December 2021

Greenwall Grantee Develops Ethics Principles to Help Feed America in Times of Crisis

When COVID-19 first made headlines in spring 2020, the economy spiraled into crisis, causing 22 million Americans to lose their jobs. Consequently, one in every five people in America received charitable food assistance throughout the first calendar year of the pandemic, with about 40% of them visiting a food bank for the first time. James G. Hodge, Jr., JD, Peter Kiewit Foundation Professor of Law at the Sandra Day O’Connor College of Law and Director of the Center for Public Health Law and Policy at Arizona State University, recognized early on that food banks and pantries were facing unprecedented levels of demand, but lacked guidance on how to ethically distribute their resources. With support from The Greenwall Foundation, Prof. Hodge set out with his Center colleagues to develop practical guidance to help these organizations meet head-spinning levels of demand in the most equitable way.

Image Credit: Joel Muniz

Nearly two years after COVID-19 emerged, Feeding America, a nonprofit organization that coordinates the efforts of more than 200 food banks across the country, reported that its partner food banks are distributing 55% more food than they did pre-pandemic. As the holiday season approaches, food insecurity will continue to affect families across the country. The Greenwall Foundation sat down with Prof. Hodge to discuss how the Model Ethics Principles that his team developed can help food banks and pantries navigate the ethical challenges that accompany resource allocation in times of crisis. 

How did the pandemic affect food insecurity in the US?

We’ve seen scarcities across so many different fronts of life regarding this pandemic, from scarcity of tests and vaccines to medical procedures. Allocating these scarce resources nationally has dominated health systems and public discourse. Less attention has been paid to the scarcity of food available to Americans. During the course of this pandemic, we’ve seen tens of millions of Americans experience food insecurity, often for the first time. Consequently, scarcity of food, particularly because of the economic impacts that we experienced early on with the pandemic, has been a profound factor that we continue to experience nationally. 

Are these effects ongoing?

They are. With thanks to donations from millions of Americans, as well as an influx of federal and state funding, food banks and pantries have done well to restock against the initial deluge of persons seeking resources early on in the pandemic. However, their operations are still strained and may not normalize until we get to that juncture where Americans are safely back to work and back to life as we knew it. Nearly two years in, the pandemic is still not remotely in our rearview mirror. The looming threat of the emerging omicron variant hints that we’re far from the end.  

How does the “first come, first served” distribution approach affect those in need when food resources are scarce and demands are high?

If we used “first come, first served” to allocate other scarce resources in emergencies, like vaccines or ventilators, we would see horrendous, disparate impacts, specifically affecting at-risk populations. We would not be able to defend those practices. Yet, this approach is often what you’re seeing at a lot of food banks and pantries. Facing a massive influx of consumer demand, they did their very best to respond. But “first come, first served” approaches invariably end with people at the end of the line who go unserved. Or worse yet, people who could not line up at all due to disability, age, child-care needs, or other barriers.

I consistently ask, “Who was left standing in line?,” “Who could not line up at all?,” “Was it those most in need?” Very likely. If so, “How can we better accommodate these persons through equitable distributions of food allocations?” Answering these questions was the genesis for this project.

How can bioethics inform the food bank distribution process in times of crisis?

That’s exactly the question we brought to The Greenwall Foundation. We raised it knowing there are specific ethical principles used to allocate other resources, like vaccines: “How would you transform and wield those principles effectively to equitably share limited food resources over the duration of emergencies?” We assessed existing allocation principles and asked which ones would help us reach those most in need. If adherence to allocation principles would allow us to distribute these limited resources equitably, let’s use them wisely and uniformly across the country. 

Are food banks or policymakers putting the Model Ethics Principles you developed into action?

Yes, I believe I’ve seen evidence of it in media accounts and other specific arenas. I’ve seen them change their practices and do what we advocated for and elucidated with these principles in real time.

I’ve seen some of the improvements that food banks have done – tailored resources, asking about the specific food needs of those most in need, and setting aside specific stock for the persons that couldn’t get to the food pantry on a particular day.

It’s about recognizing who is at most risk – not just serving the first person with a car in a line of 3,000 vehicles. It’s about asking, “Who’s at the greatest risk? How do you reach them?”

What does implementing these principles mean for those most in need?

For those who came into the pandemic vulnerable for food insecurity, it just got worse and worse. Persons with little to no savings lost their jobs, schools closed shutting off their kids’ access to breakfast and lunch programs, and the impact of widespread disease cut off traditional access points for food banks and pantries operating “grocery-style” markets.  

In addition, “first timers,” who had never experienced food insecurity before, sought assistance. These Americans have cars and relatively stable housing, but lacked immediate resources for food due to job loss or other factors. Their chances of being served under a “first come, first served” approach might be enhanced over persons who are homeless, lack stable housing, or experience mental health issues. The resulting deluge of persons with different experiences in food insecurity destabilized existing allocation practices, much the same as influxes of patients at hospitals required shifts to crisis standards of care. Persons experiencing food insecurity pre-pandemic had their existing access to food cut off or detailed; others navigated through allocation approaches with available transportation or other resources.

Whenever there is potential for sustained food shortages coupled with influx of persons seeking food bank and pantry resources, an ethical obligation to equitably distribute what is available arises. As the pandemic marches on, utilization of these ethical principles may help assure more Americans at greatest risks of food insecurity are assisted in real-time.  

If you are a food bank or pantry and would like to read more about the “Model Ethics Principles,” you can find them here. If you would like to volunteer at your local food bank, you can use Feeding America’s online tool to locate one in your area.