Underserved Columbus-area Patients Experience Soaring Level Of Nutrition Risk

COLUMBUS, Ohio, Oct. 5, 2021 /PRNewswire/ -- Echoing federal statistics that show 13.8 million U.S. households were food insecure at some time during 2020, and that up to one out of two older adults is either at risk of becoming or is malnourished, a pilot project to identify the presence of nutrition risk in the underserved populations of Central Ohio found that a stunning 63% of patients were at risk.

Of the 221 patients screened at the Charitable Pharmacy of Central Ohio (CPCO), 84 (38%) patients were positive for food insecurity, 14 (6%) positive for malnutrition risk, and 42 (19%) positive for both. Patients at nutrition risk were connected to community resources, including food pantries, home-delivered meals, and the Supplemental Nutrition Assistance Program (SNAP).

The findings are reported in a new study published in the Journal of Health Care for the Poor and Underserved. The study was performed using a malnutrition screening tool developed by the Ohio Malnutrition Prevention Workgroup. The tool is the first of its kind to screen for both food insecurity and malnutrition risk.

Patients were interviewed from January through mid-March 2020 with these four questions:

• Have you recently lost weight without trying?
• Have you been eating poorly because of decreased appetite?
• Within the last 12 months, I worried whether my food would run out before I had money to buy more.
• Within the last 12 months, the food I bought just didn't last and I didn't have money to get more.

The study notes that while nutrition risk affects all ages, older adults are at higher risk due to several factors, including multiple chronic conditions, an increased number of prescribed medications and natural physiologic changes.

The study marks the first time the measuring tool has been used in a localized setting to assess the level of nutrition risk. With Malnutrition Awareness Week now underway through Oct. 8, study co-author Jay Mirtallo, Faculty Emeritus within Ohio State University's College of Pharmacy, noted the full impact that nutrition risk can have on an individual's health. 

"The rate of nutrition risk we uncovered was alarming and is compounded by the fact that nutrition is an 'invisible' issue that doesn't get nearly enough attention," Professor Mirtallo said. "Yet we know that malnutrition and food insecurity contribute to higher health care costs and worse outcomes. We are now getting a sense of just how widespread the nutrition risk problem has become, but this is just the first step - particularly as we assess how badly communities are struggling with food access as part of the ongoing COVID-19 pandemic."

The study notes that, regarding COVID-19, "the economic crisis continues to be felt" and local food pantries are experiencing skyrocketing demand. For example, The Columbus Dispatch reported that as of December 2020, Mid-Ohio Food Collective (MOFC), which covers 20 counties including Franklin County, had nearly 30,000 first-time food pantry visitors since the pandemic began.

The team conducting the study included pharmacists and licensed CPCO social worker Beth Collier, who worked to identify local food resources on behalf of the patients. The study also shed a light on populations within the larger underserved population who are at higher malnutrition risk. With health disparities a growing part of the national conversation on health, Collier, lead author on the study, found the results troubling but not entirely surprising.

"We know that patients come to the Charitable Pharmacy because they can't afford their medication, but we also know that's often not the only thing they are struggling with," Collier says. "It's not uncommon for patients to tell us that they've had to choose between buying their medicine and buying food in the past. It makes sense then why so many would report that they've worried about running out of food or that they've lost weight unexpectedly."

Collier added that several groups were identified as having increased food insecurity, including the Black community, older adults, and those with lower economic status.

"When we consider how nutrition risk affects other health conditions, this is definitely a cause for concern," Collier said. "We know the problem is big, and now we need to marshal all available resources to tackle it."

While the study intended to go even further by identifying barriers to food access, the pandemic forced suspension of those efforts. Still, this study shows that access to food was difficult for many even prior to the pandemic.

"Many patients who could benefit from SNAP told us that the difficulty of applying was not worth the small benefit they received," Mirtallo noted. "In addition, access to a dietitian – a key resource in helping patients understand and make positive nutritional changes – was limited due to cost and insurance, which makes it that much more difficult to ensure patients are meeting their individual needs."

Study co-author and former CPCO Executive Director Jennifer Seifert echoed those concerns, adding that tackling malnutrition requires an intensive, interdisciplinary strategy.

"We had a sense that food security is a very serious problem among the patients we serve. The challenge we face now is removing barriers," Seifert said. "For example, 45 percent of the patients we surveyed had no health insurance. At CPCO, our primary mission includes coordinating access to healthcare for the vulnerable among us, and that is a real barrier when referring patients at malnutrition risk."

Additional study authors included CPCO staff pharmacist Sarah Jones and pharmacist Anna Felmer. CPCO provides medication at no cost to Franklin County, Ohio residents with a household net income at or below 200 percent of the federal poverty line. CPCO has just opened a second location of the pharmacy, co-located with a fresh produce market, giving patients access to free medication and free food under one roof. They intend to continue nutrition risk screenings in the future to address risk factors and provide referrals to those in need. For more information, visit www.charitablepharmacy.org.

SOURCE Charitable Pharmacy of Central Ohio

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http://www.charitablepharmacy.org