Rose Octave

December 6, 2022
NUTR6090
Riddle – Fall 2022

Assessment of Garnet Health Medical Center’s Food Pantry Lists to

Address Food Insecurity Among Patients
Introduction
This needs assessment was conducted on patients admitted to Garnet Health Medical Center
(GHMC) at the Middletown, NY and Harris, NY locations who had a positive screen for food
insecurity between November 18, 2022 – December 2, 2022. Patients were screened using a
validated food insecurity screening tool known as the Hunger Vital Sign. The Hunger Vital Sign
asks two questions: 1) Within the past 12 months I/we worried whether my/our food would run
out before I/we got money to buy more. 2) Within the past 12 months the food I/we bought just
didn’t last and I/we didn’t have money to get more. The result of each patient’s screening is
documented in GHMC’s electronic medical record software, Epic. The results of all screened
patients were compiled into an Epic generated report from which patients who had a positive
screen were identified and approached for participation in this study.
Patients with a positive screen were presented with the opportunity to participate in this study.
These patients were chosen for this study to inform an upcoming program to be implemented in
the Garnet Health system known as the Food Farmacy Project. The Food Farmacy Project is a
pilot study meant to supplement Garnet Health’s current intervention for food insecure patients
which is the provision of a food pantry list upon discharge. The Food Farmacy Project consists
of a closed food pantry that will supply patients with three days’ worth of food upon discharge
meant to last until patients can arrange for a visit to a food pantry.

Professional View
Several studies have investigated the relationship between food insecurity and poor or less than
optimal health outcomes. Estrella et. al. found that there is a high prevalence of food insecurity
in patients who visit the emergency room, and these patients often visit the emergency room
more frequently.1 This conclusion was also reached by Berkowitz et al. who also found that food
insecure patients have increased emergency room visits as well as increased inpatient admissions
and higher health care costs.2 Screening in these patients was found to be inherently useful and
food insecure patients recognize the need for proper nutrition to maintain health.3,4 This research
is important as it refutes the assumption that food insecurity in this population is inherently due
to poor health, food and nutrition-related knowledge deficit, or inability to correctly identify food
insecure patients. Instead, it supports the idea that food insecure patients have difficulty
accessing food. Moira Mencher, Manager of Physical Relations and Community Health at
Garnet Health's Community Health Department, stated that in her experience transportation
issues are often seen in patients with food insecurity making it difficult for them to visit a food
pantry after discharge. She’s also seen that patients often require more time to adjust and
convalesce after discharge before they can visit a food pantry. This further supports the idea that
access is the main issue in this population. Furthermore, in an Epic report consisting of Hunger
Vital Sign screenings from the past four months (September-December), 46 patients had a
positive screen for food insecurity. Within these 46 patients, 13 were over the age of 65, two
were homeless, and one had documented transportation issues. Therefore 34% of these patients
had issues related to transportation or would likely need additional time to arrange for a visit to a
food pantry. It is unknown whether the remaining 30 patients in this pool had issues that would
require additional time to visit a food pantry. These findings in conjunction with the
aforementioned research and experience support that the need in food insecure, hospitalized
patients is better access to food.

Population View
Following consent to participate in this study, patients were administered a 7-question survey
which is summarized in the table below.
Table 1. Survey Themes
Themes Topics covered
Attitude towards food, health, and Importance of reliable access to food to maintain good
food pantry list health, perceived helpfulness of food pantry list
Time between discharge and food How many days it would take patient to visit food
pantry visit pantry
Method of transportation Car, bike, cab/taxi, public transit (bus, train, etc.), other
Access to cooking/food storage Whether the patient has access to any of the following
equipment (select all that apply): stove, oven, microwave,
refrigerator
Demographics Age range, household size

A total of three patients were approached to participate in this study one of which declined.
Therefore, two patients participated in this study and both participants completed the survey in
its entirety. The results of the surveys can be found below:

Importance of reliable access to food to maintain good

health
2.5

2
Number of Participants

1.5

0.5

0
Very Important Important Neither Important Unimportant Very Unimportant
nor Unimportant
Importance
 Perceived helpfulness of food pantry list
2.5

2
Number of Participants

1.5

0.5

0
Very Helpful Helpful Neither Helpful Unhelpful Very Unhelpful
nor Unhelpful
Helpfulness

Time between discharge and food pantry visit

2.5

2
Number of Participants

1.5

0.5

0
1 to 2 3 to 4 5 to 6 7+
Days
 Transportation
1.2

1
Number of Participants

0.8

0.6

0.4

0.2

0
Car Bike Cab/taxi Public transit Other: None

Method

Access to cooking/food storage equipment

2.5

2
Number of Participants

1.5

0.5

0
Stove Oven Microwave Refrigerator
Cooking/Food Storage Equipment
 Age
2.5

2
Number of Participants

1.5

0.5

0
18-19 20-29 30-39 40-49 50-59 60-64 65+
Age Range

The results show that both participants believed that reliable access to nutritious food was very
important to maintain good health. Both participants had access to basic equipment for food
preparation and storage meaning they are able to properly cook and store the food they obtain.
They also both stated that it would take them 7 days or more to reach a food pantry after
discharge during which time they may be without food or without sufficient food. One
participant did not have access to any method of transportation which would prevent her from
visiting a food pantry. Of note, these patients were both elderly which could impact their
mobility anrd/or recovery time. The average household size was 3.5 people. This data is
consistent with findings from research, the experiences of Ms. Mencher, and data from the Epic
generated report. These findings highlight access to food as the need that must be addressed in
this population.

Areas of Overlapping Needs

The results reported above are consistent with findings from research, the experiences of Ms.
Mencher, and data from the Epic generated report. In both the professional and population view,
food insecure patients recognize the need for nutritious food to maintain good health. However,
transportation issues as well as the need for further recovery at home extending the period of
time between discharge and a food pantry visit prevents them from obtaining the food.
Therefore, the results reported above support the identification of limited access to food as the
problem in this population.

PES Statements
Limited access to food related to limited access to transportation and recent acute and/or acute on
chronic illness as evidenced by 50 % of participants without access to transportation, 100% of
participants needing 7 days or more to visit a food pantry after discharge.
 Abstract
This needs assessment was conducted on patients admitted to Garnet Health Medical Center
(GHMC) at the Middletown, NY and Harris, NY locations who had a positive screen for food
insecurity between November 18, 2022 – December 2, 2022. Patients with a positive screen were
presented with the opportunity to participate in this study to inform the Food Farmacy Project
which is currently being developed. Participants were administered a survey asking about their
attitudes toward food, health, and the food pantry list, how long it would take them to visit a food
pantry after discharge, method of transportation, access to cooking/food storage equipment, and
demographics. The study found that 50% of participants had limited access to transportation and
100% of participants would require at least a week to visit a food pantry after discharge. Of note,
100% of participants believed that reliable access to nutritious food was very important to
maintain good health and 100% of participants were elderly. The nutrition diagnosis for these
patients is limited access to food related to limited access to transportation and recent acute
and/or acute on chronic illness as evidenced by 50% of participants without access to
transportation, 100% of participants needing 7 days or more to visit a food pantry after
discharge. Based on the findings of this study, food insecure patients would benefit from an
initiative such as the Food Farmacy Project which would reduce the number of days they are
food insecure between discharge and a visit to the food pantry.

Reference List
1. Estrella A, Scheidell J, Khan M, et al. Cross-sectional Analysis of Food Insecurity and
Frequent Emergency Department Use. West J Emerg Med. 2021;22(4):911-918.
doi:10.5811/westjem.2021.3.50981

2. Berkowitz SA, Seligman HK, Meigs JB, Basu S. Food Insecurity, Healthcare Utilization, and
High Cost: A Longitudinal Cohort Study. Am J Manag Care. 2018;24(9):399-404.

3. Kress C, Durvasula J, Knievel A, et al. Patient Perspectives: Valuable Food Insecurity

Interventions. PRiMER. 2021;5:40. doi:10.22454/PRiMER.2021.233359

4. Caspi CE, Davey C, Barsness CB, et al. Needs and Preferences Among Food Pantry Clients.
Prev Chronic Dis. 2021;18:E29. doi:10.5888/pcd18.200531

Tools
Survey: Please see attached document in Blackboard submission