The Social Determinants of Health: Connecting the dots between race, health equity, and the food landscape

The Social Determinants of Health: Connecting the dots between race, health equity, and the food landscape

How racial differences in food access contribute to poorer health outcomes for communities of color

By: Caitlyn McIntosh, Development Manager and Emily Gallion, Grant & Advocacy Manager

You may have seen headlines recently that Black communities are bearing the brunt of the COVID-19 crisis. Nationally, Black individuals account for about double the proportion of the COVID-19 death toll as the portion of the overall population they represent.

Some public health officials have received criticism for suggesting that the correlation is primarily due to higher rates of obesity and other chronic diseases among the Black community. However, the relationship between chronic diseases, race, poverty, and food insecurity is much more complicated, and it has everything to do with the social determinants of health.

While “social determinants of health” may seem to be a relatively new term in the public health space, it was used as early as 2004 by the World Health Organization (WHO), which defines it as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” 

The United States Center for Disease Control (CDC) has also recognized the social determinants of health, defining it as “life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care, whose distribution across populations effectively determines length and quality of life.” 

A growing body of research suggests that these resources can have a profound effect on an individual’s health – even the length of their life – and that the unequal distribution of these resources contributes to inequity in the healthcare system.

We at The Foodbank are not experts in public health. However, we do have a responsibility to stay knowledgeable about the way food insecurity intersects with other aspects of people’s wellbeing. In fact, food insecurity is closely linked to health outcomes later in life.

While the terms “food insecurity” and “hunger” are sometimes used interchangeably, “hunger” refers to the physical feeling associated with a lack of food, but food insecurity, defined as the ability to obtain enough food to live a healthy, active lifestyle, is a much more complex issue. 

As such, not all people experiencing food insecurity are necessarily starving, and many experience higher-than-average rates of obesity. This may be due to the survival strategy of purchasing cheaper, calorie-dense foods to meet basic dietary needs. Over time, this contributes to issues such as obesity, and heart disease.

According to Feeding America’s Hunger in America 2014 study, over one in five Feeding America households report having to choose between purchasing food and paying for medical expenses every month

Food insecurity and poor health outcomes also contribute to a cycle of poverty and poor health, which keeps families trapped in patterns that can last generations. Many Feeding America households report having to choose between buying food and paying for medical care. Coping mechanisms such as underusing medications, avoiding preventative care, and failure to adhere to a medically-necessary diet (such as for treatment for diabetes) can lead to higher medical costs and poorer health in the long-term.

As people return to work, concerns of food security are still highly prevalent. Ohio food insecurity rates have doubled due to the coronavirus, jumping from 13.9% to 23%. We saw that same trend here at The Foodbank with visits to our drive thru pantry. About 2,000 families came to visit us in February and 4,684 came in March. Our numbers continued to rise throughout April, finishing out at over 8,000 families.

According to the Dayton Daily News, one in seven Ohioans are still unemployed. Many families are still focusing on trying to pay rent, mortgages, and other bills, leaving little to no room for a food budget. At our June 6 mass distribution in Greene County, we saw 667 families. What is unique about this distribution is that of those families, 521 were new to the food assistance network. This tells us that although many businesses have been able to reopen, people are still seeing emergencies everyday as a result of the pandemic.

Another often-cited contributor to health outcomes is food access, namely, whether an individual lives in a food desert. An area is defined as a food desert if it is high-poverty with no neighborhood supermarket. (The USDA includes several levels to this definition, which include the percent of individuals with access to transportation, the percent of people living in poverty, and even an area’s rural or urban classification.)

Food access and food insecurity are distinct as food insecurity refers to an individual’s ability to afford food (a function of poverty) whereas food access refers to an individual’s ability to obtain food (a function of environment and geography, which is also a function of poverty). Somebody with low food insecurity may live down the block from a supermarket, but still be unable to afford food, while somebody living in a food desert may be able to afford healthy food, but have no grocery stores nearby.

Living in a food desert is associated with similar health outcomes as food insecurity, including substantially increased risks of obesity and diabetes. Families living in food deserts are often forced to shop at corner markets and convenience stores, which typically offer limited, high-cost, or low-quality selections of fresh produce and protein items.

Food access and food equity go hand-in-hand because areas that are USDA-recognized food deserts are disproportionately communities of color and high-poverty areas. While food access is inherently regional, research from the New York Law School Racial Justice Project has estimated that Black and Latino households are half as likely and one-third as likely to have access to a supermarket, respectively.

A screencap of the USDA’s Food Access Atlas, which shows geographic regions that are low income (LI) and low food access (LA) at varying distances from the supermarket. The Foodbank’s service territory is outlined in black.

In addition to food access issues, food insecurity itself is also racialized. In the United states, 21.2% of Black households, 16.2% of Hispanic households and 10.2% of other/non-hispanic households were food insecure in 2018, compared to 8.1% of white households.

So, what does all of this have to do with COVID-19?

While it may be simple to explain the correlation between race and COVID-19 deaths as due to obesity rates — implicitly blaming victims for overeating — this ignores the reality that many people in high-poverty, predominantly black areas face factors beyond their control that contribute to poor health, such as an inability to afford healthy food or an inability to travel to obtain it.

In fact, a June 10 working paper by MIT researchers found that even after controlling for income level, health insurance coverage, rates of chronic disease such as obesity and diabetes, and public transit usage, counties with higher numbers of Black residents had higher rates of COVID-19 infections.

According to Chris Knittel, the study’s senior author, we have to look beyond these simple explanations to understand why the Black community is facing such a high toll in the COVID-19 crisis.

“The causal mechanism has to be something else,” said Knittel. “If I were a public official, I’d be looking at differences in the quality of insurance, conditions such as chronic stress, and systemic discrimination.”

To see the actions we are taking to promote equitable access to food in our service area, view our impact statement here.

If you’re curious about more of our network data or other social issues such as these, follow us @thefoodbankinc on Facebook, Instagram, Twitter, Youtube, and Linkedin!


COVID-19 Update: Continuing our relief efforts in a still-uncertain economy

 

COVID-19 Update: Continuing our relief efforts in a still-uncertain economy

How we’re coping with long lines and evolving challenges at The Foodbank

By: Caitlyn McIntosh, Development Manager and Emily Gallion, Grant and Advocacy Manager

In our March 20 blog post about COVID-19, posted two days before Governor Mike Dewine’s initial stay-at-home order, we discussed the safety measures we implemented and speculated on the impact of the pandemic on families in our lines. Two months and 3.7 million pounds of food later, it appears we too underestimated the negative impact this virus would have on the food system, our partner agencies, and the families we serve..

If you’ve been following the news, you’ve seen the abrupt and drastic increase in demand we’ve seen here at The Foodbank. Although we knew the COVID-19 crisis would devastate communities in our lines, we could never have prepared for the extent to which it would impact our own operations.

While much has changed since our last blog post, many measures remain in place. We are still not accepting volunteers from the public or food drive donations. While this was an incredibly difficult decision to make, we feel an enormous amount of responsibility because we are at the heart of the charitable food network in three counties. We cannot risk an outbreak at our headquarters.

One thing that has not changed has been the overwhelming demand we are seeing at our distributions. Traffic at our on-site drive thru has reached an all-time high. Last summer, attendance at our Drive Thru set a new record the month after the 2019 Memorial Day tornado outbreak with 3,515 households served. Last month, we served almost double that.

In the month of April, we served a total of 6,912 households — 19,498 individuals — at our on-site Drive Thru food pantry.

The most dramatic increase we have seen, however, is in the number of individuals accessing food assistance for the first time. Through the month of March, the percent of new households at our Drive Thru increased from less than 10 percent to a high of 68 percent.

To ensure that everyone was able to be served, we made the difficult decision to limit the number of times a household could visit the Drive Thru to once per month. We have never had to limit visits to our Drive Thru in this manner before.

At that time, we were seeing demand steadily increasing at the same time as many of our main sources of food procurement, such as food drives and grocery store donations, dwindled or were stopped completely. Fortunately, we were able to lift that limit this month and are now able to serve people as often as they need to feed their families three healthy meals a day.

While Dayton is our home base, we serve Greene and Preble counties as well. To ensure that everyone in our area is able to access food, we have been organizing mass food distributions in those counties so that individuals who are unable to make it to Dayton can still get the food they need.

We have already held mass distributions in Preble County at Henny Penny and in Greene County at the Wright State Nutter Center. At our Preble County distribution, we served 709 households, about 400 more than we usually see at our annual Preble County mass distribution. At our Greene County distribution, we served 1,381 households, the largest food distribution we have held in our 40 years of service.

 

Mobile Pantries

When concerns of COVID-19 first started arising, we made the difficult decision to suspend our mobile pantries until further notice. This was extremely hard for us as the mobiles are critical in providing food directly to communities most in need without access to a local food pantry.

As of June 1, we are excited to announce that we are bringing our mobile pantries back! In order to follow Stay Safe Ohio guidelines, we have set some new rules regarding mobiles.

Clients are asked to wear a mask if they have one and stay six feet apart when visiting our locations in order to stay within social distancing guidelines. Additionally, we are limiting pick ups to two households per person. We always suggest bringing your own cart or additional means of carrying potentially heavy items.

The schedule is being released on a month-by-month basis to ensure proper safety precautions are able to be put in place. You can find the schedule at thefoodbankdayton.org/needfood as well as our social media pages.

 

Partner Agencies

While we have received a lot of attention for our Drive Thru and Mass Distributions, our primary mission remains the acquisition and distribution of food to our partner agencies. We have been offering expanded Drive Thru hours and mass distributions to supplement the services of our partner agencies, many of which have been forced to close due to the COVID-19 crisis.

At present, only 75 of our 110 partner agencies are still open. The others have been forced to close due to a variety of reasons, such as the closure of their parent organization or concerns for their own volunteers. Because so many of our pantries, hot meal sites, and other partners rely on volunteers who are advanced in age, many of them have had to make the difficult decision to close down operations to protect their own.

Despite these closures, our network is still serving an extremely high number of clients. In April, we served a total of 94,651 individuals. With agency closures taken into consideration, our agencies that are open are serving over twice as many individuals as this time last year.

Agencies that remain open are serving an average of 1,262 individuals a month, over twice as many as this time last year.

The uptick in demand coincides with a rise in unemployment as businesses close or pare down operations to prevent the spread of illness and comply with social distancing measures. Over the course of the pandemic, the number of applications for unemployment has reached 10% of the population of Ohio. Local Department of Jobs and Family Services offices have been completely overwhelmed, leading to wait periods in which furloughed and laid off workers are not able to receive benefits.

We’ve known for a long time how many American workers are living precariously close to poverty. According to AARP, over half of US households do not have an emergency savings account. While workers experiencing this delay between their loss of income and unemployment benefits will be eligible for retroactive pay,

 

Up next

The Foodbank recently announced its participation in the USDA Farmers to Families box program. We are excited to participate in this program, which will dramatically increase the amount of food we are able to provide to individuals in our service area.

Farmers to Families is a food box program announced April 19 as part of the Coronavirus Farm Assistance program. Through this program, the USDA will purchase pre packaged boxes of fresh produce, dairy, and meat products for direct distribution to households in our community.

Through the Farmers to Families Food Box program, the USDA will authorize purchases of up to $3 billion in fresh produce, dairy, and meat.

For our part, we will be receiving and distributing 30,000 boxes of food every month through our direct service programs and partner agencies. In total, this will amount to 750,000 pounds of food, or about 625,000 additional meals to people affected by the pandemic.

 

Where in the world is The Foodbank, Inc.?

We have been incredibly lucky during this time to receive national recognition from several news sources.

The Ellen DeGeneres Show: https://www.ellentube.com/video/allison-janney-goes-digging-in-drawer-dash.html?fbclid=IwAR1nl7iVicJJ9azy5eN6QT8fWwFC24u65JHVuL9f8sAIp6SaP7kxm_teeGY

The Washington Post:The next threat: Hunger in America

TIME: “’It’s a Bucket Brigade on a 5-Alarm Fire.’ Food Banks Struggle to Keep Up With Skyrocketing Demand”

ABC News Nightline:Inside 2 massive food banks feeding families affected by COVID-19

Dayton Daily News:Coronavirus: Thousands show up for Greene County food distribution


Food insecurity persists in rural America as economic recovery is slow to appear

Food insecurity persists in rural America as economic recovery is slow to appear

High unemployment, declining populations, and a lack of public transportation contribute to the rural-urban divide.

Written by: Emily Gallion, Grants & Advocacy Manager and Caitlyn McIntosh, Development Manager

In our cities, we see hunger every day. It looks like a huddle of people waiting for a pantry to open, or cracked hands holding a cardboard sign asking for money for food. It can even look like boards on the windows of a neighborhood’s last remaining grocery store.

Of the top 10 percent of US counties with the highest rates of food insecurity, 76 percent are rural. On average, 15 percent of households living in rural areas are food insecure, compared to 11.8 percent of people living in urban counties.

American economic recovery has made headlines recently: the national unemployment rate has dropped to 3.6% and the Dow Jones has reached record highs. However, economic growth has been patchy. While employment rates in metropolitan areas have surpassed pre-2008 levels, rural areas have not yet recovered.

While employment in metropolitan areas is 10 percent higher than it was in 2007, data from the Economic Research Service shows non metro areas still have not reached pre-recession levels.

The Foodbank serves three counties: Montgomery, Greene, and Preble. Montgomery County is considered an urban (or metropolitan) county. Preble County is a designated rural county. Greene County contains a mix of urban clusters and rural areas, and as a result is often categorized as a suburban or small-town county. Because rural-urban designations are made at the county level, overarching data can sometimes obscure the realities of the people who live in communities within them.

Within Preble county, 12% of adults and 18.8% of children are food insecure, according to Feeding America’s Map the Meal Gap. Households with children are more likely to experience food insecurity in general, but the trend is especially pronounced in rural communities.

A common theme when discussing rural hunger is the low population density and associated lack of resources. Rural areas have also seen population decreases as individuals move away- often termed “domestic migration.” While metropolitan areas experienced a population growth of over 6 percent from 2010 to 2018, according to American Community Survey data, the most rural areas saw decreases of almost 2 percent, which contributes to the ability of local businesses to remain open.

As a result of these population trends, in addition to difficulty affording food, people who are living in poverty in non-metropolitan areas often report challenges accessing food as grocery stores struggle to remain open.

Data from the Economic Revenue Service shows trends of employment and population growth in rural and urban areas

According to The Ohio State University’s Center for Farmland Policy Innovation (CFPI), 24 percent of residents of rural Ohio have to drive at least 10 minutes to purchase food from a retailer — including convenience stores and other sellers that rarely provide an adequate selection of fresh food. Stores in this category that do sell fresh food have a reputation for doing so at inflated prices.

Additionally, not every household living within driving distance of a retail grocery store has the means to get to it. Of the households living within driving distance from a store, five percent do not own a car, and public transportation is extremely uncommon in non-metro areas.

For example, our clients living in Lewisburg must make the 11 minute drive to a grocery store in Brookville, or even 15 minutes to one in Eaton. However, if you do not have a car then you are left with options from the local convenience store in town, because there is no public transportation available.

Grocery stores are not the only resources that are sparse in rural counties. Nearly one million children living in Ohio’s rural counties live with no access to a pediatrician. This translates to one in three children who have to travel at least 40 minutes to the nearest provider. According to American Community Survey data, 152,000 Ohio children live in a home without a vehicle.

This is especially concerning given the impact food insecurity can have on children’s health. Children who are food insecure face increased rates of obesity, more frequent colds and stomach aches, behavioral health problems, and even developmental problems. Coupled with increased distances from healthcare providers, food insecurity is potentially dangerous for these children.

Knowing the impact food insecurity can have on the health of both children and adults, The Foodbank has taken steps in recent years to increase the availability of food in the rural areas we serve. While we are located in Dayton, we are constantly trying to expand our reach.

In fiscal year 2017, our pantries served a total of 5,056 clients in Preble county. At the close of our most recent fiscal year, we had increased that number to 11,151.

Another program we are using to meet this need is our Mobile Farmers Markets, which distribute fresh food directly in areas we identify as high need. We host four distributions in Preble County each month. This February, our mobiles served 1,157 people in Preble county alone.

For more information on our mobiles, come back for our next blog post about our Mobile Farmers Markets. Have suggestions for what posts you want to see in the future? Learn something cool today? Let us know in the comments below!


Composting begins at The Foodbank

Composting begins at The Foodbank

The finished product will be used in our urban garden, which provides educational opportunities for our community while relieving hunger in our area.

Written by: Emily Gallion, Grants & Advocacy Manager and Caitlyn McIntosh, Development Manager

Over 20 percent of the material in municipal landfills is food. According to the EPA, food waste is the greatest single contributor to solid waste nationwide. While food waste can easily be repurposed into compost, only a fraction – about 6 percent – is put to use in this manner.

It is troubling to see such excessive food waste and food insecurity exist side-by-side. It is estimated that one third of food produced for human consumption is never eaten, and a significant amount of food is wasted for superficial reasons: for example, retailers often cannot sell fruits and veggies that are misshapen, the wrong size, or otherwise unattractive. Meanwhile, in our own community, 116,720 people are living with food insecurity.

Hunger relief organizations such as The Foodbank are in a unique position to address this issue. By “rescuing” food that would otherwise go to waste, we can reduce solid waste while also providing healthy food to those who need it. Food rescue from retailers accounted for 3.5 million pounds of food distributed by The Foodbank in 2019.

Our spoilage rates are incredibly low. Last year, we only lost about 1 percent of the food we acquired. However, considering that we distributed over 16 million pounds of food last year, even 1 percent can make a significant impact. Meanwhile, we were also buying compost for our urban garden and paying for carts to remove food waste from our property. We knew we could do better.

Compost during the stirring process; photo by Tom Greene of Dayton Times Magazine

Many people associate composting with bins of decomposing food — a smelly process that can take upwards of three months. Thanks to generous support from the Ohio EPA, Kroger, Central State University, and a private donor, The Foodbank was able to purchase an in-vessel continuous flow composting unit from Green Mountain Technologies, a US-based company whose mission is helping organizations like us reduce their environmental footprint.

For an organization such as The Foodbank, there are several opportunities associated with composting. The amount of food waste we produce is highly variable, and sometimes we only have a very small quantity of food to dispose of at one time. Odors were a major concern for us, as our garden is often visited by volunteers and children on field trips, and we absolutely could not run the risk of attracting pests – a major food safety hazard.

The unit, constructed from a recycled shipping container, shelters food waste from pests and harsh weather while creating the optimal conditions for composting. A metal auger stirs the compost, exposing it to oxygen and pushing waste through the unit. The consistent temperature and exposure to air means that the compost is finished after 14-21 days, after which it must “cure” in a separate location for 30-60 days.

This continuous-flow model is unique because it is able to move product through the container automatically. In traditional composting, food waste must be processed in large batches, but this is not feasible for food banks, which experience fluctuations in the volume of food waste produced. This unit allows us to add smaller quantities of food each day without disturbing existing compost.

Metal auger stirring compost; photo by Tom Greene of Dayton Times Magazine

While The Foodbank’s mission centers on hunger relief, food banks are in a unique position to address the issue of food waste. There is also a dual benefit associated with the acquisition of the new composter as well: the compost produced can benefit our on-site urban garden. Last year, the garden produced over three tons of fresh produce. 

In addition to producing food for our clients, the garden provides us an opportunity to educate our community. Last year, over 400 students visited our garden. The children we see are primarily low income students from neighboring areas, which are largely urban with limited green space.

The composter will allow us to offer additional educational opportunities to the community. And while our composter is a commercial-grade system made from a large shipping container, composting can be done at any scale in any environment. 

Most of our neighbors live in apartment buildings or houses with very small yards — not ideal environments for large gardens or large shipping containers of compost. Our urban garden has allowed us to teach the community how to use alternative ways of gardening, and we plan to teach alternative ways of composting as well.

Apple represents location of The Foodbank

In addition to the educational advantages of having a composter on site, there is another advantage: the bottom line. In 2018, we spent $8,000 on trash service to dispose of spoiled food, but we were also purchasing compost from other sources for use in the garden. We anticipate seeing a cost savings of $10,000 just from producing our own compost.

We hope to be able to use the unit as a potential revenue stream within the next few years by accepting food waste from other organizations and turning it into a salable product. 

The Foodbank is constantly looking for innovative practices to help us better the community. We are currently one of the only food banks in the nation with its own in-vessel composter. As our program continues to grow, we hope that our successes and failures can serve as a model for how we all can better manage waste.

Visitors are always welcome and encouraged. Contact our Master Gardener James Hoffer at 937-461-0265 ext. 20 or JHoffer@thefoodbankdayton.org to Turnip the Beet with us!


What is the deal with trade mitigation?

What’s the deal with trade mitigation?

The Foodbank receives agricultural surpluses resulting from the Trump Administration’s $1.4 billion Food Purchase and Distribution Program. Here’s what we do with it.

Written by: Emily Gallion, Grant & Advocacy Manger and Caitlyn McIntosh, Development Manager

Hunger relief programs nationwide are familiar with The Emergency Food Assistance Program (TEFAP), which provides a significant amount of food to charitable programs. However, many people are unfamiliar with the program, how it supports food assistance programs, and what impact current events have on the availability of food. We hope the following post will shed some light on the role of TEFAP in The Foodbank’s operations.

In 2018, the Trump administration and the United States Department of Agriculture launched a trade mitigation plan to help farmers affected by trade tariffs enforced by China. This package falls under TEFAP, a larger federal program that purchases unsold food and redistributes it to food assistance programs. This program was launched in 1981 to compensate farmers for agricultural surpluses that were going unsold.

TEFAP food is allocated based upon the number of people living below the poverty line in each state, then sent to food banks, which in turn distribute the product to agencies such as soup kitchens, shelters, and food pantries. Because TEFAP is a federal program, there are special restrictions on which agencies can receive this food. These restrictions vary by state. In Ohio, agencies must attend a civil rights training and complete food safety training, and over half of the population they serve must live at or below 200 percent of the federal poverty limit.

While the purpose of the program is to provide support to American farmers, it also provides a significant portion of The Foodbank’s food. In fiscal year 2019, TEFAP product accounted for 22 percent of all food we distributed.

When the 2018 trade mitigation program was first implemented, it designated $1.2 billion to purchase apples, pork, potatoes, and dairy products. On May 2019, those funds were increased to $1.4 billion for the current fiscal year. The Foodbank and other food banks nationwide are receiving additional TEFAP product as a result. Though TEFAP food is just one of the ways we receive our product, trade mitigation has had a significant impact on the types and amount of food we distribute. 

Food we receive through this program is often fresh produce, protein product, and other healthy foods, such as beans and rice. Last year, we received especially high quantities of beans, pork, apples, peanut butter, and fresh milk. In fiscal year 2019, The Foodbank, Inc. distributed over 16 million pounds of food, which was 25 percent more than the previous year. (Many factors outside of TEFAP allocations play a hand in this statistic, including activity related to the Memorial Day tornado outbreak.)

Below is a graph depicting the increase in TEFAP food received by The Foodbank, Inc. before and after the mitigation package was launched. This data reflects all TEFAP food designated as “bonus/other” by our inventory system, which includes some product that is not purchased through trade mitigation, but trade mitigation is ultimately responsible for the upward trend. Despite the fact that we are just over halfway through our fiscal year, we have received almost as much food in this category as last year.

 

*FY20 data reflects food received through mid-January

The trade mitigation program provides a bounty of fresh food, especially high-demand products such as fresh meat. However, the influx of perishable food can pose unique challenges, especially when we receive large quantities of a single product, such as the over 61,000 pounds of garbanzo beans we received this fall.

Turning over redundant loads of product can be difficult, so we have to find solutions to encourage our agencies to pick up trade mitigation product or find additional storage. The increase in trade mitigation product is one of the driving reasons we are currently ordering more shelving. We have also had success with more creative methods of distribution with our own direct service programs, especially our on-site Drive Thru.

The Foodbank’s Drive Thru opened Summer 2018 with funding from Dayton Power and Light. The format has several advantages. First and foremost, it enables clients with mobility issues to obtain food without having to leave their vehicles or carry heavy boxes. We also envisioned it as a way for clients who have already received their maximum allotment from other pantries in our network, which often place limits on the number of times a household can visit in a month.

However, because our Drive Thru is built into our warehouse, it has also proven an important mechanism for distributing products we receive in large quantities. The Drive Thru has become an integral part of our hunger relief strategy. Last fiscal year, the Drive Thru had an attendance of 33,463 people. The Drive Thru was especially critical to our response to the recent tornado outbreak: our monthly attendance reached an all time high of 9,085 people served in June, the month following the disaster – over 5,000 greater than the previous month.

The USDA has not announced a trade mitigation plan for the next fiscal year. As an emergency relief organization, we are always preparing for an ever changing environment and will remain alert to adapt to future changes.