Screening for Food Insecurity: Short-Term Alleviation and Long-Term Prevention

This AJPH editorial focuses on the importance of screening patients for food insecurity in clinical settings using the Hunger Vital Sign, and the evidence-based household-level interventions that can alleviate the condition. More specifically, we address the questions that have arisen regarding the necessity of asking both Hunger Vital Sign questions when one might suffice, whether question wording can be changed, or why response alternatives must include “often true, sometimes true, or never true” instead of Screening for Food Insecurity “yes or no.” In this issue of AJPH, Makelarski et al. (p. 1812) provide a cautionary tale as to why such seemingly negligible alterations are ill-advised. Their finding that replacing the USFSS and Hunger Vital Sign’s three response options with the simplified “yes or no” options results in missing nearly 25% of food-insecure adults and lowers sensitivity from 94% to 76% serves to remind us of the dangers associated with tampering with the screen as used in previous validation studies.