In the United States, over 1 in 10 households experienced food insecurity in 2021. Children in households unable to access consistent nutrition can face signifiant negative health outcomes from emotional distress, nutritional deficiencies, obesity, and more. Pediatricians can use tools and community support tools to ensure that stigma is erased from food insecurity conversations and that their patients and families have reliable access to nutrition for healthy bodies and minds.
Causes & Community
Children can find it difficult to develop healthy eating and exercise habits in communities that do not or cannot offer them the resources to develop them. Your pediatric practice has unique insights on the community you serve -- what do you think most impacts the kids struggling with food insecurity in your area?
You might be thinking of the elementary school’s cafeteria options, the number of fast food chains in the area, or lack of local public space for kids to play. The point here is not to extend blame, but to determine what influences and obstacles families may be facing in their daily lives which can lead to childhood obesity. Once you know the causes, you can get to work on solutions. Some more examples might include:
- Local policies determining what businesses, including restaurants and grocery stores, are available in the area
- The affordability of low-calorie, high-nutrient foods from local stores
- Food insecure households who may be forced to weigh food costs with household bills
- The accessibility of places children can exercise and play, such as parks, playgrounds, or nature trails
- A child’s ability to play or exercise at home, including the safety of their home environment and neighborhood, accessibility to sports, and parental influence
Pediatricians can have great influence on childhood obesity not only via clinical care, but also through community outreach efforts. Once you’ve identified areas for improvement, become a part of efforts towards accessibility and food security by connecting with local programs with similar goals.
By connecting with stakeholders in the community at schools, hospitals, youth clubs, community centers, and faith-based organizations, to name a few, your practice can participate in community-centered change that can help provide kids at your practice the opportunity for healthy habits for decades to come. This change might include simple changes such as school cafeteria or vending machine changes, or larger ones such as the construction of playgrounds in public areas.
For more information about integrating with local systems to prevent chronic diseases such as childhood obesity, visit the CDC’s guide: Community-Clinical Linkages for the Prevention and Control of Chronic Diseases.
Food Insecurity, SNAP, & WIC
Food insecurity, obesity, poverty, unemployment, and inconsistent access to healthful food are interrelated factors in nutritional needs, which makes both community involvement and assistance programs necessary tools for your practice’s efforts in both reducing and eliminating hunger as well as childhood obesity.
As Dr. Steven Abrams, Chair of the AAP Committee on Nutrition, commented in The Independent Pediatrician, federal assistance programs such as SNAP and WIC are not integrated with electronic health records, making the connection between obesity or other nutrition-related conditions harder to connect to their cause -- food insecurity.
The COVID-19 pandemic impacted families' use of nutritional assistance programs like Women, Infants & Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). WIC use among children increased 8.7% among children from 2020 to 2022.
How Your Practice Can Help End Childhood Food Insecurity
Regular well visits are the backbone of making sure a child’s growth is on track and that they’re receiving the nutrition and getting the exercise they need to grow up healthy. Well visits can help you not only pinpoint risks for obesity in individual patients, but help you understand how to best help your patient population as a whole.
Among the many pediatrician-advocates working to improve access to consistent nutrition is Dr. Kimberly Montez, MD, MPH, FAAP, who gave a course on food insecurity during the American Academy of Pediatrics' 2022 National Conference & Exhibition in Anaheim, California.
“The main take-home message of the session,” she said, “is to equip pediatricians with the strategies and knowledge to address food insecurity within their practice, as well as on a community/state level." During Dr. Montez's presentation, she highlighted the AAP's partnerships with programs such as No Kid Hungry and a Project ECHO (Extension for Community Healthcare Outcomes) quality improvement program.
Among the actions pediatricians can take in practice are:
- Training all staff on food insecurity red flags and on sensitive, empathetic conversations around food insecurity
- Screenings and documented follow up with food-insecure families
- Partnerships and quality improvement programs with local resources, such as food pantries, No Kid Hungry, or similar local programs
- Utilization of pediatric resources, such as the Food Research and Action Center’s Food Insecurity Toolkit for Pediatricians.
When your practice has built the workflows to screen, document, and support families experiencing food insecurity consistently, you’ll be able to review your patient population and determine improvements on a population level. Outside of the practice? Dr. Montez encourages all pediatricians to educate and advocate for access to healthful and nutritious food in a supportive environment for families.
Advocate & Educate for Nutrition
Addressing food insecurity for children and families is a nuanced problem, tied to many other factors in a child’s life, such as environment and socioeconomic status. There are many clinical ways to help a child achieve a healthy weight and lifestyle, but in some ways, this is the simplest of a pediatrician’s tasks. More complex is a practice’s response to their communities’ contextual needs -- the social determinants of a healthy weight and lifestyle for kids.
Luckily, from connecting families to available resources to advocating for policies that will help every child get the access they need, there are plenty of ways your practice can help. While your practice is considering ways to address childhood obesity in your community, don’t forget that food insecurity as well as dealing with obesity can be hard on kids’ mental health. To integrate behavioral health at your practice and get kids access to the services they need, check out our ebook on the topic to decide which path forward is the best for your patients and your practice.
