More than 40 million people living in the U.S. face food insecurity, yet physicians are unprepared to address it as a social determinant of health.
In a national survey, only 30 percent of physician practices reported screening for food insecurity (Fraze et al., 2019). Three out of four physician practices nationwide reported that lack of knowledge was a barrier to screening for social needs, including food insecurity. Even at the largest hospital in New England, where 97 percent of providers reported discussing food insecurity with their patients, only half felt that they received sufficient training to support patients experiencing food insecurity (Greenthal et al., 2019).
The Greater Boston Food Bank (GBFB) is taking proactive measures to make sure future doctors are equipped to help end hunger. Every fall since 2016, GBFB hosts medical students from UMass Medical School, teaching them how to address food insecurity in their patients through a two-week elective course. The annual course includes lectures, field trips, volunteer experiences, and a group project. Group projects include surveying patients attending a free produce distribution at a health center, surveying food pantry leaders about their existing healthcare partnerships, and hosting budget-friendly cooking demonstrations.
Throughout the course, GBFB researchers, dietitians, and SNAP experts lead the students in discussions on topics ranging from the history of food banking to screening patients for food insecurity. Students learn about the causes and health outcomes of food insecurity, as well as the resources available to provide assistance. They also speak with physicians who have created innovative clinical programs.
Students see the real-world implications of what they learn in class by getting out into the community. They gain first-hand experience in food bank logistics while sorting food at GBFB and see the many faces of food insecurity as they volunteer to distribute food at community college Mobile Markets, food pantries, and health center Mobile Markets. The students also tour a unique hospital-based food pantry and help prepare medically tailored meals at a nonprofit providing home-delivered meals to patients with chronic disease. These field trips allow the students to connect with people facing food insecurity—people they will likely see in their clinic one day. These activities paint a complex picture of food insecurity; many students acknowledged that their assumptions and pre-conceived notions were dispelled, and their awareness and empathy increased.
“Even though I am still learning about the tools I have available to me, I can’t help but feel more equipped to tackle the social problems that may arise in my future patients,” one student said. “There could be a few very basic questions added to my patient interviewing to better treat the whole person that could perhaps make a profound difference for some people.”
Many students also noted the unique privilege as future physicians to influence public policy. As one student said, “Our voice matters because our patients are relying on us to be their advocate, both in the clinic and out in the community.”