NUTRITION

&
HOMELESSNESS

Created by Celina Chan, Keene State College Dietetic Intern 2014-2015

Table of Contents
Introduction/Purpose
Homelessness Research//NH//U.S
Needs Assessment/Survey
Shelter Information
Future Recommendations
More Resources

Introduction

Welcome to the nutrition and homelessness information packet. Inside, you

will find useful information related to homelessness in the US, NH, and Keene.
There are also resources you may use to further apply nutritional knowledge.
The purpose of this independent study was to work with a community
partner to help with an expressed need in the area of homelessness and nutrition. In
this case, it was in partnership with Tyler McGrath from Southwestern community
services.
Nutrition is important to everyone- so, why should the homeless population
be overlooked? Research shows that those who are homeless are at risk of
nutritional deficiencies. This may be due to lack of access to healthy foods,
nutrition related knowledge deficits, lack of cooking skills, transportation, money,
etc. There are many factors that relate to these causes, but all are impactful when it
comes to the health and wellbeing of this population. During this independent
study project, we were able to get a tour of the men's shelter on Roxbury Street, the
Women's/Family Shelter on Water Street, and meet with the case manager of the
transitional housing units on Elm St.
Following this tour, we also had the opportunity to converse with the tenants
living in the Water Street shelter. The results of that conversation concluded that
there are some tenants who would be interested in learning more about putting
together healthy, low cost meals. There was also some interest reflected in dealing
with children who are picky eaters. Overall, this conversation was a great starting
point for the future. Our hope is that this conversation would be continued by a
future intern to eventually create some sort of nutrition education/cooking program
for the homeless.

Research

Levinson, D., & Ross, M. (2007). Homelessness Handbook. Great Barrington,

MA: Berkshire Pub. Group.
Drake, M. A. (1992). The nutritional status and dietary adequacy of single
homeless women and their children in shelters. Public Health Reports,
107(3). May-June. 312-319.
Martins, D. C., Gorman, K. S., Miller, R. J., Murphy, L., Sor, S., Martins, J. C., &
Vecchiarelli, M. L. (2015). Assessment of Food Intake, Obesity, and Health
Risk among the Homeless in Rhode Island. Public Health Nursing.
doi:10.1111/phn.12180
Davis, L. R., Holleman, W. L., Weller, N. F., & Jadhav, M. (2008). Dietary Intake
of Homeless Women Residing at a Transitional Living Center. Journal of
Health Care for the Poor and Underserved, 19(3), 952-962.
doi:10.1353/hpu.0.0056
Koh, K. A., Hoy, J. S., O' Connell, J. J., & Montgomery, P. (2012). The HungerObesity Paradox: Obesity in the Homeless. Journal of Urban Health:
Bulletin of the New York Academy of Medicine, 89(6), 952-964.
doi:10.1007/s1154-012-9708-4

Common Health Concerns

Obesity
Heart disease
High Cholesterol
Hypertension

Acid Reflux
Anemia/Iron Deficiency
Depression
Alcohol/Substance Addiction or Abuse
Mental Health
Diabetes
HIV/AIDS
Hypothermia

Barriers to achieving optimal health (nutrition-related)

Lack of resources
No access to kitchen
Transportation to grocery stores
Skills/Knowledge
Storage capabilities
Funds
Literacy Level
Lack of consistency in meal times

Nutritional Deficiencies
Minerals: Iron, magnesium, calcium, potassium,
B vitamins: thiamine, riboflavin, niacin, folic acid, etc.
http://www.bhchp.org/BHCHP
%20Manual/pdf_files/Part3_PDF/Nutritional_Issues.pdf
http://www.nhchc.org/wp-content/uploads/2012/01/Nutrition-and-theHomeless-Person.pdf

Links: Homelessness in NH & U.S

New Hampshire Coalition to End Homelessness
http://www.nhceh.org/
New Hampshire Department of Health and Human Services

http://www.dhhs.state.nh.us/dcbcs/bhhs/homelessness.htm
National Alliance to End Homelessness
http://endhomelessness.org/library/entry/the-state-of-homelessness-inamerica-2015
Southwestern Community Services
http://www.scshelps.org/
100 Nights Shelter
http://hundrednightsinc.org/
Community Kitchen
http://www.thecommunitykitchen.org/

Contacts
Tyler McGrath
Emergency Housing Coordinator
tmcgrath@scshelps.org
Tel: 603-209-0251
Kathryn Paquette
Supportive Housing Case Manager
kathypaquette@scshelps.org
Tel: 603-357-8813

Christine Parshall
UNH Extension
christine.parshall@unh.edu
Diane Alpern
Food Bank Western MA
dianea@foodbankwma.org
Phoebe Bray
Director of Community Kitchen
pbray@thecommunitykitchen.onmicrosoft.com

Timeline of Project
Community Breakfast 2/17/15:
-hosted by the Unitarian Universalist Church
-Mon-Fri 7-8am. Show up at 6:30am to help prep
-Tuesdays--> UCC (United Church of Christ)
-Food: Eggs, potatoes, oatmeal, cereal, coffee, hot chocolate, etc.
-Mostly men. Some couples. One or two women. All about their 30-40s.
-Food "made to order".
-about 25 ppl
-Cooperative of different churches who help host the breakfast each morning
-100 nights shelter kicks ppl out at 7am. Re opens at 9am.

Meeting with Tyler & Cindy 2/17:

Men's & Women's Shelter.

Children are mostly elementary school or younger.
Other residents must be 18+.
Case Manager Role: screens residents. Creates case plan to determine length of stay.
What are their barriers, agree with the rules? Ability to get back in to
permanent housing, living status, etc.
o working? Job searching.
o Property Maintenance
o No waitlist. Just call (even if it has to be everyday)
Doesn't close during the day to kick people out
Other sites: Hotels (rare), Monadnock Center of Violence Prevention (domestic violence),
Showers available at Salvation Army on Roxbury St. tues-friday.
Reasons for homelessness in Keene:
o Drugs (heroin-esp in younger pop)
Alcohol (older)
o Jail/Prison (support system?)
Lost Job
o Disabilities
Mental Health
Jobs:
o Men: 1/2 working, 1/4 Searching, 1/2 on SSI. Waiting for SSI is a slow tough
process
o Referrals made, but no actual program. Will post info to residents if found
o Other services: MFS employment services, Folk rehab (disability work thats
doable), WIA (work force impairment. Mike Piasni. More focused on career type
work).

Bedrooms, Washer, Dryer, Showers

Commodity Foods: get delivered every other month. Frozen food etc delivered from
Concord and distributed. Vehicles come and pick it up--> to community kitchen, food
bank, etc... This food is given to members to cook with or eat. (Sharon is director)
Residents can use shelter as a mailing address. Residency letter provided. Can get food
stamps, TANF, library card.
o Shelter Plus Care vouchers, Rapid Rehousing (6mo-1yr) --> RENT vouchers
Sources of food: Can cook in the kitchen using the commodity foods. Full kitchen: stove,
crock pots, refrigerator, toasters, freezer, sink, assigned cabinet space, community
cupboards. Cook individually or cook for each other.
o Community Kitchen serves Dinner @ 5pm
o 100 nights 9-4am. Breakfast and Lunch
o 6pm head back to the shelters

o 100 nights shelter: pantry with canned goods. Resource center. Microwave
provided. Laundry. Donations by the community kitchen & food bank for lunch
(leftovers from yesterday). Mindy Cambia= Director
Food:
o Canned goods (beans, carrots, peas, fruit, etc.)
o Dry beans, rice, pasta, spaghetti, tomato sauce
o Jars, boxes, instant (mashed potatos, mac and cheese, etc)
o Whole chickens
Creation of garden at the 2 shelters. Didn't really work out b/c not enough staff or interest
to tend to. However, one yr there was a lot of interest and they were able to grow
tomatoes, onions, cabbage, & chives.
o Raised beds?
o Great for teenagers, children, AND adults. Sense of accomplishment and success
knowing that they grew and created something. Empowering and able to have
something to do and care about. Place were children and teens can release their
energy as well.

Celina Chan
Independent Study

Sample Survey Questions

How would you describe your eating habits throughout the day?
a)
b)
c)
d)

Regular meals, such as breakfast, lunch, and supper

Grazer - snacks or small meals throughout the day
Eat just once or twice a day
Other

Where does most of the food you eat come from?

a) Community kitchen food pantry
b) Grocery store
c) Convenience store

d) Community kitchen hot meals program

e) Southwesterns own food pantry
What is your preferred way of putting meals together? (Please check all that apply)
Cooking
Assembling (ex. making sandwiches, wraps, etc.)
Microwave
Pre-made (convenience)
Other:____________________________
What are your obstacles to putting meals together?
Cost
Time
Space
Know-how
Not interested
If you were offered information on putting meals together, what information do you want?
Cooking
Assembling
Microwave
Other
Not interested
If you were offered information on putting meals together, what method would you prefer to
have it delivered in? (Please check all that apply).
Online
Handout/brochure
Visual Demonstration/class
Not interested
Other: _________________________
What is the maximum amount of time you want to spend preparing a meal?
30 minutes
15 minutes
An hour
Other

If you were offered more information on how to use your EBT benefits for food, what
information would you like to know?
How would you want to receive that information?
Ex.) Group class, Handout

Water St. House Meeting Notes 7/16

32 Water St. Keene, NH 03431
10 participants- 8 female, 2 male. About 2 families with young children
Others have families but they are not in custody of their kids at the moment
Families tend to cook in the space provided.
o Walk to Hannafords. (Sometimes Aldi's)
o lot's of potatoes, pasta, etc.
o Uses the chicken from the men's shelter
o Corn potato chowders, chicken stews, etc.
o State they try to cook better foods because they have kids
o Not interested in learning how to cook (already know how to)
o Expressed interest in information for what to make for picky kids

 Individual females state they would like to cook, but there isn't a lot of space in
the kitchen. They try and cook in less than 15 minutes- get in get out. Don't want
to use the microwave to cook because of the mushy texture.
o Sick of spaghetti O's.

Sometimes uses the canned food in the pantry- not always because some things
they can only use so much of. Need variety. Lots of sauces, canned green beans,
and potatoes.
Sometimes goes to the community kitchen for meals

Some individuals had no comment. Seems like mostly convenience foods.

Drinking soda (coke & mt. dew), eating pop tarts, cookies, etc. for breakfast.
Some use EBT and WIC

Would be interested in cooking information if provided. -one women expressed

want to learn how to prepare healthier meals.
Mostly overweight or obese individuals-one with lack of dentition. Smokers.
Young - old ages.
Family/couple likes to weed the garden. Excited about what will grow from it.

Shelter Tours 6/16/15

(Water St. Shelter & Roxbury St. Shelter)
Men's Shelter 139 Roxbury St.

Kitchen, oven, 2 fridges, microwave, pots, pans, food processor

~17 ppl
cupboards marking room #'s where people can put their stuff
Fridge: mostly sugar sweetened beverages. Meat, Bread
Some will make "family dinners" and sit together to eat.
Grill outside
Garden (tomatoes, chives, radishes, basil, potatoes, etc.) --> needs to be weeded
Basement: commodity foods donated.

o
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o
o
o
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Canned green beans, refried beans, tomato sauce

Dry beans (not really used)
Canned soup
Potatoes
Frozen chicken
Frozen carrots
cereal
Rice
Pasta (not really used)
Not much cheese or yogurt --> Milk goes fast (in boxes)
Peanut Butter
Canned cranberry
Apple sauce

Women's/Family Shelter Water St.

Oven, stove, crock pot, giant cooking pan, coal grill outside, microwave currently broken
Garden outside: tomatoes, summer squash, beans, cucumbers, etc.
Baby, 2 kids, dad, mom...single women
2 Fridges: some frozen veggies, lots of milk, ice cream, cool whip, bread, packaged foods
Pantry/closet with canned goods from men's shelter basement
Walking to cumberland farms to get quick convenience foods -- pizza, soda, grinders.
Restaurants giving leftovers? --> leftover Ramunto's pizza.

Elm St. Meeting 7/16

29 Elm St. Keene, NH 03431

Contact: Kathryn Paquette -Supportive Housing Case Manager (SCS Housing

Stabilization Services) PO Box 603/63 Community Way Keene, NH 03431
kathypaquette@scshelps.org
tel: 603.357.8813.- cell: 603.313.1531.- Fax: 603.352.3618.
Transitional Housing with 5 apartments
"Next step" for those moving from the shelters --> transitional housing --> permanent
housing (Ashwelit?)
Currently 2 families living there....currently 3 open spaces
Focus is mainly families with children. Pregnant women there right now. Multiple
children. 17 yr old mother.
Common room --> large space with dining table with kitchen counter, sink, stove, oven,
toaster, and microwave.

Food is "bought" by Kathy, but may have access to a SCS card to purchase food if class
was started? No commodity foods are donated there. Gets donations from somewhere
else but it is of toys and house hold items. (mugs & jelly)
Plenty of pots, pans, and cooking utensils available.
Sometimes Kathy cooks large meals for them to share. Would like to see a nutrition class
started because she needs to offer them some sort of trainings, and doesn't like to see the
children walking around with junk food all the time. Parents not eating healthy either.
Idea: Start very simple with basic nutrition information and preparing meals. Talk about
low cost healthy meals to make.
Some tenants go to the community kitchen for meals.
Potential class for all 3 places? (Tyler's, Kathy's, and the permanent shelter?)
Safety: (?)

Tyler McGrath
Emergency Housing Coordinator
tmcgrath@scshelps.org
Tel: 603-209-0251
Kathryn Paquette
Supportive Housing Case Manager
kathypaquette@scshelps.org
Tel: 603-357-8813

Potential Class Topics

Microwave Cooking
Basic Cooking
Cooking without a kitchen
Food Safety
Maximizing EBT (or WIC) -"more bang for your buck"
Healthier eating at Convenience Stores
Making Food Pantry Items Healthier
Healthy Eating on a Budget
*Can tailor according to the winter months & whether or not families have children

Suggestions:

Classes should be offered at consistent times to ensure participation

Incentives: free meal, Tupperware, grocery store gift cards, food to take home, supplies,
etc.
Do not assume that participants will have the basic necessities (for ex. storage space,
cooking knowledge, kitchen tools-can opener, knife, plate). Always ask first.

Excellent sources for more information!!!

Food bank of Western MA
http://www.foodbankwma.org/what-we-do/nutrition/nutrition-tips/
Microwave Cooking
Cooking without a kitchen
Food Pantry Items
Convenience Items
EBT
Using leftovers
Food Safety
-microwave cookbook available (ask Cindy)

Homelessness Nutrition Education Toolkit (Sacramento Hunger Coalition)

http://www.sachousingalliance.org/wp-content/uploads/2013/03/HomelessNutrition-Education-Toolkit-FINAL.pdf
-entire pilot nutrition program for the homeless

Home Cooking without a Kitchen (Project Bread)

http://www.projectbread.org/reusable-components/accordions/home-cookingwithout-a.html?print=t?referrer=https://www.google.com/
-includes microwave cooking recipes and helpful information