With millions of U.S. children living in homes consistently without enough food, a national pediatrics organization is urging pediatricians to screen all patients for food insecurity and refer parents to public-assistance agencies if they need help.
The American Academy of Pediatrics on Friday urged pediatricians to screen all patients for food insecurity and to refer parents to appropriate agencies so children do not go hungry.
Sixteen million children live in homes where there is consistently not enough food, according to the Department of Agriculture. Those children get sick more often, have poorer overall health and are hospitalized more frequently than peers who are adequately nourished.
So-called food insecurity also has been linked to behavioral and emotional problems from preschool through adolescence.
“It’s high time,” Mariana Chilton, the director of the Center for Hunger-Free Communities at Drexel University, said of the new policy. “We know food insecurity drives up health-care costs, and is associated with more hospitalizations, and is related to poor childhood development and health.”
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Few pediatricians research childhood hunger, said Chilton, a principal investigator of Children’s HealthWatch, a national network tracking the impact of public assistance programs on pediatric health.
“It’s been very difficult to get the broader pediatrician community to pay attention to food insecurity, and yet it’s one of the most important vital signs of a child’s health and well-being,” Chilton said.
The academy’s new policy also encourages pediatricians to familiarize themselves with local food banks and federal nutrition programs.
“If you think about meeting families where they are — they are in schools and in doctors’ offices,” said Melissa Boteach, a vice president of the poverty-to-prosperity program at the Center for American Progress. “Having pediatricians connect them to resources they need could really have a big impact.”
The academy said pediatricians might identify hungry children with a screening tool that posed two questions to parents: whether, in the last year, they worried that their food would run out before they had money to buy more; and whether the groceries they bought lasted until they had more money available to buy more.
Answering yes to either question identifies 97 percent of families that are insecure about food, said Erin Hager, a nutritional epidemiologist at the University of Maryland School of Medicine who helped validate the tool.
Across-the-board screening may encourage worried parents to step forward, experts said. “A big barrier to accessing resources for families is they are scared and embarrassed to ask,” said Maryah Fram, an associate professor of social work at the University of South Carolina who has researched food insecurity in children.
Besides sharing information about resources, pediatricians also can reassure parents. “They can let them know it’s not just them, and this is a common situation,” Fram said.
The questionnaire also may take the guesswork out of trying to identify children forced to skip meals or go to bed famished.
“People think you can recognize food insecurity when you see it, or that people with food insecurity look poor,” Dr. Sarah Schwarzenberg, a lead author of the new policy statement and director of pediatric gastroenterology, hepatology and nutrition at the University of Minnesota Masonic Children’s Hospital.
“People who look just like you and me have food insecurity,” she added. “Income is more unpredictable than it used to be.”
Unemployment, underemployment and poverty are all linked to food insecurity, the academy noted, helping make chronic hunger a problem for millions of families.
Asia Thompson, a 22-year-old mother of two and a student at Misericordia University in Dallas, Pa., never told their pediatrician that the family sometimes lacked food, even though she worried about it frequently.
“Imagine having two children who are equally if not more hungry than you are, and only having one ration of food to split between three of you,” Thompson said. “That’s what is happening in homes in America right now.”
Thompson hoped universal screenings for hunger “would take away the embarrassment of having to reach out yourself, because it does take a lot of courage to talk to your pediatrician about not being able to feed your kids. It’s embarrassing as a parent.”
Food stamps have been “incredibly helpful,” she said, but they still run out “before the month is over.”
The new policy also urges pediatricians to use their influence beyond their offices. “It’s very important that pediatricians advocate for programs that provide food, particularly healthy food for children,” Schwarzenberg said.
Assistance programs “are always under pressure to be cut, diminished or changed,” she said. “Pediatricians know about children’s health; they should be right up there saying you’ve got to make them stronger and to keep them in place.”