Explaining Food Insecurity and Why It Should Be a Medical Priority

Explaining Food Insecurity

Food insecurity is a term officially set to describe when a household cannot acquire enough food to meet the nutritional needs of all of its members. Households can be singular or include multiple persons. It is considered to be a social determinant of health, since food insecurity is tied to income and can be an important predictor of unhealthy eating behaviors which lead to higher rates of diabetes and heart disease, for example. Closely related to lack of access to nutritious food, food insecurity is also associated with high costs of healthcare due to increases in acute and chronic health conditions. Overall, food insecurity is highly detrimental to both the individual and the community, and addressing population health requires addressing it.


Food Insecurity as a Medical Priority

Shifting priorities to disease prevention and not just snapshot care or even longitudinal symptom care is a continuous discussion in the medical field. Is it our duty to not only treat symptoms of current medical conditions, but to prevent further harm from coming to our patients whenever possible? This is a point of contention since it requires a more holistic view of patient health and how this arises from the patient environment and community conditions. It stretches the fabric of what it means to be a healthcare practitioner and what it means to invest in patient health.

One of the major methods for linking patients with other resources in their community to promote their health is through the use of community health partners (CHPs). CHPs are often individuals but can work for local organizations such as churches and support services, which are often trusted in low-income communities. They are much better equipped to bring resources to their communities than a larger tertiary medical center, for example, which may be viewed with distrust. It takes a village to raise a person, but this concept also pertains also pertains to maintaining their holistic well-being. It takes the work of many to transform community culture to one of proactive health. Clearly, there is space to form better partnerships between patient clinics and community health organizations in order to improve community health, especially in regards to improving food insecurity as a social determinant of health. These partnerships have been popping up all over the country, including here in Durham!


Duke Outpatient Clinic Meets Farmer Foodshare

Delivery of food to vulnerable patients decreases food insecurity. This is a no-brainer, and is a model that has previously been used in many communities, as nutritional supplementation improves disease complications and can reduce emergency visits and other costly health expenditures. Food delivery in the age of the COVID pandemic is also especially relevant. Food insecure patients from the Duke Outpatient Clinic (DOC) are referred to a Duke organization called Root Causes, which partners with Farmer Foodshare to package and distribute weekly bags of fresh produce to these patients. Patients receive fresh produce and other items as well as recipes and information about health-promoting behaviors. This relationship not only provides necessities but also builds rapport between patients and their healthcare team.

It is pertinent to allocate resources to this at-risk population. The patient population served by the DOC is disproportionately poor, black, elderly, and affected by chronic diseases including diabetes and heart disease – all significant risk factors for COVID-19 co-morbidity. They are also common conditions amongst food insecure persons due to lack of nutritional food access. Starting with this population and addressing their social determinants of health through clinic-community partnerships is a key step towards improving community health in Durham, a model that could be extended across the country.

My research with Farmer Foodshare aims to examine the biweekly delivery of fresh produce and shelf stable items to our low-income, food-insecure patients referred from the Duke Outpatient Clinic. This analysis hopes to find increasing food security and reduced perceived stress levels due to enrollment in the program. We are taking a snapshot look at food insecurity in this population and how we might better serve them as this program continues to mature. I look forward to reporting back soon with all that I have learned over the course of this project. Until then – stay happy, stay healthy, stay in community.