Pediatric Reflections on Food Insecurity

Saba Khan, MD, is medical director of the Healthy Weight Program (HWP) and an Attending Physician in the Division of Gastroenterology, Hepatology and Nutrition.

Deepak Palakshappa, MD, MSHP, is a General Pediatrics Attending Physician and an academic investigator for HWP.

Questions that can change a child’s health

In late 2015, during a routine two-question screening for food insecurity ("Food insecurity screen" below) at the CHOP Care Network South Philadelphia primary care practice, a mother added these words to the paper screener: “Please help.”

When the care team contacted her to see if she would like to speak to someone about accessing benefits or resources, she began to cry over the phone and shared part of her story with us. An immigrant and a mother of three, this mother had high ambitions for herself and her family. She had dreams of her children attending college, but that dream was slipping away as she was struggling to pay for necessities such as food and shelter.

Her story is like many others: Low-income families that make too much for food stamps or too little to live, in both urban and suburban settings. One out of 5 children in the United States lives in food-insecure households.

We know that food insecurity can negatively impact a child’s health: Children in food-insecure households are at higher risk for anemia, obesity, increased hospitalizations, poor academic performance, psychosocial and behavioral problems, and other chronic health conditions. We also know that SNAP benefits are not sufficient to support a family in need for the entire month, with over half of SNAP recipients exhausting their benefits within the first two weeks.

It is clear we are trying to work with a broken system, but in October 2015, the American Association of Pediatrics responded to this epidemic with a policy statement highlighting pediatricians’ central role in screening and identifying children at risk for food insecurity in any community — not only traditionally underserved ones.

While some of CHOP’s primary care practices have been working to address this problem for nearly four years, we feel that it is necessary to adopt screening for food insecurity as a standard of care in all well-child visits for all children, and, when appropriate, to share information about existing community resources (food pantries, community-supported agriculture programs, etc.).

By connecting families to a network of resources, struggling families, like the one that shared its challenges with us, would not necessarily have to choose between essentials such as education and food.

Food insecurity screen

1. "In the last 12 months, we were worried whether our food would run out before we got money to buy more.”
2. “In the last 12 months, the food we bought just didn’t last and we didn’t have money to get more.”

Listen to a recent podcast for physicians about food insecurity.