Health Care Screenings Help Identify Hunger in Pittsburgh
The Greater Pittsburgh Community Food Bank works with local providers to better identify and assist patients without reliable access to healthy food.
Prescriptions for a broad range of medications carry a simple, three-word instruction on their labels: “Take with food.” It’s a requirement that many of us never have had to consider. But it becomes an impediment to health if you don’t have any food to begin with.
That’s a specific yet illustrative example of a dilemma the Greater Pittsburgh Community Food Bank hopes to address by working with health care providers to screen for food insecurity among patients. Taking its lead from a 2014 survey conducted by the domestic hunger relief organization Feeding America, the food bank aims to broaden the scope of health care providers during patient visits with these new initiatives.
“Food insecurity has an impact on people’s health; we know that,” says Lisa Scales, the food bank’s president and CEO. The goal is to convince health systems to incorporate questions about food security into routine health screenings; practitioners then would be able to add data about hunger to normal reports of vital signs such as temperature and blood pressure.
Determining whether or not an individual is food-insecure can be more complicated than it may seem, Scales points out. “There’s a limited amount of time that health care providers spend with people,” she says. “So the challenge [involves] addressing all of the needs that people have that address their health.”
The wording of the questions is of vital importance. Many patients are reluctant to admit that they’re eating poorly or not at all, so simply asking if a need exists often will not yield the right information. For that reason, the food bank suggests that providers read patients two statements, drawn from the U.S. Household Food Security Survey’s “Food Insecurity Screener.”
The statements are: “We worried whether our food would run out before we got money to buy more;” and, “The food that we bought just didn’t last, and we didn’t have money to get more.” Patients are asked if those statements were often, sometimes or never true in their households in the previous 12 months.
The answers to those questions can help a provider to identify patients who need further assistance. Those patients may be directed to resources such as the food bank or enrollment in the Supplemental Nutrition Assistance Program.
Ideally, this also can lead to health care centers and providers maintaining a food pantry on-site; Karen Dreyer, director of the Southwestern PA Food Security Partnership, cites a program underway at ProMedica Toledo Hospital in Ohio, where doctors can write food-insecure patients a prescription to be filled at the hospital’s own pantry. “That is a great option; it’s a very good way to do it,” Dreyer says.
“But our end-goal is that [these] screenings would become integral in the health care system.”
The food bank has had preliminary conversations with both UPMC and Allegheny Health Network and has begun partnering with other organizations for pilot programs. Dan Swayze, the vice president and COO of the Center for Emergency Medicine and the project manager of the CONNECT Community Paramedic Program, says he’s observed a tangible impact since implementing the food bank’s suggestions into the organization’s health screenings in February.
“We work with a lot of vulnerable patients in the county, and food security is a very vital issue for them,” Swayze says. “Thanks to the partnership, we’re now able to actually leave food behind with them after performing that assessment.”
Widespread implementation of these efforts still is a long way off, as administrative hurdles are cleared and management strategies are devised. The potential impact of those two simple statements, however, could be enormous in addressing one of the key social determinants of health.