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Food insecurity is defined as unstable and unreliable access to adequate, nutritious food. In the United States, at least 1 in 7 children experiences food insecurity. Because this critical social determinant of health can have negative implications on child health and development, it is important for pediatric practitioners to screen for, and identify, food insecurity in children and their households by using the Hunger Vital Sign. Food insecurity has been shown to disproportionately affect high-risk groups, including racially marginalized groups and homes headed by a single caregiver. In the clinical setting, food insecurity can present in various ways, including nutrition deficiencies, less optimal child feeding behaviors, poorer mental health and academic outcomes, and higher rates of emergency department use. This chapter also summarizes resources available at the local, state, and national levels to address food insecurity and outlines possible strategies for managing food insecurity in the clinic setting. As we expand our understanding of food insecurity in the pediatric population, recommendations on how to best approach it will continue to evolve.

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