Household and Pediatric Inpatient Food Insecurity: Analysis and Implications for National Efforts

Area of Science:

• Pediatric Health
• Public Health
• Healthcare Management

Background:

• Food insecurity (FI) significantly impacts child health outcomes, making its identification and mitigation a healthcare priority.
• While outpatient interventions for FI are well-documented, evidence on pediatric hospital initiatives is scarce.
• This study addresses the gap by examining pediatric hospital efforts in tackling household FI (HFI) and inpatient FI (IFI).

Purpose of the Study:

• To describe current pediatric hospital strategies for addressing HFI and IFI.
• To develop a conceptual model for guiding nationwide hospital-based FI initiatives.
• To identify factors influencing the activation and sustainability of hospital FI programs.

Main Methods:

• A mixed-methods approach combining quantitative surveys (May 2023) and qualitative interviews (Nov 2023-Sep 2024) with hospital staff.
• Surveys targeted staff responsible for FI initiatives in statewide hospitals with pediatric beds.
• Qualitative interviews explored program characteristics, partnerships, challenges, and solutions in detail.

Main Results:

• Seventeen hospitals reported varied HFI screening methods, with referrals to social work or community resources.
• IFI was primarily assessed through informal caregiver conversations.
• Common interventions included meal trays, food pantries, and gift cards, though institutional support for sustainability was limited.
• Hospital leadership culture and stakeholder engagement were key drivers for FI program activation.

Conclusions:

• Innovative programs addressing both IFI and HFI exist despite limited formal screening.
• Understanding activation factors can guide new hospital initiatives.
• Hospitals can combat food insecurity through advocacy, partnerships, and creative programming.
• Sustainable FI efforts necessitate dedicated funding and governance for accountability.