A Promising Opportunity to Address Food Insecurity and Promote Equity: The Crucial Role of Federally Qualified Health Centers.

OBJECTIVE

To explore how Federally Qualified Health Centers (FQHCs) are addressing food insecurity by understanding their existing and needed services, policies, and community partnerships using a social determinants of health perspective to promote health equity.

DESIGN

A mixed-methods, exploratory case study research design consisting of two phases was conducted in 2023. Phase I involved a survey of FQHC leaders in Ohio. From these data, eight FQHC cases were identified for Phase II qualitative interviews of staff and patients.

SETTING

Ohio Federally Qualified Health Centers.

PARTICIPANTS

Executives, Frontline Staff and Patient Board Members of Federally Qualified Health Centers.

MAIN OUTCOME MEASURES: Policies, services, and community partnerships used by FQHCs to address food insecurity; FQHC screening staff and tools; resources to support food security; facilitators and barriers; FQHC methods to address health equity.

RESULTS

The majority of survey respondents (54%) stated that nutrition counseling was the most popular FQHC service provided, followed by the National Diabetes Prevention Program, and National Hypertension Control Initiative each at 24%. Policies related to federal food programs were listed by most respondents (N = 18) for addressing food insecurity, followed by food assistance programs including food pantries and food banks (N = 14). Farmers markets (40.54%) and local health departments (21.62%) were listed most frequently as community partners for FQHCs. Equity-related responses included screening all patients for food insecurity and having the screening tool available in multiple languages.

CONCLUSIONS

FQHCs provide services to underserved and at-risk patients. The top three diet-related chronic diseases addressed by FQHCs were diabetes, hypertension, and obesity. The most common social determinants of health concerns were food insecurity and transportation. Federally Qualified Health Centers staff and patient board members indicated that there should be an increased focus on equity.