James*, a 7-year-old boy, did not have any known medical problems. His vital signs were normal. No fever, his heart rate normal for his age. He had no allergies, and there was no significant family medical history.
As I do with every patient, I started thinking through my differential diagnosis as I walked to his room. Abdominal pain, one of the most common concerns kids present with, has a broad differential. Gastroenteritis, appendicitis, ulcers, trauma, urinary tract infection, cancer—there are dozens upon dozens of things that can cause abdominal pain. In medical school, we learn to ask questions in a methodical way, mentally sorting this long list of possibilities. We move the most likely diagnoses to the top of the list while moving others down or crossing them off the list completely. That list then informs what we do next. The list guides us in knowing which labs to order. Do I need imaging or further diagnostic studies? Do I need to call a subspecialist?
As I asked James and his parents my normal questions, nothing was moving to the top of my list. I learned that this was his third ER visit for abdominal pain. He had been to two different emergency rooms in the last three weeks. He had some labs done and even a CT scan of his abdomen. They left the ER both times without an answer. Through this history, I quickly eliminated many of the common causes of abdominal pain—constipation, food poisoning—as well as the rarer, “scary stuff” we never want to miss. His pain started soon after school let out for the year and had persisted all summer. It seemed to wax and wane throughout the day. I was perplexed.
Then I asked about James’ diet. “What has James been eating lately?”
The energy in the room shifted. James’ mother looked at the floor as she explained that things had been difficult at home. During the school year, James receives free breakfast and lunch at school. In the summer, there is never enough to eat at home. My own stomach dropped.
Suddenly, the answer seemed glaringly, and yet heartbreakingly, obvious.
James’ stomach was hurting because he was hungry.
I see hunger every single day in my practice. We live in one of the wealthiest nations in the world, and yet 13 million kids in America face hunger. When you walk down the street and see five kids, the chances are most likely that you've seen a kid who is experiencing hunger. This is impacting families in all our communities.
Summer EBT, a program that provides families with $40 per month per eligible child for food during the summer, is an incredible opportunity to make a difference for families like James’. Kids experience the highest rates of food insecurity during the summer when many of the meals they receive in school disappear.
There is no downside to supporting Summer EBT. The benefits go beyond alleviating hunger for millions of kids. We know that these kids will also have less of a learning loss during the summer months and will come back to school ready to learn, helping teachers so they can focus on new material instead of playing catch-up with students. Summer EBT can also help taxpayers save millions of dollars on medical costs. Kids who experience hunger have higher rates of hospitalization and are significantly more likely to experience chronic diseases.
Every day as a pediatrician, I see firsthand how desperately Texas needs this program. There are only benefits—for our kids, for our communities, and for the future of Texas and America. We must feed our children, and we have the opportunity to do it. We cannot afford to miss our chance.
*All patient details in this article have been modified to protect the identity and privacy of individual patients.
