Skip to main content

Focus on 3 Steps to Address Food Insecurity Among Your Patients

Analysis  |  By Christopher Cheney  
   May 11, 2020

Either through direct investments or community partnerships, healthcare organizations can help patients secure nutritious food.

Healthcare organizations can play an active role in addressing food insecurity among patients, a recent report from the National Quality Forum and Humana says.

Social determinants of health (SDOH) such as housing, food security, and transportation can have a pivotal impact on the physical and mental health of patients. In 2018, an estimated 11.1% of U.S. households were food insecure at some point during the year, with food insecurity defined as household members having their eating patterns disrupted because financial and other resources were inadequate to obtain nutritious food.

To address patient food insecurity, healthcare organizations should focus on three steps, the recent report says.

1. Screening and assessment

The first step is determining which patients and populations in your service area are food insecure.

"To identify who may need targeted support, healthcare organizations can integrate screening strategies into standard care. Screening for food insecurity as part of broader efforts to integrate SDOH into healthcare conversations will enable healthcare organizations to better meet their patients' needs and improve population health," the report says.

Success strategies to support screening include:

  • Incorporating consistent screening as part of routine care, which decreases prejudice, accounts for chronic and episodic food insecurity, and helps track positive changes in nutrition
     
  • Utilize a screening tool that identifies food insecurity in both individuals and families
     
  • Enlist a multidisciplinary team to design screening methods that decrease strain on healthcare workers

Success strategies for screening individuals include:

  • Work with community-based organizations (CBOs) to identify food insecure individuals who are in your service area but are not receiving services from your organization—these individuals could be at risk for negative health outcomes
     
  • Pair food insecurity screening with other SDOH screening to develop a comprehensive view of an individual's social needs
     
  • Train healthcare workers about food resources in your service area to promote screening—some healthcare workers may be reluctant to screen individuals unless they are familiar with community resources

2. Clinical action

Once screening and assessment methods have identified individuals or families as food insecure, the next step is matching these people with the best resources. "The level of effort, investment, and impact of the various food insecurity interventions can vary across organizations and communities," the report says.

The primary focal points for clinical actions are public programs, food access, and access to supporting resources.

  • Public programs: Federal, state, and local public programs help food insecure people access food but often do not provide food directly. "Assisting individuals to participate in these programs can be a first step toward moving them into food security. Public program strategies should be paired with strategies that supply food to individuals and families in need," the report says.
     
  • Food access: An inability to access nutritious food is a key factor in food insecurity. Healthcare organization interventions to promote food access include the "Food is Medicine" strategy, which matches food to a patient's specific health condition, and establishing partnerships with CBOs to provide direct food delivery or financial assistance to overcome food access barriers such as limited mobility.
     
  • Access to supporting resources: People who are food insecure often face related SDOH challenges such as housing instability and unemployment. "Providing access to food alone will not help those who are food insecure overcome the circumstances that led to their food insecurity. Giving individuals access to resources they need will help them overcome barriers and challenges to sustainable food security," the report says.

3. Tracking and evaluation

Monitoring metrics demonstrates which food insecurity interventions are effective or generate negative unintended consequences. "Organizations can use data to show return on investment through improved health outcomes, lowered costs, reduced care utilization, and positive changes in other metrics of interest, such as patient satisfaction and number of healthy days reported," the report says.

Technology is an essential element of tracking and evaluating interventions. "When considering which strategies to implement, healthcare organizations should conduct an analysis of both their own technological infrastructure and the patient's ability to access various types of technology and the Internet," the report says.

Success strategies to support tracking include:

  • Adding food insecurity workflows to electronic health records (EHRs) to ease data management and increase productivity
     
  • Understanding the capabilities and needs of CBOs to support their data collection and evaluation efforts
     
  • Learning what is most important to patients, and creating methods to track and report data in ways that do not alienate, prejudice, or encumber food insecure patients

Success strategies to track food insecurity and evaluate the results of interventions include:

  • Setting follow-up appointments during the screening process
     
  • Using your EHR to identify food insecure patients and monitor health outcomes linked to food insecurity
     
  • Obtaining consent for data sharing, which can boost continuity of care between healthcare practitioners and settings

Targeting interventions

Food access interventions need to be tailored to community circumstances and the specific needs of patients, Kathleen Giblin, RN, senior vice president of quality innovation at the National Quality Forum, told HealthLeaders.

"Patients living in communities with few grocery stores, food pantries, or food banks, or those with mobility challenges, lacking reliable and affordable transportation, or facing financial barriers may need to be referred to in-house interventions to provide direct access to food to have their needs met. In areas with strong community resources and programs, it may be more effective for healthcare providers to connect patients to CBOs that can provide access to nutritious food," she said.

Social determinants of health factors do not exist in a vacuum, Shantanu Agrawal, MD, MPhil, president and CEO of the National Quality Forum, told HealthLeaders.

"Our Food Insecurity and Health Implementation Guide, developed in collaboration with Humana, is a critical step in addressing an essential social determinant. Other SDOH such as transportation, housing, and social isolation are issues that healthcare providers are beginning to tackle through both direct investments and community partnerships," he said. 

Regardless of whether healthcare organizations pursue direct investments or community partnerships, SDOH initiatives require teamwork, Agrawal said.

"Bringing together patients, communities, healthcare providers and organizations, and community-based workers to discuss goals, resources, and values can help to build trust, prevent duplication of efforts, and establish shared ownership of actions to address food insecurity and other social determinants of health," he said.

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

About 11.1% of American households experience food insecurity at some point during the year, according to the U.S. Department of Agriculture.

For healthcare organizations, the first step in helping patients to overcome food insecurity is screening and assessment.

Food access interventions need to be tailored to community circumstances and the specific needs of patients.

Tagged Under:


Get the latest on healthcare leadership in your inbox.