The Association Between Food Insecurity and Census Tract-Based Indexes in an Urban Academic Reproductive Clinic: Can Residence Predict Food Insecurity in Reproductive Patients? [ID 2683613

Abstract

INTRODUCTION: Identifying food-insecure patients remains a priority in reproductive clinics given nutrition’s effect on maternal health. We sought to determine the association between self-reported food insecurity with census tract-based indexes including the Childhood Opportunity Index (COI), Social Vulnerability Index (SVI), and the U.S. Department of Agriculture (USDA) low-income and low-food access areas (LILAs), to identify which indexes can help identify at-risk patients. METHODS: This is a cross-sectional survey study (UMBHP-00099693) of patients presenting for reproductive care at one urban academic center. Food insecurity was scored as greater than 0 on the 6-Item USDA Food Security Module, and living within a LILA was collected from the 2019 USDA database. We categorized social vulnerability as moderate/low/very low vulnerability or high/very high vulnerability using the SVI. We categorized childhood opportunity using the COI as very low/low and moderate/high/very high. RESULTS: Of the 179 participants in the study, 84 (47%) reported food insecurity. The following proportions lived in a: LILA 96 (54%); high/very high vulnerability tract 138 (77%); and low/very low childhood opportunity (CO) tract 144 (86%). Living within a LILA was associated with an increased odds of experiencing food insecurity (odds ratio [OR] 1.8 [1.0, 3.4]). Living within a high/very high vulnerability tract was not significantly associated with food insecurity (OR 1.2 [0.6, 2.4]), nor was living within a low/very low CO tract (OR 1.6 [0.8, 3.5]). CONCLUSION: Residence within a LILA could be associated with food insecurity in patients seeking reproductive care, which can inform the development of future clinical and geographic interventions. As one in two patients were food insecure, we recommend universal screening of all patients at reproductive appointments.