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Q&A with dietitian, Katrina Doljanin and the hardship of accessing nutritional food.

Responding to Food Insecurity

Vinnies VIC: Q&A with dietitian, Katrina Doljanin and the hardship of accessing nutritional food.

<h5>Katrina Doljanin is a <a href="https://www.cohealth.org.au/service/dietitian/" target="_blank" rel="noopener">dietitian </a>at community health service <a href="https://www.cohealth.org.au/location/central-city/" target="_blank" rel="noopener">co-health</a>, which has a number of sites in the city, inner north and western suburbs and offers medical and well-being services at significantly reduced costs for low-income earners.  </h5>
People who are homeless (sleeping rough, in temporary accommodation or rooming houses) or at risk of homelessness do not pay fees. Katrina, who works in its Fitzroy office, helps people in hardship to access a nutritional diet. She regularly refers clients to Vinnies Soup Vans. Here, she responds to <a href="/vic/stories/meet-gerry" target="_blank" title="Meet Gerry" rel="noopener">Gerry’s story</a> and describes how she works with people experiencing food insecurity. 
How Vinnies responds to food insecurity
Our soup van volunteers are familiar with the issues that Katrina raises and provide personalised care for the people we assist. For example, for some time now, we have been keeping a record of the type of cooking facilities that people we deliver a regular grocery hamper too have so that the food they get matches their circumstances. Likewise, we provide rough sleeper packs to people without housing that includes ready-to-eat items such as sandwiches, muesli bars and fruit.  
Katrina mentions that some of her clients do not feel safe going out at night to access our soup vans. Vinnies is aware of this, which is why earlier this year we launched a new program to serve this need – mobile pantries. This is a daytime service that runs on a weekly or monthly basis in locations around Melbourne. As the name suggests, the mobile pantries are small grocery shops on wheels providing free store-cupboard basics along with fresh food, eggs and chicken, or other protein options. Individuals and families come along with a bag and take what they need, saying that it saves them at least $50 a week on groceries that they can use to pay rent or a utility bill. 
Are you seeing many people like Gerry at the moment? 
Gerry's story is unfortunately a very common scenario. We’ve seen a significant increase in the past six months of people struggling with the cost of living. People on low incomes and Centrelink payments are having to choose between paying their gas or electric bill, so they go without heating but also cooking utilities. And so often, it is food they can't afford. That is all affecting their physical and mental health. 
Can you define food insecurity? 
In terms of food insecurity, dietitian look at whether people are able to access affordable food from across the five food groups, with their income. It's not about trying to achieve a perfect diet. So, what we find is that when people struggle financially, they have to start cutting more expensive items from their shopping, such as meat and fruit and vegetables. Like Gerry, the staple that people usually end up with is carbohydrates. Dietitians also talk to clients about whether their access to food is safe, socially or culturally acceptable and meets their unique needs and preferences. And whether people can store or prepare meals; so we talk about skills as well as housing and facilities.  All of these influence people’s food security. 
What’s your approach to helping people? 
Carbs are not bad – they are a lower cost food that is great at filling us up and they are an important source of energy and some vitamins and minerals. Gerry was also having some diary, which was good. Dietitians can help people improve their diet by starting with what people are managing to do, and then work with them to find ways to access the other food groups. 
How is your health affected when you cut out foods? 
When we cut out food groups, we're missing out on the range of vitamins, minerals and nutrients that the body needs, which can result in vitamin and mineral deficiencies. The sluggishness Gerry talks about may be related to what he was not getting from his diet rather than too many carbohydrates. Lack of nutrients also means your immune system will not work as well as it should and you can be more susceptible to illness. 
Can food insecurity lead to low moods? 
Yes, food is really important for our mood and skipping meals can affect brain function. Our brain needs carbohydrates, protein, fats and different vitamins and minerals to work well. We often see that when people are missing meals, they feel flat or low in mood and energy. When people do not have enough money for food, it’s common that people have to choose which meal to skip. They are more likely to skip meals during the day so that they can eat in the evening and go to bed with something in their tummy. But that means that their body will have less energy during the day.  
Does it affect mental health? 
Definitely. People also experience anxiety when they are not sure where their next meal's coming from -- that constant worry can really add to the strain on people’s mental health. I was struck by the relief that Gerry said he felt once he had got the care he needed from Vinnies, and knowing that there was somewhere he could turn to if he needed help again. That would have been a huge lift to his mental health. 
What other challenges do you see people experience around food? 
We know that people who are struggling [to afford food] will often put others first. If someone has children, if they’re caring for an elderly or ill relative, or even if they have pets, they will often prioritise those in their care over themselves. To be able to care for someone, you can’t be stressed about how you’re going to feed yourself obviously, so this is a big area of concern for us and we try to get people connected to food access points as soon as we can. 
What barriers do people face to accessing healthy food? 
Cooking facilities, transport and mobility are issues. We know it’s easier to budget and make food stretch when you can cook in batches or buy in bulk. But sometimes people have no way to cook because their gas has been disconnected or their cooker is broken, and not everyone has a car or can afford petrol to get to cheaper supermarkets, or they have mobility issues and can’t carry groceries. Some people need to shop for small amounts of food at a time or are reliant on ready-to-eat meals, which are more expensive. At co-health, we think about these barriers and work with clients to link them with local services that meet their personal and nutritional requirements. People need a personalised response to their food access issues and I love how Vinnies is doing this!

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