The health and economic effects of the Covid-19 pandemic are causing increased demand for supplemental food on Martha’s Vineyard, according to a report from the University of Massachusetts Medical School’s Rural Health Scholars program.
“Covid has had a huge impact on access to food on the Vineyard, especially given the seasonal nature of work on the Island,” said Gabby Pacquette of Berkley, one of six medical students who gathered on Zoom Thursday to present the results from their two-week study of food needs among specific groups of Islanders.
The UMass medical school teams up yearly with the Martha’s Vineyard Hospital and other Island agencies, bringing future nurses and doctors here to research topics affecting Vineyarders’ health and well-being.
This year’s mission was to learn how food insecurity is experienced by three different Island populations: the Brazilian community, the aging and elderly and those with chronic or acute illnesses.
With Island Grown Initiative as a leading partner, the rural health scholars contacted dozens of local agencies and conducted scores of confidential interviews, largely by Zoom, to arrive at the conclusions and recommendations they shared Thursday.
Brazilians Are Segregated
Ms. Pacquette and teammate Charles Feinberg of Brookline researched the Brazilian community, interviewing students, adults, school nurses and teachers, Elio Silva of Vineyard Grocer and numerous members of the Island’s social services network.
Portuguese-speaking Brazilians from the states of Minas Gerais and Espiritu Santu account for up to a third of the Vineyard’s year-round population, said the scholars, who used anecdotal evidence and school data to estimate 5,000 to 6,000 Brazilian residents on the Island, about half of them undocumented.
This sizable community is under-reported, under-represented and essentially segregated from the English-speaking Island, the scholars said.
“We have documented a long history of under-reporting of the Brazilian population,” Mr. Feinberg said.
While Brazilian families make up the majority of Island food bank clients, the health scholars said, a lack of English language skills — and in some cases, illiteracy in their native tongue as well — means that many miss out on other ways to add healthy foods to their diets.
Lacking the legal right to drive, and with limited public transportation, undocumented Brazilians can’t always reach available food, while their incomes generally don’t allow them to shop at stores like Cronig’s, the scholars said.
Additionally, the demanding physical work performed by many Brazilian immigrants leaves less energy and time for home-cooked meals, leading to more reliance on processed and takeout foods to feed their families.
“There’s a lack of food literacy as well, due to language barriers and coming from more rural areas [where] they might not have as much processed or packaged food,” Ms. Pacquette said.
Cultural norms in Brazil encourage parents to fatten their children on national staples like rice, beans and meat, while salad is not a customary dish, the scholars said.
“In Brazil, thin children are considered unhealthy,” Ms. Pacquette said.
While children in Martha’s Vineyard schools are eating and learning about healthy foods, their parents lack similar resources. Ms. Pacquette and Mr. Feinberg suggested incorporating food education, such as teaching how to interpret the nutritional information panels on packaged groceries, into English language lessons through the Martha’s Vineyard Adult Learning Program.
Other short-term recommendations included expanding the Island Grown mobile market and meals-to-go programs to the Brazilian community and celebrating Brazilian culture through food with all-Island events and media coverage.
Among their longer-term suggestions, the health scholars strongly recommended integrating Brazilian Islanders into community organizations and local government positions.
Developing internships for high school students at community service organizations such as Island Grown and the food pantry would be a good step in that direction, they said.
Seniors Are Isolated
In studying the Island’s elderly population, rural health scholars Marianna Paradise of North Andover and Mike Urbanowski of Paxton found that seniors, too, suffer from isolation, scarcity and lack of transportation.
“A term that we heard a lot of times is that ‘there are a lot of people at the end of long dirt roads,’” Ms. Paradise said.
Many elders they spoke to also felt a sense of shame at accepting supplemental food — “the stigma of receiving,” as Mr. Urbanowski put it.
For those who do receive supplemental food, there still are challenges.
“A lot of the elders don’t have the ability to cook for themselves,” Ms. Paradise said. Others who may never have cooked now find themselves caring for spouses who can no longer do so.
“Many interviewees noted the situation of elders taking care of other elders was a frequent occurrence,” Mr. Urbanowski said.
Providing more prepared foods, creating medically tailored meals and beefing up the Island’s volunteer delivery network to reach more seniors at home were among the scholars’ recommendations for improving elders’ access to food.
The team also saw a need for more psychology professionals to address mental health needs and substance abuse, particularly alcoholism, among homebound seniors.
Health scholars Elizabeth Brown, of Hamilton, and Nick Bergeron, of Durham, N.H., said Covid-19 has changed the mix of Islanders living with chronic and acute illnesses.
“There are 167 patients receiving cancer care at Martha’s Vineyard Hospital,” Mr. Bergeron said. “That’s a pretty significant increase.”
The number of dialysis patients at the hospital is also up, he said, as patients shun urban health centers for treatment on the Vineyard.
The health scholars found a diversity of challenges that face ailing Islanders. “The chronically ill and the acutely ill are not a monolith,” Mr. Bergeron said.
As with other groups, isolation and lack of transportation are significant barriers to food access for Islanders with illnesses.
“We heard a lot about the patients down that long dirt road,” Mr. Bergeron said.
“Even if someone can get to the grocery store by bus, they might not be able to carry groceries home,” Ms. Brown added.
With close to 100 Island families inadequately housed or at risk of homelessness, the scholars said, cooking facilities may be limited.
And, as with the seniors, some patients simply balk at accepting aid.
“There’s a mentality of ‘others need it more,’” Ms. Brown said.
But there is plenty for everyone, the team said.
Help Networks Are Uncoordinated
“The resources are there, the communication between them isn’t,” Mr. Bergeron said. “We heard that there is enough food on the Island . . . That was a really common theme.”
The scholars recommended strengthening volunteer networks and adding community health officers to assist Islanders negotiating long-term illnesses.
“When someone is diagnosed with a chronic condition, they need a lot of nutrition education,” Ms. Brown said. “There’s a lack of that [on the Vineyard].”
To assist vulnerable Islanders, the rural health scholars recommended unifying services across all six towns.
“Cross-linking these different organizations we have together, and forming together to make one centralized source, would be super, super beneficial,” Mr. Bergeron said.
While their research was extensive, the scholars cautioned that it’s likely far from complete.
“Pride is a massive part of being an Islander, so having a patient be honest with you is still a challenge when discussing subjects such as food insecurity,” Mr. Feinberg said.
Martha’s Vineyard Hospital chief of staff Dr. Daniel Pesch, who introduced Thursday’s presentation, said the rural health scholars’ full presentation will be posted on the Dukes County Health Council web page, https://www.dukescounty.org/health-council, and cablecast on MVTV.