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. 2020 Oct 21;15(10):e0239778. doi: 10.1371/journal.pone.0239778

Table 2. Structural characteristics perpetuating hunger and obesity among systems clients: Illustrative quotes.

Structural Theme Representative Statement
Access to unhealthy food from donors “I think the way the food bank system was designed, it was designed to take any surplus food that was available and distribute it… this long-held fear of losing donors—and by donors I mean corporate food and beverage donors… who are donating these large quantities, donations of food. You know, the good, the bad and the ugly.”
Federal food assistance programming and policy “If food pantries receive food from the TEFAP program—temporary emergency federal assistance program—then they are required to have all of their clients sign a paper with their income eligibility… some food pantries will decide not to take TEFAP funding so that they don’t have to have all that paperwork for their clientele.”
State-level food assistance programming and policy “We have a program called the state food purchase program—some states have these, some don’t. It’s basically like TEFAP but state dollars. There’s another program or policy rather that has been picking up momentum in some states around connecting dollars…providing dollars so that food banks can buy from local farmers.”
Variation in risk across geography “As I talk with food banks around the country, some of them will feel like if they are not within an agricultural belt, geographically, that urban center where there’s not a lot of fresh produce being grown locally, they could be marginalized because there’s just fewer farmers locally who would think to donate to their food bank.”
Food supply does not adequately meet nuanced client needs “There’s a lack there [in the food bank system] of getting certain very low sodium, very low fat, high fiber—the kind of things that the folks who are dealing with diabetes and heart disease and other health issues. When their doctor says, take with food, change your diet, maybe you have to be gluten-free now because we’re finding celiac disease, how can food banks respond and get the food that’s needed to not only serve a vulnerable population just in the way of food insecurity, but probably also a population that has some fairly specific food needs.”