Skip to main content

Advertisement

SpringerLink
Log in

Food Insecure Families: Description of Access and Barriers to Food from one Pediatric Primary Care Center

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Despite evidence that food insecurity negatively impacts child health, health care providers play little role in addressing the issue. To inform potential primary care interventions, we sought to assess a range of challenges faced by food insecure (FI) families coming to an urban, pediatric primary care setting. A cross-sectional study was performed at a hospital-based, urban, academic pediatric primary care clinic that serves as a medical home for approximately 15,000 patients with 35,000 annual visits. Subjects included a convenience sample of caregivers of children presenting for either well child or ill care over a 4 months period in 2012. A self-administered survey assessed household food security status, shopping habits, transportation access, budgeting priorities, and perceptions about nutrition access in one’s community. Bivariate analyses between food security status and these characteristics were performed using Chi square statistics or Fisher’s exact test. The survey was completed by 199 caregivers. Approximately 33 % of families were FI; 93 % received food-related governmental assistance. FI families were more likely to obtain food from a corner/convenience store, utilize food banks, require transportation other than a household car, and prioritize paying bills before purchasing food. FI families perceived less access to healthy, affordable foods within their community. Thus, FI families may face unique barriers to accessing food. Knowledge of these barriers could allow clinicians to tailor in-clinic screening and create family-centered interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

FI:

Food insecure

USDA:

US Department of Agriculture

WIC:

Special Supplement Nutrition Program for Women Infants Children

SNAP:

Supplemental Nutrition Assistance Program

NSLP:

National School Lunch Program

FS:

Food secure

PPC:

Pediatric primary care

IQR:

Interquartile range

References

  1. Bickel, G., Nord, M., Price, C., Hamilton, W., Cook, J. (2000). Guide to measuring household food security. Revised 2000. Alexandria, VA: Office of Analysis, Nutrition, and Evaluation, Food and Nutritoin Service, US Department of Agriculture.

  2. Coleman-Jensen, A., Nord, M., Andrews, M., Carlson, S. (2012). Household Food Security in the United States in 2011. US Department of Agriculture, Economic Research Service. Contract No.: ERR-141.

  3. Alaimo, K., Olson, C. M., Frongillo, E. A., Jr, & Briefel, R. R. (2001). Food insufficiency, family income, and health in US preschool and school-aged children. American Journal of Public Health, 91(5), 781–786.

    Article  PubMed  CAS  Google Scholar 

  4. Skalicky, A., Meyers, A. F., Adams, W. G., Yang, Z., Cook, J. T., & Frank, D. A. (2006). Child food insecurity and iron deficiency anemia in low-income infants and toddlers in the United States. Maternal and Child Health Journal, 10(2), 177–185.

    Article  PubMed  Google Scholar 

  5. Casey, P. H., Simpson, P. M., Gossett, J. M., et al. (2006). The association of child and household food insecurity with childhood overweight status. Pediatrics, 118(5), e1406–e1413.

    Article  PubMed  Google Scholar 

  6. Metallinos-Katsaras, E., Must, A., & Gorman, K. (2012). A longitudinal study of food insecurity on obesity in preschool children. Journal of the Academy of Nutrition and Dietetics, 112(12), 1949–1958.

    Article  PubMed  Google Scholar 

  7. Cook, J. T., Frank, D. A., Berkowitz, C., et al. (2004). Food insecurity is associated with adverse health outcomes among human infants and toddlers. The Journal of nutrition, 134(6), 1432–1438.

    PubMed  CAS  Google Scholar 

  8. Rose-Jacobs, R., Black, M. M., Casey, P. H., et al. (2008). Household food insecurity: associations with at-risk infant and toddler development. Pediatrics, 121(1), 65–72.

    Article  PubMed  Google Scholar 

  9. Casey, P. H., Szeto, K. L., Robbins, J. M., et al. (2005). Child health-related quality of life and household food security. Archives of Pediatrics and Adolescent Medicine, 159(1), 51–56.

    Article  PubMed  Google Scholar 

  10. Richards, R., & Smith, C. (2006). Shelter environment and placement in community affects lifestyle factors among homeless families in Minnesota. American journal of health promotion, 21(1), 36–44.

    Article  PubMed  Google Scholar 

  11. Wiig, K., & Smith, C. (2009). The art of grocery shopping on a food stamp budget: factors influencing the food choices of low-income women as they try to make ends meet. Public health nutrition, 12(10), 1726–1734.

    Article  PubMed  Google Scholar 

  12. Nord, M., & Romig, K. (2006). Hunger in the summer: seasonal food insecurity and the National School Lunch and Summer Food Service programs. Journal of Children and Poverty, 12(2), 141–158.

    Article  Google Scholar 

  13. Kendall, A., Olson, C. M., & Frongillo, E. A., Jr. (1996). Relationship of hunger and food insecurity to food availability and consumption. Journal of the American Dietetic Association, 96(10), 1019–1024.

    Article  PubMed  CAS  Google Scholar 

  14. Leung, C. W., Ding, E. L., Catalano, P. J., Villamor, E., Rimm, E. B., & Willett, W. C. (2012). Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program. The American journal of clinical nutrition, 96(5), 977–988.

    Article  PubMed  CAS  Google Scholar 

  15. Rose, D. (1999). Economic determinants and dietary consequences of food insecurity in the United States. The Journal of nutrition, 129(2), 517S–520S.

    PubMed  CAS  Google Scholar 

  16. Hendrickson, D. S. C., & Eikenberry, N. (2006). Fruit and vegetable access in four low-income food deserts communities in Minnesota. Agriculture and Human Values, 23, 371–383.

    Article  Google Scholar 

  17. Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.

    Article  PubMed  Google Scholar 

  18. Powell, L. M., Slater, S., Mirtcheva, D., Bao, Y., & Chaloupka, F. J. (2007). Food store availability and neighborhood characteristics in the United States. Preventive Medicine, 44(3), 189–195.

    Article  PubMed  Google Scholar 

  19. Sloane, D. C., Diamant, A. L., Lewis, L. B., et al. (2003). Improving the nutritional resource environment for healthy living through community-based participatory research. Journal of General Internal Medicine, 18(7), 568–575.

    Article  PubMed  Google Scholar 

  20. Chung, C., & Myers, S. L. (1999). Do the poor pay more for food? An analysis of grocery store availability and food price disparities. Journal of consumer affairs, 33(2), 276–296.

    Article  Google Scholar 

  21. Andreyeva, T., Middleton, A. E., Long, M. W., Luedicke, J., & Schwartz, M. B. (2011). Food retailer practices, attitudes and beliefs about the supply of healthy foods. Public health nutrition, 14(6), 1024–1031.

    Article  PubMed  Google Scholar 

  22. O’Malley, K., Gustat, J., Rice, J., Johnson, C. C. (2013). Feasibility of increasing access to healthy foods in neighborhood corner stores. Journal of community health. Epub 2013/04/03.

  23. Sharkey, J. R., Dean, W. R., & Nalty, C. (2012). Convenience stores and the marketing of foods and beverages through product assortment. American Journal of Preventive Medicine, 43(3 Suppl 2), S109–S115.

    Article  PubMed  Google Scholar 

  24. Martin, K. S., Havens, E., Boyle, K. E., et al. (2012). If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT. USA. Public health nutrition, 15(10), 1973–1978.

    Article  Google Scholar 

  25. Clifton, K. (2004). Mobility strategies and food shopping fo low-income families: A case study. Journal of Planning Education and Research, 23(402), 402–413.

    Article  Google Scholar 

  26. Kirkpatrick, S. I., & Tarasuk, V. (2011). Housing circumstances are associated with household food access among low-income urban families. Journal of urban health, 88(2), 284–296.

    Article  PubMed  Google Scholar 

  27. Kirkpatrick, S. I., & Tarasuk, V. (2007). Adequacy of food spending is related to housing expenditures among lower-income Canadian households. Public health nutrition, 10(12), 1464–1473.

    Article  PubMed  Google Scholar 

  28. Bhattacharya, J., DeLeire, T., Haider, S., & Currie, J. (2003). Heat or eat? Cold-weather shocks and nutrition in poor American families. American Journal of Public Health, 93(7), 1149–1154.

    Article  PubMed  Google Scholar 

  29. Kirkpatrick, S. I., & Tarasuk, V. (2010). Assessing the relevance of neighbourhood characteristics to the household food security of low-income Toronto families. Public health nutrition, 13(7), 1139–1148.

    Article  PubMed  Google Scholar 

  30. Jones, P., & Bhatia, R. (2011). Supporting equitable food systems through food assistance at farmers’ markets. American Journal of Public Health, 101(5), 781–783.

    Article  PubMed  Google Scholar 

  31. George, D. R., Kraschnewski, J. L., & Rovniak, L. S. (2011). Public health potential of farmers’ markets on medical center campuses: A case study from Penn State Milton S. Hershey medical center. American Journal of Public Health, 101(12), 2226–2232.

    Article  PubMed  Google Scholar 

  32. Carney, P. A., Hamada, J. L., Rdesinski, R., et al. (2012). Impact of a community gardening project on vegetable intake, food security and family relationships: A community-based participatory research study. Journal of Community Health, 37(4), 874–881.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Angela Howald for her help with data collection. This project was supported by funds from the Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS), under the CCHMC NRSA Primary Care Research Fellowship in Child and Adolescent Health (T32HP10027). The information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by the BHPR, HRSA, DHHS or the US Government (DeMartini). Dr. Beck is supported by the Cincinnati Children’s Hospital Medical Center Procter Scholar Award. The authors have no conflicts of interest or financial relationships to disclose.

Author information

Authors and Affiliations

  1. Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, ML 7035, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Tori L. DeMartini & Robert S. Kahn

  2. Division of General and Community Pediatrics and Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, ML 7035, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Andrew F. Beck & Melissa D. Klein

Authors
  1. Tori L. DeMartini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew F. Beck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert S. Kahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melissa D. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tori L. DeMartini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

DeMartini, T.L., Beck, A.F., Kahn, R.S. et al. Food Insecure Families: Description of Access and Barriers to Food from one Pediatric Primary Care Center. J Community Health 38, 1182–1187 (2013). https://doi.org/10.1007/s10900-013-9731-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-013-9731-8

Keywords

Search

Navigation