Rongstad Rachel, Neuman Megan, Pillai Parvathy, Birstler Jen, Hanrahan Larry
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
WMJ. 2018 Aug;117(3):122-125.
Food insecurity is a household-level economic and social condition of limited or uncertain access to adequate and nutritional food that is associated with diabetes, obesity, anxiety, depression, and behavioral disorders. The presence of these comorbidities motivated the UW Health Pediatrics Department to start screening for food insecurity.
Our study describes demographic characteristics of screened patients, comparing risk factors and health status between food insecure patients and food secure patients. We extracted variables on all screened patients: sex, age, race, ethnicity, insurance type, height, weight (to calculate body mass index [BMI] and BMI percentile), and any diagnosis of diabetes, hypertension, sleeping problems, restless leg syndrome, anemia, elevated blood lead levels, depression, anxiety, or attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD).
Over the 8-month screening period, 1,330 patients were screened for food insecurity, and 30 screened positive. Insurance type was a significant predictor for food insecurity; patients on public or with no insurance had 6.39 times greater odds of being food insecure than those on private insurance (CI 3.81, 13.29). Also, diagnoses of anemia and ADD/ADHD were both significantly higher in the food insecure group. The odds of having anemia was 8.47 times greater for food insecure patients (CI 3.03, 23.63), and the odds for having ADD/ADHD was 5.89 times greater for food insecure patients than food secure patients (CI 1.48, 23.55).
These results provide useful information to clinicians as the screening process moves toward widespread adoption. These results also provide a baseline for expanded research once screening is implemented throughout all pediatric clinics within our health care organization.
粮食不安全是一种家庭层面的经济和社会状况，即获得充足营养食物的机会有限或不确定，这与糖尿病、肥胖症、焦虑症、抑郁症和行为障碍有关。这些合并症的存在促使威斯康星大学健康儿科部门开始筛查粮食不安全情况。
我们的研究描述了接受筛查患者的人口统计学特征，比较了粮食不安全患者和粮食安全患者之间的风险因素和健康状况。我们提取了所有接受筛查患者的变量：性别、年龄、种族、民族、保险类型、身高、体重（以计算体重指数[BMI]和BMI百分位数），以及任何糖尿病、高血压、睡眠问题、不安腿综合征、贫血、血铅水平升高、抑郁症、焦虑症或注意力缺陷障碍/注意力缺陷多动障碍（ADD/ADHD）的诊断。
在8个月的筛查期内，1330名患者接受了粮食不安全筛查，30名筛查呈阳性。保险类型是粮食不安全的一个重要预测因素；参加公共保险或无保险的患者粮食不安全的几率比参加私人保险的患者高6.39倍（CI 3.81，13.29）。此外，粮食不安全组中贫血和ADD/ADHD的诊断率均显著更高。粮食不安全患者患贫血的几率比粮食安全患者高8.47倍（CI 3.03，23.63），粮食不安全患者患ADD/ADHD的几率比粮食安全患者高5.89倍（CI 1.48，23.55）。
随着筛查过程逐步得到广泛采用，这些结果为临床医生提供了有用信息。一旦在我们医疗保健机构的所有儿科诊所实施筛查，这些结果也为扩大研究提供了基线。
