Examining food insecurity in a regional New Zealand emergency department: A cross-sectional study

To determine the prevalence of food insecurity (FI) among patients in a regional New Zealand ED, factors associated with FI and feasibility of an ED-based FI screening programme with voluntary social work (SW) follow up.

Cross-sectional study of patients presenting to the Whangarei Hospital ED, using the validated two-item Hunger Vital Sign screening tool to assess for FI. Participants were offered SW follow up to discuss community food resources.

Of the 300 participants who completed the questionnaire, 111 (37.0%, 95% confidence interval [CI] 32.0-43.0) were food insecure. Factors associated with FI include Māori ethnicity (odds ratio [OR] 2.12 [95% CI 1.19-3.80], P = 0.011), household crowding (OR 1.19 [95% CI 1.02-1.39], P = 0.024) and lower socioeconomic status (OR 1.13 [95% CI 1.00-1.27], P = 0.048). There was no statistically significant association between FI and number of comorbidities or the primary reason for ED attendance. Of participants who were food insecure, only half reported being aware of (n = 56/111, 50.5%) or had used (n = 60/111, 54.1%) food resources. Participants who were food insecure were more likely to have utilised resources, either currently or in the past (OR 8.50 [95% CI 4.46-16.18], P < 0.001). Forty (13.3%) participants requested SW follow up and of those, most (n = 31/40, 77.5%) were successfully contacted. FI was associated with interest in SW follow up (OR 16.95 [95% CI 5.81-49.42], P < 0.001). At follow up, the majority (n = 24/31, 77.4%) of participants requested further information regarding food resources.

FI was prevalent among patients in a regional NZ ED. An ED-based FI screening programme with voluntary SW follow up was feasible and acceptable to ED patients.