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Published on: February 19, 2021
Inpatient Food Insecurity in Caregivers of Hospitalized Pediatric Patients: A Mixed Methods Study
Alice M Lee1, Michelle A Lopez1, Heather Haq1
1Department of Pediatrics, Section of Pediatric Hospital Medicine, Baylor College of Medicine, Texas Children's Hospital (AM Lee, MA Lopez, H Haq, and R Quiñonez), Houston, Tex.
Insights
Nearly half of caregivers for hospitalized children experience food insecurity. This inpatient food insecurity is linked to household food insecurity and impacts a caregiver's ability to support their child's care.
Area of Science:
- Pediatric Health
- Nutrition Security
- Caregiver Well-being
Background:
- Household food insecurity (FI) affects 14% of US households with children, correlating with adverse health outcomes.
- Limited data exists on food access challenges for caregivers during a child's hospitalization (inpatient FI).
Purpose of the Study:
- To investigate the prevalence and associated factors of inpatient food insecurity among caregivers of hospitalized children.
- To explore caregivers' perceptions of food accessibility and its impact on their child's care.
Main Methods:
- A mixed-methods study involving primary caregivers of hospitalized children (0-18 years).
- Utilized a modified US Household Food Security Survey and semistructured interviews.
- Logistic regression analyzed associated factors for inpatient FI.
Main Results:
- Prevalence of inpatient FI was 43%, significantly associated with household FI (P < .01).
- Factors increasing odds of inpatient FI included low income (<$30,000), public transport use, distance from hospital, poor self-rated health, maternity leave, and SNAP utilization.
- Qualitative data revealed barriers like unaffordable options and caregivers skipping meals, highlighting the importance of their own nourishment for effective caregiving.
Conclusions:
- Inpatient food insecurity is a substantial issue affecting caregivers of hospitalized children.
- Pediatric hospitals should prioritize caregiver food access to facilitate their active participation in child care.
Background And Objective:
Among US households with children, 14% are food insecure. Household food insecurity (FI) is associated with poorer health outcomes and increased hospital admissions. There is less known about caregivers' ability to obtain adequate food during hospitalization (inpatient FI).
Methods:
We conducted a mixed methods study of primary caregivers of hospitalized children 0 to 18 years. A modified US Household Food Security Survey was used to identify inpatient FI. Associated factors were identified using logistic regression adjusted for covariables. Caregiver semistructured interviews were conducted to elicit perceptions on food accessibility and effects of and solutions for inpatient FI.
Results:
The prevalence of inpatient FI was 43%. Household FI was present in 38% of families. Inpatient FI was associated with household FI (P < .01). In multivariable analysis, odds of inpatient FI were increased among caregivers with annual household income <$30,000 (adjusted odds ratio [aOR] 2.14), public transportation use (aOR 6.33), living >30 miles from the hospital (aOR 2.80), self-rated fair/poor health (aOR 3.31), maternity leave (aOR 4.75), and past/current Supplemental Nutrition Assistance Program benefit utilization (aOR 2.52). Qualitative analysis identified barriers to food access, such as lack of affordable options, and found that caregivers made sacrifices for their hospitalized child, including skipping meals. Caregivers viewed their presence at their child's bedside and personal nourishment as important factors affecting their child's care.
Conclusions:
Inpatient FI may affect a significant proportion of hospitalized children's caregivers. Pediatric hospitals should ensure that caregivers have access to food in order to fully engage in their child's care.
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