In an article being early released this week in Pediatrics, “Reducing Caregiver Hunger During Hospitalization,’ Auger et al shed light on a less well-known impact that hospitalization has on some families of children enrolled in Medicaid—exacerbation of food insecurity (10.1542/peds.2022-058080). Hospital meals can be unaffordable to some families and, thus, can worsen hunger.
The authors of this study sought to find the percentage of caregivers who self-reported hunger during their child’s hospitalization by having research assistants ask eligible parents about their experience with hunger during the hospitalization. This was conducted for both the intervention (vouchers/food access) and control groups and performed before and during the COVID-19 pandemic in an urban hospital. Among families of patients enrolled in Medicaid and those with no health insurance, the authors implemented a multi-pronged approach to improve access to affordable food that included educating staff about the presence of food insecurity to providing vouchers and easily accessible non-perishable food items on the inpatient unit.
The authors found that providing only 1 meal voucher per caregiver per day did not significantly reduce self-reported hunger but providing 2 meal vouchers per day did significantly reduce self-reported hunger (down to 39% from 81%). Making the vouchers easier to obtain (e.g., having a charge nurse distribute them) additionally reduced self-reported hunger down to 15%.
The authors’ contribution is quite timely given the expiration of some of the COVID-19-related economic supports (e.g., ending of the child tax credit) that have helped to reduce poverty and associated food insecurity among children. Additionally, the recent ending of the COVID-19 national emergency declaration may have direct and indirect economic impacts, including limiting Medicaid expansion, free immunizations, etc., that may exacerbate extant food insecurity. All changes are occurring in the context of inflation-associated increases in food prices.
This article reminds us of AAP’s recommendation that we screen our patients/families for food insecurity. Additionally, we should continue to advocate for interventions that can reduce hunger, which can take many forms including providing food for all caregivers and patients regardless of their ability to pay (akin to free lunch for all public-school students) to allowing hospital cafeterias to accept supplemental nutrition assistance program (SNAP) benefits.
