Widely prevalent but rarely discussed clinically, food insecurity (FI) in the United States is a preventable condition in need of attention and creative, multidisciplinary solutions. Defined as a household-level economic and social condition of limited or uncertain access to adequate food, FI affects nearly 20 percent of all households with children nationally and 14 percent (17.4 million) of all US households.
FI can exacerbate chronic health conditions such as diabetes, may precipitate non-compliance with medical therapy, and puts children at risk for developmental, behavioral, and psychosocial problems as well as increased risk of hospitalization. In 2014 health-related costs attributable to FI were estimated at $160 billion US dollars, nearly equal to direct medical costs associated with diabetes care annually.
Despite this, doctors do not commonly screen for FI and have reported that they do not feel confident in their ability to address the social needs of their patients, such as access to healthy food. Fortunately, that may be changing as recent national and state policies have begun to incentivize the health care system to address patient hunger, collaborate across sectors, and find sustainable solutions.
By knitting the medical and hunger-relief community together, these policies have the potential to help end hunger and improve health by smartly leveraging existing resources. Food banks, for example, already bring to bear impressive logistic and distribution capacity to get food to areas of need. The Feeding America network includes over 200 food banks throughout the nation.
Among them is the Greater Boston Food Bank (GBFB), New England’s largest hunger-relief organization which, in 2001, partnered with Boston Medical Center (BMC) to create the first hospital-based food pantry in the nation. Named the Preventive Food Pantry, this collaboration is a “brick and mortar” food pantry housed inside the walls of BMC. Providers at BMC screen their patients for FI; their findings are incorporated into the patient’s EMR and those who screen positive are given a ‘prescription’ which they can take to the food pantry in order to receive food.
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