Food Insecurity and Obesity in New York City Primary Care Clinics

Authors:
  • BFByron Alexander Foster
    Byron Alexander Foster
  • VMVictoria Mayer
    Victoria Mayer
  • VPVanessa Pratomo
    Vanessa Pratomo
  • DMDiane McKee
    Diane McKee
  • SMStacia Maher
    Stacia Maher
  • GCGiselle Campos
    Giselle Campos
  • MAMatthew Anderson
    Matthew Anderson
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Abstract
Hunger continues to be a problem in New York City; paradoxically, the city also has disproportionally high rates of diabetes and obesity. Some research suggests that food insecurity leads to obesity. We undertook a cross-sectional "card study" in which doctors working at 8 New York City area primary care practices administered a brief, anonymous survey to patients they saw during clinic sessions. The survey included a 2-question food insecurity screen and questions about enrollment in nutrition assistance programs. Height and weight were also measured at the visit. Cards were completed for 558 patients (65.1% female; 74.7% adults; 78.5% conducted in English). Fifty-five percent of patients were receiving some form of food assistance. More than half of patients (51.7%) reported some degree of food insecurity. Of adult participants, 21.8% had normal weight, 29.1% were overweight, and 48.2% were obese. Food insecurity was significantly associated with increasing body mass index in women not receiving food assistance. There was no significant association between body mass index and food insecurity in children. In an urban population, overweight and obesity are very common as is food insecurity. We found an association between food insecurity and obesity only among women not receiving food assistance suggesting a possible protective role for food assistance. Providers should consider food insecurity in similar populations when trying to address obesity.