Assessing food insecurity in primary care: A comparison between an internal medicine- and a student-run clinic

OBJECTIVES: Food insecurity has been rising in the United States, disproportionally affecting populations with no insurance, low socioeconomic status, and racial minorities. It is associated with overall poorer health, especially in terms of glycemic control, mental health, and cardiovascular disease. Addressing it is critical because although studies show its significance, most physicians do not screen for different social determinants of health, including food insecurity. 

METHODS: A cross-sectional study of household food security status was performed on 209 patients from June to August 2021 at the University of Florida's Springhill Clinic (run by Internal Medicine) and the Equal Access Clinic, a student-run free clinic. The US Department of Agriculture's Spanish and English versions of the Household Food Security Survey were used. The χ(2) tests were used to determine whether the number of respondents in each food security category varied significantly by sex, age group, primary language, presence of children in the home, insurance status, and clinic site. 

RESULTS: Among the 209 participants, food insecurity was reported by 23.4% of patients. The only statistically significant sociodemographic factors that corresponded to food security status levels were the patient's insurance status and clinic site. A total of 82.6% of insured patients were food secure, whereas only 65.2% of uninsured patients were food secure. A total of 14.5% of Equal Access Clinic patients experience severe food insecurity, whereas 0% of patients at the Springhill Clinic do. The χ(2) tests determined that the number of respondents in each food security category varied significantly by insurance status (P = 0.01). 

CONCLUSIONS: This study highlights the prevalence of food insecurity at primary care clinics, especially student-run clinics. Although limited by sample size and cultural barriers of the given survey, the findings emphasize the gap in standardized screening protocols for food security and the importance of physician sensitivity. Addressing this topic can improve food security and the health benefits that follow through early intervention.