Paeds Vivas · preventive-and-community-paediatrics
Housing insecurity, food insecurity and child health — branching viva
Structured oral on Hunger Vital Sign, housing domains, marginal food security and closed-loop care.
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Target exams
Stem
You are seeing an 18-month-old for preventive care. The caregiver mentions late rent and an empty fridge. [1]
Examiner: How do you screen for food insecurity in clinic? [5]
Strong answer: Use the Hunger Vital Sign — two items about worry that food will run out and food not lasting with no money to buy more. Either affirmative response is a positive screen and should trigger help, not silence. [5]
Examiner: The child is not underweight. Does that exclude food insecurity? [1]
Strong answer: No. Food insecurity can coexist with normal weight or overweight when cheap energy-dense foods predominate. Screen and history, not body size alone, decide. [1]
Examiner: Is “marginal” food security clinically safe? [8]
Strong answer: No. Marginal food security still associates with adverse health outcomes in young children and mothers. Do not wait for very low food security. [8]
Examiner: Name four housing-insecurity domains beyond street homelessness. [4]
Strong answer: Affordability stress, residential instability/moves or eviction threat, poor quality (cold, damp, pests), overcrowding, and temporary doubled-up arrangements without a fixed safe home. [4]
Examiner: You screen but have no referral list. What is the problem? [1]
Strong answer: Screening without a closed-loop pathway is incomplete care. Build named local food and housing connections before or while scaling screening. [1]
Examiner: Why do nutrition-assistance programmes matter medically? [14]
Strong answer: They improve food security and access markers; loss of programmes such as SNAP associates with food insecurity and poorer health in families with young children. Name the local equivalent in ANZ/UK practice. [14]
References
- [1]COUNCIL ON COMMUNITY PEDIATRICS, COMMITTEE ON NUTRITION Promoting Food Security for All Children. Pediatrics, 2015.PMID 26498462
- [4]Council on Community Pediatrics Providing care for children and adolescents facing homelessness and housing insecurity. Pediatrics, 2013.PMID 23713108
- [5]Hager ER Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics, 2010.PMID 20595453
- [8]Cook JT Are food insecurity's health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers. Advances in nutrition, 2013.PMID 23319123
- [14]Ettinger de Cuba S Loss Of SNAP Is Associated With Food Insecurity And Poor Health In Working Families With Young Children. Health affairs, 2019.PMID 31059367