Stability of food insecurity status in paediatric primary care

Area of Science:

• Pediatric primary care
• Public health
• Social determinants of health

Background:

• The American Academy of Pediatrics recommends food insecurity (FI) screening at well-child visits due to adverse childhood outcomes.
• Children under age 3 have frequent recommended primary care visits, but the stability of FI status at this screening frequency is unknown.

Purpose of the Study:

• To examine the stability of household food insecurity (FI) status in young children (0-3 years) using retrospective electronic health record data.
• To determine the optimal screening frequency for identifying transitions in food insecurity among infants and toddlers.

Main Methods:

• Retrospective analysis of electronic health records from a pediatric primary care practice.
• Included 3451 patients aged 0-3 years with at least two FI screens between 2012 and 2018.
• Age-stratified analyses and regression models estimated transitions in FI status based on time since last screening.

Main Results:

• Overall, 9.5% of patients experienced a transition in household FI status.
• Transitions from food insecure to secure (5.0%) and food secure to insecure (4.5%) were similarly frequent.
• Toddlers screened more than a year prior were twice as likely to transition to FI compared to those screened within 0-6 months.

Conclusions:

• Household food insecurity status demonstrates some instability in children under age 3.
• Annual or more frequent screening may not substantially increase the identification of transitions to food insecurity.
• Further research may be needed to optimize screening protocols for early identification of food insecurity.