Feed1st – A Model for Alleviating Hunger With Dignity

By Jie Zhao, Ph.D., B.M., Claire Fendrick, M.P.H., Stacy Tessler Lindau, M.D., M.A.P.P.
The University of Chicago
Posted March 29, 2024

Feed1st, an open-access food pantry available to patients and their families at the University of Chicago Medicine began in a chapel closet. It was an idea sparked in 2010 by the hospital's chaplain, Reverend Karen Hutt. Initially, the food made available to the community via Feed1st was sourced from the Greater Chicago Food Depository, and the pantry was managed by faculty, staff, and community volunteers.

No Barriers to Food

Personal care items being stocked in a Feed1st open-access pantry.

Food insecurity is among the most prevalent health-related social risk factors affecting the population served at UChicago Medicine. An early needs assessment found that 32% of families experienced food insecurity during their child's hospitalization. Today, Feed1st operates 11 clinically integrated sites across the adult, pediatric, inpatient, and outpatient areas of academic health system’s South Side medical campus, including nearly every floor of the children's hospital, as well as oncology, obstetrics/gynecology, primary care, trauma clinics, adult and pediatric emergency rooms, and a hospital retail cafeteria. The Feed1st pantry sites are fully self-serve and open 24/7/365. No eligibility criteria, registration, documentation, or prescription are needed to obtain food.

Signage that reads: "Food for Everyone" is prominent at each location and encourages people to take the food they need for themselves or others. This approach minimizes stigma and maximizes the dignity of people experiencing hunger. It also creates awareness of food insecurity in our community and inspires people to contribute.

Meeting Needs at Critical Times and Places

Early during the COVID-19 pandemic, the Feed1st team added five strategically located pantry sites to meet the fast-growing need for food support. One pantry was located in the main lobby of UChicago Medicine Comer Children’s Hospital where we were conducting the NIMHD-supported CommunityRx for Hunger study (read the study article on PubMed). This pantry quickly became one of the largest distribution sites for Feed1st.

Given long clinical shifts and the need for some staff to live in temporary housing to mitigate the risk of COVID-19 spread, the staff breakroom became another pantry site. Feed1st’s total food distribution during the pandemic was more than double that of the pre-pandemic period. By contrast, another hospital using a traditional eligibility-based approach reported a decline in food distribution during the same period.

Since 2010, Feed1st has distributed more than 173,000 pounds of non-perishable food, reaching an estimated 82,000 individuals. Beginning in 2016, employees across medical center departments created the UChicago Medicine Garden Committee. This group uses space on garage rooftops and other medical center grounds to grow fresh produce. Since 2020, we have collaborated with the Garden Committee to distribute more than 6,000 pounds of fresh produce.

UChicago Medicine's Garden Committee members harvesting fresh produce to distribute to patients via Feed1st pantries.

Today, the daily Feed1st operations, including keeping pantry sites stocked, are managed largely by a volunteer workforce, drawing on the Feed1st Medical Student Organization at the Pritzker School of Medicine and the Premedical Student Organization, both at the University of Chicago. The hospital volunteer program also deploys its workforce to support Feed1st and helps credential student volunteers.

Collaborations That Ensure Warm Hand-offs

Dr. Stacy Lindau, the principal investigator of the CommunityRx for Hunger study, leads bimonthly Feed1st social care teaching rounds. The teaching rounds are an interprofessional learning program that includes students, staff, partners, and guests seeking to support or replicate the program. As part of the teaching rounds, volunteers are in direct contact with faculty leaders and program management staff, and together, they visit and inspect all pantry sites. Teaching themes typically include:

1. Social drivers of health and illness, especially food insecurity.
2. Understanding stigma and maximizing dignity in healthcare.
3. Quality assurance and improvement.
4. Community engagement.

Dr. Stacy Lindau (bottom left) leading Feed1st's interprofessional teaching rounds with UChicago Medicine's students, staff and guests.

At each pantry site, faculty members observe students as they introduce themselves to unit staff, provide brief education about Feed1st, and ask for ideas about how the program can better meet local needs. Students receive real-time feedback about their communication skills and ideate strategies for ongoing engagement and communication with local champions and partners.

A Feed1st pantry in the Sky Cafe (hospital retail cafeteria).

In October 2023, informed by findings from the ongoing CommunityRx for Hunger trial, Feed1st partnered with Aramark, the medical center's food service vendor, to launch a Round-Up program at three retail food sites. This program invites customers to "round up" their purchase to donate to Feed1st (e.g., a $5.95 purchase could be rounded to $6 to make a 5-cent contribution). To our knowledge, this is the first hospital-based food pantry to test a scalable and replicable philanthropic model for financial sustainability. We are currently studying the impact of this innovation.

The Feed1st program is both the focus of ongoing research and innovation, and it is critical to the success of our larger program of social care intervention research. Our team is currently conducting three NIH-funded social care trials. Feed1st enables an emergency source of food support to be available to study participants who identify as food insecure in the course of our research.

Feed1st Toolkit

Our free, downloadable Feed1st Toolkit can be used to help replicate and implement the Feed1st model. We regularly consult with hospitals and other healthcare organizations across the country who are inspired to open integrated food pantries utilizing an open-access approach. To our knowledge, at least three other hospitals have replicated some or all of the Feed1st model, including Johns Hopkins Children's Hospital (Baltimore, MD), Swedish Hospital (Chicago, IL), and Roseland Community Hospital (Chicago, IL).

Jie Zhao, Ph.D., B.M., is associate director of operations and the Feed1st manager.

Claire Fendrick, M.P.H., is Feed1st’s operations lead.

Stacy Tessler Lindau, M.D., M.A.P.P., is the Catherine Lindsay Dobson Professor of Ob/Gyn and Professor of Medicine-Geriatrics and Palliative Medicine at the Comprehensive Cancer Center at the University of Chicago.

They work together at the Lindau Lab.