Talking to Patients About Food Insecurity

Abstract

Food insecurity is highly prevalent in the United States. Even in the best of times, some 10% of the U.S. population self-reports food insecurity in the U.S. annual census instrument, and some 23.3 million Americans use the community-based emergency food system. Unemployed or underemployed individuals, the elderly, single parents, substance abusers, and uninsured or underinsured individuals with medical illnesses are at increased risk for food insecurity. This article discusses clinical approaches to food-insecure individuals. Measurement tools developed to define and document the extent of hunger and food insecurity in the U.S. population are presented as templates for discussion between doctor or dietitian and patient. Information is provided to help clinicians guide patients with food insecurity to appropriate resources.

Insegurança Alimentar e estado nutricional de crianças de São João do Tigre, no semi-árido do Nordeste

“…É um fenômeno que possui elementos socioeconômicos e culturais: insatisfeita, prolongada ou apenas parcialmente saciada, cria vulnerabilidades e muitas vezes se traduz em importantes patologias 4,5,18 . O grupo populacional mais vulnerável à insegurança alimentar são as crianças, visto que as consequências nutricionais são mais imediatas e graves, e também porque, quando uma criança apresenta problemas no estado nutricional por insuficiência alimentar, pode-se conjecturar que no domicílio os adultos estejam se alimentando de maneira insuficiente há algum tempo 19,20 . Com esta justificativa, o presente estudo tem como objetivo analisar, numa localidade intencionalmente estudada por seu acentuado grau de pobreza, com baixo índice de desenvolvimento humano (IDH), o estado nutricional de menores de 5 anos e sua relação com a situação de (in)segurança alimentar das famílias.…”

Health care providers' attention to food insecurity in households with children

“…Several authors recommend that screening in low-income populations for food insecurity occur at well-child visits (Burkhardt et al, 2012;Fleegler et al, 2007), possibly as part of a larger overall screen for psychosocial problems (Garg et al, 2007(Garg et al, , 2009). Messer and Ross (2002) recommend that initial impressions and questions be used to ascertain risk for FI, followed by use of a validated instrument.…”

“…The American Academy of Pediatrics has identified food security as one of five health-related social domains that should be addressed in a pediatric visit (Fleegler et al, 2007), yet health care providers, from the few studies available, do not generally broach the topic with patients (Fleegler et al, 2007;Garg et al, 2009;Granger and Holben, 2004;Kleinman et al, 2007;Messer and Ross, 2002;Shih et al, 2004). Practitioners who are older and/or have more years in practice tend to report being more knowledgeable about FI and are more likely to ask about food availability (Granger and Holben, 2004;Shih et al, 2004;Tscholl and Holben, 2006).…”

Clinical Management of Food-Insecure Individuals With Diabetes

“…38 This handout is available at no charge and is written at a reading level appropriate for this population. Another excellent resource developed by Messer et al 39 includes additional nutrition counseling strategies.…”