Importance of Food Insecurity Screening During Outpatient Visits

Abstract

Abstract Objectives This case illustrates the importance of screening for food insecurity during outpatient visits. According to the USDA Economic Research Service, food insecurity affected approximately 38.3 million people in the United States during 2020. Health outcomes studies have shown that food insecurity is associated with increased rates of mental health problems and poor outcomes on health exams in non-senior adults, but only a minority of healthcare professionals regularly screen for food insecurity in their patients. Methods A 53-year-old woman with no significant past medical history presented to a student-run free clinic for evaluation of shoulder. The patient was unemployed, had lost weight unintentionally, and was a vegetarian with meals that consisted of vegetables, beans, and nuts. She mentioned that she fasted multiple times a month, describing it as “detoxing,” but also alluding to financial reasons for her dietary choices. The team proceeded to ask more direct questions about food insecurity, at which point the patient disclosed that she did struggle to afford her meals. The team discussed resources, and the visit concluded with the patient being referred to the clinic's Patient Navigation team and being provided with a comprehensive list of resources for adults experiencing food insecurity of which the patient had been previously unaware. Results Incorporating questions about food insecurity into the social history is an important aspect of integrating social determinants of health into medical education. Without the assessment for food insecurity, her dietary restriction could have been mistaken for an eating disorder. In the case of this patient, her food insecurity was a likely contributing factor to her stress, and without the knowledge of her financial challenges, a referral to mental health resources alone would not have helped alleviate the problem. Conclusions Screening for food insecurity should be incorporated into the social history at baseline. Creating a nonjudgmental and open environment within the visit to allow for sensitive discussions such as food insecurity or financial challenges is crucial for patients to feel comfortable disclosing such issues. In order to adequately respond to patient concerns about food insecurity, it is important for providers to be well-versed in the available resources. Funding Sources None.