Food insecurity is associated with increased healthcare expenditures

January 11, 2023

3 minutes to read

Disclosures:
Palakshappa reported receiving support from the National Heart, Lung and Blood Institute. Please see the study for all relevant financial disclosures of the other authors.


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A recent study showed that families facing food insecurity have higher healthcare expenditures than those who are food insecure.

“We know that Food insecurity he have Negative effect on individual health outcomes“,” Deepak BalakashabaMD, MSHP, said an assistant professor of general internal medicine at Wake Forest University, in a news release. “But we need a better understanding of the financial impacts on families and healthcare expenditures.”

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Data derived from: Palakshappa D, et al. Health Affairs. 2023; doi 10.1377 / healthhav. 2022.00414.

Palakshappa and colleagues evaluated data from 14,666 people in 6,621 families who participated in the 2016 and 2017 Medical Expenditure Panel Survey. The nationally representative survey, which collects information from healthcare providers across the United States, is conducted annually by the Agency for Healthcare Research and Quality .

10.1% of the participants suffer from food insecurity.

“We found that food insecurity in 2016 was associated with increased care expenditures in 2017 among families regardless of the type of insurance coverage,” Palakshappa said in the release.

More specifically, the total health care expenditures for families facing food insecurity were 20% higher than for families who were food insecure—a difference of $2,456 per year ($14,625 vs. $12,169).

Although Palakshappa and colleagues did not find a significant association between food insecurity and child health care expenditures, the researchers note that food insecurity among individual adults in 2016 was associated with higher health care expenditures in 2017—$6,693 (95% CI, 5,694- 7693) versus $5,387 (95% CI, 5,148–5,625), a difference of $1,307 (95% CI, 279–2,335).

In addition, households that faced food insecurity in 2016 but were food secure the following year had higher total expenditures in 2017 than households that were food secure in both 2016 and 2017 – $13,622 versus $12,247 , a difference of $1,375 (95% CI). , 538-2,211).

The researchers note that “food insecurity was not associated with more subsequent out-of-pocket expenditures, but was associated with more out-patient expenditures across all other health expenditure categories” such as emergency department visits, inpatient visits, outpatient visits, and prescription medications.

The association between food insecurity and higher expenditures was consistent across all patterns of household insurance, including approximately 20% of families with mixed coverage.

“Interventions that address food insecurity in one or more specific family members may … provide benefits to others in the home,” Balakshaba said in the statement. “There is a potential financial benefit for insurance companies to invest in these programs.”

For families all covered by the same carrier, initiatives at the insurance company level may increase each family member’s access to food, improve family health and reduce health care expenses “in a way that unlocks financial and health benefits,” the researchers wrote.

“More parents are enrolling their children for Medicaid or CHIP instead of employer-sponsored health insurance due to increased out-of-pocket expenses,” Palakshappa said in the statement. “However, expanding public benefits such as the Supplemental Nutrition Assistance Program or child tax credits can alleviate food insecurity.”

The researchers wrote that their findings have “important implications” for both clinical practice and policy.

“From a policy standpoint,” they write, “there has been increased investment by Medicare, Medicaid, and commercial health insurers in addressing food insecurity as a means of improving health, mitigating avoidable use, and reducing healthcare expenditures.” Examples include more robust screening for food insecurity, referrals to community organizations, and the provision of medically tailored meals. Our findings are consistent with the promise of this approach, as we found greater healthcare spending in families that experienced food insecurity.”

Palakshappa and colleagues conclude that there are clinical implications, writing that “although this study identified variance in health insurers within families, there may be a similar challenge for clinical care providers, where an increasing number of food insecurity interventions are being conducted.”

Among national pediatric societies, the researchers said there was “strong support” for pediatricians to routinely screen for and treat food insecurity.

“Although addressing food insecurity in children’s visits can have important long-term benefits for children, we found … that a short-term return on investment in the form of reduced healthcare expenditures may not occur,” they wrote. “However, improving families’ access to food at the pediatrician’s visit can have important health benefits for children and other adults in the home, and may bring about short-term reductions in healthcare expenditures for adult family members.”

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