Beyond the Kitchen Table: A Cross-Sectional Study on Food Insecurity and Emergency Department Use in the Community.

AIM: Food insecurity affects 33.8 million Americans and is associated with physical and mental health challenges and increased emergency department utilization. This study examined food insecurity prevalence among community-dwelling adults and identified demographic and social factors associated with emergency department use.

DESIGN

Cross-sectional study design.

METHODS

This study used a needs assessment survey administered to adults at health and wellness events over 3 years. Food insecurity was measured using The Hunger Vital Sign, a validated two-question screening tool. Emergency department use was assessed through self-report. Analyses included descriptive statistics, chi-square tests and binary logistic regression.

RESULTS

Among 705 participants, 75.9% were female, 80% identified as non-Hispanic Black or Hispanic and 46.5% earned under $20,000 annually. Overall, 66.5% were at risk for food insecurity and 32.8% reported emergency department use. Adults at risk for food insecurity had significantly higher emergency department utilization than those not at risk (37.7% vs. 22.9%). Food insecurity risk was significantly associated with Hispanic ethnicity, lower education and income, lack of insurance, unsafe neighbourhoods and housing instability. In multivariate analysis, lack of health insurance, unstable housing and food insecurity remained independently associated with emergency department use.

CONCLUSION

Food insecurity is prevalent among community-dwelling adults and significantly associated with emergency department utilization.

IMPLICATIONS FOR NURSING PRACTICE: Screening for food insecurity can identify modifiable social determinants of health and may help reduce inappropriate emergency department overuse, pointing toward the need for comprehensive, multi-level interventions addressing both immediate and structural drivers.