support. and today, we are here to discuss the issue of food security. and i think that opening the comments by all of our supervisors really set the tone, on why this is an important issue and we are really thankful for your leadership on this issue. and we are here to talk about food security as well as the opposite problems which are hunger and food insecurety and health implications from this and we will present the data from the recent reports that provide the detailed understanding of the food landscape in san francisco and especially the landscape for more the vulnerable residents and the data was prepared by the city agencies non-profit organizations, and academic partners who are working on the front line in san francisco and in the shelters, in our hospitals and in our community-based organizations, collectively, these organizations are food programs like cal fresh and wic, for women, infant and children and they are funders and service providers for our senior meals

and grocery and our summer lunch and after school snack programs and serve the free meals in the dining rooms and shelter and serves fresh fruits and vegetables. >> to offer more nutrition food and offer the nutrition programs and even in the food in the urban gardens and they also treat the health needs of the residents and many of whom do not have have the food. and this is the result of many, many people coming together and these this help to identify the assets and the challenge and develop the recommendation to ensure that all sff ans are food secure and free. >> and the leaders of a non-profit organizations that are working in the food systems and i will be presenting the information and some of the colleagues from the task force

to also present. and so, first of all, we are just going to cover the outline for the presentation and we are going to present a framework for understanding the food security and the public health and the economic implication and apply this to identify challenges, and define the scope of the problem and discuss priority solutions and proposed action steps and when we talk about the scope of the problem and going to give a couple of examples of how to use the report and in the particular districts and the priority solutions and the steps that we prioritized and we focus the attention and i like what you said, supervisor yee that maybe we can think of others because that is exactly why we are doing this hearing and we want to bring more team into the information and get many more minds thinking about this. and we prioritized and focused the attention on reaching the most people or the most

vulnerable people and we are going to propose the solutions that are really increasing the utilization of the food. and to meet the growing need and create a healthy food supplement and to support the health eaty and increase to the cooking and kitchens for the residents without those and we feel that these recommendations will require the alignment of the public and private sector and we do feel like we have a key asset in place to do that. and the support of a private sector and we have the robust food programming and we have an understanding of the negative health implications. and i would like to stop for a moment and really talk about what we mean when we say food security. it is really more than just hunger, it is more than the absence of hunger. this is a definition that we have. and i will say it, it is from

the health code and it was actually created in 2005. with the creation of the food security task force and the definition is that all persons, obtain a nutritionally adequate diet. and through the local and non-emergency sources and i want to take a moment to talk about this non-emergency sources. and when this really refers to the programs like food pantries and free dining rooms. and when the task force was created in 2005, the belief was that we would not lose these programs but today we have a better understanding that these community based programs are an integral part of the system and are essential for many of the residents, they represent, the strong collaboration and commitments between the public and the private sector and between the government and community, and businesses and they are integral to making sure that san francisco is food secure, so we can no longer

consider these to be a part of the emergency sources. i would also like to talk about what food insecurity is. and that exists when the ability to obtain and prepare nutrition food is uncertain or not possible. it is going hungry or being at risk of going hungry. we really look at this, even though it is very difficult thing to measure we used the income as a proxy, we know that this is a high cost of living in san francisco and that the federal pofcy are not adjusted so we use a below 200 percent of poverty as a proxy for being at risk for food insecurity. and i am going to show you a map right now that just kind of illustrates the number of residents that are at that income level, in each census district and the darker colors are showing the concentration between 2,000 and 3800 residents and the little bit

lighter gray, and it is still a dark gray is between 1,000 and 2,000 of peach in each that are below 200 and even in the city where it is a medium shade, and each of those is 200 and 1,000 people below 200 percent of poverty. >> so as you can see... >> my apologies, you don't have a copy, do you? >> i could send it to you. >> i have it on my phone. >> so, we know that this is a problem throughout all districts in san francisco. and i would like to talk a little bit about the health and implications food security is

linked to health i would like to ask dr. hillary seligrim, who is with the san francisco general hospital to actually give us more information about the health implications. and she is an expert in food and security and health and she treats outpatients and in-patients at san francisco general hospital. >> thank you, and thank you, supervisors, for letting me speak today. i'm going to speak about food insecurity as more than a basic human right and talk just for a moment about food insecurity in its impact on health. we know that food insecurity is highly associated with poor health and is probably a very important driver of health disparities in this city and beyond and it functions through three mechanisms if you can share the slide. >> the first is by poor nutritional intake and we know that the people are forced to shift the diet intake and the

relatively more fruits and vegetables that offer the micronutrients and towards the higher intake of less expensive fats and sugars in highly processed foods. we know that food who have insecurity, and develop the behave ors that exist for decades and potentially and throughout their life span, like bing eating and rationing the amount of food and preferences for high sugar foods to feel full, these are eating behaviors that predispose to later in the life span and we know that it is highly associated with extreme distress and anxiety and takes the band width away with cope with other needs like parenting and finding jobs and reregistering for benefits and things that are important for

keeping the household going. hospitalizations are important for the parents who give the care to the children and have difficult maintaining the employment. we know that the food insecurity woman who are pregnant deliver smaller sicker babies, who are sicker throughout their childhood and resulting in more school being lost and more difficulty achieving their economic potential as they grow older. we know that adult and seniors who are food insecure are at higher risk of obesity and diabetes and we know that the key medicine that we give is healthy food. and the options are less available to help to treat the obesity and the diabetes. once the people have the

diabetes, if they are food insecure are less likely to keep the diabetes under control. we know that only are the food insecure people to have mentalness, and they are less likely to need the emergency services and we know that if the food insecure, and they are more than likely to maintain independent living. it is associated with hiv related wasting and inability for us to control the virus levels even when you are on the effective theory and we are less able to keep the people with hiv healthy and alive. the department of public health and honda and san francisco general hospital and also the school district and the police department and other agencies,

and including hsa. >> i would like to ask that the slides be kept up as i go through them. and so now you have heard why it matters. >> dr. jones, could i just ask you to go back to the map that supervisor yee and campos are studying, and i know that every corner of san francisco is impacted by large numbers of low income people and families. but if you could let us know what neighborhoods where there is the most concentration of food insecure people and families because i see and it looks like the key areas and bay view hunter's point, and there is even areas of the outer sunset, and large and the richmond district which is there are thousands and thousands of people that are food insecure. and could you let us know where the highest concentration of

the people are. >> i think that you hit it on the head and. and it is in china town and also in the area of the omi and the sunset. and you can see, and they mentioned in district one, and that there is relatively high concentrations of of people who are below poverty and it is really throughout the city and our labors throughout, all of san francisco. and there is every neighborhood is impacted by this. and if i may, i mean, looking at the map in my district, i see that the areas that seem to be affected tend to have a larger proportion of minority communities so i can see here, that the portal has a large chinese population. and the mission, that has a large latino immigrant population, and it is, and i don't know if or how it breaks down in terms of that, but it

is interesting to see it on the map. >> yes. i think that you are right and we know that, families with children, we know that they have higher rates of food insecurity and especially neighborhood where they are higher and seniors. and so i think that i will, do you have any questions on it right now? >> no. >> and just wondering, maybe you have this later on, and it is the impact on the disabled community. >> seniors and adults with disabilities and the people without homes. >> now you have heard why it

matters and as the collaborativive groups, the food security task force and the tender loin, represent again, many city agency and community based organizations working every day on this issue and i would like to mention the groups involved. from the city side, it is from the serve agency and the cal fresh office and from the department of the ag and services, and the yoegt and the family and the department of public health and the department of the environment. and that are involved in the two collaborativive groups that are community campaign and the services of san francisco, and the foundation and the meals on wheels of san francisco, and the project open hand, and the san francisco and the food banks and the tender loin, development and the ucsf center for populations at san francisco general hospital. as we come together, we really work to figure out how to collaborate and how to improve

this situation we know that there are programs that we can get data for but we wanted to see the system as a whole and to be able to have the data to analyze that and we wanted to make this information available to groups and other department so that we will be able to join in and make sure that all are eating healthy. and i am going to go into the framework that we have utilized for this analysis and supervisor mar touched on it in his opening comments. we know that food security and healthy eating are really complex policy issues and you cannot just look at the issue from one dimension. and we search for a way to communicate this better and understand it better but we found it from the world health organization to be helpful for us and we have modified that. and so it has allowed us to

accurately examine the issue. food resource and access and consumption, the ability to have the resources to purpose the food. and this can come from your income oracle fresh or wic and other programs. access to nutritionally appropriate food convenient to you and either through the food retaylor the food meal programs. and then, the food consumption really refers to the ability to prepare healthy meals and then the knowledge basic of the nutrition and food safety and cooking and so this is where, the whole area around cooking nutritional education and comes into play as well as. through the rest of the

presentation and through the report we have used this framework to present the data as well as present our challenges in each area and our recommendations and our what is working. and today, i am going to go through the challenges we don't have time and that is why you have the report.

>> i want to note for the record that we have been joined by scott weiner. >> and the second challenge around the food resources is the fact that again, cal fresh which is the food stamp program is highly effective but it is under enrolled as a state of cal, we actually ranked last in the country, in terms of participation in this program. the local food stamps has been growing over the past years. and the growth is pretty phenomenal. >> now as you all probably heard in the media, there was a cut to the food stamp benefit levels at the end of october. and that was as a result of the stimulus funding that went away.

and now, the average dollar value of for the food stamps for the meals is about a dollar 40 and so it went down from a dollar 60 to a dollar 40 and even though that is small, you will see late kneer it has a major impact on the people's budgets and then the last challenge with this is many of the residents who really need the food resources are not eligible for cal fresh. we have over 45,000 residents, on supplemental security income. and they are not eligible for cal fresh, these are low income seniors and adults with disabilities. and also, our residents who without documentation are not eligible for cal fresh as well as anyone who has a gross income over 130 percent of poverty is not eligible and just as metric is added it is 25,000 for a family of three. and so i sort of looked and said that if you were working full time with a minimum wage job which is as a high minimum wage in san francisco. and you will only be making a

little less. and you would not be eligible for cal fresh. >> and in food, access, some of our challenges really at this point are that the demand for food programs, is straining or exceeding the careful of many of these programs, and many of our non-profit that operate on the site meals are having a increasing number of clients and we also have some with the late and they are really vulnerable residents who are put on the wait list for programs that are critical which is moment delivered meals and groceries as well as the pantries have wait lists now >> another challenge is the child nutrition programs are as low participation in many of them and there is limited capacity for some of them to grow. and in our school district, we are very fortunate to have wonderful leadership from the administration of the school district that is really working hard on improving the school meal program and the participation and so we are

very excited by the leadership from the administration of the school district and right now we have a third of the eligible students are not accessing the school lunch and each fewer are accessing the school breakfast. for the summer lunch program, we actually do well as a county, but, about a quarter of the students, that are eating, then, and the normal school day, and our after school meal program that is an opportunity that i think that we can really grow that program, and it is federally funded and we would like to see that grow in san francisco. and for food, retail, and unfortunately, we have, well, fortunately we have a great new program, and healthy retail funded program and it is working to increase the healthy food in the corner stores and it is an important step in making sure that the neighborhoods have healthy food. and the chat edges really is around the affordable food, i think and also we need to support the demand for that

food. and many grocery stores and super markets in san francisco do not accept the federal benefits to purchase the groceries and cal fresh and wic. and in food consumption, the true challenges resolve around lack of kitchen and then the constrained challenges of cooking in the environment with either, without a proper equipment, or with con trained food resources. and according to the census, we have over 19,000 housing units lacking complete kitchen and that definition of a complete, is a sink and a stove and a fridge, and we think that this is under counted.

cooking where you may only have a mike wave or a crock pot. >> i would like to move into, this report and this is going to sort of give a high level view of how to use this report. and we will focus on a couple of districts and it will illustrate some of the data that is in the report. and we have compiled, around 50 unique program indicators from the salt lake agencies. >> and non-profit and we have

organized it through the framework and the food access and the food resources. and and the city wide analysis. >> and for the district level. and for the analysis for the population of the groups of children and families. and the disabilities and. and you will see the data from the two districts is 66 and it is not surprising that district six gets the highest rates of food insecurity and it is a hub for services. and service provided are located. and you even have the neighborhood focus, and well as the coalition and i think that you can see from this, this is the highest number of for the homeless and one of the highest number of the housing units

without kitchens. and this shows you the food program that are available and it has the highest concentration of food resource and even with all of these resources, we will know that there are gaps that the food is increases and i am going to go to another district which you might not think of as being viewed as having a high number of food insecure residents and it is district one and it is the richmond district. we have only pull odd data from just seniors, because there is a high number of seniors, and the seniors that are over 65 or over 11,000 and the number, and the poverty and the two food pantries in the district. and it is serving around 1600 residents and there are 276 on sight lunches for seniors and again, this slide. and it will give us a snap shop of the need and being available.

and so at this point, i would actually like to ask my colleague, terry who is the chair of the food security, and to come up and provide us with a little more data and to form the recommendations that she will also be presenting. thank you. and supervisors, if we could have this slide, that will be reflected on the monitor that would be great. and while each district has its own character and the reports going into the incret able detail, about the food insecurity and for sure we can see it from looking at these maps, it is a city wide problem, and i would like to combat the number residents and how they are disbursed across the city. and those are the overlays and the food pantries that are

sponsored. and they are with the size of the pantries and of course there are clusters where you would expect to see them in the areas, as you can see, and a corner of the city and because for, for the demand because we are a demand driven organization and a demand driven tan tris and we also can draw the conclusions about the cooperation required to make this vast network to provide services to meet the needs. and the food is distributed the food at over 200 pantries in the city, and those are the community centers and schools and public housing sites and senior centers and the like and that requires the cooperation between us and that delivers the food and of course, the host sites that provide their own resources, and the space and the coordinators to make it all work together.

>> and about 100,000 people, are receiving food this way and did the weekly grocery and 60 percent of the food is fresh produce and which is one of the most cost effective ways and we have the programming right now. and we are some that are at risk for food insecurity and, it is worth, as dr. jones did, that the pantries especially all of those open to the public, again, looking to see this as evidence in the problem of the problem being city wide. the next side, i want to take a talk about demand. and this slide shows what with the providers every day and that is that the demand seems to be unending. and you were asked a question of how do you know when you know the need. you do more and more, each year, and it never seems to end and we will put a finer foint

on the answer to that. and on the poverty and equality and try to figure it out. and you included in the slide today, because this is a result of the work in which we call the missing meals reach. and we put it on the slide because it is the analysis of the needs in san francisco and it could be used to understand the food system. and that relative scale and also the limitations of the different components of food. and because of that, it provides a becon for where we should be focusing the efforts i will explain about the methodology and i think that it gets complicated. and they created a calculations where they looked at the number of people who are living on lower income. and they used a figure of 185 percent of poverty level, they looked at where these people

are able to obtain food, either from their own income, from things such as cal fresh and school meals and non-profit programs and then, engaged in a sophisticated analysis, to be able to compare those all at equal units to calm pair apple and apple and what you see this. about a third of the meals, that are needed by this population can be covered by income, and what to be expected to be covered by people's own income and this is a striking point, i think. secondly, about a third of the meals are covered by a combination of the government programs and the non-profit network and you can see by looking at this slide that it is about half and half. and the government is about equality matched and the government is higher. and you can see that there is a slight line there, that shows the important of cal fresh about two-thirds of the is