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Effects of Food Insecurity on Asthma Outcomes in the Pediatric Emergency Department

Hendrickson, Marissa A. MD*†; O'Riordan, Mary Ann MS; Arpilleda, Joyce C. MD†‡§∥; Heneghan, Amy M. MD‡¶

doi: 10.1097/PEC.0b013e3181fb0dab
Original Articles

Objectives: Food insecurity is associated with a wide variety of adverse health conditions in adults and children, but its relationship to asthma outcomes in children has not been described. The objectives of this study were to assess and characterize the food security status of an inner-city asthmatic population and to determine whether and to what extent household food insecurity is independently associated with negative clinical outcomes in children presenting to a pediatric emergency department (ED) with asthma exacerbations.

Methods: This study is a cross-sectional survey of a convenience sample of families of children presenting to an urban children's hospital ED for asthma exacerbations. Data were gathered through structured chart review and interview, including a published food insecurity questionnaire.

Results: A total of 127 families were enrolled, with a median patient age of 6.6 years. Of all families, 81% were black and 10% were white. Of these families, 35% met criteria for household food insecurity. 78% of food-insecure and 46% of food-secure households received food stamps. Of all food-insecure households, 67% reported never using food pantries or free community meals. 36% of food-insecure and 31% of food-secure patients lacked an adequate home supply of asthma medications. The overall admission rate was 37%; no significant difference was found in admission rate or length of stay.

Conclusions: The rate of household food insecurity in families of asthmatic children presenting to an urban ED is high, with relatively low participation in a number of safety net programs. This study failed to demonstrate an association between household food insecurity and negative asthma outcomes.

From the *Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; †Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH; ‡Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH; §Department of Pediatric Emergency Medicine, Rady Children's Hospital-San Diego, San Diego, CA; ∥Department of Pediatrics, University of California-San Diego, San Diego, CA; and ¶Palo Alto Medical Foundation, Palo Alto, CA.

Reprints: Marissa A. Hendrickson, MD, Division of Emergency Medicine, Department of Pediatrics, University of Minnesota, MMC814, 76VCRC, 420 Delaware St S.E., Minneapolis, MN 55455 (e-mail:

An interim analysis was presented in poster form at the annual meeting of the Midwest Society for Pediatric Research, October 18, 2007, in Indianapolis, IN.

The authors have no funding sources to disclosure.

© 2010 Lippincott Williams & Wilkins, Inc.