Physicians are being encouraged to do more to help promote food security, according to a new policy statement issued by the American Academy of Pediatrics.
The organization’s Council on Community Pediatrics’ Committee on Nutrition is recommending screening patients for food insecurity during scheduled health maintenance visits or sooner; becoming familiar with community resources, such as the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), SNAP, school nutrition programs, local food pantries, summer and child care feeding programs, and other programs to refer those who may have food insecurity issues; and be aware of the factors that may increase food insecurity.
©stevanovicigor/thinkstockphotos.com
AAP’s policy was published Oct. 23 in Pediatrics (2015 Oct. 23 [doi: 10.1542/peds.2015-3301]).
Erin R. Hager, Ph.D., et al. designed a practical in-office two-item screening tool. Answering “yes” to either of the questions identified food insecurity with a sensitivity of 97% and a specificity of 83% (Pediatrics. 2010 Jul;126[1]:e26-e32). The two screening items are as follows:
1. Within the past 12 months, we worried whether our food would run out before we got money to buy more. (Yes or No)
2. Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more. (Yes or No)
The statement notes that in 2013, “17.5 million U.S. households, or 14.3% of all households and 21% of all children, met the U.S. Department of Agriculture definition of a food-insecure household, one in which access to adequate food is limited by a lack of money or other resources.” And while poverty is a key factor leading to food insecurity, it adds that food insecurity “is associated with many factors. ... Unemployment and underemployment are also strongly associated with food insecurity.” Families at risk include immigrants, those that are large, those headed by single women, those with less education, and those experiencing parental separation or divorce.
Children with food insecurity also “have poorer overall health and more hospitalizations than do children who live in food-secure households.” Additionally, food insecurity could be an indirect cause for obesity and is linked with lower cognitive indicators, dysregulated behavior, and emotional distress.
In the office, be aware of factors that may increase vulnerability of food-insecure populations to obesity, such as “lack of access to healthy and affordable foods, cost of healthy food (and the low cost of many unhealthy foods), media messaging that promotes nonnutritious foods and beverages, and the role of stress in decision-making related to food,” according to the statement.
On a national advocacy level, AAP also is calling for food insecurity, including screening tools and community resource guidelines, to be incorporated into medical school education; and for support for interdisciplinary research to better understand the relationship between stress, food insecurity, and adverse health consequences.