Louisville Medicine Volume 66, Issue 6 | Page 17

FOOD INSECURITY CHILD HUNGER: A Hidden Epidemic V. Faye Jones, MD, PhD & Marian Morris, MD V ery rarely do children or their parents come out and say, “We’re hungry!” at a doctor’s visit. More often, clues they are hungry lie hidden in a medical complaint or problem. These clues vary from obesity to failure to thrive, from difficulty focusing in school to toddler tantrums. Those who lack consistent access to adequate food may choose affordable, high caloric density & low nutritional content foods or consume less than the adequate number of calories for the day. Both of these options can have major impacts on children’s mental, physical and developmental health. A parent’s relief may be palpable when the physician realizes the family doesn’t have enough to eat (food insecure) and helps them locate food assistance. Food insecurity can be defined as “limited or uncertain avail- ability to acquire food in socially acceptable ways.” 1 According to Feeding America’s “Map the Meal Gap 2018,” which is derived from 2016 data, 15.5 percent of Kentucky residents are food insecure, totaling over 685,000 people. 2 Specifically in Jefferson County, 15.8 percent of its residents are food insecure, with >120,000 residents without consistent access to food. Fifty-three percent of Jefferson County residents have household incomes <130 percent of the fed- eral poverty level, which makes them eligible for Women, Infants & Children (WIC), Special Supplemental Nutrition Program (SNAP) and free school meals. 2 In 2015, the American Academy of Pediatrics (AAP) recom- mended universal screenings of families for food insecurity and assisting families in locating local resources. Quick screening can be done in the office easily, utilizing the following two-question screener developed by Hagel et al, where an affirmative answer on either question results in a positive screen for food insecurity. 3 1) Within the past 12 months, we worried whether our food would run out before we got money to buy more (yes or no) 2) Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more (yes or no) The consequences of food insecurity can be life-long. Often, the most visible impact is alterations to the child’s growth parameters. However, such visible changes are rarely seen amongst food-insecure children in the US, though this does not preclude health impacts of malnutrition. Some studies suggest that children ages six to 11 with personal food insecurity are more likely to be obese, potentially as result of consumption of affordable, high caloric density foods in combination with chronic stress response. 4,5 Families of children experiencing food insecurity are more likely to rate their children’s (continued on page 16) NOVEMBER 2018 15