In the fall of 2009 Stewart enrolled in Homelessness and Health, a year-long course in the Community Health Program of the School of Arts and Sciences. Co-taught by the Somerville Homeless Coalition, the course was part of Tisch College’s Project PERIS (Partnering for Economic Recovery Impact through Service). Then in its inaugural year, and supported by a grant from the federal Corporation for National and Community Service, Project PERIS came to include 23 courses and 26 summer fellowships, engaging 11 faculty, 264 students, 20 community co-educators, over 60 community youth, and more than 1400 community members.
Stewart was a leader in the course for all of its three years, each one building on the achievements of the past. The class began by surveying area providers, and identifying their needs. Stewart worked on a group project to create an easy-to-use and widely accessible map of emergency food resources and other services for the homeless in Somerville. The team created overlays in six categories, ranging from food pantries to medical services, on a Google map of the city and surrounding communities. It is featured prominently on the homepage of the Somerville Homeless Coalition, and can be viewed directly.
This work led Stewart to an internship with Lisa Brukilacchio at the Somerville Community Health Agenda (SCHA), a part of the Cambridge Health Alliance, looking at determinants of health in Somerville, particularly issues of food insecurity. Acting as liaison between the SCHA and the Tufts Community Health Program, Stewart contributed to the Rapid Assessment, Response, and Evaluation of Food Insecurity in Somerville (RARE-FIS) project, which sought to identify at-risk populations.
That in turn led Brukilacchio to direct Stewart, a Biology and Community Health major, to review research on the effects of stress on weight gain, and what has come to be known as the Food Stamp Cycle.
“The Food Stamp Cycle was picked up in multiple disciplines in the last few years,” explained Stewart. “Not just nutritionists and public and community health researchers, but sociologists and economists were noticing the same patterns as well. Basically the allowances are so modest, it makes it very difficult to budget. People tend to eat calorie-dense foods in the first three weeks of the month, and struggle to eat at all for the last week. The resulting hunger feeds the imbalance the next month, and the cycle of under-nourishment followed by over-nourishment signals the body to preserve energy and gain weight.”
It was unclear to what extent these issues were playing a role locally. Enrollment in the Supplemental Nutrition Assistance Program (SNAP, the federal program formerly known as food stamps) has been rising in Somerville since the mid-2000s, with a dramatic increase since the start of the recession in 2008, when the Community Action Agency of Somerville began hosting a case-worker from the Department of Transitional Assistance. Stewart, the Somerville Homeless Coalition, and Community Health Agenda all wanted to understand the local barriers to food security.
To find out, the partners launched the Food Insecurity Among Somerville SNAP Contingents (FIASSCo) project. Stewart, along with Maegan Lillis, A11, joined as Tisch Active Citizenship Summer (ACS) Fellows. Last summer, over 150 SNAP users from Project SOUP, the Somerville Homeless Coalition, the Somerville Housing Authority, and other local organizations were surveyed about educational, financial, and physical barriers to food security. The results were analyzed during the fall 2011 semester by students in the Homelessness and Health course. Stewart, who graduated in May 2011, served as a TA for the class.
The full report of all the projects findings will be released soon, and Stewart summarized their conclusions. “Education among SNAP users in Somerville is pretty good,” she said. “The main barrier is finance, and there are some groups with significant physical barriers to food access, particularly older residents, and those with disabilities that limit their mobility.”
Not content with delineating the scale of the problem, Stewart and her students designed interventions and raised funds to implement them. One, a walk-in cooler for Project SOUP, which will significantly boost the amount of fresh produce they can provide, is now fully funded, thanks to a large completion donation from students in the Tufts course Experimenting with Philanthropy.
Stewart is eager for new challenges. She is headed to medical school at Stanford University, drawn by their scholarly commitment to community health medicine, and contemplating pursuing a dual master’s in public health through UC Berkeley.
“It’s because of my experiences through Project PERIS that I remain committed to working on the downstream consequences of food insecurity, like obesity and metabolic disease,” she said. “Social inequality creates serious health outcomes, and the better we can understand them, the better we can prevent them.”
Originally published July 2012