Using malnutrition and food insecurity screening to identify broader health-related social needs amongst older adults receiving emergency department care in the Southeastern United States: A cross-sectional study |
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| Authors: | Aileen F. Aylward Jessa Engelberg Anderson Andrea Morris Montika Bush Brenda Schmitthenner Rayad Bin Shams Folafunmi Omofoye Santosh Bodepudi Heidi Roche Julia Cimpian Liane Wardlow Timothy F. Platts-Mills |
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| Affiliation: | 1. Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA;2. West Health Institute, San Diego, CA, USA;3. Gary and Mary West Foundation, CA, USA;4. University of North Carolina School of Medicine, Chapel Hill, NC, USA;5. Quantworks, Inc, Carrboro, NC, USA |
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| Abstract: | Unmet health-related social needs are common amongst older US adults and impact both quality of life and health outcomes. One of the ways that unmet health-related social needs impact health is through malnutrition, an imbalance in a person's intake of energy and/or nutrients. Lack of reliable access to a sufficient quantity of nutritious food is a specific health-related social need that can be assessed rapidly and, when unmet, is a direct risk factor for malnutrition and may be indicative of a broader range of unmet health-related social needs. We conducted a cross-sectional study to characterise malnutrition and food insecurity amongst older adults receiving emergency department (ED) care using brief, validated measures and to assess the burden of a broader range of health-related social needs amongst these patients. Patients were asked about their need for and willingness to receive a range of social services. The study was conducted in an academic ED serving a racially and socioeconomically diverse population in the Southeastern United States. A convenience sample of noncritically ill adults aged 60 years and older was approached between November 2018 and April 2019. Study patients (n = 127) were predominantly non-Hispanic white (67%), community dwelling (91%) and urban residents (66%) with 28% screening positive for malnutrition risk, 16% for food insecurity and 5% for both. Of those at risk for malnutrition, 25 (69%) reported ≥2 unmet health-related social needs and 14 (38%) were receptive to social services. Amongst food insecure patients, 18 (90%) reported additional unmet health-related social needs and 13 (65%) were receptive to receiving social services. In conclusion, a brief set of questions can identify subgroups of older ED patients who are food insecure or at risk for malnutrition. Individuals who screen positive for food insecurity have a high burden of unmet health-related social needs. |
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| Keywords: | emergency care health and social services older people older people's services |
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