Screening of Pediatric Patients at Cardiology Clinic Identifies High Prevalence of Food Insecurity

Food insecurity (FI) is a social driver that profoundly affects the health of children. Nutritional optimization is essential in patients with congenital heart disease (CHD).

We performed a cross-sectional survey screening for FI among patients aged 0-21 years at an outpatient pediatric cardiology clinic between September 2023 and December 2024. Sociodemographic and clinical data from encounters were collected, and diagnostic codes were used to classify CHD severity. The zip code-level median household income was determined using data from the U.S. Census. The Childhood Opportunity Index categorization was used to determine neighborhood-level resources. Univariate and multivariate logistic regression were used to assess sociodemographic associations with FI.

There were 955 encounters with completed FI screening. Positive screens were demonstrated in 200 surveys (20.9%). Compared to English-speaking White families, those with FI were more likely to be of Hispanic ethnicity (66% vs. 45.2%) and primarily speak Spanish (42.5% vs. 15.0%). Families with FI also lived in areas with lower median household income and fewer available resources. In multivariable analysis, after adjusting for ethnicity, income, and neighborhood-level resource availability, Spanish primary language was the only independent risk factor associated with FI (OR 2.7, 95% CI 1.7-4.2, p < 0.0001). There were no differences in FI status by CHD severity.

FI was highly prevalent in this cohort and was associated with low-income and low-resource neighborhoods, Hispanic ethnicity, and a Spanish primary language. These results may have implications for targeting future FI interventions.