US doctors advised to screen child patients for signs of hunger

The American Academy of Pediatrics issued unprecedented guidelines on how to determine child’s food security and provide resources for struggling families

Doctors should screen all their child patients for hunger, a national association of US pediatricians advised on Friday.

This is the first time the American Academy of Pediatrics has made such a recommendation, and the US secretary of agriculture Tom Vilsack is expected to tout the new policy on Monday.

About 16 million children in the US live in households that struggle to put food on the table consistently, the AAP found in an examination of data from 2014. The US Department of Agriculture released data in September showing that the number of children getting enough food to stay healthy was at its highest since 2007. Numbers dipped drastically during the recession years, particularly in 2011, said Sarah Schwarzenberg, one of the policy statement’s lead authors.

But “it could be much higher”, Schwarzenberg said, referring to the number of children who receive an adequate amount of food.

Hunger and food insecurity in children can lead to several health problems in adulthood, including diabetes, hyperlipidemia, cardiovascular disease, and mental and emotional distress. Other issues include iron deficiency and lower bone density in preadolescent boys. Children who go without an adequate amount of healthy food might not be able to concentrate or perform well in school.

The slide into food insecurity can occur with small changes to income, expenses or access to federal or state-funded programs, the AAP policy statement said.

“The demographic of food-insecure Americans extends beyond the areas of concentrated urban poverty and into suburbs and rural America, areas often mistakenly thought to be immune to this problem,” the authors wrote.

To mitigate this, the AAP suggests pediatricians and family practitioners become aware of food and meal planning resources and how to refer eligible families to such programs.

The AAP recommends medical practitioners screen their patients during routine health maintenance visits. A common screening procedure a doctor can employ in-office is a two-question process. The doctor asks the patient to answer yes or no to two statements to figure out if the patient is food insecure:

• Within the past 12 months, we worried whether our food would run out before we got money to buy more.
• Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more.

Once they figure out where a patient stands, pediatricians are urged to offer access to programs that will help a patient obtain food with regularity. These include programs such as WIC and Snap, school nutrition programs, local food pantries, summer and child care feeding programs and other community resources.

It becomes complicated, Schwarzenberg said, because it is difficult to tell when a child or family is going hungry or “food insecure”.

“I don’t think you can look at someone and say who is food insecure,” she told the Guardian. “They often look OK, they may even be obese. But they may not know where their next meal is coming from.”

Furthermore, some families are embarrassed or uncomfortable to ask for resources, Schwarzenberg said.

“Some never expected to need that kind of help,” she said. “Sometimes you can guide people to good resources. That’s why doctors should be asking.”

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