O0659 Oct.4: 5:08pm - Mind the Resource Gap: Depleted Federal Benefits Predicts Ongoing Food Insecurity

Background: One in six American children experiences food insecurity (FI), an inconsistent access to enough food for a healthy, active life. Given associations between FI and negative health and developmental outcomes, the American Academy of Pediatrics (AAP) recommends universal pediatric screening for FI and referral to appropriate services/resources. However, FI persists despite the assistance of federal food benefits such as the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants, and Children (WIC). It remains unclear to what extent and why families receiving benefits have ongoing FI, as well as how FI relates to emergency food access and ability to provide healthy meals.

Objective: To investigate associations between FI and receipt of federal benefits, benefit duration, household composition, frequency of emergency food access, and trade-offs in meal cost and quality.

Design/

Methods: During a 3-month period, we surveyed families seeking care for a child at a Federally Qualified Health Center (FQHC). The 10-question survey included 7 items from the validated Food Security Questionnaire with additional questions about food access issues. Chi-square and univariate logistic regression analysis were performed to evaluate relationships among survey variables.

Results: Of the 104 households surveyed, the median (range) household consisted of 4 members (2-12), including 2 children (1-10). FI affected 64% of households despite the majority receiving federal benefits such as SNAP, WIC, or both (Table 1). Benefits did not last the full 4 weeks for most households receiving benefits (mean duration 2.8 weeks, SD ± 1.0; Table 2). While receipt of benefits did not correlate with FI, families were 16 times more likely to experience FI when one of their benefits lasted less than 4 weeks (OR 16.02, p<0.0001; Table 2). Families with FI were more likely to report preparing less healthy (p=0.001) or less expensive meals (p<0.001), as well as a need to access the emergency food system (p=0.05).

Conclusion: In contrast to the national FI rate (11%), FI affected 64% of families with children seeking care at one FQHC site. Moreover, federal benefit enrollment alone did not ensure protection against FI since, when depleted before 4 weeks, the odds of FI significantly increased. Thus, simply referring for federal food benefits may not be adequate when FI is identified. Implementing follow-up questions about duration of benefits may identify resource gaps and inform appropriate community resource connections.