Abstract
Estimates suggest that over 10% of the UK population are affected by food insecurity. International evidence indicates that food insecurity is a risk factor for many long‐term health conditions, and can adversely affect people's ability to manage existing conditions. Food insecurity is thus not only a serious social concern but also a healthcare issue requiring the attention of UK health professionals. An exploratory qualitative study was undertaken to investigate the experiences and views of health professionals in north east Scotland, with a particular focus on support for people with long‐term conditions whom they believed were affected by food insecurity. Two focus groups and nine semi‐structured interviews were undertaken with a total of 20 health professionals between March and July 2016. Thematic analysis generated three main themes. The health professionals had (a) diverse levels of understanding and experience of food insecurity, but between them identified a range of (b) negative impacts of food insecurity on condition‐management, especially for diet dependent conditions or medication regimes, and for mental health. Even for those health professionals more familiar with food insecurity, there were various (c) practical and ethical uncertainties about identifying and working with food insecure patients (it could be difficult to judge, for example, whether and how to raise the issue with people, to tailor dietary advice to reflect food insecurity, and to engage with other agencies working to address food insecurity). This study indicates that health professionals working with food insecure patients have learning and support needs that warrant further investigation. Debates about health professionals’ responsibilities, and interventions to guide and support health professionals, including tools that might be used to screen for food insecurity, must also reflect the diverse lived needs and values of people who experience food insecurity.
Highlights
Food insecurity is an indication of economic struggle and a serious healthcare issue (Chilton, Knowles, & Bloom, 2017; Gundersen & Ziliak, 2018; Patil, Craven, & Kolasa, 2017; Scottish Government, 2015)
(2) Between them the health professionals identified a range of negative impacts of food insecurity on condition‐man‐ agement, especially for diet dependent conditions or medication regimes, and for mental health
(3) Health professionals can face significant practical and ethical uncertainty about identifying and re‐ sponding to food insecure patients
Summary
Food insecurity is an indication of economic struggle and a serious healthcare issue (Chilton, Knowles, & Bloom, 2017; Gundersen & Ziliak, 2018; Patil, Craven, & Kolasa, 2017; Scottish Government, 2015). Food insecurity arises when a person or household has inadequate or insecure access to food due to financial or other constraints (Seligman, Davis, Schillinger, & Wolf, 2010) It is increasingly recognised as a problem in low‐income households in high‐income countries (Lambie‐Mumford, 2019; Loopstra, Reeves, & Tarasuk, 2019; Reeves, Loopstra, & Stuckler, 2017). Food insecurity is associated with increased risk of serious non‐ communicable health conditions including cancer, diabetes, cardiovascular disease (Gundersen & Ziliak, 2015). It compromises health condition‐management, leading to sub‐optimal health outcomes (Gucciardi, Vahabi, Norris, Del Monte, & Farnum, 2014; Laraia, 2013; Seligman et al, 2010; Vozoris & Tarasuk, 2003). In North America it has been independently associated with increased healthcare use and costs (Berkowitz, Basu, Meigs, & Seligman, 2018; Tarasuk et al, 2015)
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