When kids visit the outpatient center at Philadelphia’s St. Christopher’s Hospital for Children, they don’t just get their medical needs addressed. Pediatricians also screen for food insecurities, and write prescriptions for fresh fruits and vegetables.

The focus on food is necessary because children are going hungry or eating unhealthful foods because of a lack of resources.

“When you think of starvation, you may think of people in developing nations who have bloated bellies and are losing their hair,” says St. Christopher’s Hans Kersten, M.D., medical director, the Grow Clinic. “That’s not what you see here in the U.S.”

Instead, children from food-insecure families can be identified by such traits as lack of proper growth or poor developmental outcomes, while others may be obese. Growing evidence links food insecurity with obesity, possibly because of the high cost of healthful, fresh foods compared with that of processed foods, Kersten says. Malnourishment is also associated with increased infections and hospitalizations, among other problems.

Since 2011, St. Christopher's has distributed 7,000 boxes of organic produce to families, most of whom earn less than $25,000 a year. Every Friday, parents and their children can pick up a discounted $10 or $15 box at the hospital — located in the middle of a food desert — and pay for it with food stamps, if necessary. Families can also watch a demonstration of how to make a recipe with the produce. Besides connecting food-insecure families with produce, St. Christopher’s is helping them to sign up for food stamps and other federal programs.

The children's hospital uses a brief screening tool to identify chronically hungry children. A “yes” answer to one of two questions is strongly associated with food insecurity: “Over the past year, did you run out of food and not have money to buy more?” and “Over the past year, did you worry about running out of food before having money to buy more?” The approach was supported by a 2010 Pediatrics article and essentially was endorsed by the American Academy of Pediatrics.

St. Christopher’s has received anecdotal reports that the hospital’s food programs are helping families to improve their diets. In the near future, Kersten hopes to follow up more thoroughly with families to assess any direct correlations. He recently received a local grant that will allow him to hire someone to help coordinate the program and institute some improvements, such as expanding the food-insecurity screening to inpatients. 

For more information on this issue, see our Food Insecurity page with links to H&HN coverage and other AHA resources.