Following her tour of the Johns Hopkins Children’s Center building as a new intern in 2016, Hanae Fujii-Rios joined her group for another tour, this one of the neighborhoods bordering the hospital. For her, what stood out most was the high volume of fast food restaurants.

“I realized very quickly there was tremendous access to fast food but very little access to healthy, nutritious food,” says Fujii-Rios, now a third-year pediatric resident. “There appeared to be a high prevalence of food insecurity in Baltimore City.”

Food insecurity, Fujii-Rios explains, is defined as a lack of consistent access to affordable nutritious food and a healthy lifestyle. Several studies, she adds, have shown that food insecurity is associated with poor health outcomes, including increased risk for hospitalization, obesity, hypertension, iron deficiency, anemia, developmental delay, anxiety and depression. Face to face with the food desert outside the hospital where she worked, Fujii-Rios decided to do something about it.

“I felt a lot can be done by screening for the silent symptoms of food insecurity and preventing some of these health outcomes for our pediatric population,” she says.

In a collaboration with pediatric emergency medicine physicians Therese Canares and Ann Kane, and with guidance from former pediatric residency director Janet Serwint, Fujii-Rios led the development of a food pantry pilot project in the pediatric emergency department. Providers there now screen patients and families for food insecurity, using the Hunger Vital Sign screening tool endorsed by the American Academy of Pediatrics. Families that screen positive may receive two meals and two snacks recommended by Johns Hopkins dieticians. All families screened, some 500 to date, receive handouts that include information on community resources and educational materials regarding the benefits of nutritious foods and recipes for preparing them. The response?

“Families have been incredibly appreciative,” says Kane, citing feedback in follow-up surveys. “Some note that the food doesn’t last paycheck to paycheck,” she adds, “and with several young children at home it can become hard to get by.”

“They say having a resource like this is convenient and beneficial,” says Canares. “Overall people seemed supportive and interested in learning more about healthy foods and how to prepare them.”

Fujii-Rios is compiling the responses for a research project and possible expansion of the pantry program beyond the pediatric emergency department.    

“The overarching goal is to provide a hospital based food pantry that provides all patients access to healthy nutritious food,” says Fujii-Rios. “The idea is to empower health care providers to be able to screen for food insecurity and prescribe food as medicine for inpatients and outpatients, as well as those in the emergency room.”