Abstract
Food insecurity is associated with many poor health outcomes yet is not routinely addressed in clinical settings. The purpose of this study was to implement a food insecurity screening and referral program in Student-run Free Clinics (SRFC) and to document the prevalence of food insecurity screening in this low-income patient population. All patients seen in three SRFC sites affiliated with one institution in San Diego, California were screened for food insecurity using the 6-item United States Department of Agriculture (USDA) Food Security Survey between January and July 2015 and referred to appropriate resources. The percentage of patients who were food insecure was calculated. The screening rate was 92.5% (430/463 patients), 74.0% (318/430) were food insecure, including 30.7% (132/430) with very low food security. A food insecurity registry and referral tracking system revealed that by January 2016, 201 participants were receiving monthly boxes of food onsite, 66 used an off-site food pantry, and 64 were enrolled in the Supplemental Nutrition Assistance Program (SNAP). It is possible to implement a food insecurity screening and referral program into SRFCs. The prevalence of food insecurity in this population was remarkably high yet remained largely unknown until this program was implemented. Other health care settings, particularly those with underserved patient populations, should consider implementing food insecurity screening and referral programs.
Highlights
Food insecurity is an “economic and social condition of limited or uncertain access to adequate food” (United States Department of Agriculture: Economic Research Service, 2016)
There are various length survey instruments used by the USDA to measure food insecurity, which include a 10-item tool and an expanded 18-item tool utilized for households with children (United States Department of Agriculture Economic Research Service, 2016; Bickel et al, 2000)
The American Academy of Pediatrics (AAP) recently released a policy statement “Promoting Food Security for All Children” (Council on Community Pediatrics, 2015). This statement urges clinicians to screen all children for food insecurity, not just those in underserved communities, as many middle class families are vulnerable to food insecurity with small changes in income (Council on Community Pediatrics, 2015)
Summary
Food insecurity is an “economic and social condition of limited or uncertain access to adequate food” (United States Department of Agriculture: Economic Research Service, 2016). There are various length survey instruments used by the USDA to measure food insecurity, which include a 10-item tool and an expanded 18-item tool utilized for households with children (United States Department of Agriculture Economic Research Service, 2016; Bickel et al, 2000). The American Academy of Pediatrics (AAP) recently released a policy statement “Promoting Food Security for All Children” (Council on Community Pediatrics, 2015). This statement urges clinicians to screen all children for food insecurity, not just those in underserved communities, as many middle class families are vulnerable to food insecurity with small changes in income (Council on Community Pediatrics, 2015). Appropriate referrals to food resources include local food pantries, Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), Women Infants and Children (WIC), and free or reduced-price school lunch programs (Council on Community Pediatrics, 2015)
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