American College of Physicians, Washington, DC (J.S.).
University of Arkansas for Medical Sciences, Little Rock, Arkansas (O.A.).
Ann Intern Med. 2022 Aug;175(8):1170-1171. doi: 10.7326/M22-0390. Epub 2022 Jun 28.
Food insecurity functions as a social driver of health, directly negatively impacting health status and outcomes, which can further negatively impact employment and income and increase medical expenditures-all of which exacerbates food insecurity. Progress in meaningfully reducing the food-insecurity rate has stalled in recent years. Although rates have decreased since their peak during the Great Recession, these gains have been reversed by the economic implications of the COVID-19 pandemic. As the federal government is the largest provider of food assistance, there is much potential in better leveraging nutrition assistance programs like the Supplemental Nutrition Assistance Program (SNAP) and the Child Nutrition Programs to increase access to healthful foods and improve public health. However, these programs face many funding challenges and internal shortcomings that create uncertainties and prevent maximal effect. Physicians and other medical professionals also have a role in improving nutritional health by screening for food insecurity and serving as connectors between patients, community organizations, and government services. Governments and payers must support these efforts by providing sufficient resources to practices to fulfill this role. In this position paper, the American College of Physicians (ACP) offers several policy recommendations to strengthen the federal food-insecurity response and empower physicians and other medical professionals to better address those social drivers of health occurring beyond the office doors.
食物不安全是影响健康的社会驱动因素之一,它直接对健康状况和结果产生负面影响,进而可能对就业和收入产生负面影响,并增加医疗支出——所有这些都使食物不安全状况恶化。近年来,在大幅降低食物不安全率方面进展停滞不前。尽管自经济大衰退期间达到峰值以来,这一比率有所下降,但新冠疫情对经济的影响使这些改善成果出现了逆转。由于联邦政府是食品援助的最大提供者,因此,充分利用补充营养援助计划(SNAP)和儿童营养计划等营养援助计划,增加获得健康食品的机会并改善公共卫生,具有很大的潜力。然而,这些计划面临着许多资金挑战和内部缺陷,这些问题造成了不确定性并限制了其最大效果。医生和其他医疗专业人员也可以通过筛查食物不安全状况并在患者、社区组织和政府服务之间建立联系,在改善营养健康方面发挥作用。政府和支付方必须通过为实践提供充足的资源来支持这些努力,以履行这一角色。在这份政策立场文件中,美国医师学会(ACP)提出了若干政策建议,以加强联邦应对食物不安全的措施,并赋予医生和其他医疗专业人员权力,使其能够更好地应对办公室以外存在的这些健康的社会驱动因素。