Food Insecurity in the Bronx: A Card Study

Background: The Bronx has recently been ranked the “hungriest county” in the US. The Bronx also has disproportionally high rates of diabetes and obesity. Some literature suggests that food insecurity leads to obesity. Methodology: We undertook a cross-sectional “card study” in which doctors working in six New York City primary care practices administered a brief, anonymous survey to patients they saw during their clinic sessions. A two question food insecurity screen was used, height and weight were measured, and questions asked about enrollment in Nutrition Assistance Programs (WIC and Food Stamps). Preliminary Results: 401 cards have been completed to date in five practices (116 males; 108 pediatric visits; 71 Spanish speakers, 330 English speakers; 13: self-pay, 260 Medicaid, 107 private insurance. 184 patients received food-stamps; 97 received WIC. 190 (47%) patients had no food insecurity; 107 (27%) had moderate food insecurity and 102 (26%) had severe food insecurity on our 4 point scale. BMI data for adults showed 58 patients were thin, 90 had normal weight, 82 were overweight and 129 were obese. We did not find an association between food insecurity and higher BMI's. Discussion: Preliminary data in our population where overweight and obesity are common, show that over half the patients experienced some form of food insecurity. We did not find a relationship between food insecurity & BMI. Card study data, however, is subject to several biases. We were concerned about the prevalence of food insecurity, a problem we had not addressed routinely in primary care visits.