Applause.)
           11              JIM MORRIS:  Now, we're here to talk about
           12      something far more important than professional
           13      basketball, but there will be a card table set up as
           14      you leave with season tickets available in packages
           15      of 5, 10, 15, whatever you need.  I'm honored to be
           16      here, pleased to be here.  I'm so grateful to you, so
           17      grateful for your passion, your humanitarian heart,
           18      the way you care about the people who are at risk and
           19      sad and lonely and vulnerable, and the burden of this
           20      issue generally falls on the backs of women and
           21      children, and there is no constant through all of the
           22      subjects you are going to hear about this morning
           23      more important, more significant than hunger and
           24      seeing that a child has 2300 well-balanced, good,
           25      nutritious calories every day.  The World Bank said
                                                                        5

            1      that the most important investment any city, any
            2      country in the world, the same for the U.S. and
            3      Canada, Bangladesh and Kenya, wherever you're talking
            4      about, the most important investment a place can make
            5      in its future is to see that children are born to
            6      healthy mothers during pregnancy and that kids have,
            7      children have, a good diet the first thousand days of
            8      life.  If that happens, they have a chance.  I was
            9      chairman of the sponsoring group of UN aides for a
           10      while and when you would go to a community that had a
           11      very high HIV prevalence rate, the first thing they
           12      would ask for would be food and water.  If the body
           13      is not nourished, all the medicine in the world won't
           14      make any difference.  So the issue of addressing the
           15      hunger issue, you feed that little girl wherever she
           16      might be and you make it possible for her to go to
           17      school, to have good health, you make it possible for
           18      her to be a better mother, a better citizen, a better
           19      teacher, everything about her life changes for the
           20      better and it's a powerful notion.  When I came home
           21      after those five remarkable years, where for two
           22      years we fed the entire population of Iraq, we fed a
           23      third of the population of North Korea, very
           24      difficult places to do business, but I checked on the
           25      hunger situation in our city and our state and, you
                                                                        6

            1      know, to think that in this marvelous state of
            2      Indiana and our incredible city but 200,000 people in
            3      Marion County are food insecure sometime during the
            4      course of the year and maybe as many as a million
            5      people in the state of Indiana are food insecure.
            6      Now, folks went together in this partnership, this
            7      collaborative effort, and said "Well, that's just not
            8      acceptable and we're going to change that," and they
            9      figured out that at least in Marion County we're
           10      about 40 million meals a year short of being able to
           11      say we had solved the hunger issue, especially for
           12      children, and they got it down from 40 million to
           13      zero and it's now back up maybe to six million meals
           14      short, but my view of our city is that there's
           15      nothing more important than taking care of our
           16      children and if we take care of our kids I believe
           17      that everything else will take care of itself, and my
           18      dream has been that we can put our hand up and tell
           19      the world that we are a city that does not have a
           20      single hungry child.
           21              (Applause.)
           22              JIM MORRIS:  The partnership that is
           23      possible -- You know, all the great faiths -- If
           24      you're a Christian, you say "I was hungry and you fed
           25      me."  The Jewish community would say "God has given
                                                                        7

            1      us an abundance of food and the most important
            2      Commandment of all is that it be shared by all."  Our
            3      Muslim friends, the Prophet Muhammad said "You can't
            4      go to sleep tonight on a full stomach if your brother
            5      is trying to sleep across the way on an empty
            6      stomach," and life is a search for community, what
            7      brings us together, how do we find unity, and my own
            8      strong belief is that the one or two or three notions
            9      that hold us in common is we don't want kids to be
           10      hungry, we want to share what we have, and we want to
           11      love each other, and working on the issue that this
           12      effort addresses is a profoundly strong notion that
           13      brings us together but as we learn to do this
           14      together and we have these wonderful relationships
           15      and we know each other and we work together being
           16      certain that kids aren't hungry in our community, we
           17      build trust and we build relationships and it's
           18      impossible to imagine how that can overflow into the
           19      rest of Indianapolis.  So thank you for being here.
           20      My motto at the World Food Program was "Do more, do
           21      it better and do it together," and that's a pretty
           22      good motto for our city.  Bless you.  Thank you.
           23              (Applause.)
           24              GREG MORRIS:  Okay, thank you, Jim, very
           25      much, we appreciate it.  That was a perfect framework
                                                                        8

            1      for the rest of our program.  Breakfast is served.
            2      We will be back with you shortly.  Thank you.
            3              (VIDEO SCRIPT: "What if you had to make the
            4      choice between meals and medicine, between making
            5      rent and filling lunch boxes?  What if you didn't
            6      have enough money to keep the power on at home and
            7      nourish a healthy body?  42 million Americans, that's
            8      one in eight, are food insecure.  This means they
            9      lack consistent access to enough nutritious food for
           10      an active healthy life.  Our neighbors who are food
           11      insecure cannot always stretch their household
           12      budgets to meet their basic needs, even with the
           13      support of federal nutrition programs or help from
           14      family, friends and community organizations.  Food
           15      insecurity can have serious long-term effects on a
           16      person's health.  Healthy bodies and minds at every
           17      age require nutritious meals.  When people don't have
           18      enough food, when they consistently need to choose
           19      inexpensive, low quality calories or experience
           20      chronic stress about where they will get their next
           21      meal, their health can suffer.  People who experience
           22      food insecurity are at higher risk for diet-related
           23      diseases, such as Type 2 diabetes, high blood
           24      pressure, heart disease and obesity.  More than half
           25      of households served by the Feeding America
                                                                        9

            1      Nationwide Network of Food Banks have at least one
            2      member with high blood pressure, one-third have at
            3      least one member with diabetes.  When an individual
            4      or family cannot afford enough nutritious food, they
            5      sometimes adopt coping strategies and trade-offs that
            6      work in the short term to avoid hunger.  However,
            7      over time these can increase the risk for diet-
            8      related disease and make it more challenging to
            9      manage.  This reality can lead to a cycle of poor
           10      health.  The cycle begins when an individual or
           11      family cannot afford enough nutritious food, the
           12      combination of financial stress and inadequate
           13      nutrition can result in poor disease management.  The
           14      time and money needed to respond to these worsening
           15      health crises further drains the household budget,
           16      leaving little money for essential nutrition and
           17      medical care.  This causes the cycle to continue.
           18      Food insecurity also negatively impacts the lives of
           19      future generations.  In the United States today 13
           20      million children lack regular access to nutritious
           21      food.  Children at risk of hunger are more likely to
           22      be in poor health and struggle in school.  For some
           23      it may have negative lifelong implications that could
           24      prevent a developing child from reaching their full
           25      potential.  Together we can make real change, we can
                                                                       10

            1      break the cycle and build healthy, strong
            2      communities.  Join the Feeding America Nationwide
            3      Network of Food Banks as we work to ensure all
            4      Americans have access to the nutritious foods we need
            5      to thrive.  Take action.  Advocate.  Volunteer.
            6      Donate.  Visit hungerandhealth.org to learn how you
            7      can make a difference today.  Together we can end
            8      hunger.
            9              ANDREWS:  Good morning, everyone.  I'm IBJ
           10      Editor Greg Andrews.  We're almost ready to get
           11      started on our panel discussion, but first a few
           12      words on the format this morning.  Your moderator
           13      will be IBJ's Managing Editor Lesley Weidenbener.
           14      She'll be asking a mixture of her own questions and
           15      those provided by audience members.  You can submit
           16      questions two ways, by tweeting using the hashtag
           17      "health and hunger," the hashtag "health and hunger,"
           18      or by writing them down and raising your hand.  IBJ
           19      staff members will be on the lookout for questions
           20      and will come by to pick them up.  There are pads of
           21      paper at every table for questions.  Please look for
           22      coverage of today's event in today's IBJ mailing.
           23      We'll also be posting video at IBJ.com.  Now I would
           24      like to introduce the moderator, Lesley Weidenbener.
           25      We're pleased to have Lesley join us at IBJ in August
                                                                       11

            1      2015.  She previously spent four years as Executive
            2      Editor at the Statehouse File, a state government
            3      news and politics website produced by Franklin
            4      College journalism students.  Before that Lesley
            5      spent 11 years as the Indiana state health reporter
            6      for the Courier-Journal and six years as The Fort
            7      Wayne Journal Gazette's State House reporter.  Now
            8      Lesley would like to introduce our panelists.
            9              WEIDENBENER:  Thank you so much.  As Greg
           10      mentioned, I spent 20 years covering politics, and
           11      when you're immersed in all of that it's a lot of fun
           12      to get to come do an event like this, and I got to
           13      meet with the panelists before this event just to go
           14      over some of the things they wanted to talk about and
           15      so I could learn a little bit more about their
           16      expertise and I just feel so grateful that we have
           17      such amazing people today on the panel who are
           18      experts, I mean any one of them could carry off an
           19      event like this in their own right, so I'm pleased to
           20      announce Dr. Virginia Caine, who's the Director of
           21      the Marion County Health Department; Dr. Lewis
           22      Ferebee, the Superintendent of Indianapolis Public
           23      Schools, who is also a member of the Gleaners Board
           24      of Directors; Dr. Paul Halverson, who is the Founding
           25      Dean of the IU Richard M. Fairbanks School of Public
                                                                       12

            1      Health; Jonathan Nalli, the Chief Executive Officer
            2      at St. Vincent Health; and Troy Riggs, the Vice
            3      President of the Sagamore Institute, and, of course,
            4      he's a former Public Safety Director here in
            5      Indianapolis and also a member of the Gleaners Board.
            6      So let's give them a welcome.
            7              (Applause.)
            8              WEIDENBENER:  So I actually wanted to start
            9      today with Troy Riggs.  The Sagamore Institute just
           10      recently came out with an analysis of poverty and
           11      census data and really unveiled some just startling
           12      statistics about poverty in Indianapolis.  Troy, can
           13      you tell us a little bit about what you found?
           14              RIGGS:  Well, certainly.  Good morning.
           15      Thank you for having me here today, and I'll tell
           16      you, about a year ago Sagamore Institute came to me
           17      and asked about the data that we had been working on
           18      for the last four or five years between Mayor Ballard
           19      and Mayor Hogsett's Administrations and we talked
           20      about it in great length and they asked me to come by
           21      and to look at the top 11 cities, which ended up
           22      being cities of 70,0000 or more, in Indiana and then
           23      also look at the top 50 cities in America so we could
           24      draw some comparisons and see how we're doing against
           25      our regional competitors, and what evolved out of
                                                                       13

            1      that was something called a Public Good Index, and
            2      you can go online now and see publicgoodindex.com and
            3      see the top 11 cities in the state of Indiana which
            4      Indianapolis is part of.  We will be releasing the
            5      top fifty cities in America over the next few months,
            6      probably by the first of the year or sometime within
            7      January.  But from the Public Good Index I want to
            8      give you some data and it's troublesome data and
            9      we'll give some good data a little bit later as well,
           10      but some of the data we think that leads to food
           11      security, poverty and the things that we're talking
           12      about today, one is in modern-day America where you
           13      have to have a college education to get a middle-
           14      income class job, all studies show that now,
           15      Indianapolis is trailing behind our regional
           16      competitors and our national competitors.  Right now
           17      our graduation rate for college is 28.3 percent, we
           18      rank 35th out of the 50 largest cities in America,
           19      and that has changed over the years, at one time we
           20      were a little bit higher and we seem to be regressing
           21      and going down.  As a result, that has hurt our
           22      median income for residents.  So the study looked at
           23      2000 to 2015.  During that timeframe the residents of
           24      Indianapolis saw a 5 percent increase in their median
           25      income.  Unfortunately, the inflation rate, even
                                                                       14

            1      though it was relatively low, increased by over 35
            2      percent, which means that a normal Hoosier here in
            3      Indianapolis makes 70 cents on every dollar after 15
            4      years.  What's even more troublesome from that
            5      finding is that between the years of 2010 and 2015
            6      the median income of the average Indiana resident
            7      dropped and we're only one of a handful of cities
            8      that saw that across the nation.  Then we look at
            9      poverty.  With low education, with median incomes
           10      struggling, you know poverty rates are going to go
           11      up.  In 2000 our poverty rate was 11.8 percent.  In
           12      2015 it had surged to 21.3 percent.  Our population
           13      growth for this city, which is held up as a pretty
           14      robust population growth, was a little over 89,800
           15      individuals.  That's a very good population growth.
           16      It's not as good as Columbus, it's not as good as
           17      Austin, Texas, the two cities I point out simply
           18      because they have passed us in population size, but
           19      what's really troublesome is that 89,000 new
           20      individuals in our community but our poverty rate
           21      grew by 85,000, so if you were the CFO, the chief
           22      financial officer, for the city in the year 2000-2015
           23      you look at yourself in 2015 and realize you have
           24      fewer than 5000 people paying taxes to try to support
           25      an additional 85,000 residents in poverty.  We have
                                                                       15

            1      more people living in poverty both in numbers and
            2      percentages than in the history of Indianapolis.
            3      Some people have been left behind by our recent
            4      prosperity as a state and are recent prosperity as a
            5      nation, and it's so good to see you here today to
            6      talk about these issues.  Thank you.
            7              WEIDENBENER:  Dr. Ferebee, at Indianapolis
            8      Public Schools you're obviously dealing with the
            9      impact of these numbers on a regular basis, your
           10      teachers, your principals, see this every day in
           11      their schools.  How do these poverty issues, how do
           12      hunger issues, impact students and their learning?
           13              DR. FEREBEE:  Good morning.  I think
           14      oftentimes the perception is "Well, students are
           15      going to be distracted if they're thinking about when
           16      the next meal is going to come or their stomach might
           17      be growling during the day, but actually it's much
           18      more concerning than that.  What we see is that
           19      there's a tendency to have slow development in
           20      cognitive skills and students who do not receive
           21      regular nutritious food often have cognitive delays
           22      and brain development challenges that result in
           23      achievement challenges and learning disabilities in
           24      our schools, and so what we see is many times
           25      students come to us in kindergarten and even
                                                                       16

            1      preschool lacking the early literacy skills to be
            2      successful in the elementary experience and then when
            3      they're challenged in the elementary experience that
            4      extends into middle grades and high school, and so we
            5      spend a significant amount of time addressing those
            6      deficits and those early literacy skills throughout
            7      their experience in kindergarten and 1st and 2nd
            8      grade which requires a lot of resources and time of
            9      our staff to ensure that our students are successful.
           10              WEIDENBENER:  Dr. Caine, poverty and these
           11      issues obviously are a passion of yours and a
           12      responsibility at the Department of Health to try to
           13      impact the problems.  From your perspective how is
           14      this increase in poverty impacting the health of the
           15      residents of Marion County?
           16              DR. CAINE:  So first let me just tell you
           17      just a little bit more statistics with Troy about the
           18      poverty rate and what's happening in Indianapolis
           19      from a trend standpoint.  Back in 2007, if we looked
           20      at households with children, basically one in five
           21      households with children met below the Federal
           22      Poverty Guidelines.  Fast-forward up to 2012, the
           23      poverty levels increased to one now in every three
           24      households with children are now meeting the below
           25      Federal Poverty Guidelines.  Overall if we looked at
                                                                       17

            1      Marion County's poverty rate, we're at 21 percent
            2      compared to the national average in the United States
            3      of 15.5 percent, and if we looked at Indiana State's
            4      poverty rate, it's 15.4 percent, so Marion County is
            5      at least 10 percent higher, but more frightening is
            6      our children are at 32 percent, so 32 percent of the
            7      children here in Marion County are meeting below the
            8      poverty line and the national average is 21 percent.
            9      So what happens when you are hungry, we see a high
           10      association of depression associated with children,
           11      adults who are very, very hungry and that translates
           12      into depression, and so in Marion County we were
           13      shocked to find that when we just looked at our 18 to
           14      25-year-olds, 48 percent stated in the last 30 days
           15      greater than 14 of those days they were so depressed
           16      they couldn't carry out normal activities, and when
           17      we looked at the younger children, 5 to 12, our
           18      depression runs almost about 10 percent higher than
           19      the national average, so very difficult.
           20              WEIDENBENER:  Jonathan, Dr. Caine talked a
           21      little bit about mental health.  You know, you're
           22      seeing these issues appear in your emergency rooms,
           23      you're seeing them in the health system overall.  How
           24      have things changed over recent years in terms of the
           25      way the health system is impacted by the growth in
                                                                       18

            1      poverty?
            2              NALLI:  Absolutely.  Thank you, Lesley.
            3      Thank you, everybody, for coming out to push momentum
            4      on something that can easily add additional resources
            5      and ultimately solving.  With it what we're seeing is
            6      the evolution of what data shows us today in that
            7      poverty and other social determinants, such as lack
            8      of transportation, lack of water, what we're seeing
            9      in terms of lack of food, play such an impactful role
           10      in diminishing health outcomes, and the role then
           11      that health systems play and health providers is how
           12      do you utilize that and shift your focus, your
           13      resources toward staving those off so that you can
           14      have a better impact in increasing the health
           15      outcomes of individuals anywhere in the state and
           16      anywhere in the country and anywhere in the world.
           17      What we also know is that an individual that is food
           18      insecure or a family that's food insecure on an
           19      annual basis incurs 1800 more dollars in health care
           20      expenditures than those who have food security, and
           21      the two issues that we find with that are, one, that
           22      is a population that has no chance of being able to
           23      afford that additional $1800 as well as that is a
           24      population that is going to quickly choose between
           25      food and health care expenditures or access to health
                                                                       19

            1      care, they're going to absolutely choose feeding
            2      themselves out of basic necessity, which to us then
            3      presents an issue that if they're not getting the
            4      right food and have food security, there's going to
            5      be a higher incidence of issues such as hypertension
            6      and diabetes, I want to say 58 percent, 33 percent,
            7      respectively, in those, and then you can trail off
            8      and put even further down into it so the access or
            9      lack of access to good food impacts any chance and
           10      ability for someone with diabetes to be able to then
           11      get the right care and keep the diabetes under
           12      control which further creates that spiraling out of
           13      control that we've got, and so not just as the CEO of
           14      St. Vincent but really as the father of four kids and
           15      how do we look at what is the right nutrition that
           16      Dr. Ferebee's talking about that we've got to put
           17      forth in our household and then how do we then at St.
           18      Vincent look at that and say "How do we have to
           19      impact the patients we see, go out and find the
           20      patients that don't understand what health care is to
           21      be able to give them an opportunity at appropriate
           22      brain development, giving them a shot," so we believe
           23      that's where our energy and efforts have got to be
           24      focused on that we're seeing on a daily basis.
           25              WEIDENBENER:  Dr. Halverson, we're talking
                                                                       20

            1      about such a broad -- When you start talking about
            2      poverty and hunger, the impacts are across so many
            3      different areas.  What does it mean for our economy
            4      in general?
            5              DR. HALVERSON:  Well, it's a big cost.  Let
            6      me just say there's a long-standing relationship
            7      between poverty and poor health and that really does
            8      play into the equation.  I guess before I give you a
            9      number, let me just again acknowledge that one of the
           10      most important issues is to look in the face of a
           11      child who's hungry and it's not hard to see the
           12      anguish and the spirit that is in many ways
           13      diminished, the pain and the suffering that people
           14      live with every day, but then there is the cost, so
           15      if you look at the overall level there's an estimate
           16      for Indiana of about three billion dollars a year in
           17      costs that not only include our medical expenses but
           18      also include our lost economic opportunities, the
           19      higher cost, actually, of public education and the
           20      opportunities lost related to that, so there's an
           21      enormous cost.  So if we think about three billion
           22      dollars a year here in Indiana that we forego, it
           23      seems to me that there's an enormous importance for
           24      us to acknowledge the fact that most of that can be
           25      prevented and that ultimately I think is a challenge
                                                                       21

            1      for us to say "Wouldn't we really rather spend three
            2      billion dollars in a different way?"  And so I think
            3      that's one of our challenges and I think that number
            4      ought to motivate all of us in this room to focus on
            5      ways in which we can actually use that money more
            6      productively.
            7              WEIDENBENER:  Troy, I wondered if you could
            8      take a minute to put poverty in perspective for us.
            9      I mean we're a pretty lucky group of people in this
           10      room and I want to make sure that we know the numbers
           11      that we're talking about.  What does it mean to be
           12      poor?
           13              RIGGS:  Well, it means you're going to like
           14      opportunities, and one of the things that we realized
           15      when we started looking at data when I was Public
           16      Safety Director four years ago, five years ago, when
           17      I began was when you look at those numbers and you
           18      look at the areas where there's a degradation of
           19      quality of life, we have small pockets in our
           20      community.  We began with six small areas where 4.7
           21      percent of our population resides in Indianapolis,
           22      but yet in those areas that were determined by using
           23      data 4.7 percent of the population resides 30 percent
           24      of our murders, 30 percent of our non-fatal
           25      shootings, about 50 to 70 percent of our mental
                                                                       22

            1      health runs, every fourth or third home was vacant,
            2      all of those issues exist in those small areas,
            3      inordinate amount of services going there, but what
            4      we're doing is we're just putting a Band-Aid on it,
            5      and what happens as a result, children are living
            6      there, living there without hope, people that are
            7      living there are living there afraid and scared for
            8      their safety, we're talking about a lot of numbers.
            9      Remember, these numbers represent human beings, and
           10      when you look at the number of poverty itself and the
           11      depression that Dr. Caine talked about that's added
           12      to that and you look at these numbers we have 175,000
           13      people, 175,000 people living in poverty today, and
           14      to get in poverty a single person living in
           15      Indianapolis has to make 11,000 and I think 301
           16      dollars, somewhere in that area, to not live in
           17      poverty, so these numbers are based on those low
           18      numbers of salary.  It's hopelessness, despair, and
           19      as a result can cause a lot of not only mental health
           20      issues but physical issues and lack of opportunity
           21      for the future.
           22              WEIDENBENER:  Of course everybody here
           23      believes that there needs to be more done to try to
           24      deal with this problem, but it's not as if the
           25      government, the country, is not doing anything.
                                                                       23

            1      Millions and billions of dollars are spent to provide
            2      free and reduced lunch, to try to provide other
            3      programs to help with food.  Dr. Ferebee, you feed
            4      thousands of students on a regular basis.  How is
            5      that not enough?
            6              DR. FEREBEE:  We're really proud of the work
            7      we've done in the last couple of years in my
            8      listening to what I heard loudly and clearly from our
            9      students that food insecurity is a major challenge in
           10      Indianapolis Public Schools and as a result you
           11      mentioned free and reduced lunch, we established a
           12      breakfast and lunch program where every student
           13      received breakfast and lunch at no cost.  In addition
           14      to that, we expanded the Federal Fresh Fruit and
           15      Vegetable Program across our district with local
           16      dollars to ensure that in addition to breakfast and
           17      lunch every student receives a fresh vegetable or
           18      fruit every day, so if you have an early lunch, you
           19      get a snack in the afternoon and if you have a late
           20      lunch you get it early in the day and what we've seen
           21      is we've exposed students to food that they've never
           22      had at home and the opportunity to see a youngster
           23      eat cauliflower for the first time is just amazing
           24      for us.
           25              (Laughter.)
                                                                       24

            1              DR. FEREBEE:  We try to get our young people
            2      to enjoy vegetables.  And then we've been fortunate
            3      to partner with the Indianapolis Indians to offer
            4      dinner for families in the evenings, but what we
            5      worry about is our ability to tap into the weekend
            6      time and the evening time, and so we've extended our
            7      meals to winter break, fall break, we just completed
            8      fall break and we served over 6000 meals over a
            9      two-week period.  We do that over the summer, but
           10      we're not there in the evenings and the weekends and
           11      so we still need to do more to ensure that are
           12      students are fed well when they're not with us and
           13      not in school.
           14              WEIDENBENER:  Dr. Caine, the weekends, the
           15      evenings, and adults, of course, people who are not
           16      coming to school every day that don't have these
           17      opportunities, so many of those folks live in food
           18      deserts, they don't have the same access to fresh
           19      food, what does Marion County need to be doing
           20      differently and how can we empower convenience
           21      stores, you know, other retailers to provide the kind
           22      of food that would be helpful for all of these
           23      people?
           24              DR. CAINE:  Well, first just a question I
           25      want to ask Dr. Ferebee, are your schools year-round,
                                                                       25

            1      all of them?
            2              DR. FEREBEE:  We're what we call a balanced
            3      calendar where we have a real short summer of about
            4      four weeks and we feed all throughout the summer.  We
            5      have a fall break of two weeks and a spring break of
            6      two weeks and a winter break of also two weeks that
            7      we also provide food.  Actually, we launched our
            8      School Bus Cafe, so we actually have a bus that we
            9      take throughout the communities to feed families as
           10      well.
           11              DR. CAINE:  So to get back to that answer,
           12      especially in the poverty really high zone areas you
           13      have a lot more convenience stores, so a lot of those
           14      products in those convenience stores are a lot of
           15      high-fat, processed content there.  You don't see the
           16      vegetables, of course, in the convenience stores and
           17      very little fruit that's available, so it's a really
           18      difficult issue, and we have a tremendous amount of
           19      food desert places, but we have a lot of fast-food
           20      restaurants in those communities, and so it's very
           21      tough when I'm given a big discount for the largest
           22      amount of Coca-Cola you can get, you know, and I
           23      think one of the fast-food places talks about this
           24      1200-calorie burger that they offer that you can buy
           25      at a discount, it's very difficult for the families,
                                                                       26

            1      especially for our transportation issue, to get to a
            2      good grocery store in order to get those products, so
            3      we need to do more health assessments in these
            4      communities where we can bring grocery stores there,
            5      we can validate the value of bringing those resources
            6      to the people who need it the greatest, and we really
            7      have to think about this with this food insecurity.
            8      If you just look at the mental health issues that are
            9      taking place, we're having youngsters start at 13
           10      developing drug problems because they're trying to
           11      self-medicate themselves from their anxiety and their
           12      depression and so you then understand why we might be
           13      seeing this opioid surge crisis that is taking place
           14      in our communities because people are so anxious,
           15      depressed, but the resources are not there.
           16              WEIDENBENER:  Jonathan, what kind of role do
           17      you think health systems can play in trying to both
           18      educate people about healthy eating but also trying
           19      to provide those opportunities in the communities?
           20              NALLI:  One of the great aspects of Indiana,
           21      amongst the several, are the work that I would say
           22      every health system in the state puts forth about not
           23      only the recognition of what food insecurity does in
           24      impacting being able to provide health care but the
           25      initiatives they take to extend that and do even
                                                                       27

            1      more, and from St. Vincent's aspect we look at it in
            2      terms of what is the short-term and the long-term
            3      elements and initiatives that we have to put into
            4      place, and so one of the short-term pieces is what we
            5      referred to as the weekend feeding program, as you've
            6      heard here, and the initiative we put forth was how
            7      do we systemically throughout the state of Indiana
            8      where we have physical locations and where our
            9      hospitals are, so that's almost northern Indiana all
           10      the way down to Vanderburgh County and southeast
           11      Indiana, understand our administrations and locations
           12      working with local food banks and schools to provide
           13      those weekend feeding programs so that we were able
           14      to bridge that gap so that you don't have that child
           15      that will go all weekend without sustenance when
           16      they've been able to have phenomenal access during
           17      school hours with the breakfast, lunch and nighttime
           18      program.  Gleaners actually has a leading program in
           19      partnership with 200 schools around the state of
           20      Indiana and it's something that we felt we've got to
           21      do.  Another aspect is the emergency food pantries,
           22      and almost every one of our hospitals in the past
           23      year has set up or advanced the emergency food pantry
           24      that we have within our emergency rooms because we've
           25      recognized we can send somebody home taken care of
                                                                       28

            1      until they can get to a primary care physician on the
            2      next day or day and a half after, we can get them
            3      appropriate medicine for a couple days, but we're
            4      recognizing they're not going to follow up because
            5      they're a hungered family, a hungered individual, and
            6      so then in recognizing what we're doing in the short
            7      term we've advanced two long-term aspects, one was
            8      adding a two-question screening to all of our intake
            9      from the emergency process as well as in our primary
           10      care centers to understand are they food insecure, is
           11      this individual, is this family, and so the two
           12      questions, I'll read them for you, that we are
           13      rolling out now are straight from the USDA Food
           14      Security Questionnaire "Within the past 12 months
           15      we've worried whether our food would run out before
           16      we got money to buy more?"  That's a "yes" or a "no,"
           17      and then the second question is "Within the past 12
           18      months the food we bought just didn't last and we
           19      didn't have the money to get more?"  That's data that
           20      we're going to be able to incorporate throughout our
           21      entire medical record system to be able to share and
           22      allow to see how can we tighten up the numbers to get
           23      an even more colorful picture of what is food
           24      insecurity in a family, in a home, by zip code, by
           25      county, so that we can further target those
                                                                       29

            1      initiatives.  The other aspect is really the need for
            2      health systems to continue to go out to neighborhoods
            3      and be present where we either were not present in
            4      the past or we had those patients coming to us and
            5      recognizing that we can't because of lack of
            6      transportation or opportunities, so, you know, I'm
            7      excited to announce that on November 14th we're
            8      extending our St. Vincent Medical Group to Gleaners
            9      Food Bank, the hours that they're open, we'll have a
           10      nurse practitioner, a physician on site, to see those
           11      patients, to encourage them to get health care, to
           12      get regular access to a provider or a practitioner,
           13      and in addition to it we've added RUAH, which is a
           14      Rural & Urban Access to Health, it's a division we
           15      created that solely works on helping people
           16      understand who they are from a financial perspective
           17      or what options they have to get any type of health
           18      care coverage, which, as you know, the more health
           19      care coverage and knowledge an individual or family
           20      has the better they're going to access it, so RUAH
           21      will also be placed at Gleaners so that we can get
           22      people more connected with what good access to health
           23      care options they may have.
           24              WEIDENBENER:  Yeah, I think we're all
           25      probably learning about a lot of synergies here that
                                                                       30

            1      we weren't aware of where people are working
            2      together.  Dr. Halverson, where do you see the gaps?
            3      Where are the places where the community could be
            4      addressing hunger and health issues but are not doing
            5      that?
            6              DR. HALVERSON:  Well, I think it's important
            7      to go back to a comment that Jim Morris made early on
            8      in the presentation this morning and that is to see
            9      hunger as part of an overall foundation for health,
           10      so the linkage between health and hunger is really
           11      critical.  I guess a couple points.  One is we don't
           12      all suffer equally, and one of the studies that our
           13      faculty did was to look at the differences in life
           14      expectancy, and if you take a look at the Monon Trail
           15      and you consider as that begins in the southern part
           16      of our city and extends to Hamilton County, there's
           17      over a 14-year difference in life expectancy between
           18      the zip code just short of where we're at today and
           19      Hamilton County, 14 years, which means that a little
           20      baby born today not far from here will live 14 years
           21      less than a baby born in Hamilton County just 28
           22      miles away, and so it's important to recognize that
           23      this is not a uniform suffering, if you will, that we
           24      can't just say one answer is good for everyone, and
           25      so we really need to customize and develop an
                                                                       31

            1      approach that fits for the communities throughout
            2      this particular area.  I also think it's important to
            3      recognize that, again, we don't operate food programs
            4      in isolation of other health programs, and although
            5      we've got great hospitals and medical care
            6      facilities, it's important for us to recognize that
            7      we're one of the most unhealthy states in the country
            8      and we've been that way for a long while.  Actually,
            9      we've made a little bit of progress.  We're ranked
           10      now 39th out of 50 states in terms of our health.  We
           11      used to be 41, so we've made some progress, I guess
           12      we should take some solace in that, but the reality
           13      is we've got huge obstacles.  Unfortunately, if you
           14      look at the public health systems that support our
           15      state, we are ranked 49th out of 50 states in terms
           16      of support for public health activities and functions
           17      in our state.  That should be alarming to us because
           18      part of the way in which we deal with issues around
           19      hunger is in large part engaging with our public
           20      health system, so there are substantial functional
           21      infrastructure issues that I think handicap us in our
           22      ability to address these issues fully.
           23              WEIDENBENER:  We have a question about the
           24      fact that the government is spending a tremendous
           25      amount of money on this issue and provides millions
                                                                       32

            1      of meals for people who are poor and there are
            2      proposals to cut back on how much money will be
            3      allocated to those programs.  I'm kind of opening
            4      this up for anyone who wants to answer, but how
            5      concerning are possible cuts to some of these safety-
            6      net programs?
            7              DR. CAINE:  So when we looked at the data in
            8      Marion County, we have like about 172,000 individuals
            9      who meet the category of food insecurity.  When we
           10      actually looked at the cost associated, what would it
           11      take in order to feed those individuals adequately in
           12      Marion County, and that cost was nearly 85 million
           13      dollars, so we may think that there's a lot of money
           14      being put out there, but it's not meeting the entire
           15      need of our communities.
           16              DR. HALVERSON:  Well, I was going to say that
           17      the other side of the reduction in food programs,
           18      particularly if we look at WIC or SNAP, both of which
           19      really relate to allowing vouchers and people to
           20      purchase these kinds of foods, not only will we have
           21      more people hungry and more food insecure and all of
           22      the health issues that go along with that, but
           23      remember the impact on the economy, it's actually
           24      billions of dollars that are spent if we look across
           25      the state in terms of these programs, which are so
                                                                       33

            1      essential, but those are dollars that won't be spent
            2      in the grocery store, that won't be spent in
            3      purchasing fresh fruits and vegetables, so in
            4      addition to the health consequences, there's also a
            5      substantial economic impact which we need to really
            6      recognize as part of the overall economy because
            7      we're already getting hit by the economic costs of
            8      hunger and now this would actually be a substantial
            9      blow and further erode that safety net.
           10              NALLI:  The last time we saw a reduction in
           11      these food programs was 2013 and health systems were
           12      able to directly correlate an increase in those
           13      populations who are food insecure with greater
           14      utilization of unnecessary health care expenditure
           15      because of the emergency room's unnecessary admission
           16      based on the fact that they didn't have access to
           17      what was already a necessity in their lives, and so
           18      we'd see that $1800 number creep up yet again when
           19      we've worked to bring that down and continue to see
           20      it go down.
           21              WEIDENBENER:  So we've talked a lot about how
           22      to provide meals, how to actually provide food for
           23      people, but I think it's fair to say that everybody
           24      in the room would love for people to have jobs, to
           25      have their own opportunities so that they can go to
                                                                       34

            1      the grocery store and have access to the food, food
            2      on their own.  What do we need to do in our community
            3      to boost incomes, to boost economic opportunities
            4      that will make a lot of this government spending in
            5      these programs unnecessary?  Troy, I'll start with
            6      you.
            7              RIGGS:  Well, I think one of the things we
            8      have to do is what we're already seeing happening in
            9      Indianapolis is that, you know, remember what I
           10      talked about that Mayor Ballard started this data but
           11      Mayor Hogsett continued it and in those six areas we
           12      originally talked about we really put a lot of effort
           13      into finding services in those areas and putting
           14      government money that existed at the time in those
           15      areas, but also nonprofits rallied around and helped
           16      out greatly as well, and then you look at when Mayor
           17      Hogsett came in, took those six areas and made it 15
           18      square miles and we restructured the way we did
           19      policing those areas and that was important, but the
           20      most important part was a story that hasn't been told
           21      as often is that in these six areas that became 15
           22      square miles and 15 beats for police officers to
           23      interact with the community, during the timeframe we
           24      did that we started seeing approximately 30 million
           25      dollars being raised to go to meet the needs, not
                                                                       35

            1      government money, nonprofit money that was coming
            2      into this area, thousands, over 2000 volunteers to go
            3      in these areas and help with these issues, and that's
            4      the difference between just sending money and
            5      spending money with people that have a purpose and
            6      holding individuals accountable, helping them rebuild
            7      their lives, that's how you have sustainable.  Money
            8      sometimes is a Band-Aid, but having people there from
            9      the faith-based institutions and from other
           10      organizations helping has a tremendous impact.  We've
           11      seen that in Indianapolis.  It's probably the
           12      greatest untold story here but told across the nation
           13      that when we were seeing spikes in violent crime
           14      across the nation, we've had our fair share here,
           15      just north of us in Chicago 50 percent spike in
           16      violent crime, Louisville, Kentucky, my hometown, 50
           17      percent spike in violent crime, last year we were up
           18      3 percent in murders and down in non-fatal shootings
           19      and you know the reason why we weren't up 50 percent
           20      is because individuals like yourself gave money, put
           21      those millions of dollars in that area now and for
           22      the next three to five years and as a result in our
           23      highest crime areas the murder rate went down 11
           24      percent, non-fatal shootings went down 7 percent.  We
           25      know what works.  What it's going to take is not just
                                                                       36

            1      money but people being actively involved, and I have
            2      to say I give Gleaners a deal of credit for that
            3      because Gleaners went to those tough areas when they
            4      heard about it and fed people and met their needs day
            5      in and day out, and now hearing what Mr. Nalli is
            6      saying about providing health care, that's outside of
            7      government now, it's starting to take on a life of
            8      its own, being led by Gleaners, and that's going to
            9      be what sustains us, stabilizes us and slowly
           10      rebuilds this city and our inner-city over time.
           11      It's a good news story, we need to remember that.
           12              DR. FEREBEE:  If I could provide a little bit
           13      different perspective in terms of I agree with Troy
           14      that more funding is not a panacea, but you also
           15      should be aware that school corporations in high
           16      poverty urban areas such as Indianapolis Public
           17      Schools receive less funding today than we received
           18      years ago and the greatest thing that we can do, and
           19      I think Jim Morris hit this very well, our greatest
           20      responsibility is our young people and our economy
           21      hinders on strong school systems to develop the
           22      skills to build the labor force that we need, and
           23      it's unfortunate that we've seen decreases in
           24      dollars, in the state of Indiana it's in the category
           25      of complexity dollars which are resources for school
                                                                       37

            1      districts like IPS, those dollars are not where they
            2      used to be and, unfortunately, they're in other
            3      surrounding counties like Hamilton County that has
            4      received an increase in funding, and so I'm just
            5      challenged by that idea that we aren't truly
            6      investing where we know we have more needs.
            7              DR. CAINE:  I'd like to comment, too.  I
            8      think we have a falseness of security in the sense
            9      that for the average public resident they look on the
           10      news and say "Wow, Marion County's unemployment rate
           11      is very, very low, so we must be doing fantastic
           12      because most of the people have jobs here," but we
           13      don't report out how many people have jobs that are
           14      meeting the living wage, meaning you're making enough
           15      money so that I don't report "I'm hungry two days or
           16      three days out of the week and I've got to decide on
           17      for my social determinants whether I pay rent or,
           18      man, my child has an ear infection but if I don't
           19      have any insurance, you know, wow, that antibiotic is
           20      like $75, I've got to figure out whether I feed them
           21      or not."  We need to start tracking how many people
           22      who have jobs that are not living wages and so you
           23      can tell how successful you are as a community
           24      whether we're really providing the resources for
           25      these parents in order to take care of their children
                                                                       38

            1      or not, that's the only way you really know how
            2      successful your community is going to be.  Jobs alone
            3      doesn't really tell us anything.
            4              WEIDENBENER:  Troy, how important is this
            5      connection between the growth of Marion County and
            6      the growth of the poverty rate?  So you mentioned
            7      that if you're the CFO of the city and you're looking
            8      at your tax revenue coming in, you've got, you know,
            9      5000 additional people trying to support 85,000 poor
           10      people, how important is that and what kind of
           11      leadership do we need to see at the city level to try
           12      to turn that around?
           13              RIGGS:  Well, we have to identify it, and
           14      this is going to be a dangerous statement, we have to
           15      take the politics out of it, we have to have a
           16      conversation and not blame the current mayor or the
           17      current leadership for issues that have developed
           18      over decades, we have to take that out of it, we have
           19      to be honest as a community and get the politics out
           20      of the way because human lives are at stake, and have
           21      a conversation, a robust conversation, about how we
           22      change that around, and that's the good news is the
           23      city has a long history of working together and
           24      there's no doubt that as we talk about these issues
           25      we're in a good position to do something about it,
                                                                       39

            1      but if you look at just Indiana as a whole and we're
            2      looking at how we have to deal with these issues,
            3      let's remember the state of Indiana has a tremendous
            4      surplus, so the issues that we face we have money to
            5      invest.  As we're looking across the nation, it's not
            6      there for other states, it's not there for other
            7      cities.  The problem for Indianapolis is because of
            8      this poverty growth, because of the lack of people
            9      making good paying jobs and living wage that
           10      Dr. Caine's talking about, it's hurting our financial
           11      stability.  Out of 116 cities in America of over
           12      250,000 residents, our city ranks 46 in fiscal
           13      stability and those that did the study think that
           14      it's falling.  Our second largest city in the state,
           15      Fort Wayne, ranks 110th out of 116 cities.  Every one
           16      of our major cities in Indianapolis saw an increase
           17      in a percentage of those living in poverty.  It's an
           18      Indianapolis issue but it's also a major city issue
           19      and a state issue and the long-term viability of our
           20      state is dependent on how we deal with these issues.
           21      It's not out of control, we can handle it, but it's
           22      going to take some time.
           23              WEIDENBENER:  There's a tremendous -- and I
           24      think this is a natural thing that happens in
           25      politics is if you're in office you've got to feel
                                                                       40

            1      good about what you're doing, so we spend a lot of
            2      time in Indiana talking about how we're growing,
            3      we're bringing in jobs, but, Dr. Halverson, can you
            4      talk about the importance of having a statewide
            5      approach and maybe a regional approach to this issue
            6      instead of having Indianapolis be kind of an island
            7      dealing with this?
            8              DR. HALVERSON:  Well, you know, increasingly
            9      we're recognizing that at the heart of improvement
           10      are systems, right, so as we think about economic
           11      development I think the state has benefitted by
           12      having a strong economic development strategy for the
           13      whole state, and, frankly, I think we need that same
           14      sort of health strategy which certainly includes
           15      hunger in a statewide approach that ultimately says
           16      "Here are some things that we value, we see the
           17      connection between health and our economy and
           18      economic development, and let's find out ways in
           19      which we can take advantage of the state's assets to
           20      begin to do a better job in looking at some of the
           21      systemic issues."  Certainly food insecurity and
           22      hunger are big parts of it, but there are other
           23      issues as well where we know the connection between
           24      poverty and health and it certainly is a lot cheaper,
           25      frankly, to deal with issues around improving and
                                                                       41

            1      preventing illness than it is to simply wait until
            2      people are so far into a disease state and then they
            3      come to the hospital and they say "Well, I now have,
            4      you know, 20 years of cardiac risk factors that
            5      could've been prevented, but, you know, please help
            6      me with the issues that I face today because of my
            7      cardiac disease" or "stroke" or whatever, so the
            8      issue is that we need to get ahead of our disease
            9      state, we need to invest in prevention, and we need
           10      to focus on systemwide, statewide strategies that
           11      ultimately cost us less money, improve our health and
           12      economically develop a health system that actually is
           13      not focused on trying to catch people as they're
           14      falling but actually help build them up so that they
           15      don't fall.  I know that our hospital systems have
           16      done a great job in developing the latest and the
           17      greatest structures of tertiary care, but I think all
           18      of the CEOs that I've talked to would say they'd love
           19      to be out of business in some of those areas because
           20      ultimately if we can keep people from needing those
           21      complex services it's less expensive for us and
           22      ultimately it goes to the well-being and happiness
           23      and economic prosperity of our state.
           24              WEIDENBENER:  This is such an overwhelming
           25      issue and the more you all talk the more I think we
                                                                       42

            1      could spend the whole day here, we don't have that,
            2      so I'd like to go down the line and I'd like to ask
            3      each of you to address one thing that you would like
            4      the folks here to take away or one issue that you
            5      would like to see the state or the city address that
            6      you think could make a difference so maybe in a year
            7      we weren't in the same situation we're in now, so Dr.
            8      Caine.
            9              DR. CAINE:  I'd probably start by saying that
           10      I would love more resources for prevention from a
           11      comprehensive standpoint.  You know, each of us do
           12      our little bit over here, a little bit over there, a
           13      little bit over here, but it's like a race, so if I'm
           14      focused and I'm going straight to my target as
           15      opposed to I move a little bit over here, move a
           16      little bit over there, I think I could reach our goal
           17      and I would love it.  As I think Paul Halverson said,
           18      as a state we rank 49th in public health funding for
           19      prevention activities, I think we could really
           20      improve on that.
           21              WEIDENBENER:  Dr. Ferebee?
           22              DR. FEREBEE:  Get serious about socioeconomic
           23      mobility particularly here in our city and Marion
           24      County.  If we look at the 50 largest cities in the
           25      nation, we're at the bottom of the list in socio-
                                                                       43

            1      economic mobility, which means if you're born in
            2      Indianapolis/Marion County in poverty, you're more
            3      likely to remain in poverty compared to most urban
            4      cities in the nation.  We can do better than that.
            5              WEIDENBENER:  And I just want to follow up,
            6      Dr. Ferebee, where do you see the focus?  Is there
            7      one place where you think, and maybe it's education.
            8              DR. FEREBEE:  I'm biased to education,
            9      obviously.
           10              (Laughter.)
           11              DR. FEREBEE:  But I think it has been the
           12      leg-up in our nation for a long time, it has been the
           13      equalizer, a quality education has tremendous
           14      outputs, so that's my bias.  I think there are other
           15      efforts around education that can support greater
           16      economic prosperity, particularly for those families
           17      that are living in poverty and our young people that
           18      are born into poverty, but if we don't get serious
           19      about that, all of the other issues around health and
           20      violence and crime and drug addiction I don't think
           21      get resolved successfully until we really get at that
           22      core issue.
           23              WEIDENBENER:  Dr. Halverson?
           24              DR. HALVERSON:  So I think it's a two-step
           25      issue.  One is the recognition that health is driven
                                                                       44

            1      by the social determinants of health which in large
            2      part start with food and food security.  Secondly,
            3      there is an iron-clad linkage between good health and
            4      good economic prosperity and we need to recognize
            5      that you can't have one without the other, and this
            6      is a major disconnect in our state, incredible
            7      economic development, but it will ultimately be
            8      hampered by our poor health and we need to recognize
            9      that and take action.
           10              WEIDENBENER:  Jonathan?
           11              NALLI:  To me there's got to be this
           12      understanding and strategy that we have to take two
           13      parallel paths and it can't be a choose one or the
           14      other, it's got to be both, and it's related to what
           15      is the short-term and long-term aspects of how do we
           16      solve the problems of food insecurity and health
           17      outcomes, as Paul was saying, and that on one track
           18      it's the short-term elements of what are we doing to
           19      help those who are the working poor because if you
           20      see who comes into food banks and who is accessing
           21      assistance, it's the working poor, it's those below
           22      the livable wage who need assistance to make ends
           23      meet and that's where our resources today have got to
           24      help focus on because if nothing more is going to
           25      bring up the self-esteem and provide hope to
                                                                       45

            1      individuals who can help pass it down to our
            2      children, the next aspect has got to be that
            3      recognition that the vision is a long-term, continual
            4      18 to 20-year investment in food insecurity and early
            5      childhood literacy, which isn't just reading, it's
            6      reading, it's colors, it's numbers, and the more we
            7      align our resources around early-childhood literacy
            8      and feeding and getting kids that sustenance for the
            9      thousand days that Jim Morris talked about, we begin
           10      to stem the issue over time, but unless we have that
           11      recognition of the both, we'll never be able to solve
           12      it.  And I'll say this, we have a phenomenal state
           13      government and our legislators, not only do they
           14      understand it, but the more information and data you
           15      give them, the more responsive they are about how do
           16      we need to put forth legislation that helps correct
           17      that with that, so our legislators are listening,
           18      it's how do we come together as one with breakfasts
           19      like these and symposiums to put forth plans that
           20      they will act upon and do well with.
           21              WEIDENBENER:  Troy, before you jump in, I
           22      wonder, because you have this study information, if
           23      you could elaborate a little bit on how much of this
           24      is -- We've talked a lot about Indianapolis and
           25      Marion County.  What are we seeing in the surrounding
                                                                       46

            1      areas in terms of are poverty issues increasing there
            2      as well, are hunger issues increasing there as well?
            3              RIGGS:  In Indiana our major cities food
            4      insecurity is increasing, poverty is increasing in
            5      our major cities.  Four of our major cities lost
            6      population and they still saw a major increase in
            7      poverty.  It's troublesome when you see that, but
            8      we're seeing a little bit of that trending across the
            9      nation as well.  As more and more people move to the
           10      cities, as more and more immigrants come to our
           11      cities to live for services and they can't find good
           12      paying jobs or services, more and more people being
           13      left out of the job market because they don't have
           14      the education levels, we're seeing more and more of
           15      that develop and people are very concerned about that
           16      for the future of all cities, not just Indianapolis
           17      and Indiana.  But I will say, back to the original
           18      question of some things that we can do, before I say
           19      that, let me just remind you that these are difficult
           20      systemic issues that occurred over time, i've said
           21      that a couple times before, but everybody wants a
           22      quick-fix.  There's not a quick-fix.  People talk
           23      about crime issues.  I shared with you some of the
           24      good news on crime issues and it'll get better this
           25      year and it could get better next year, but if we
                                                                       47

            1      lose sight of what got us there it'll come right back
            2      if we don't deal with the poverty, but we have to
            3      make sure that if we are patriotic, God-fearing,
            4      loving Americans, and we believe that all God's
            5      people have the right to life, liberty and the
            6      pursuit of happiness, then there's two things that we
            7      need to do, we need to do what this country's done
            8      from its inception is we need to roll up our sleeves
            9      and get to work, we need to give to those
           10      organizations that focus on helping people, that have
           11      a proven track record and get involved, and if we do
           12      that as we have done many times before in this great
           13      state, that Indiana's third century I truly believe,
           14      even with this adversity, can be its finest yet.  So
           15      thank you for being here today.  Mr. Morris, thank
           16      you for putting this together and IBJ.
           17              GREG MORRIS:  Absolutely.
           18              WEIDENBENER:  We do actually have a few
           19      minutes left, so I do want to follow up with Jonathan
           20      because you mentioned the Legislature.  You said if
           21      we educate legislators about what the problems are
           22      that they will react.  Can you elaborate a little bit
           23      more on what does everybody need to do then, do you
           24      feel like, what kind of education needs to take
           25      place, what is it that our public officials, not just
                                                                       48

            1      lawmakers, but maybe city officials, others, what do
            2      you think they need to understand that would help
            3      them solve this problem in a better way?
            4              NALLI:  Absolutely.  We have a state that
            5      works from a government perspective, and somebody
            6      who's resided in Tennessee, Kentucky, Pennsylvania,
            7      I've seen state government that does not work or
            8      doesn't work nearly as well, and so what I've learned
            9      in my 11 years here in Indiana is that our
           10      legislators in the state, not only their ears are
           11      open, but they're open to that collaborative process,
           12      and what we've seen is providing our legislators good
           13      data that shows an impact and a strategy and what
           14      that plan looks like as well as how multiple
           15      organizations come together to fuel that and support
           16      that, it's easy for them to come up with legislation
           17      that can advance, that ultimately I believe grows
           18      economic development and prosperity of business in
           19      Indiana with it, and so what we've done, not just as
           20      St. Vincent, there are times when we're able to put
           21      forth with our legislators on St. Vincent's specific
           22      initiatives, but working together with all the health
           23      systems we have been successful in several measures,
           24      one of which was tobacco cessation and how do we stop
           25      that social determinant and what that health outcome
                                                                       49

            1      has done in the state and together as the Indiana
            2      Hospital Association, the Indiana Chamber of Commerce
            3      coming together, our legislators were able to not
            4      just move it forward in one session but say "How do
            5      we continue to evolve this for the good?"  Food
            6      insecurity, early-childhood literacy are two elements
            7      that we know we can help advance that together and
            8      collectively and that's what these breakfasts are for
            9      to figure out what are those call-to-actions that our
           10      legislators are extremely open to and they want to
           11      help knowing that it impacts every corner of the
           12      state.
           13              WEIDENBENER:  I thank you all so much for all
           14      the great information that you've provided here.  The
           15      study that the Sagamore Institute did, we have a
           16      story about that coming out in the Indianapolis
           17      Business Journal in the paper that comes out on
           18      Saturday, so we hope that you all will take a look at
           19      that, and let's give our panel a round of applause.
           20              (Applause.)
           21              ELLIOTT:  On behalf of Gleaners' staff and
           22      board I'd like to thank you as well.  To some extent
           23      you could say I knew what I was going to hear this
           24      morning in general themes but you have exceeded my
           25      expectations and I think reinforced the urgency of
                                                                       50

            1      the call to action and the connectivity of hunger to
            2      others, so thank you very much, the panel, once
            3      again.
            4              (Applause.)
            5              ELLIOTT:  And, obviously, there were a lot of
            6      other people that were involved in getting to this
            7      morning.  I'd start first of all with the hardest
            8      working hunger champions in this state and that would
            9      be the staff and the board of Gleaners Food Bank,
           10      many of whom are in the room and two of which happen
           11      to be on the dais as well, so please thank them.
           12              (Applause.)
           13              ELLIOTT:  And the definition of true
           14      partnership, as I said earlier, IBJ has genuinely
           15      been a partner in this journey, which to some extent
           16      I would say, my hope is, this morning is the first
           17      chapter in a story that all of us are going to write
           18      together and end up with a different ending that we
           19      might've thought about before today.  So if we've
           20      done our work this morning, we've done two things,
           21      first we've changed a community pattern of intense
           22      focus on one challenge at a time, sometimes in
           23      isolation, to a new model of community dialogue that
           24      accepts the interconnected nature of the challenges
           25      these families face today.  More than one person
                                                                       51

            1      talked about real people behind these numbers and
            2      these are real families with real challenges and,
            3      frankly, never one challenge at a time, so let's
            4      raise the solutions up simultaneously.  Second, I
            5      would say my fellow hunger leaders, some of whom I
            6      mentioned today and there are others in the room, we
            7      can't be the only people who wake up every morning
            8      and wonder how we're going to feed one in seven of
            9      our hungry neighbors.  You have to join us.  We know
           10      health care workers wake up every morning in a
           11      similar way concerned about physical and mental
           12      health needs, a similar urgency to those of us who
           13      are feeding the hungry.  The food we eat is critical
           14      to our health, we heard that earlier, I think Paul or
           15      someone mentioned earlier $1800 a household.  Well,
           16      some of those households have $200 a week to begin
           17      with.  My question is have we given you a sense of
           18      urgency and a strong desire to accept this call to
           19      action?  This will be a participatory church event
           20      where you speak from the back of the room.
           21              (Laughter.)
           22              ELLIOTT:  So I hope for those of you who are
           23      sitting there saying "Well, I already help, I donate
           24      to Gleaners, I donate to Second Helpings, I volunteer
           25      here."  Thank you.  But I'm asking you to do more on
                                                                       52

            1      top of what you already do, and to those of you who
            2      are not doing something for any organization that
            3      helps feed the hungry or wrestle with poverty I'm
            4      asking you to step up and join those who already are
            5      and who will do more.  Please share your time and
            6      your talent and treasure.  As indicated a couple
            7      times, too, there's a lot of value in advocacy and
            8      being the informed messenger as well and make sure
            9      that others join us.  So, frankly, I hope that when
           10      you leave here you can't get this out of your head.
           11      Much like I've told others on the Gleaners' staff and
           12      all, too, one of my measures of success for this
           13      morning is it's like when I've left the Riley
           14      Hospital lunches, I can't stop thinking about those
           15      kids.  Well, I hope when you leave here today you
           16      can't stop thinking about hunger and the
           17      interconnected issues and have a sense of urgency to
           18      do something about it.  So on behalf of our hungry
           19      neighbors in need, who I know you will help, thank
           20      you in advance for accepting a shared sense of
           21      responsibility and to help you along with that
           22      process.  As you leave today there will be Gleaners'
           23      staff members who will hand you resource folders.
           24      Both in that folder and at your table are what I
           25      would call commitment cards.  They'll ask you what
                                                                       53

            1      you think is urgent, what you think in terms of ideas
            2      that you would share and suggestions on what we can
            3      all collectively do about it, and then ask you what
            4      do you commit, don't just give us a good idea or a
            5      great idea, what will you help do about that or some
            6      other great idea.  So we're looking forward to your
            7      commitments and your great ideas.  There were a lot
            8      more questions.  Lesley did an amazing job, by the
            9      way.  I told her earlier she had the hardest job in
           10      the room to get a group of people who could fill the
           11      whole hour themselves corralled and focused, so thank
           12      you.  But we commit to you that on the Gleaners'
           13      website we will have the questions and the answers,
           14      those that got addressed this morning and those that
           15      didn't, and we're going to figure out a way that that
           16      might reinforce a bit of a forum as well, maybe
           17      that's something that our friends at IBJ can help us
           18      with in terms of communications expertise.  So,
           19      again, please accept the call to action, please join
           20      us, accept that these are interconnected issues, have
           21      a great day and thank you again for joining us.
           22              (Applause.)
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