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Food insecurity and acute care utilisation: a systematic review and meta-analysis
Sandra Berzins1,2,3,4, Rudra Dahal1, Kamala Adhikari2,5,6
1Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
BMJ Public Health
|March 6, 2026
Summary
Food insecurity (FI) is linked to increased hospitalizations and emergency department (ED) visits. Addressing food insecurity is a priority for health systems to improve patient outcomes and reduce acute care use.
Area of Science:
- Public Health
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Food insecurity (FI) is a significant barrier to adequate nutrition and is linked to adverse health outcomes.
- Existing research on the relationship between FI and healthcare utilization presents conflicting evidence.
- This study focuses on acute care utilization, a critical aspect of healthcare access and cost.
Purpose of the Study:
- To systematically review and meta-analyze the association between food insecurity and acute care utilization.
- To synthesize evidence on the impact of FI on hospitalizations and emergency department (ED) visits.
- To identify key findings that can inform health system priorities.
Main Methods:
- A systematic search was conducted across multiple electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, SocINDEX) in December 2024.
- Inclusion criteria focused on original research in adult populations reporting associations between FI and acute care outcomes (hospitalizations, ED visits, readmissions, length of stay).
- Data extraction and quality assessment were performed by two reviewers using the Newcastle-Ottawa Scale, with meta-analysis for hospitalizations and ED visits.
Main Results:
- The review included 52 studies with over 1.6 million participants, revealing a significant association between FI and increased acute care utilization.
- Meta-analysis indicated that food insecurity was linked to higher rates of hospitalizations (pooled OR 1.44) and ED visits (pooled OR 1.61).
- High statistical heterogeneity was observed for both outcomes, and limitations included a predominance of observational studies and inclusion of mainly high-income countries.
Conclusions:
- Food insecurity is demonstrably associated with higher rates of acute care utilization, particularly hospitalizations and emergency department visits.
- Identifying individuals experiencing food insecurity and implementing targeted interventions to address their needs is a crucial health system priority.
- Further research may be needed to address heterogeneity and expand evidence from diverse global settings.
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