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Prevalence of Food Insecurity Between Pediatric Critical Care and Hospital Ward Setting
Kendra S Haas1, Bethany Selby2, Sukruthi Yerramreddy2
1Department of Pediatrics, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, KY.
Insights
Food insecurity (FI) is more common in pediatric intensive care unit (PICU) patients than on hospital medicine (HM) floors. Black and Hispanic children face higher odds of FI, underscoring the need for screening and interventions in critical care settings.
Area of Science:
- Pediatric critical care medicine
- Public health nutrition
- Health disparities research
Background:
- Food insecurity (FI) is a significant social determinant of health impacting pediatric populations.
- Understanding FI prevalence in different hospital settings is crucial for targeted interventions.
- Previous research has not extensively compared FI rates between pediatric intensive care units (PICUs) and general hospital medicine (HM) floors.
Purpose of the Study:
- To determine the prevalence of food insecurity among pediatric patients admitted to the PICU.
- To compare the prevalence of FI between PICU and HM floor admissions.
- To identify clinical and demographic factors associated with FI in pediatric hospital admissions.
Main Methods:
- Retrospective chart review of pediatric patients (0-18 years) admitted for ≥24 hours in 2023.
- Utilized the Hunger Vital Sign tool to screen for food insecurity.
- Compared FI prevalence using chi-square testing and logistic regression, analyzing demographic and clinical variables.
Main Results:
- Of 2820 eligible patients, FI prevalence was higher in the PICU (9%) compared to the HM floor (6.5%).
- Black and Hispanic pediatric patients exhibited significantly higher odds of food insecurity compared to White patients.
- Admission location, age, gender, and length of stay were not independently associated with FI.
Conclusions:
- This study is the first to compare FI prevalence between PICU and HM patients and the largest to date on PICU FI.
- FI is more prevalent in PICU admissions, disproportionately affecting Black and Hispanic children.
- Findings emphasize the necessity of implementing screening and intervention strategies for food insecurity within the PICU environment.
Objective:
We aim to evaluate the prevalence of food insecurity (FI) among pediatric patients admitted to the PICU, compare the prevalence between patients admitted to the PICU vs. hospital medicine (HM) floor, and determine associations between the presence of FI and clinical and demographic variables.
Design, Setting, And Patients:
A retrospective chart review was conducted for patients 0-18 years old admitted for at least 24 hours between January 1 and December 31, 2023 to a tertiary pediatric hospital PICU or HM floor.
Interventions:
None.
Measurements And Main Results:
FI was measured using the Hunger Vital Sign tool. Self-identified demographic data were obtained and reported using descriptive statistics, and associations with FI were examined using chi-square testing and logistic regression. Of the 4457 identified patients, 2820 met inclusion criteria (621 in PICU, 2199 in HM). FI prevalence was higher in PICU patients compared with those admitted to the HM floor (9% PICU vs. 6.5% HM, p = 0.034; 95% CI, 0.504-0.962). Higher odds of FI were found in Black patients (aOR 2.40; 95% CI, 1.39-4.09, p = 0.001) and patients self-identifying as Hispanic (aOR 5.44; 95% CI, 2.94-9.81, p = < 0.001) as compared with White patients. Admission location, age, gender, and length of stay were not independently associated with FI.
Conclusions:
This is the first study reported comparing the prevalence of FI between PICU vs. HM floor patients, and the largest study to date on FI prevalence in the PICU. FI was more prevalent among patients admitted to the PICU than HM floor and predominantly noted in Black patients and patients self-identifying as Hispanic. These findings highlight the need for screening and intervention strategies to address FI within the ICU setting.
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