The prevalence and effects of hunger in an emergency department-patient population

Objectives: Little is known about the prevalence and health effects of hung er among ED patients. The objectives of this study were to determine the:pr evalence of hunger among patients in a large urban ED and to examine whethe r it has adverse health effects. Methods: A survey about hunger, choices be tween buying food and buying medicine, and adverse health outcomes related to food adequacy over the preceding 12 months was administered to a conveni ence sample of adult non-critically ill ED patients from afternoon and even ing shifts. The study was conducted in the ED of Hennepin County Medical Ce nter in Minneapolis, Minnesota. Results: Of the 302 eligible patients who w ere asked to participate, 297 (98%) agreed. Eighteen percent reported not h aving enough to eat at least once in the preceding 12 months: 14% reported that they had "gotten sick" as a result of not being able to afford their m edicine, resulting in an ED visit or hospital admission 50% of the time. Pr edictors of making choices about buying food vs medicine include having a c hronic health condition, lack of private health insurance, having a reducti on in food stamps, having an annual income less than $10,000, and lack of a lcohol-use. By patient report, a reduction in food stamps was a predictor o f ED visits and hospitalizations as a result of making choices about buying food over medicine. Conclusion: The ED patients in this urban setting have high rates of hunger and many must make choices between buying food and me dicine, which patients report results in otherwise preventable ED visits an d hospitalization. Loss or reduction of food stamps is associated with incr eased hunger and increased perceived adverse health outcomes as a result of not being able to afford medicine.