Screening pediatric patients for food insecurity: A retrospective cross-sectional study of comorbidities and demographic characteristics

Background: Food insecurity is a household-level economic and social condition of limited or uncertain access to adequate and nutritional food that is associated with diabetes, obesity, anxiety, depression, and behavioral disorders. The presence of these comorbidities motivated the UW Health Pediatrics Department to start screening for food insecurity.

Methods: Our study describes demographic characteristics of screened patients, comparing risk factors and health status between food insecure patients and food secure patients. We extracted variables on all screened patients: sex, age, race, ethnicity, insurance type, height, weight (to calculate body mass index [BMI] and BMI percentile), and any diagnosis of diabetes, hypertension, sleeping problems, restless leg syndrome, anemia, elevated blood lead levels, depression, anxiety, or attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD).

Results: Over the 8-month screening period, 1,330 patients were screened for food insecurity, and 30 screened positive. Insurance type was a significant predictor for food insecurity; patients on public or with no insurance had 6.39 times greater odds of being food insecure than those on private insurance (CI 3.81, 13.29). Also, diagnoses of anemia and ADD/ADHD were both significantly higher in the food insecure group. The odds of having anemia was 8.47 times greater for food insecure patients (CI 3.03, 23.63), and the odds for having ADD/ADHD was 5.89 times greater for food insecure patients than food secure patients (CI 1.48, 23.55).

Discussion: These results provide useful information to clinicians as the screening process moves toward widespread adoption. These results also provide a baseline for expanded research once screening is implemented throughout all pediatric clinics within our health care organization.