RALEIGH, N.C. - As North Carolina farmers work to put food on the tables of the state's residents, many are doing so without health insurance or preventive care.

According to the Agromedicine Institute, at least 30 percent of farmers and more than 90 percent of farmworkers do not have health coverage. Francesca Hyatt, Come to the Table director for Rural Advancement Foundation International, said the data points to a cultural practice among farmers.

"They just tend to really be outside of the system," she said, "and so it's been a problem for a long time that farmers have had insufficient access to health care, and farmers will be focusing on everything but their own well-being."

The Affordable Care Act could provide health coverage for some farmers, but because North Carolina did not authorize a Medicaid expansion, Hyatt said many could fall into a coverage gap based on their income and not qualify for help.

Along with a lack of access to medical care, workers in the agricultural industry in North Carolina have a 7 1/2-times greater chance of dying on the job than people in other professions. That figure also is from the Agromedicine Institute, where director Robin Tutor-Marcom noted that it's hard for farmers to make time for medical care, with many of them working during office hours.

"Traditional hours for obtaining medical care are not conducive necessarily to farmers getting care," she said.

Because the system created under the Affordable Care Act involves reporting information to the government, Hyatt said, some farmers may be hesitant to take part.

"Farmers, they tend to be suspicious of enrolling in something through the government," Hyatt said. "So, there's partly, I think, just sort of a cultural barrier, that there's a lot of mistrust about what this is."

Hyatt said it's important to note that the government considers income and not assets for deciding whether a person qualifies for federal assistance in getting health insurance.

The Agromedicine Institute serves all 100 counties in the state and is providing help to farmers as well as people in the fishing and timber industries who want information about the ACA.


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By Mary Hennigan for The Arkansas Advocate.
Broadcast version by Freda Ross for Arkansas News Service reporting for The Arkansas Advocate-Winthrop Rockefeller Foundation-Public News Service Collaboration.

More than 567,000 Arkansans — 18.6% of the state’s total population — know what it’s like to experience food insecurity and struggle to find access to healthy food.

Arkansas’ food insecurity rate in 2022 was the second highest in the nation, with only Mississippi in front by 0.2%. This top two pairing is not new, however, as Arkansas has trailed Mississippi for the last decade, according to Feeding America data released in May.

Feeding America was established as a national nonprofit in the 1960s and is part of a network that organizes with food banks and other meal assistance programs, including the Arkansas Food Bank. The nonprofit has mapped food insecurity data down to the county level for more than a decade; the most recent information reports findings from 2022.

The food insecurity rate in Arkansas has been steadily increasing since 2020, and the 2022 rate was the highest it’s reached in five years, according to Feeding America. Arkansas also ranked second nationwide for the highest food insecurity rate among children, with nearly one in four children lacking access to healthy options.

“It’s heartbreaking,” said Brian Burton, CEO of the Arkansas Food Bank. “I can’t say I’m surprised because there’s been sort of a vortex of pressures and economic events … just the inflation that has put lower income families in a real bind in our country. They can’t catch a break.”

Burton said he thinks the increased food insecurity rate could be related to the rising cost of groceries and the loss of additional assistance since the COVID-19 public health emergency ended.

“I think we are a state that has under participated in public assistance programs,” Burton said. “We’re one of the lowest participants in the Supplemental Nutrition Assistance Program (SNAP), and that is self-inflicted harm.”

Last year the Arkansas Legislature approved a bill that raised the asset limit for SNAP, commonly referred to as food stamps, from $2,250 for most families to $6,000. This change expanded the qualifications for people in need, but not to its originally intended level.

The bill initially sought to raise the limit to $12,000, but sponsor Sen. Jonathan Dismang, R-Searcy, lowered it to have a stronger chance of approval. At the time, Dismang said he thought $6,000 was too low and discouraged poor Arkansans from saving enough money to become financially stable.

Having any SNAP asset limit is a barrier for folks, Burton said. He said he would rather see the limit be removed entirely so it wouldn’t be a “hindrance to someone who’s trying to move out of poverty.”

The existing limit is one feature that could stop someone who falls in Arkansas’ ALICE (Asset Limited, Income Constrained, Employed) population from qualifying for assistance. The ALICE population includes people with income levels too high for programs like SNAP, but they still struggle to pay for their basic needs.

The Feeding America report isn’t limited to people who fall below the federal poverty level; it includes others who have difficulties accessing healthy food. Burton said the study is self reporting, which means more Arkansans than the reported 587,000 could be food insecure.

County snapshot

Every county in Arkansas reported a food insecurity rate higher than the national average of 13.5%, which Burton agreed shows that the issue is not dependent on rural or urban settings.

Searcy County, located in north central Arkansas, reported the highest overall rate at 24.5%. 

Giezele Treat, director of the Searcy County Senior Center, was unsurprised to hear the county ranked first. 

“It’s just sad,” Treat said. “We’re a poor county.”

Located in Marshall, any resident older than 60 can visit the senior center to receive a meal, Treat said. A staff dietician ensures the meals are well balanced and nutritional. Menu picks can include hamburgers and beef stroganoff with accompanying vegetables and bread, Treat said.

Staff also dispatches meals to about 70 households in Searcy County through Meals on Wheels, Treat said. Both hot and frozen meals are available to people who meet homebound criteria, meaning they physically can’t get food for themselves.

Burton, who has worked closely with people experiencing food insecurity for nearly three decades, said the toll it takes on one’s body is visible.

“It ages a person — the strain, anxiety and stress that are created by that constant worry,” he said. “The result of years of poor diets and nutrition when someone does not have sufficient resources to buy healthier, more expensive food … you see that shorten their life expectancy.” 

Phillips County, located along the state’s eastern border, reported the highest rate of food insecurity among children with 45.8%, according to Feeding America.

Burton said children experiencing malnourishment are largely affected in the classroom.

“They are not as alert, their bodies are not developing to their potential, and it’s particularly harmful, I think, in the youngest years of physical development,” he said.

Feeding America also reported the food insecurity rate among Arkansas’ Black, Hispanic and white populations. The rates came in at 30%, 22% and 16%, respectively.

“One out of three of our African-American neighbors struggle with food insecurity,” Burton said. “That would be called an epidemic. It’s not just something that happened in the last year; I think this is a result of years and decades of people who have been marginalized, obstacles they’ve had to transcend and limited access to opportunity.”

Statewide efforts

Food insecurity doesn’t have a simple solution. Arkansas has a myriad of organizations and programs scattered across the state that help residents access food, including the Arkansas Food Bank and its participating pantries.

“It’s a complex problem, but we can all be a part of the solution,” Burton said. “We can all donate to our local food banks and our favorite charities that are doing heroic, life-changing work on the front lines.

Last September the Arkansas Rice Federation donated 240,000 pounds of rice to the Arkansas Food Bank. In November, Arkansas State University joined the fight against hunger and announced it partnered with Arkansas Hunters Feeding the Hungry to provide beef jerky snacks to school children.

The Arkansas Hunger Relief Alliance, a prominent food assistance nonprofit, addresses hunger by promoting nutrition education, securing funding, increasing out-of-school meal participation, advocating for food policy and more.

In January, Gov. Sarah Huckabee Sanders announced the state would participate in a federal food assistance program called the Summer Electronic Benefit Transfer. The program provides students’ families with money for meals while school is not in session. It starts in June.

“That’s a bright spot on the horizon,” Burton said. “That’s work that our own [U.S.] Sen. John Boozman helped bring about. … It’s a brand new program that could bring tens of millions of dollars into the state if everybody would participate in it.”


Mary Hennigan wrote this article for The Arkansas Advocate.


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Congress is back in session two more weeks before the August recess. Wisconsin voices worried about the future of a key hunger relief program hope lawmakers protect its funding with a deadline looming.

The Supplemental Nutrition Assistance Program - or SNAP - falls under the Farm Bill, which needs to be reauthorized by the end of September.

House Republicans have blocked efforts to maintain White House authority to make non-inflation adjustments to SNAP benefits - a move President Joe Biden made in 2021 when he carried out a record increase.

Meghan Roh, program director of the group Opportunity Wisconsin, said not having that option would put recipients at a disadvantage.

"SNAP benefits help over 700,000 Wisconsinites afford food, which is one in eight people in our state," said Roh. "And so, gutting this assistance would mean that these families have to make difficult choices."

The Congressional Budget Office says removing the provision would limit the scope of future SNAP increases by $30 billion. Advocates say that amounts to a large cut.

Wisconsin U.S. Rep. Derrick Van Orden, R-Prairie du Chien, was called out for a recent committee vote to keep the option shelved.

In a social media post, he accused Democrats of lying when saying the panel was cutting benefits.

Other Republicans say their approach protects SNAP in the event a future GOP president would want to unilaterally reduce benefits.

But Suzanne Becker, executive director of the Feed My People Food Bank in Eau Claire, said politics shouldn't come into play. She argued that elevating SNAP levels as much as possible is a wise move.

"We can never replace the impact that SNAP has on our neighbors," said Becker. "Nonprofits can't do that. We make a difference every day. We strive to, but this is a critical piece in making sure that all Americans have what they need."

Becker said the debate comes as her location sees a lot of demand among working families. Her team works with income-eligible clients to sign up for SNAP benefits, noting that it's a lifeline for older populations.

Some North Dakota leaders believe healthy food is part of what is needed to help all kids achieve better outcomes and they hope low-income families sign up for new summer food assistance to keep their children on track.

State officials say eligible households have until Aug. 30 to apply for help buying groceries for kids while they are on break. North Dakota is one of many states to accept federal funding through the Summer Electronic Benefits Transfer program. Families receive a card with $120 on it for each eligible child, to spend on food.

Jared Slinde, communications manager for the Great Plains Food Bank, said there has always been concern about the "summer slide," and some kids also saw their learning suffer during the pandemic.

"Kids fell off track during COVID," Slinde observed. "Maybe they didn't have the best resources, which was certainly understandable. (The) Summer EBT program can help alleviate certain struggles that kids might have."

He explained staying nourished over the summer can help put them in a better position to learn once school starts and hopefully see their test scores rebound. Kids already receiving free or reduced-priced meals during the school year were automatically enrolled in Summer EBT but officials said more children may still qualify, and their parents are encouraged to sign up.

Slinde noted there are other programs, including ones offered by Great Plains Food Bank, helping families get food over the summer. He acknowledged things like transportation barriers might prevent some from getting to the sites distributing meals. The Summer EBT option could allow them to buy groceries from a neighborhood store.

"Our mission here is to end hunger together," Slinde stressed. "Any time we can have a number of different moving parts providing food assistance, we're going to be all for this."

He added they continue to see heightened demand overall for food assistance across North Dakota. So far, 32,000 North Dakota kids have been enrolled in the summer program.


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