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Pediatric Emergency Department-based Food Insecurity Screening During the COVID-19 Pandemic
Stephanie Ruest1, Lana Nguyen2, Celeste Corcoran3
1Hasbro Children's Hospital, Division of Pediatric Emergency Medicine, Warren Alpert Brown University School of Medicine, Providence, Rhode Island.
Insights
The COVID-19 pandemic saw a significant rise in food insecurity (FI) among families visiting urban pediatric emergency departments (PEDs). Nearly 60% of families screened reported experiencing FI, highlighting the critical need for screening and support services in these settings.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Security
Background:
- Emergency departments (EDs) serve as crucial safety nets for families facing basic needs insecurity.
- The COVID-19 pandemic exacerbated national food insecurity (FI) rates.
- Limited data exists on FI prevalence in pediatric ED (PED) populations during the pandemic.
Purpose of the Study:
- To determine the prevalence of food insecurity (FI) among families in an urban pediatric ED.
- To assess awareness and utilization of supplemental food services.
- To examine FI in the context of the COVID-19 pandemic.
Main Methods:
- Cross-sectional survey of families screened for FI in an urban PED (February-October 2022).
- Utilized electronic screening surveys with validated USDA food security questions.
- Performed descriptive and bivariate analyses of sociodemographics and FI status.
Main Results:
- 56.7% of 612 surveyed families demonstrated food insecurity (FI): 25% low FI, 31.7% very low FI.
- Significant differences observed in supplemental food service awareness and use based on FI status, income, and language.
- High rates of FI found, with 30% reporting household income <$25,000 and 32% between $25,000-$49,999.
Conclusions:
- Nearly 60% of families in an urban PED during the pandemic experienced food insecurity, exceeding previous reports.
- Supports the role of EDs in FI screening, especially during public health crises.
- Highlights the necessity for targeted outreach and interventions within PED settings.
Introduction:
The emergency department (ED) is a safety net, caring for families who lack adequate access to food and other basic needs. The COVID-19 pandemic caused a dramatic rise in food insecurity (FI) nationally; however, little is known about the prevalence of FI among families seen in pediatric EDs (PED). In this study we aimed to determine the prevalence of FI, as well as awareness and utilization of supplemental food services, among families seen in an urban PED during the COVID-19 pandemic using an electronic screening survey.
Methods:
This was a cross-sectional survey of families screened for FI in an urban PED. An electronic survey was advertised to all families via posters placed in patient rooms and other locations in the PED between February-October 2022. Surveys in English and Spanish were accessed on personal electronic devices via QR codes. Six validated US Department of Agriculture household food security questions and sociodemographic questions were included. We calculated respondents' food security and performed descriptive and bivariate analyses of patient sociodemographics and responses to FI questions.
Results:
Of 42,697 PED visits, 612 surveys were completed and analyzed (1.4%). Nearly 50% of respondents identified as White and non-Hispanic, with approximately 80% female. Thirty percent had a household income of <$25,000 and 32% between $25,000-<50,000. Among survey respondents, 56.7% demonstrated FI: 25% with low food security, and 31.7% with very low food security. We identified statistically significant differences in awareness and use of supplemental food services by FI status, household income, and primary language spoken.
Conclusions:
Nearly 60% of survey participants in an urban pediatric ED during the COVID-19 pandemic experienced food insecurity, substantially higher than previous reports. These results support the ED's contributory role in FI screening, particularly during times of a public health crisis, and highlights the need for targeted outreach in this setting.
