Should Doctors Ask Their Patients About Food Access?

According to the American Academy of Pediatrics (AAP) and Bright Futures, a national health promotion and prevention initiative, children from infancy to twenty-one should see a doctor annually for a wellness visit, more frequently for newborns. During that exam, the healthcare professional will perform a physical, taking measurements to track growth (height, weight, head), provide vaccinations, perform sensory and autism screenings, and perform developmental surveillance throughout the years. Routine physicals can prevent health problems, especially as you age. 

AAP guidelines are updated annually, listing different tests and screenings suggested to be performed at various stages of life, depending on your sex and medical history. Around the age of twelve, children begin to answer developmental, social, behavioral, and mental health questions as part of the exam. Although not law, patients can expect to be asked about their fitness routine, drug or alcohol usage, if they smoke, depression, sexual activity, and suicide risk. Parents are asked to leave the room to allow for a more honest answer from the child.

Unfortunately, economic status can determine your access to a medical professional and whether you have wellness visits. Poor children are less likely to see a doctor regularly, and half the children in the U.S. fall below the poverty line (via AAP). During the critical time between adolescence and early adulthood, physical and mental health needs are crucial, predicting children's future health as adults and quality of life. With so much at stake, what is appropriate for doctors to ask?

In March 2021, a poll was taken by researchers from the University of Michigan interviewing 1,156 participants, fourteen to twenty-four-year-olds (also referred to as "Gen Z"), asking whether they believed medical professionals should address social determinants of health (SDOHs). SDOH affects a person's quality of life, drawing a correlation between health and housing, transportation, education, income, access to healthy, nutritious foods, and many other factors.

The results published in the "Journal of Adolescent Health" saw an overwhelming majority, 81%, indicating they believe healthcare professionals should inquire about SDOHs. 25% wanted their healthcare professional to take action with the information they receive, while 13% asked for referrals and 22% for advice. The biggest threat to asking these personal questions, at 30%, was embarrassment. The results suggest that youth want medical professionals to know about their lives, opening the door to treating the problem's root cause, not just the symptom.

Questions about food access can lead to treating many preventable health issues. Healthy eating involves more than a trim waist and watching calories. A diet low in sugar, sodium, trans, and saturated fats, lowers the chances of chronic diseases and aids in preventing high blood pressure, diabetes, and certain cancers (via Healthy People). Healthy food is crucial for adolescents during puberty, and a poor diet can delay it. Delayed puberty can contribute to several diseases, including "inflammatory bowel disease, eating disorders including anorexia nervosa and bulimia nervosa, and chronic conditions that create malnutrition."

Unfortunately, barriers to accessing healthy options like fresh fruit, vegetables, and whole grains are increasingly more challenging to overcome the younger you are. "Food deserts," communities with limited access to major supermarkets and healthier choices, make healthy foods more expensive and difficult for young people, the elderly, and those without transportation to attain. Poorer communities have a disproportionate amount of cheap, fast food, adding to the issue (via Healthy People).

The AAP advocates for asking questions about SDOHs. Bringing awareness to the issue helps doctors, often community leaders, understand the cause and effect and hopefully be a part of the solution. Working with existing support, medical professionals can link families in need to community resources such as access to food banks, the Supplemental Nutrition Program for Women, Infants, and Children (WIC), and S.N.A.P. (Supplemental Nutrition Assistance Program) benefits. Leaders can work with local and state governments to improve transportation, provide access to better-paying jobs and more food options, enticing supermarkets to open in poor communities. Additional educational resources may be necessary to break the cycle of poverty, allowing more destitute children upward mobility. 

The environments in which we are "born, live, learn, work, play, worship, and age" can often predict a person's future (via Health.gov). Breaking negative patterns begins with knowledge, and a doctor is one part of the solution, along with teachers, church leaders, and mentors within the community. Communication amongst these leaders leads to change. Protecting children who are the most vulnerable in society is the start of a better world.