Adressing food insecurity in pediatric celiac patients through a prescription food program

ABSTRACT

Background: Food insecurity affects approximately 11% of American households (1) and individuals with celiac disease may be at greater risk of experiencing food insecurity due to dietary restrictions and the high costs of medically necessary gluten-free foods.(2) Food Equality Initiative (FEI), based in Kansas City, Missouri, is a novel prescription food assistance program founded in 2014 that provides access to safe foods and nutrition education for individuals with celiac disease and food allergy. To qualify, patients must be referred by a physician for diagnosis of celiac disease or food allergy and have a combined household income at or below 250% of the federal poverty line.(3) The aim of the current study was to describe the demographics of the pediatric celiac patients enrolled in a local a prescription food program. Methods: This is a retrospective review of de-identified data for FEI clients who initiated services between May 2016 and April 2021. Only data from clients with celiac disease were included in analyses. Results: A total of 50 pediatric clients with celiac disease (MeanAge = 11.33 years, SD = 4.45, 52% males, 82% Caucasian) whose parents self-identified as food insecure enrolled in FEI prescription pantry services between 2016-2021. The average annual household income was $35,756 (SD = $17,926), with an average of four persons per household (SD = 1.55, range 1-7). In 2020, there was a 70% increase in new client enrollment as compared to the prior year. Conclusions: Food insecurity is a significant issue that disproportionally impacts children with celiac disease and other medically necessary diets. Food assistance programs, such as FEI, offer a novel way to support food insecure families while meeting the demands of a gluten-free diet. We saw a significant increase in enrollment in 2020. Factors that may have increased demand for FEI services include the COVID-19 pandemic and a shift in food distribution model from a physical pantry to direct shipments to individual's homes. Additional research on the prevalence of food insecurity in families impacted by celiac disease and its impact on dietary adherence is needed in the future.