Abstract
BackgroundFood insecurity and other social determinants of health are increasingly being measured at routine health care visits. Understanding the needs and behaviors of individuals or families who screen positive for food insecurity may inform the types of resources they need. The goal of this research was to identify modifiable characteristics related to endorsement of two food insecurity screener questions to better understand the resources necessary to improve outcomes.MethodsAnalysis was conducted focusing on cross-sectional survey data collected in 2015–2016 from participants (N = 442) living in urban neighborhoods in Ohio with limited access to grocery stores. Food insecurity was assessed by the endorsement of at least one of two items. These were used to categorize participants into two groups: food insecure(N = 252) or food secure (N = 190). Using logistic regression, we estimated the association between several variables and the food insecure classification.ResultsThose that used their own car when shopping for food had lower odds of reporting food insecurity, as did those with affirmative attitudes related to the convenience of shopping for and ease of eating healthy foods. As shopping frequency increased, the odds of food insecurity increased. Food insecurity also increased with experience of a significant life event within the past 12 months. There was an 81% increase in the odds of reporting food insecurity among participants who received Supplemental Nutrition Assistance Program benefits compared to those not receiving Supplemental Nutrition Assistance Program benefits.ConclusionsAlong with referrals to SNAP, clinicians can further address screening-identified food insecurity through provision of transportation supports and linkages to other social services while collaborating on community initiatives to promote convenient and easy access to healthy foods. The needs and behaviors associated with screens indicating food insecurity also have implications for impacting other SDH, and thus, health outcomes.
Highlights
Food insecurity and other social determinants of health are increasingly being measured at routine health care visits
The present analysis aimed to identify needs and behaviors related to the endorsement of two food insecurity screener questions like those included in the Hunger Vital SignTM
A homemaker A student Employed for Wages Out of work for < 1 year Out of work for > 1 year Refused to work Retired Self-employed Unable to work Number of people living in household (mean (SD)) Experienced significant changes in life in past year (%) Receives Supplemental Nutrition Assistance Program (SNAP) benefits (%) Income Less than $10,000 $10,000–$20,000 $20,001–$30,000 Over $30,000 Health Information Have health insurance (%) Chronic disease (%) Food Shopping and Dietary Behaviors Frequency of food shopping at primary store in days per month (mean (SD)) Shops with own car (%) 2010 Healthy Eating Index score (mean (SD)) Beliefs about Food Shopping and Diet I have enough time to shop for fresh and healthy foods. (%)
Summary
Food insecurity and other social determinants of health are increasingly being measured at routine health care visits. Food insecurity is most often the result of a combination of financial and structural barriers and research demonstrates that it affects the health and well-being of individuals by contributing to higher rates of obesity, fewer heathy foods served at meals, lower quality diets, mental distress, and functional limitations [3,4,5,6]. These consequences differ based on demographic characteristics (i.e., race, ethnicity, and age) contributing to health inequities across populations [7, 8]. Balancing a value for healthy eating with the need to stretch food budgets sometimes results in dietary behaviors (i.e., reducing fruit and vegetable purchases) that have negative implications for health [11, 12]
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