According to the USDA Economic Research Service, 35.2 million people or 10.5% of households were food insecure some time during 2019. Food insecurity is defined as “the disruption of food intake or eating patterns because of lack of money and other resources.”
While national unemployment has declined to 6.3% per the U.S. Bureau of Labor Statistics, it’s still significantly greater than the February 2020 rate of 3.5%. With an unemployment level this high, Americans who may not have been food insecure before the onset of COVID-19 are more likely to need food assistance.
Dietitians, whose focus is optimizing the nutrition status of their clients and patients have a unique opportunity to assess and improve food security of those with whom they work. Dietitians can use various validated tools to assess household food security with clients. Two such tools are the six-item Food Security Questionnaire (FSQ) and the abbreviated two-item FSQ, which asks clients to respond with “often,” “sometimes,” or “never” to the following two validated questions about their food security within the past 12 months:
- The food I/we bought just didn’t last and I/we didn’t have money to get more.
- I/we couldn’t afford to eat balanced meals.
Once food insecurity is identified, dietitians can take a variety of actions. They can find a local food bank by searching the Feeding America website by clients’ ZIP codes. Dietitians also can print or e-mail a list of local food banks to clients. Food banks throughout the country provide food monthly, weekly, and daily.
In addition, RDs can assist clients by making them aware of programs such as SNAP (Supplemental Nutrition Assistance Program) and WIC and by helping them complete applications for these programs. Applying for this government assistance can be confusing, especially for those who, in the age of COVID-19, may be applying for the first time. Dietitians can reach out to their local SNAP offices to learn more about the application process to support clients and patients.
Some dietitians may be able to provide food directly to clients and patients. Due to the pandemic, some organizations are looking for ways to give back to and engage with the community. Food pantries and food banks are a great way of providing this support. Dietitians can talk to the leaders in their organizations about the benefits these services may provide to their communities.
For example, at an inpatient rehabilitation hospital in Columbus, Ohio, clinical dietitians have created a food pantry for patients. Each patient admitted is screened for food insecurity with two questions, and patients answering “sometimes” to one or both questions are offered a food pantry item as well as a list of food banks in their area.
The food in the pantry provides heart-healthy, shelf-stable foods (eg, brown rice, no-salt-added canned vegetables, and salt-free seasonings) to assist in reinforcing education offered at the hospital regarding a cardioprotective diet. The pantry also stocks foods compliant with various dysphagia diets for patients who require altered texture diets. Other organizations may want to consider how to offer specialized food products in their food bank to optimize MNT goals.
Dietitians in a variety of settings have a unique opportunity to connect patients to resources to improve their food security and, in some cases, to provide the resources directly. In this way, RDs can be a part of alleviating the strain COVID-19 has had on their patients and communities at large.
— Jena Tucci, RDN, LD, CNSC, is a clinical dietitian in Columbus, Ohio. Having worked in foodservice and in the community with an infant mortality taskforce, she looks for ways beyond the inpatient stay to maximize patients’ nutrition status.