Objectives: To determine changes in the prevalence of hunger among emergency department (ED) patients over the last three years.
Methods: This was a cross-sectional study at an urban, Level I trauma center with 98,000 annual visits. We prospectively screened all patients presenting to the ED during a randomized distribution of 8-hour periods between June 1 and August 31 in 2007, 2008, and 2009. Consenting patients completed a survey on demographics and how often they experienced hunger or made choices between buying food and buying medicine. Data were analyzed using descriptive statistics and chi-square tests.
Results: 18,287 patients presented during the study, 10567 were eligible, and 8771 (83%) were enrolled. For 2007, hunger from food scarcity was reported in 3.8% daily, 4.4% 2-3 times/week, 3.0% weekly, 4.4% monthly, 4.6% yearly, and 78.7% never. Having to choose between buying food and buying medicine was reported in 5.3% weekly, 6.8% monthly, 7.9% yearly, and 73.2% never. For 2008, hunger from food scarcity was reported in 7.7% daily, 7.4% 2-3 times/week, 4.5% weekly, 4.7% monthly, 4.6% yearly, and 71.2% never. Having to choose between buying food and buying medicine was reported in 4.8% weekly, 5.8% monthly, 7.9% yearly, and 81.6% never. For 2009, hunger from food scarcity was reported in 12.2% daily, 10.9% 2-3 times/week, 6.5% weekly, 5.0% monthly, 4.7% yearly, and 60.8% never. Having to choose between buying food and buying medicine was reported in 6.8% weekly, 7.3% monthly, 8.0% yearly, and 73.2% never. The rate of patients reporting any hunger was 20.4% in 2007, 28.8% in 2008, and 39.2% in 2009 (p < 0.001). The rate of patients reported ever having to chose between food and medicine was 20.0% in 2007, 18.5% in 2008, and 22.6% in 2009 (p=0.006).
Conclusions: The experience of hunger from food scarcity within the last year was reported in 21.3% of adult ED patients in 2007, 28.8% in 2008, and 39.2% in 2009. This rate appears to be increasing among our ED patient population.