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Am J Public Health. 2015 Aug;105(8):e98-e104. doi: 10.2105/AJPH.2015.302719. Epub 2015 Jun 11.

Feed First, Ask Questions Later: Alleviating and Understanding Caregiver Food Insecurity in an Urban Children's Hospital.

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Jennifer A. Makelarski and Stacy Tessler Lindau are with Department of Obstetrics/Gynecology and The University of Chicago Medicine Urban Health Initiative, The University of Chicago, Chicago, IL. Stacy Tessler Lindau is also with Department of Medicine-Geriatrics, The University of Chicago, and the MacLean Center for Clinical Medical Ethics, Chicago. Daniel Thorngren is with the Pritzker School of Medicine, The University of Chicago.



We estimated the prevalence of caregiver hospital food insecurity (defined as not getting enough to eat during a child's hospitalization), examined associations between food insecurity and barriers to food access, and propose a conceptual framework to inform remedies to this problem.


We conducted a cross-sectional study of 200 caregivers of hospitalized children in Chicago, Illinois (June through December 2011). A self-administered questionnaire assessed sociodemographic characteristics, barriers to food, and caregiver hospital food insecurity.


Caregiver hospital food insecurity was prevalent (32%). Caregivers who were aged 18 to 34 years, Black or African American, unpartnered, and with less education were more likely to experience hospital food insecurity. Not having enough money to buy food at the hospital, lack of reliable transportation, and lack of knowledge of where to get food at the hospital were associated with hospital food insecurity. The proposed conceptual framework posits a bidirectional relationship between food insecurity and health, emphasizing the interdependencies between caregiver food insecurity and patient outcomes.


Strategies are needed to identify and feed caregivers and to eradicate food insecurity in homes of children with serious illness.

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