A real-time surveillance system for detecting local spikes of food insecurity to inform timely interventions - More than 10% of U.S. households have experienced food insecurity (FI) every year for the past two decades. FI is associated with depression, hypertension, obesity, and type 2 diabetes and costs the U.S. healthcare system $53 billion annually. Therefore, addressing FI can have a significant impact on public health. Progress in reducing FI is hampered because FI is a dynamic problem: people can experience it multiple times throughout a year; individual- and community-level disruptions contribute to local and temporal surges of FI; and these disruptions can impact people who have never experienced FI. This dynamism creates unexpected local surges in FI, while our current food system is not equipped to deal with these sudden surges in FI. Federal nutrition assistance programs, while necessary and impactful, cannot provide immediate assistance as their application processes can take up to a month. They also fail to reach all low-income individuals with FI and to provide enough benefits to their clients. This has led to an influx of food demands for emergency food providers (e.g., food banks/pantries, Soup Kitchens). However, we still do not know when and where these resources are most needed. This leads to an inability to meet the local food demands promptly, and thus, people experiencing unmet food needs will face the health consequences of FI. Without addressing this gap, FI will continue to contribute to health differences. A local, real-time understanding of FI can inform timely interventions. One potential early warning metric for local surges of FI is the 2-1-1 network (211). 211 is a nationwide, free public referral system that responds to >20 million requests for help each year from U.S. residents. Service navigators at 211 direct callers to resources that can address unmet needs. For instance, navigators connect callers with food needs to nearby food pantries. Our objective in this project, to be conducted in Utah, is to gauge the usefulness of 211 food-related calls to be used as a local, real-time surveillance system for FI. Using the CDC’s guidelines for public health surveillance systems, we will determine the timeliness and validity of 211 food-related calls in detecting FI aberrations. Based on preliminary analyses and literature, we hypothesize that the system can quickly detect statistically significant ZIP Code-level FI aberrations (timeliness) and can replicate external sources of FI-related trends (validity). The rationale for our project is that FI is a dynamic problem and requires prompt responses, yet we do not know when and where surges in food demands happen to intervene. Using advanced geographic information system and aberration detection methods, our Specific Aims are to: (1) Determine the timeliness of 211 food-related calls in detecting FI aberrations; and (2) Determine the validity of 211 food-related calls for FI surveillance. The expected outcome of this project is a scalable, timely, and valid surveillance system to detect local FI aberrations, which can enable place-based, timely FI interventions.
