Frequently Asked Questions about Screening for Food Insecurity

At Stanford Medicine Children’s Health, a team led by pediatrician Baraka Floyd, MD, is deploying a systematic new way for our healthcare providers to ask about and respond to needs in patients’ lives that occur outside the medical system.

A recent story in Stanford Medicine magazine explains how the team is working to help all patients’ families gain reliable access to food, a step in a larger effort to make health care more responsive to social factors that influence patients’ health. Below are answers to frequently asked questions about the new program.

Why is Stanford Medicine Children’s Health expanding the types of questions covered by our electronic health records?

Our patients’ health is affected by many things that happen outside our clinics and hospital units. Known as social determinants of health, these include such factors as whether a family has enough to eat, stable housing or reliable transportation. When problems arise in these areas, it can be harder for families to focus on medical needs.

Clinicians across the country are recognizing that it is important to ask about social determinants of health to boost their opportunities to provide support and holistically address patients’ medical needs.

What is food insecurity?

People experiencing food insecurity often have limited access to safe, nutritious food. They might worry about running out of food before they have money to purchase more, for example.

Food insecurity is common in California, affecting an estimated 11-20% of the state’s population, and is more common among families with children. The COVID-19 pandemic worsened food insecurity for many families, with many of them using food assistance for the first time.

Who will be screened for food insecurity at Stanford Medicine Children’s Health?

Stanford Medicine Children’s Health is building a program to screen every patient for food insecurity. As part of our routine intake questionnaire, all patients’ families will be asked whether, in the previous 12 months, they worried their family’s food would run out — or food did run out — before they had money to buy more.

The screening program is currently being pilot-tested by several of our clinics and units. We expect it will be rolled out to every patient across the organization in the second half of 2023.

If a family tells a member of the health care team they are experiencing food insecurity, what will happen?

The information will be added to the patient’s electronic health record, which will prompt the clinician to have a discussion with the family about whether they would like resources. The clinician can generate an electronic referral to Second Harvest Food Bank. An employee of the food bank will contact the family to evaluate their needs and connect them to food resources, such as by helping them enroll in California’s Women, Infants and Children program or the federal Supplemental Nutrition Assistance Program, or identifying a nearby food bank location where they can pick up food at no charge.

Information about food insecurity will be kept confidential, following the same privacy guidelines applied to other parts of the electronic health record.

How will the screening program help to reduce food insecurity?

In addition to enabling Stanford Medicine Children’s Health to connect individual families to local food resources, our teams will be able to use de-identified data from our electronic health records to learn from the patterns of food insecurity we see among our patients. This will help us generate better ideas for how to reduce the problem among the families and communities we serve.