The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care

This study aimed: (1) to examine the sensitivity and specificity of the 2-item Hunger Vital Sign against the 18-item Household Food Security Survey Module (HFSSM) in identifying young children in food insecure households in emergency department and primary care sites and (2) to examine associations...

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Main Authors: Rajender K. Gattu, Grace Paik, Yan Wang, Prema Ray, Richard Lichenstein, Maureen M. Black
Format: Article
Language:English
Published: MDPI AG 2019-10-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/6/10/107
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spelling doaj-3a393f0ed93a4e3bb0cb73b06ad4add82021-04-02T08:10:53ZengMDPI AGChildren2227-90672019-10-0161010710.3390/children6100107children6100107The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary CareRajender K. Gattu0Grace Paik1Yan Wang2Prema Ray3Richard Lichenstein4Maureen M. Black5Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADivision of Growth &amp; Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADivision of Growth &amp; Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADivision of Pediatric Emergency Medicine, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADivision of Pediatric Emergency Medicine, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADivision of Growth &amp; Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USAThis study aimed: (1) to examine the sensitivity and specificity of the 2-item Hunger Vital Sign against the 18-item Household Food Security Survey Module (HFSSM) in identifying young children in food insecure households in emergency department and primary care sites and (2) to examine associations between food insecurity and adverse health conditions. We conducted cross-sectional surveys from 2009&#8722;2017 among 5039 caregivers of children age &lt;48 months. We measured adverse child health by caregiver-reported perceived health, prior hospitalizations, and developmental risk (Parents&#8217; Evaluation of Developmental Status). Analyses were conducted using covariate-adjusted logistic regression. Sensitivity and specificity of the Hunger Vital Sign against the HFSSM were 96.7% and 86.2%. Using the HFSSM, children in the emergency department had a 28% increase in the odds of experiencing food insecurity, compared to children in primary care, aOR = 1.28, 95% Confidence Interval (CI) = 1.08&#8722;1.52, <i>p</i> = 0.005. Using the Hunger Vital Sign, the increase was 26%, aOR = 1.26, 95% CI = 1.08&#8722;1.46, and <i>p</i> = 0.003. The odds of children&#8217;s adverse health conditions were significantly greater in food insecure households, compared to food secure households, using either HFSSM or the Hunger Vital Sign. Screening for food insecurity with the Hunger Vital Sign identifies children at risk for adverse health conditions in both primary care and emergency department sites, and can be used to connect families with resources to alleviate food insecurity.https://www.mdpi.com/2227-9067/6/10/107food insecurityadverse child healthemergency departmentprimary careyoung childrenhunger vital sign
collection DOAJ
language English
format Article
sources DOAJ
author Rajender K. Gattu
Grace Paik
Yan Wang
Prema Ray
Richard Lichenstein
Maureen M. Black
spellingShingle Rajender K. Gattu
Grace Paik
Yan Wang
Prema Ray
Richard Lichenstein
Maureen M. Black
The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
Children
food insecurity
adverse child health
emergency department
primary care
young children
hunger vital sign
author_facet Rajender K. Gattu
Grace Paik
Yan Wang
Prema Ray
Richard Lichenstein
Maureen M. Black
author_sort Rajender K. Gattu
title The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
title_short The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
title_full The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
title_fullStr The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
title_full_unstemmed The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care
title_sort hunger vital sign identifies household food insecurity among children in emergency departments and primary care
publisher MDPI AG
series Children
issn 2227-9067
publishDate 2019-10-01
description This study aimed: (1) to examine the sensitivity and specificity of the 2-item Hunger Vital Sign against the 18-item Household Food Security Survey Module (HFSSM) in identifying young children in food insecure households in emergency department and primary care sites and (2) to examine associations between food insecurity and adverse health conditions. We conducted cross-sectional surveys from 2009&#8722;2017 among 5039 caregivers of children age &lt;48 months. We measured adverse child health by caregiver-reported perceived health, prior hospitalizations, and developmental risk (Parents&#8217; Evaluation of Developmental Status). Analyses were conducted using covariate-adjusted logistic regression. Sensitivity and specificity of the Hunger Vital Sign against the HFSSM were 96.7% and 86.2%. Using the HFSSM, children in the emergency department had a 28% increase in the odds of experiencing food insecurity, compared to children in primary care, aOR = 1.28, 95% Confidence Interval (CI) = 1.08&#8722;1.52, <i>p</i> = 0.005. Using the Hunger Vital Sign, the increase was 26%, aOR = 1.26, 95% CI = 1.08&#8722;1.46, and <i>p</i> = 0.003. The odds of children&#8217;s adverse health conditions were significantly greater in food insecure households, compared to food secure households, using either HFSSM or the Hunger Vital Sign. Screening for food insecurity with the Hunger Vital Sign identifies children at risk for adverse health conditions in both primary care and emergency department sites, and can be used to connect families with resources to alleviate food insecurity.
topic food insecurity
adverse child health
emergency department
primary care
young children
hunger vital sign
url https://www.mdpi.com/2227-9067/6/10/107
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