For the first time ever, the American Academy of Pediatrics is recommending that its members begin screening their patients -- all their patients -- for food insecurity.
"It is important that everyone knows how to screen so that at every available opportunity they can do it," said Dr. Sarah Jane Schwarzenberg, lead author of the new policy statement. "We can't tell just by looking who is food insecure or not -- they look just like you and me."
The authors of the statement define a food-insecure household as one in which access to adequate food is limited by a lack of money or other resources.
"These are people who are sometimes hungry and sometimes not, but they can't predict what they are going to be on any given day," said Schwarzenberg, who is also a pediatric gastroenterologist and hepatologist at the University of Minnesota Masonic Children's Hospital.
"Hunger is bad, but the toxic stress of not knowing each day whether you are going to be hungry or not adds another layer of psychological stress and children feel it," she said.
In 2013, about one-fifth of children in the U.S. lived in households that were food insecure, according to the statement. That's a total of 16 million kids.
The authors also note that kids who come from food-insecure households have poorer overall health and more hospitalizations compared with kids who come from food-secure households. Food insecurity is also linked to behavior problems in young children, suicidal thoughts in teenagers and lower cognitive indicators in all kids.
"As time progresses the weight of the number of health consequences related to food insecurities has become so profound that the academy felt they had to be educating pediatricians on this, and offering them tools to help their patients," Schwarzenberg said.
The screen does not have to be lengthy to be effective. Previous studies show that an affirmative answer to just two statements is 97% as accurate as the official 18-question Household Food Security Survey.
The two statements are, "Within the past 12 months we worried whether our food would run out before we got money to buy more," and "Within the past 12 months, the food we bought just didn't last and we didn't have money to get more."
The new policy statement also includes a list of federal resources for food-insecure families that paediatricians can recommend to patients, as well as the recommendation that doctors familiarize themselves with local resources like food pantries and summer and childcare feeding programs as well to help patients secure adequate meals.
"Twenty years ago we knew food insecurity existed and we thought it was unpleasant, but not terrible," Schwarzenberg said. "Now we know that it does have terrible health consequences, and that's what every pediatrician cares about -- healthy kids."