Dr. Seth Berkowitz and Economist Hunt Alcott join us to discuss nutrition, food insecurity, and their relevance to emergency medicine. What questions can we ask to identify food insecurity quickly? What resources can we offer patients? How might it affect our clinical decision making?  

Objectives:

1. Explore how nutrition affects the health of patients in the ED
2. Identify factors that contribute to patient’s nutritional status
3. Understand how to effectively and efficiently address nutrition with ED patients
   
   

Take-home points:

1. Food insecurity can play a critical role in the health outcomes of ED patients in the following ways:
2. 1. Food insecurity can lead to poor quality diet with health consequences
   2. Patients with food insecurity may have competing demands. If you are worrying about paying for meals, you might have to decide between food and important issues like housing or medications, all of which can affect your health.
   3. High levels of stress related to food can put a strain on a patient’s mental and physical health.
   1. Know your hospital and community’s ability to address food insecurity. If a patient screens positive on the Hunger Vital Sign, you can link them to community resources like food pantries, SNAP or WIC.
3. Consider screening your patients for food insecurity using the Hunger Vital Sign (see link in references). 
4. Low income neighborhoods have less access to lots of things, including grocery stores. Many stores in these neighborhoods limit options for healthy eating.
5. Nutrition education for your patients can make a difference. Recognize that nutrition education may be the limiting factor as to why your patients are not eating nutritious food, so taking a moment to talk about it can make a difference.
6. Be mindful of how food access may affect your treatment plan for your patient, particularly with food-sensitive conditions like diabetes. 

Additional Resources:

1. Food Deserts and the Causes of Nutritional Inequality, Alcott et al.  
2. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017, The Lancet. 
3. The Hunger Vital Sign
4. Gattu RK, Paik G, Wang Y, Ray P, Lichenstein R, Black MM. The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care. Children (Basel). 2019;6(10):107. Published 2019 Oct 2. doi:10.3390/children6100107
5. SNAP-ED

Guests:

Dr. Seth Berkowitz is an assistant professor in the division of general medicine and clinical epidemiology of medicine at the University of North Carolina and has done extensive research on food insecurity and its relation to human health, particularly in low-income patients and patients suffering from type II diabetes.

Hunt Allcott is an Associate Professor of Economics at NYU whose research includes investigation on consumer behavior.  He recently co-authored a 2018 study entitled “Food Deserts and the Causes of Nutritional Inequality”. 

Contributors:

• Bobby Needleman
• Dennis Hsieh
• Shannon Moffett
• Tony Spadaro