Food insecurity — it’s real and it’s a problem in the High Country

One in two people who use food pantries or church-based meal programs in Watauga and Caldwell counties don’t know where their next meal is coming from, said Dr. Adam Hege, an Appalachian State University public health researcher who looked at hunger in Caldwell and Watauga counties.

“From an economic perspective, if people are struggling to find food, we’ve got a public health catastrophe upon us, in terms of being able to take care of people,” Hege said.

The study was conducted in 2015 and 2016, using both focus groups and surveys. In Caldwell County, Hege worked with churches and the South Caldwell Christian Ministry. In Watauga County, he and his colleagues worked with the Hunger and Health Coalition. He is currently working on a similar study in McDowell County.

Hege is an assistant professor of public health in the Department of Health and Exercise Science in Appalachian’s Beaver College of Health Sciences.

He found that of the people he surveyed, 66 percent could be considered food insecure, while 46.5 percent met the U.S. Department of Agriculture’s standard for “very low food insecurity.” Food insecurity is defined as a lack of access to affordable, healthy foods. Many people experience food insecurity from time to time, Hege said, but to have very low food insecurity is more serious because it’s stressful both physically and mentally.

The problem likely goes even deeper than his research indicates, Hege said. His study looked at a small sample of people who were willing to seek out assistance. Other hungry people were likely hidden or overlooked.

Overall in the U.S., 13 percent of people were considered food insecure between 2013-15, according to the U.S. Department of Agriculture Economic Research Service. North Carolina has an overall food insecurity rate of 16 percent, ranking it eighth among U.S. states.

Creating real change

Understanding the complex factors that interact to create food insecurity is key to making real change, Hege said.

“Anytime you talk about food insecurity, you start with poverty,” Hege said. “You’re never going to address the root causes of food insecurity unless we deal with poverty and educational and employment opportunities.”

One of the biggest contributors to hunger is that people who have jobs work for very low wages, Hege said. One man in a focus group said that he makes $11 an hour working in maintenance. He buys everything as cheaply as he can.

In the past, people in rural areas had family farms, so food insecurity wasn’t a major issue, Hege said. Now most food comes from big farms. If people aren’t farming, they have to have transportation to get to a grocery store, which can be difficult in rural areas without a lot of public transportation.

Many focus group respondents told researchers they often chose between food and medicine, Hege said, and that food stamps don’t provide enough support each month.

High disability rates in rural areas — due to family health history and the types of work people do — play a part in food insecurity, too, Hege said.

“Another thing that stood out is a lot of the assistance we provide is great, but is it going to be sustainable?” he said. “People love the assistance. It helps get them through the rough spots, but crisis assistance can’t be there every week.”

Coping with hunger

In focus groups, Hege asked participants to talk about what keeps them from eating nutritious food, enough food and what their specific challenges were related to food security.

He also asked those surveyed how often in the last year they ran out of food; how often they cut meals or skipped meals; how often they can afford to eat balanced meals; and how they coped with not having enough food.

Here’s how survey responders said they cope with food insecurity:

  • Attend community functions solely for free food
  • Plan menus before buying food
  • Stretch food to make it last longer
  • Obtain food from food banks or pantries
  • Buy cheap, processed foods
  • Borrow money from family and friends
  • Eat less healthy meals in order to be able to eat more food
  • Eat more when food is plentiful

“What’s good is that rural people tend to have a sense of resilience and independence to solve their own problems,” Hege said. “They have high levels of social capital. As public health interventionists, we shouldn’t look down on that. We should capitalize on it.”


Faces behind the research

Sarita Beach and Bruce Rohrer are sometimes hungry, but they don’t let that stop them from giving back. Both of them eat and volunteer at F.A.R.M. Cafe in Boone. Like many people in the High Country, they’re disabled and often face tough choices when it comes to food. Here are their stories.

Bruce Rohrer

Bruce Rohrer, a volunteer and patron of F.A.R.M. Cafe, a pay-what-you-can restaurant in Boone. Rohrer worked in construction until illness destroyed most of his left lung. He’s now on disability and his food budget consists of what’s left after paying bills. Photo by Marie Freeman

Bruce Rohrer
F.A.R.M. Cafe volunteer and patron

Bruce Rohrer said he volunteers at F.A.R.M. Cafe three days a week and eats there five days a week. The cafe “helps immensely with having one meal I don’t have to worry about paying for,” he said.

“I worked in carpentry and construction until I became disabled from a flesh-eating bacterial infection that destroyed most of my left lung. That infection led to a heart attack, stroke and breathing difficulties.

“My food budget is what’s left over after bills, and I have to make it stretch all month. I mostly buy from Lowe’s since it’s in walking distance. I don’t go to the farmers market. That’s a hard walk uphill and I have breathing difficulties,” he said.

To make his food supplies last, Rohrer said, “I try to buy in large quantities so I can wrap and freeze it.”

Sarita Beach

Sarita Beach is disabled after two car accidents. She volunteers and eats at F.A.R.M. Cafe, a pay-what-you-can restaurant in Boone. Beach receives $121 a month in food stamps and has to stretch these to make them last the second half of the month. Photo by Marie Freeman

Sarita Beach
F.A.R.M. Cafe volunteer and patron

Sarita Beach has volunteered at F.A.R.M. Cafe since 2012 and eats there every day.

“I can eat healthy, even if it’s just once a day,” she said.

Beach currently receives disability benefits due to injuries sustained in two car accidents, and receives $121 per month in food stamps. Beach lost her car in the last accident.

“I try to eat healthy,” Beach said. “I get fruit, cheese and a lot of beans.” 

“When I lived in the country,” she said, “I had to catch a ride or take the bus five to eight miles to the grocery store. Now that I live in town, I can walk half a mile and ride the AppalCart to get to the grocery store.”