Human Trafficking and Food Insecurity: A Conversation with Esther Liew

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Human trafficking doesn’t happen in a vacuum. It happens in result of, in combination with, and at the intersection of many other social issues impacting our communities. Understanding human trafficking requires us to look carefully at all of these other issues to help us be more effective in the fight against it. Today we talked with Esther Liew, the Health Partnerships Manager at the Houston Food Bank to explore the impact of food insecurity on human trafficking. Esther’s primary role at the Houston Food Bank includes supporting healthcare organizations in implementing food intervention programs that aim to decrease food insecurity and improve the health outcomes of our communities. Through the implementation and testing of food interventions and food distribution methods, she hopes to move food banking toward developing programs that will advance health equity.

Kathryn: I’m Kathryn Rogers, Development Director for A 2nd Cup. We are continuing our work in examining the intersections of social and economic issues, and how circumstances that people in our communities face, that are perpetuated by systemic or structural policies influence our work in fighting human trafficking. Today I am speaking with Esther Lieu, who works with the Houston Food Bank. Esther, do you mind sharing what your role is and what programs you oversee at the Houston Food Bank?

Esther: I am the Health Partnerships Manager at the Houston Food Bank, and am part of a Department called Food for Change, which has the goal of addressing root causes and downstream effects of food insecurity. So in my role, I connect the Houston Food Bank with healthcare partners to implement food interventions and to provide their clients and their patients with nutritious food. So, one of the programs that I oversee is called First Link and that helps healthcare partners to be educated on what food insecurity is, to know how to screen their patients for food insecurity, and then connect them with food resources like SNAP, which is the Supplemental Nutrition Assistance Program and also get pantry referrals. Another program is Food Prescriptions, so that patients can enroll into this food prescription program, which allows them to go to a unique food bank pantry to pick up nutritious food with a heavy emphasis on produce. And then the third program is a chronic condition self-management program in which participants learn about how to manage their chronic conditions, learn about nutrition, physical activity, how to create an action plan so that they can progress in their goals toward achieving better health. 

So as a Food Bank, we are wanting to seek equitable ways to distribute food and resources to the community, and work to not overlook communities that need food resources the most. 

Kathryn: Yeah, so you mentioned a term at the beginning of that, food insecurity. Do you mind defining that for us and some of the other terms that we need to know and understand when we’re having this conversation?

Esther: Yes, so I like to also distinguish between hunger and food insecurity. So, hunger is a physiological condition that everyone experiences, and it’s defined as the uneasy or painful sensation caused by lack of food. So everyone experiences hunger when your body tells you that it needs food. You could be hungry, but have the means to purchase nutritious food whenever you choose. On the other hand, food insecurity is defined as the inability to obtain adequate nutritious food in a socially acceptable way. So, unlike hunger, food insecurity is a household economic and social condition that leads one to have limited or uncertain access to food. So food insecurity is a more accurate term to describe the topic and discussion today. In fact, even if you worry that you won’t have enough food, that’s an indication of food insecurity. So the USDA puts food security on a spectrum, from high to low. High food security means that one does not have food access problems or limitations, and low food security means that one has multiple disrupted eating patterns and reduced intake of food. So some examples are a parent might water down milk to make it last longer for their children. Or, a college student might skip meals because there’s just not enough food to make it through the day on top of the other things they have to take care of, like paying their tuition, paying rent, paying for gas to get to school. So, here are some statistics that I think will put food insecurity into perspective locally.

Harris County has an overall food insecurity rate of 14.8% and usually the child food insecurity rates are higher, so within our county, the child food insecurity rate is 21.2%. Overall the food insecure rate of Texas is 15%. So there are some other terms you might have heard of, such as food deserts or food swamps. Food deserts are places in which there is limited access to grocery stores or other sources of healthy and affordable foods. Food swamps are places that have an abundance of fast foods or places like convenience stores, liquor stores, or unhealthy food. So, those are a few of the terms that might come to mind, when they think of food resources, food access, in our community.

Kathryn: So, I’m hearing a couple different things when you’re talking about food insecurity. I’m hearing you mention both physical access, so when you used the term food desert, like lack of access to a grocery store, but I’m also hearing the inability to purchase food. What are some of the reasons why someone might be experiencing food insecurity?

Esther: Yes, so I’ll address the first question about food insecurity first. So, a lot of times people might equate food deserts with food insecurity but that’s actually not an accurate assumption because food insecurity could happen anywhere, to anyone. So for example, even in a place that isn’t considered a food desert, if someone doesn’t have the means of transportation to get to a grocery store or isn’t able to leave their home due to a medical condition, then they would be considered food insecure. So, a couple of examples here, in the 2008 recession, we saw an increase in food insecurity rates across the U.S. And, despite the increased amount of food that food banks nationally were continuing to distribute, we saw that the food insecurity gap wasn’t closing. So that told us there was something deeper that we needed to discuss. When people lose their jobs, or have a sudden and significant financial burden – let’s say their car breaks down and they aren’t able to make that repair and get to work – then they lose their job. So, when that happens sometimes that translates into food insecurity if they don’t have a cushion. Let’s use this pandemic as an example. Pre-pandemic, in the Food Bank’s service areas, which is 18 Southeast Texas counties, we had an estimated 1.1 million people who are food insecure. And now, just in the past few months, the current estimate of people who are food insecure rose to 2.7 million. These are people who may be struggling with food insecurity, and it’s like an acute kind of food insecurity because previously they may not have worried about being able to purchase the food that they need to, but now because of job loss, because of illness, because having to take care of more people in their family, they just aren’t able to make ends meet. And so, an interesting fact is that more than a million people in our service area have applied for unemployment benefits since March. 

Kathryn: I’m so glad that you mentioned the pandemic, that was something I was interested in talking to you about because, um, just as you said, the unemployment rate is so high and there are so many more people who are experiencing things like food insecurity along with the other issues that might go along with that, but for a lot of our community food insecurity is not something that’s acute or timely, it’s chronic because they have been or are continuing to experience that. And something that we have been establishing through some other interviews with other social workers talking about issues like racial justice and LGBTQ+ services, we’ve been having a lot of conversations about how human trafficking is something that thrives when there’s room for exploitation when people are vulnerable. So for a person not having access to something as basic as food, that creates a significant vulnerability. So there were some articles that we looked at, which are going to be linked on our website, that kind of talk a little bit about the relationship between food access and human trafficking, so I’d love to hear from your experience what your thoughts are on that issue.

Esther: Yeah something like human trafficking or even the factors that create these vulnerable situations that people are in, they’re multifaceted and there’s a lot of intersectionality. So, reducing food insecurity or maybe as some people think “solving hunger” will take a multifaceted approach, and it’s more than just distributing food to the community, sending out more and more packages of food, that won’t do it. So, yeah we need to look deeper and address the structural and systemic factors that create situations that cause people to be more at risk for being exploited, and more at risk for being at risk for food insecurity. So, I’m just thinking about some of the big factors like employment status, whether or not people are housed, level of education, and if they have access to basic things like healthcare and transportation to get to where they need to be. They’re all examples of factors that will affect people’s food insecurity status and also increase their risk factors of being exploited.

So, we know that health disparities occur at a higher rate in communities of color and I don’t think that’s independent of the fact that human trafficking also disproportionately affects communities of color. So, when someone is living in poverty, they are trying to survive, and they have limited choices from which to obtain work or food, to support themselves or their families. So they get exploited, and at times they receive resources like food or money in exchange. Then they have to deal with the psychological trauma associated with food, so if trafficking happened to them when they were a child, this is something they will carry with them to adulthood and even as adults too, the trauma they experience is just not something that will go away if they exit, they are being brought out of that trafficking situation. So, as a Food Bank, I think we’re looking more and more into the relationship that people have with food. So food is not necessarily associated with family meal times, or joy, for people who have traumatic experiences with it. So, just providing food access and cooking lessons is a very insufficient form of intervention and we need to more deeply examine the whys of food insecurity, the whys of people in situations where they are being exploited and help people to develop a healthy relationship with food and this takes a whole lot more work than just doing pure food distribution.

Kathryn: Yeah so what are some ways that, because I personally have seen the community coming together during this pandemic over the last few months, and I’ve seen a lot of support of the Houston Food Bank and other organizations that are working to impact hunger, but what are some other ways that our community can support the work that you’re talking about, the deeper work, in the community that’s struggling with access to food or the relationship with food?

Esther: Yeah so I think that one can begin by educating themselves on the relationship between food security and health. So, if you’re interested, you can look up Feeding America Health and Hunger, and you will find a list of resources that talks about this intersectionality – food insecurity and implications on their health. And then, I’m thinking of the Urban Institute, they have some really great resources on SNAP. So SNAP is the Supplemental Assistance Nutrition Program, and SNAP has been proven to decrease food insecurity. So reading up on SNAP allows you to read up on policies and just how decisions are made to help our community. And then, like I mentioned before, because food insecurity is not just a siloed issue, learning about things like social determinants of health, the other factors that influence someone’s health, and topics like racial equity and health equity, that will give us a fuller understanding of the context that our vulnerable communities live in, and equip with knowledge and be a better advocate for policies and programs that we want our both local and higher level government to support and fund.

We are so grateful for the work Esther and many others are doing to address vulnerabilities in our community. Below are some additional resources that we’ve gathered to further your learning on the link between food security and human trafficking.

UT Health // Houston Area Food Access Analysis Tool

UNICEF USA // Food Access and Child Trafficking

Villanova Law Institute // Food Insecurity Leads to Survival Sex and Commercial Sexual Exploitation for American Teenagers

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