AUSTIN, Texas — As rates of COVID-19 cases grew in Travis County during the spring and summer, researchers from Dell Medical School at The University of Texas at Austin found another troubling phenomenon alongside the pandemic: food insecurity.
Before COVID-19 struck, 1 out of every 5 children and 1 in 4 adults in Travis County were food insecure – meaning they suffered from limited or uncertain availability of food.
In a new study, a Dell Med Department of Pediatrics research team led by Megan Gray, M.D., MPH, and Ana Avalos, M.D., partnered with CommUnity Care Health Centers to conduct a study of 645 Austin-area families between April to August 2020 who sought care at two CommUnityCare clinics. The study showed food insecurity affected families surveyed 33% to 70% during this time, with an average of 47%. The fluctuations corresponded to Travis County COVID-19 rates and hospitalizations, and with changes in the labor market.
“In May, when steps were taken to reopen the Texas economy, food insecurity flexed downward, only to peak at 70% of families during July, when local COVID rates worsened,” said Gray, an assistant professor in the departments of Pediatrics and Population Health at Dell Med.
“While these numbers of increased or decreased percentages of food insecurity give us a snapshot of what our community is facing, the reality of food insecurity goes beyond just having enough money to buy food. It’s about the chronic stress and mental health impact of families who are worried about not being able to meet their children’s needs,” said Gray.
“And looking at these numbers, it’s very concerning that COVID-19 has erased decades of progress in food access and food equity, which will likely get worse this winter as COVID-19 rates rise in our community.”
Asking the Right Questions
In the 20-week study, Gray’s team screened CommUnityCare patients and their families for food insecurity. Most patients received assistance through Medicaid and were under 2 years of age partly because CommUnity Care prioritized access for the youngest pediatric patients at the start of the pandemic.
The standardized screening process consisted of two questions posed to parents about having enough money to buy food and worries about food running out. Researchers asked additional questions about recent job loss in the family and reliance on community resources.
The increases in food insecurity were most significant among Hispanic and Spanish-speaking families. Some of the factors that families cited were being out of work due to having COVID-19 illness themselves or a need to quarantine.
A Call to Action For – and Beyond – Health Care Providers
As COVID-19 numbers have begun to surge again in Travis County, Gray said she hopes her research will spark more discussions among providers and families.
“Food insecurity is hiding in plain sight. We don’t know unless we ask,” said Gray, who adds that pediatricians see families along the food insecurity spectrum daily, but they may not be aware without proactively addressing it.
The American Academy of Pediatrics calls for pediatricians and family care providers to proactively “screen, intervene and advocate,” to identify food insecurity among their patients.
But asking isn’t as simple as one would hope, said Gray. “We need to get past the fear of feeling awkward or upsetting patients by asking about their access to foods. The overwhelming majority of our patients were incredibly appreciative that we brought this up,” she said.
However, Gray believes the duty to show concern extends beyond the medical community. “Anyone in a public-facing job needs to educate themselves about resources to refer families to,” she said. “We’re in this for the long haul, but we’re in this together, and we are in an excellent position to help.”