Data Storyteller

Food insecurity has doubled since the onset of the COVID-19 pandemic in March 2020, and has tripled among families with children. Not having enough access to food is a key contributor to negative health outcomes for adults and children alike, and it is important now more than ever for health centers to identify and support patients who are experiencing food insecurity.
This resource is designed to support health center efforts to identify and assist patients who are experiencing food insecurity. It outlines key considerations around integrating social determinants of health (SDoH)-related screening and intervention into the electronic health record (EHR) workflow, highlights standardized screening tools and data elements to monitor the prevalence of food insecurity among patients, and describes several strategies to meet food-related needs. 

The collection of data related to patients non-medical needs through use of Social Determinant of Health (SDoH) assessment tools, can accelerate systemic population health improvement, as well as engage patients in addressing their social non-medical needs (such as transportation, shelter, or intimate partner violence services) through coordinated access to appropriate services or community-based supports. This case study discusses the process a health center may use to identify and stratify need, and profiles a number of community referral platforms, including Aunt Bertha, Now Pow, and 211 Community Information Exchange for connecting patients to appropriate community resources.