Tuesday, March 28, 2023

Experts Call for Consistent Screening of Food Insecurity Among Adolescents

It is well established that adolescents experiencing food insecurity (inconsistent access to enough safe and affordable food to live an active, healthy life) are at greater risk of physical and mental problems. In a Viewpoint article published yesterday in JAMA Pediatrics, Kaitlyn Harper, Ph.D., M.Sc., M.A., of Johns Hopkins Bloomberg School of Public Health and Hilary Seligman, M.D., M.A.S., of the University of California, San Francisco (UCSF), describe the need to integrate an accurate and reliable screening tool to assess food insecurity into clinical settings.

“The Biden-Harris national strategic plan emphasizes the importance of reaching populations that have been inadequately served by existing food and nutrition security programs and policies,” they wrote. “Adolescents fall into this gap.”

Harper is a postdoctoral fellow at Hopkins whose research is focused on improving food and nutrition security for children and adolescents in the United States through federal programs. Seligman is a professor of medicine, epidemiology, and biostatistics at UCSF and an expert in food insecurity and its health implications across the life course.

In the article, Harper and Seligman described efforts to date to quantify adolescent food insecurity in the United States by surveying heads of households. The authors pointed out that these surveys likely underestimate the extent of the problem—as research shows caregivers’ responses and adolescents’ responses on food security rarely match.

Food insecurity during adolescence can lead to short- and long-term morbidity and early death, as well as increased risk of engaging in risky health behaviors. “Although it is difficult to disentangle trauma directly related to food insecurity from other trauma often experienced simultaneously, such as racial discrimination, unstable housing, and neighborhood violence, adolescents living in households with food insecurity have an increased risk of mental health disorders, including depression, anxiety, substance use or substance use disorder, and suicidality,” Harper and Seligman wrote. “The health ramifications of food insecurity among adolescents underscore the need for an accurate and reliable screening tool that may be widely used in clinical settings.”

They described several food security screens that have been tested on adolescents in research settings, including the nine-item Self-Administered Food Security Survey Module for Youth Ages 12 and Older and the two-item Hunger Vital Sign.

They concluded, “Screening adolescents for food insecurity can help providers understand the unique adolescent experience with accessing affordable and nutritious food. It can also serve as the first step toward referring high-risk patients to food security programs, including SNAP (Supplemental Nutrition Assistance Program) and the U.S. Department of Agriculture’s Produce Prescription Program. Finally, screening may create momentum for policies and programs that are uniquely tailored to the food security needs of adolescents.”

For related information, see the book The Social Determinants of Mental Health.

(Image: iStock/SelectStock)

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