Gwynne Latimer, MD
Childrens National Health Systems
Washington, District of Columbia
Disclosure information not submitted.
Kofi Essel, MD, MPH
MD, MPH
Children's National Hospital, United States
Disclosure information not submitted.
Title: Food Insecurity in the Pediatric Intensive Care Unit
INTRODUCTION/HYPOTHESIS: Food insecurity (FI) is the worry or inability of families to obtain enough food for everyone. FI is associated with worse health outcomes in children. While research on FI focuses on non-hospitalized children, the prevalence of FI in hospitalized children has been reported to be as high as 25%. There is little known about FI in critically ill children. We hypothesize that given the association of FI and worse health outcomes, there may be a higher prevalence of FI in the pediatric intensive care unit (PICU). The goal of this study is to characterize the prevalence of FI in the PICU.
Methods: This is a prospective cohort study of families admitted to an urban, quaternary care PICU during four-week enrollment periods in Fall 2020, Winter 2021, Spring 2021, and Summer 2021. English-speaking families of children under 18 years who had an unplanned admission to the PICU were approached for enrollment. Participants completed a brief survey including the USDA 18-item Food Security Supplement to explore depth of FI.
Results: 272 families were enrolled. 78 (28.7%) in the Fall, 68 (25%) in the Winter, 72 (26.5%) and 54 (19.9%) in the Summer. 47.7% (130) families self-identified as Black, 25% (68) White, 8.8% (24) Hispanic, 4.8% (13) Asian, 11% (30) multi-racial. Overall, 213 families (78.3%) were food secure and 59 families (21.7%) were food insecure. Of the food secure families, 32 (15%) experienced marginal food security. Of families experiencing FI, 35 (59.3%) had children experiencing child-level FI, 7 (12%) had children experiencing very low food security among children, and 24 (40.7%) experienced very low household food security.
Conclusions: This is the first study describing prevalence and severity of FI in critically ill children. In 2019, only 13.6% of households with children reported FI and only 0.6% of households reported very low food security among children. While data on FI during the COVID-19 pandemic is pending, our study suggests that FI in our PICU may be higher than that of the general population and is similar to rates reported in hospitalized children. Notably, our data shows that over half of families experiencing FI experience child-level FI, and that the prevalence of very low food security in our population is higher than previously reported in the general population.