An Emerging Crises and How Community Hospitals Are The Solution

In a matter of only two years, Covid-19 has displaced our daily lives, resulting in profuse uneasiness in many ways. In 2022, the unfortunate story is still being written as the aftermath continues to threaten the health and wellness of the public with record inflation rates. As a result, there is an emerging crisis lurking within our communities:?Food Insecurity.

food in·se·cu·ri·ty

Definition: A household-level economic and social condition of limited or uncertain access to adequate food or a nutritious diet.

Historically, food insecurity has affected over 10% of Americans; however, because of extreme inflation, that number has climbed to a critical 15%.[1] Of the millions of Americans who face food insecurity, most reside in communities that are less densely populated. Statistically, these nonmetro areas make up 14%[2] of the U.S. population, and 86% of our country’s produce originates from farmlands in these areas.[3]?So, if nutritious options are available locally, why are people struggling in these areas where resources are abundant? Key factors to note are unemployment rates, low income, chronic health issues, and lack of access to healthcare.[4]?

While food insecurity remains a critical concern, an alarmingly increasing symptom that has been directly linked to food insecurity is mental illness. A recent study conducted by BMC Public Health found that in 2020, prior to inflation, food insecurity was associated with a 257% higher risk of anxiety and 253% higher risk of depression.[5] In 2022, reportedly 19.86% of adults have experienced some form of mental illness, and 7.74% of youth.[6] ?A side-by-side comparison of 2020 to 2022 shows the alarming increase of the Consumer Price Index and how there is a possible direct connection to mental illness:?

Our current climate indicates a direct correlation between a life-altering event, Covid-19, and increased food insecurity-related mental illness.

Creating Change: Community Hospitals

America consists of 6,093 hospitals, of which 85% are considered community hospitals and 30% are in nonmetro areas.[7 8] Less populated areas face the most significant concern. As quoted from Ally Hardebeck in Feeding America Action,

“12.5 percent of individuals living in rural communities were food insecure. Further, rural communities make up 63 percent of all counties in the United States, but 87 percent of counties with the highest rates of overall food insecurity are rural.”

Food insecurity doesn’t necessarily mean a shortage of food for a household. While this can be an attributing factor to the statistic, most food-insecure households directly result from unhealthy choices made due to the lack of affordable healthy options. These food insecurities fuel mental illness because 65% of nonmetro areas do not have psychiatrists, and more than 60% of the population live in areas that have mental health provider shortages.[9]?While food insecurity is a problem, the rapid growth of mental health concerns needs immediate attention and local community hospitals can help. Community hospitals typically represent the largest employers in their towns and are uniquely positioned to be a local influence for nutrition and wellness programs. These hospitals are a household name “shining like a beacon of light through the community,” where everyone knows your name. The opportunity to reduce food insecurities and prevent mental health issues is at stake. To promote awareness, focus on the two “I’s”:[10]

1.??????Intervene

• Screen for food insecurity in your patients
• Educate patients on better nutrition that works for their budget
• Leverage your nutrition department to connect better food options to the home
• Offer continuum of care and transition of care nutrition planning

2.??????Influence

• Connect with your community to encourage local resources at home
• Promote proper nutrition and fresh food through your retail and patient dining
• Integrate local farms into your programs and educate on how to utilize
• Open your cafeteria to the public for community dining, promoting affordable nutrition

?

Strategic Initiatives Make the Difference

Too often, smaller community hospital nutrition teams are limited in their scope. Integrating programs that address food insecurities and avert mental illness can be done with the support and guidance from a partnership with an industry expert in food and nutrition management. Strategic partners are positioned to provide dining management services to America’s community hospitals.

Community Engagement

As the prominent fixture in town, hospitals must become the standard for how people view health and wellness. Create retail programs that promote local integration to offer nutritious yet cost-effective menu options and support leveraging the cafeteria as an affordable community dining spot on the weekends or a hub for food pickup and delivery - a proven successful program for the elderly population. Much like a school lunch to a child, it may be the only nutritious meal they receive.

Patient Education

Initiatives include:

• Wellness education events emphasize healthier lifestyle
• Direct access to registered dietician support clinical teams that follow the Nutrition Care Process to ensure all patients receive timely and evidenced-based clinical nutrition care
• Discharge transition and continuum of care planning to help relieve at-home dietary planning
• Meal pickup and delivery: Affordable fresh food programs from the retail operation available for the community

The Risk of Doing Nothing

The opportunity is now. Hospitals play a critical role in ensuring the health and healing of their community. The time a patient may be in a hospital can vary greatly, but while in your care, it is an opportunity to bring awareness to the importance of nutrition for mental health intervention. There is also a demand for advocacy outside the hospital walls. Not giving proper attention to the impacts of food insecurity and mental illness could pose catastrophic consequences for a small-budget hospital as there is the risk of:?

1. Increased chronic disease
2. Increased financial strain on insecure homes from unexpected medical costs
3. Increased hospital admissions or readmissions by an underinsured population, affecting the hospital’s financial outlook
4. Depleting populations reduces the need for the local community hospitals

In conclusion, there is a significant correlation between inflation, increased food insecurities, and a decline in mental health. As a hospital, supporting the nutritional needs of a community can be complex, but it’s not an issue to be solved alone. Undine is the expert in supporting individual community hospitals, honoring their unique culture, and delivering the resources to help focus on local needs.

Written By: Derek Harris

Resources

[1] Coleman-Jensen, Alisha, Rabbitt, Matthew P., Hashad, Reem N., Hales, Laura., Gregory, Christian A. USDA Economic Research Service U.S. Department Of Agriculture (2022, April 22). Definition of Food Security. Retrieved from: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/#:~:text=Food%2Dinsecure%20households%20include%20those,from%2010.5%20percent%20in%202019

[2] Dobis, Elizabeth A., Krumel Jr, Thomas P., Cromartie, John, Conley, Kelsey L., Sanders, Austin., Ortiz, Ruben. USDA Economic Research Service U.S. Department Of Agriculture. (2021). Rural America at a Glance. Retrieved from: https://www.ers.usda.gov/webdocs/publications/102576/eib-230.pdf?v=4409

[3] American Farm Bureau Federation. (2021). Fast Facts About Agriculture & Food. Retrieved from: https://www.fb.org/newsroom/fast-facts

[4] Feeding America. (2022). Hunger and Food Insecurity. Retrieved from: https://www.feedingamerica.org/hunger-in-america/food-insecurity

[5] Fang, Di., Thomsen, Michael R., Nayga Jr, Rodolfo M., BMC Public Health. (2021, March 19). The association between food insecurity and mental health the COVID-19 pandemic. Retrieved from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10631-0#citeas

[6] Mental Health America. (2022). State of Mental Health in America. Retrieved from: The State of Mental Health in America | Mental Health America (mhanational.org)

[7] American Hospital Association. (2022, January). Fast Facts on U.S. Hospitals, 2022. Retrieved from: https://www.aha.org/system/files/media/file/2022/01/fast-facts-on-US-hospitals-2022.pdf

[8] American Hospital Association Survey Database. (2015-2019). Fast Facts U.S. Rural Hospitals. Retrieved from: https://www.aha.org/system/files/media/file/2021/05/infographic-rural-data-final.pdf

[9] Morales, Dawn A., Barksdale, Crystal L., Beckel-Mitchener, Andrea C. (2020, May 4). A call to action to address rural mental health disparities. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681156/#:~:text=There%20is%20a%20significant%20lack,provider%20shortage%20areas%20%5B13%5D.

[10] American Hospital Association. (2017, June). Food Insecurity and the Role of Hospitals. Retrieved from: https://www.hpoe.org/Reports-HPOE/2017/determinants-health-food-insecurity-role-of-hospitals.pdf

[11] U.S. Bureau of Labor Statistics. (2022). Consumer Price Index, Calendar Year Historical, 2017-2021. Retrieved from: https://www.bls.gov/regions/southwest/data/consumerpriceindexcyhistorical_southwest_table.htm

[12] U.S. Bureau of Labor Statistics. (2022). Consumer Price Index. Retrieved from: https://www.bls.gov/cpi/

[13] U.S. Department of Agriculture. (2021, March 3). Biden-Harris Administration’s Actions to Reduce Food Insecurity Amid the COVID-19 Crisis. Retrieved from: https://www.usda.gov/media/press-releases/2021/03/03/biden-harris-administrations-actions-reduce-food-insecurity-amid