This is a guest blog by Dr. Robin Dickinson, MD. Dr. Dickinson is a family physician at Community Supported Family Medicine, a safety net clinic in Englewood, Colorado.
Having experienced poverty as a child, one of my goals in becoming a physician was to help other families in need; another of my goals was to never have to live with food insecurity again.
Five years ago, when my son was almost four years old and my daughter just seven months old, I suffered a vertebral artery dissection (tear of an artery in my neck). The tear clotted and sent small clots to my cerebellum: I had multiple small strokes. While I was blessedly spared any cognitive effects from the strokes, I was constantly dizzy and completely exhausted.
As the sole income for my family of four, I was suddenly struggling to see patients for an hour at a time before needing a nap. I couldn’t physically manage the work of caring for our two small children, so it made more sense financially for me to focus on getting my career back as I recovered, while my husband cared for all three of us.
We found ourselves unable to afford medical care or healthy food at a time when we needed them the most.
It was a strange time for me. I still looked like a physician and talked like a physician and worked as a physician and, simultaneously, we were running out of food. You cannot tell from outward appearances who is and isn’t food insecure. Many people have reasons for hiding their true situation, ranging from social embarrassment, not wanting to admit weakness at work, or a fear that they will lose respect due to cultural myths about food insecurity.
Physicians know the importance of screening everyone in a risk category regardless of how they appear. I don’t decide that someone doesn’t look like a smoker and therefore not ask about their tobacco habits. Food insecurity exacerbates existing disease and increases the risk for poor health. Those struggling with food insecurity may be forced to make trade-offs between food, medicine, and other basic necessities. To improve patient health, it is critical to screen for food insecurity to identify at-risk patients and then connect at-risk patients to the federal nutrition programs like SNAP and to emergency food providers.
Any change in life circumstance can increase food insecurity. One of my patients with newly diagnosed diabetes found himself food insecure for the first time because he was paying for medications, labwork, and doctor visits at the same time as he was removing inexpensive carbs from his diet and replacing them with more costly whole foods. Suddenly, he was faced with the choice of buying medication or buying food.
Health care clinicians already ask patients so many personal questions, yet often feel uncomfortable or unprepared to talk about food insecurity – which is one reason I am so excited about the new course that FRAC and the AARP Foundation created. Health care providers and community-based partners can learn how to screen adults age 50 and older for food insecurity and connect them to key nutrition resources. While the course focuses on adults 50+, much of the information and many of the strategies are relevant across the lifespan.
Those taking the free, 1-hour course will learn how to:
- define food insecurity;
- identify the risk factors for food insecurity among older adults;
- identify the negative health outcomes that food-insecure patients may face;
- use the Hunger Vital Sign™ screening tool; and
- connect individuals to the Supplemental Nutrition Assistance Program (SNAP), other nutrition resources, and community partners.
The course also includes a number of free, downloadable resources, including posters and charts that are ready to use in clinical settings. I encourage everyone in a position to screen and refer patients to needed resources to take the course so food insecurity can be effectively addressed in more health care settings across the nation.
FRAC and the AARP Foundation wish to thank Dr. Dickinson and Kaiser Permanente for permission to include a video featuring Dr. Dickinson in the course.