Links between food security and health are well-established both for children and adults. Though there is overlap with other social factors like poverty, not all poor people are food insecure, and some people above the poverty line are food insecure. As of 2007, over 36 million people in the US were food insecure, and about a third of those were children.
(Graphic from USDA: http://www.ers.usda.gov/briefing/foodsecurity/stats_graphs.htm#geographic)
A. How does food insecurity affect children?
B. How does food insecurity affect adults?
There are multiple formats for food security screening, whether on paper, computer or in person. And the range of questions/screening forms can sometimes be overwhelming. A few ways to assess for food security are listed below. Don’t let perfect be the enemy of good. A study conducted in Boston showed that families are open to discussing social needs in clinical health settings. Asking about food security with even one question about food security can help a family receive resources that they really need. The question can be as simple as “In the past month, was there any day when you or anyone in your family went hungry because you did not have enough money for food?”  But there are ways to collect more nuanced information about food security.
The table included below was retrieved from the report by John Cook and Karen Jeng, Child Food Insecurity: The Economic Impact on our Nation, and is also available through the USDA.
This is ultimately the point of screening for food security. The answer to this question depends on what your clinical resources are, and actions can range in time and resource intensity according to your clinic’s capacity.
Consider making referrals to:
Also consider an evaluation for how this food insecurity may affect the patient’s physical and mental health or the health of family members.
For more information, check out the Massachusetts-based Project Bread’s report at:
Other resources include those from the footnotes below, and:
Laura Gottlieb, MD MPH is Asst. Professor of Family and Community Medicine at the University of California, San Francisco and co-founder of HealthBegins. She completed fellowship training in the social determinants of health with the RWJ Foundation's Health and Society Scholars Program at UCSF and UC Berkeley.
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 Cook JT et al. Food insecurity is associated with adverse health outcomes among human infants and toddlers. J Nutr, 2004 Jun; 134(6):1432-8.; Casey PH et al. J Nutr. 2004;134:1432-1438)
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 Cook J and Jeng K. Child food insecurity: the economic impact on our nation. A report on research on the impact of food insecurity and hunger on child health, growth and development commissioned by Feeding America and The ConAgra Foods Foundation. Feeding America 2009. http://feedingamerica.org/SiteFiles/child-economy-study.pdf