Food Insecurity and Health Care Use

Peltz, Alon; Garg, Arvin

doi:10.1542/peds.2019-0347

Cited by 54 publications

(56 citation statements)

References 25 publications

(47 reference statements)

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“…In parallel, given the aforementioned association between multimorbidity and food insecurity, US-based research has suggested that food-insecure individuals tend to make extended use of the health care services, irrespectively of their age [6,12]. Due to the differences in the two healthcare systems, this finding was not verified in the present sample.…”

Section: Discussioncontrasting

confidence: 54%

“…Although a lack of relevant pre-recession data is apparent, proxy measures as food banks and food assistance indicate that the number of food-insecure older adults surged as an epiphenomenon of the financial crisis and the austerity measures taken by the government [4,35]. In the US, the prevalence of adult food insecurity inside the health care setting has been reported to range between 13.2-19.1% [12,13,36]; however, one possible explanation for the observed among-country difference lays to the fact that in Greece, health care provision is provided to all for free, whereas in the US only insured individuals make use of the health care resources. In parallel, even in the US, research in the private health care setting has revealed a much lower prevalence of food insecurity compared with the public sector [37].…”

Section: Discussionmentioning

confidence: 99%

“…Since food insecurity is dependent on household income, any health expenses [6,7] and, subsequently, diseases increasing medication costs and hospitalization needs, act as risk factors for food insecurity. Food-insecure individuals tend to make frequent use of the healthcare system [8][9][10][11][12], with a collateral increase in national healthcare expenditures [13]. In parallel, multimorbidity, a common problem during older age, has been shown to have a reciprocal association with food insecurity in the US, with either situation inflating the other [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

et al. 2020

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Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

et al. 2020

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“…FI is often transient, with children and families moving in and out of FI over time due to changes in family circumstances or seasonal fluctuations in food availability due, for example, to changes in household expenses, and availability of school meals [11][12][13]. However, to date, the majority of studies evaluating programs that screen and address FI in clinical care settings have been cross-sectional [3,14,15]. Few studies have demonstrated FI patterns longitudinally among a cohort of pediatric participants in a clinical setting [16].…”

Section: Introductionmentioning

confidence: 99%

Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study

et al. 2021

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Background Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program. Methods In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0–18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics. Results Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p < 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (− 7.9, 95% CI: − 11.7, − 4.1%; p < 0.0001). Conclusions Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI.

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“…Poverty and associated social determinants of health, such as food insecurity and housing instability, can adversely affect children' s health and development. [1][2][3][4][5] In 2016, the American Academy of Pediatrics (AAP) released a policy statement encouraging community pediatricians to screen for unmet social needs in order to identify families in need and connect them to community resources. 6 However, implementing successful screening and referral programs has been challenging.…”

mentioning

confidence: 99%

Differences in Pediatric Residents’ Social Needs Screening Practices Across Health Care Settings

Vasan

Kenyon

Palakshappa

2020

Hospital Pediatrics

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The American Academy of Pediatrics recommends that all pediatricians screen for social determinants of health to identify families in need and connect them to available resources. We examined pediatric residents' screening practices for social needs in different clinical settings and explored the influence of electronic health record (EHR) prompts on screening. METHODS:In this cross-sectional study, pediatric residents participated in a brief electronic survey assessing (1) screening practices for unmet social needs and (2) perceived barriers to and facilitators of routine screening in the inpatient and outpatient settings. The differences in screening by care setting were assessed by using Fisher's exact test. Mixed-effects logistic regression was used to examine the association between EHR prompts and resident screening practices.RESULTS: Ninety-two pediatric residents (64% of the residency program) responded to the survey. Respondents reported significantly higher rates of social needs screening in the outpatient as compared with the inpatient setting (98% vs 37%; P , .001). Residents cited time constraints, lack of knowledge about available resources, and discomfort with screening questions as barriers to screening in both settings. Residents were more likely to screen for social needs when screening questions were embedded in the EHR (odds ratio 5 9.6; 95% confidence interval: 6.7-13.9). CONCLUSIONS: Pediatric residents were more likely to screen for unmet social needs in the outpatient than in the inpatient setting despite reporting similar barriers to screening in both settings. EHR-based social needs screening templates could be used to increase rates of screening and reach additional families in need.

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Food Insecurity and Health Care Use

Cited by 54 publications

References 25 publications

Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study

Differences in Pediatric Residents’ Social Needs Screening Practices Across Health Care Settings

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