The paragraph above is powerful, illustrating how health care providers may overlook issues of food insecurity in our society. One might wonder how much the tests and procedures cost the health care system. On the individual level, this family spent time, worry, and probably money getting their son tested and did not get the help they needed. The purpose of this article is to raise awareness about this topic with providers who work with children and families (especially if the child has a chronic health need that may overshadow the issue of food insecurity), to review the effects of food security on children’s health, and to describe ways that health care professionals can identify and assist food insecure families. (See Glossary on page 12.) The authors introduce a “Hunger Screening Algorithm” (Figure 2 on page 3 and 4) used in the State of Vermont as a model for professionals to help them identify and assist families at risk for hunger.
In 2010, based on the most recent reported data, 14.5% of households reported food insecurity as shown in Figure 1. Additionally, over 20% of US households with children did not have a consistent supply of nutritionally adequate food due to economic constraint and therefore were considered food insecure.1 The rate of food insecurity is almost double (39%) for low income families with children. Poverty guidelines are prepared yearly by the Assistant Secretary for Planning and Evaluation (ASPE) from the US Department of Health and Human Services (HHS) (See aspe.hhs.gov/poverty/12poverty.shtml.) ASPE does not provide percent of poverty information; for example, a low income for a family of four is defined as a family income of less than 185% of poverty or a total family income of less than $42,643/year. Various other federal, state and local organizations and agencies may publish percent of poverty tables for their own programs often using the poverty guidelines from ASPE to calculate 150% or 185%, etc. An example of a table of this type is available online. (See www.dhs.ri.gov/Portals/0/Uploads/Documents/Public/General%20 DHS/FPL.pdf).
Food insecurity is a measure of the household budget available for food and therefore represents a balance between cost of living and available resources. Households with higher expenses such as medical, transportation or housing costs have higher rates of food insecurity for the same income. Families raising a child with a disability are particularly at risk for food insecurity because of higher financial burdens and greater risk for being underemployed.
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Food Insecurity and Children with Special Health Care Needs
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