167 - Characterizing food insecurity and assessing food insecurity-based interventional efforts of one regional health system in Southeastern Virginia

Publication Number: 167.4089

Mackenzie Kelley, Eastern Virginia Medical School, Norfolk, VA, United States; John W.. Harrington, CHKD, Chesapeake, VA, United States; Turaj Vazifedan, Eastern Virginia Medical School, Norfolk, VA, United States

Background: Virginia Medicaid mandates that pediatricians screen for food insecurity (FI) and other social determinants of health (SDOH) in order to improve healthcare outcomes and costs. The Children’s Hospital of The King’s Daughter Health System (CHKDHS) serves over 500,000 patients in Southeastern Virginia and screens for SDOH using the Safe Environment for Every Kid (SEEK) tool. CHKDHS includes General Academic Pediatrics (GAP), an academic-based practice serving primarily Medicaid patients, and Children’s Medical Group (CMG), composed of 28 community practices that serve patients with mixed insurances.

Objective: This study aims to characterize the prevalence and geo-spatial patterns of FI and other SDOH among CHKDHS patients. Furthermore, the study seeks to assess providers’ interpretation of SEEK results and how they address the concerns they identify.

Design/Methods: SEEK data for patients at GAP (n=14784) and CMG (n=57760) between April 2022 and May 2024 was extracted from the electronic medical record by CHKDHS and provided to the research team. Descriptive analysis was performed using SPSS 29 (Chicago, IL). All statistical tests were 2-sided, and p< 0.05 was considered statistically significant.

Results: The rate of FI among GAP patients (7.6%) was significantly higher than that of CMG patients (4.3%). Rates of FI ranged from 1.7 to 15.8% across CMG practice zip codes, with significantly higher rates found in several areas of Norfolk as well as zip codes in Newport News, Hampton, and Virginia Beach. FI was significantly associated with higher likelihood of illegal drug use, depression, harsh punishment, intimate partner violence, and major stress in households of patients at GAP and CMG. Twenty-two percent of GAP patients were marked as “at risk” by providers based on their interpretation of SEEK results. Fifty-eight percent of these patients were referred to some intervention to address concerns that the provider identified. Eleven percent of CMG patients were marked as “at risk,” 22% of whom were referred to some intervention. There was no significant difference in the rate of risk identified among those with FI between GAP and CMG. However, the rate of risk identified among those with no FI was significantly higher at GAP.

Conclusion(s): This work provides an overview of FI and other SDOH among CHKDHS patients. While GAP patients experienced higher rates of FI, these patients were more likely to be referred to an intervention as compared to CMG patients experiencing FI. Findings could support capacity building to better identify and address concerns at CHKDHS.