Hunger in an adult patient population

JAMA. 1998 Apr 15;279(15):1211-4. doi: 10.1001/jama.279.15.1211.


Context: Although clinical observations suggest that some patients experience hunger and food insecurity, there are limited data on the prevalence of hunger in adult patients.

Objective: To determine the prevalence of hunger and food insecurity in adult patients at an urban county hospital.

Design: Cross-sectional survey conducted in 1997.

Patients: The primary survey included all patients aged 18 years or older who were admitted to the medicine, surgery, and neurology services during a 2-week period, and all patients who attended the hospital's general medicine clinic during 1 week. A second survey included primary care patients who received insulin from the hospital pharmacy during a 1-month period.

Main outcome measures: Rates of hunger and food insecurity.

Results: Of 709 eligible patients, 567 (participation rate, 80%) were interviewed in either the clinic (n=281) or hospital (n=286). An additional 170 patients who received insulin were interviewed by telephone (response rate, 75%). Of the primary sample, 68 (12%) respondents reported not having enough food, 75 (13%) reported not eating for an entire day, and 77 (14%) reported going hungry but not eating because they could not afford food. A total of 222 (40%) had received food stamps in the previous year and of those, 113 (50%) had their food stamps reduced or eliminated. Recipients whose food stamps had been eliminated or reduced were more likely to report not having enough food (18% vs 13%, P=.006), not eating for a whole day (20% vs 16%, P=.01), going hungry but not eating (20% vs 16%, P=.08), and cutting down on the size of meals or skipping meals (33% vs 27%, P=.01). In multivariate analysis, independent predictors of hunger included an annual income of less than $10000 (odds ratio [OR], 7.55; 95% CI, 3.01-18.92), drug use (OR, 3.56; 95% CI, 1.46-8.66), and a reduction in food stamp benefits (OR, 1.73; 95% CI, 1.01-2.96). Predictors of food insecurity included an annual income of less than $10000 (OR, 4.12; 95% confidence interval [CI], 1.98-8.58), drug use (OR, 2.11; 95% CI, 1.66-5.08), and a reduction in food stamps (OR, 2.02; 95% CI, 1.23-3.32). In addition, 103 (61%) patients in the sample of diabetics reported hypoglycemic reactions; 32 (31%) of these were attributed to inability to afford food.

Conclusion: Hunger and food insecurity are common among patients seeking care at an urban county hospital.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Food Services
  • Hospital Bed Capacity, 300 to 499
  • Hospitals, County / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Hunger*
  • Logistic Models
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Multivariate Analysis
  • Nutrition Surveys
  • Poverty*
  • Prevalence
  • Socioeconomic Factors
  • Starvation / epidemiology*
  • Urban Health / statistics & numerical data*
  • Urban Population