Hunger, Poverty And Health: Community-Academic Partnerships That Improve Food And Nutrition Security In Rural Appalachia

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Melissa Gutschall, Associate Professor and Director, Didactic Program in Dietetics (Creator)
Alisha Farris PhD, Assistant Professor (Contributor)
Appalachian State University (ASU )
Web Site:

Abstract: Background/Purpose: Malnutrition, present as both overnutrition and undernutrition, is the largest single contributor to disease in the world. This article will describe the relationship between hunger, poverty and health, from the global to local level, with a focus on the relationship between hunger and obesity in the United States. The socio-ecological model will be used to present a community-academic partnership for addressing food insecurity and improving health in rural Appalachia. Partners: Hunger and Health Coalition, Appalachian State University Department of Nutrition and Healthcare Management, and the Appalachian Regional Healthcare System collaborated to address the hunger-obesity paradox in Appalachia. Target population: Individuals in Watauga County, which has the third highest poverty rate in North Carolina. The population of 51, 079 residents is 94.5% White, 1.7% African American, and 3.4% Hispanic or Latino and 59% are recipients of food assistance. Methods: Describe community, organizational and policy-level initiatives implemented by the partnership, including community forums, nutrition education, sustainable food systems, healthcare-based food security screenings and resource referrals. Discuss facilitators and barriers over time, and the interface among academic and local partner responsibilities, resources, and goals. Outcomes: Action steps focus on growing the community-clinical partnership, influencing policy, systems and environmental change, and ultimately fostering a clinical shift toward sustainable health. Improved food security and health status of the target population, nutrition professionals prepared for non- profit work, and a partnership model that can be replicated or scaled nationwide. Conclusions Social, economic, and environmental factors have a profound impact on nutrition-related health outcomes and call for integrated, system-based approaches. Community-academic partnerships offer a unique opportunity to address food insecurity as a social determinant of health.

Additional Information

Gutschall, M., Hege, A., Farris, A., Young, E., Furman, M., & Fox, R. (2021). Hunger, Poverty and Health: Community-Academic Partnerships that Improve Food and Nutrition Security in Rural Appalachia, The Journal of the Blue Cross NC Institute for Health & Human Services: Sustainable Health. Appalachian State University. V. 1, March 23, 2021. NC Docks permission to re-print granted by author(s). Publisher version of record available at:
Language: English
Date: 2021
hunger, poverty, health, Watauga County, North Carolina, Appalachia, healthcare, Hunger and Health Coalition, Appalachian State University

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