Identify food insecurity in hospitalized kids

About one-quarter of children who recently have been hospitalized live in food insecure households, which suggests that hospitalization presents a potential opportunity to identify these youngsters and help their families access nutrition assistance.

Using data from the National Health and Nutrition Examination Survey, 2007 to 2012, for children and adolescents aged through 19 years (a total of 12,627 individuals), investigators analyzed parental responses to a questionnaire designed to measure household food security during the preceding 12 months.

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The questionnaire consisted of 18 queries; households that answered “yes” to 3 or more of the queries were considered food insecure. As part of the survey, respondents also were asked if their child had been a patient in a hospital overnight in the past 12 months and if any member of the household had received Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits or were enrolled in the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps.

Of the 706 recently hospitalized children, 25.3% overall lived in food insecure households, with higher prevalence in recently hospitalized girls, non-Hispanic black children, Hispanic children, those of other or mixed race, and older children aged from 6 to 11 years and from 12 to 19 years. The highest prevalence of all was in recently hospitalized, low-income children and the uninsured-38% and 38.4%, respectively.

In addition, more than one-quarter of potentially eligible families for WIC or SNAP benefits were not enrolled in these programs (Banach LP. Acad Pediatr. 2016;16[5]:438-445).

Commentary: The American Academy of Pediatrics (AAP) Council on Community Pediatrics and Committee on Nutrition recently published a revealing and helpful policy statement on food insecurity in the United States (Pediatrics. 2015;136[5]:e1431-e1438). This document describes in detail the prevalence of food insecurity in the United States and a role for pediatricians in screening for and addressing the problem. Instead of the comprehensive 18-item survey investigators used to measure food insecurity in this study, the AAP policy statement references a nearly-as-good, sensitive, specific screening tool with just 2 statements to which the respondent answers “yes” or “no”:

1. Within the past 12 months, we worried whether our food would run out before we got money to buy more.

2. Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more.

A positive response to either statement indicates household food insecurity. And what do you do if the screen is positive? First, ask if the family has applied for WIC and SNAP and know how to access those programs in your community. Also, investigate this website for information on food pantries and other resources in your area: http://healthyfoodbankhub.feedingamerica.org/. If you begin screening for food insecurity as recommended by the AAP, you may be surprised at how often you find it. -Michael G Burke, MD

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.