Hungry? 

By Mallory Carteaux, MS, Johns Hopkins All Children’s Hospital 

“This is such a blessing. Times are really hard for us right now,” said the father of five as he chose fresh fruits and veggies for his children at the AllKids Campus Market, Johns Hopkins All Children’s Hospital’s family and employee food pantry. One child was about to have surgery that required a soft diet during recovery, and mom and dad were relieved to see applesauce and canned veggies available. Times like this can cause a strain on already tight budgets, especially for families that don’t qualify for SNAP or other assistance programs but still struggle to make ends meet. This is a common refrain these days as the cost of food and gas soar.  

Universal screening for food insecurity 

Reliable access to healthy food—notably fruits, vegetables, whole grains, and lean protein—is linked to improved health, better psychological well-being, reduced risk of chronic and metabolic diseases, and reduced healthcare costs. People who can’t afford to put food on the table face high rates of anxiety, and parents may sacrifice their own meals to ensure their children can eat.  

These people may be suffering silently, unwilling or unable to ask for help. Individual financial circumstances can quickly change—an injury, illness, caregiving responsibilities, or job loss/change can rapidly alter a person’s ability to purchase quality meals. Making assumptions about who should be screened for food insecurity can cause patients and families falling through the cracks. 

It may be tempting to only screen patients who fit certain criteria, but one can’t identify food insecurity by demographics, diagnosis, insurance status, income bracket, or appearance. The best course of action is to universally screen for food insecurity and have a plan for referrals if a patient screens positively. Identify what resources are available to patients within your organization and community. Collaborate with the social work, community, and nutrition teams to compile a resource guide to help patients connect to pantries, hot meals, and “Food as Medicine” programs.  

Changing circumstances 

Pride or fear may preclude some patients from divulging their food security status even when screening is conducted in a caring and empathetic manner. To ensure these patients don’t miss out on vital resources, providers can share food and nutrition resources as posters, pamphlets, and flyers in clinical spaces. Posters about the onsite pantry hours or flyers advertising food as medicine programs can go a long way to show that the organization values the role of nutrition in healthcare.  

Providers should screen for food insecurity annually and also consider times that can impact access to food. A big one is summertime—students will no longer receive free breakfast and lunch at school, so clinicians need to know about federal, state, and community programs that bridge this meal gap in the summer months.  

Four simple tips for providers: 

Meaningful differences can occur without extra strain on healthcare professionals.

1. Screen every patient for food insecurity.  

The two-question Hunger Vital Sign screening tool is quick and reliable. Universal screening removes the guesswork and streamlines the process.  

2. Build your network. 

Collaborate across departments, bringing together clinical, nutrition, social work and community teams to lessen the burden and unify the message. 

3. Know the resources and refer when indicated.  

Familiarize yourself with the food programs available within your community and organization to connect patients with the resources that will benefit. Share this information even with patients who don’t screen positive to show it’s available for them if their situation changes. 

4. Ditch the stigma. 

Food insecurity can affect anyone at any time. Build rapport with your patients to make the conversations feel less sterile. The more comfortable the patient is, the more likely they are to share their circumstances.  

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.