(P20-055-24) Food Insecurity at a Large Academic Medical Center: Understanding the Five-Year Prevalence, Trends, Associated Health-Related Social Risks, and Requests for Assistance

Objectives: Health care systems are increasingly screening for and integrating food insecurity and other social determinants of health (SDH) into electronic health records. However, there remain knowledge gaps on the efficacy of screening practices in large clinical settings. The primary study objective was to evaluate the five-year prevalence and associated risk factors of food insecurity among adult primary care patients at a large, tertiary care academic medical center (encompassing 21 primary care clinics) in Michigan. A secondary objective was to examine factors associated with patients’ interest in social assistance among those with food insecurity.

Methods: We conducted a retrospective cohort study among 106,087 adult ( >=18 years) patients who had completed SDH screening at a primary care patient encounter between August 2017 (when screening was initially implemented) and August 2022. Food insecurity was assessed using the validated Hunger Vital Sign. Patients also indicated their interest in social assistance through the standardized SDH questionnaire. Patients’ demographic and health characteristics were obtained from their electronic health records. Analyses were conducted using chi-squared tests and multivariate logistic regression models.

Results: The five-year prevalence of food insecurity was 4.2%, with monthly trends ranging from 1.5% (August 2018) to 5.0% (June 2022). Food insecurity was significantly higher among patients who were younger, female, minority race and ethnicity, unmarried or unpartnered, and with public health insurance. Food insecurity was significantly associated with a higher burden of other social risk factors. Only 20.6% of patients with food insecurity expressed interest in social assistance. Predictors of interest in social assistance including being non-Hispanic Black, unmarried or unpartnered, a current smoker, and having a higher burden of other social risk factors.

Conclusions: Challenges remain in ensuring all patients are screened for food insecurity and other social determinants of health. Furthermore, health care systems should identify best practices to connect patients with food insecurity to community resources and government programs.

Funding Sources: This study was supported by Grant Number P30DK092926 (MCDTR) from the National Institute of Diabetes and Digestive and Kidney Diseases.