P3.158: Geospatial Connections Between Food Insecurity and Zip Code in the Pediatric Hospitalized Population

Background: Food insecurity (FI) is a significant issue in pediatric households, impacting the health and wellbeing of children. Furthermore, FI has been associated with other social determinants of health (SDOH) such as poverty and healthcare shortages. However, there has been limited data describing FI in the pediatric inpatient population in the context of SDOH observed in their respective communities. Our study aims to describe the relationship between FI status and geospatial location as defined by zipcode and/or county in hospitalized patients. Additionally, we describe the connection between geospatial locations and poverty rate, child opportunity index (COI), and Health Professional Shortage Area (HPSA) scoring.

Methods: We conducted a subset analysis of a retrospective chart review evaluating the prevalence of FI in pediatric patients admitted to our tertiary children’s hospital for >/= 24 hours between January 2023 - 2024. The zipcodes for FI patients were collected and quantitative analysis was performed utilizing comparable data collected from the 2023 ACS Census survey and COI normalized to state-level comparison.

Results: Of 3435 patients admitted, 2824 met inclusion criteria, and 198 patients screened positive for FI. A total of 79 different zipcodes and 40 different counties were identified for FI patients. By county, 56.4% (n = 112/198) of FI patients resided in Jefferson County of Louisville, KY, where our tertiary hospital is located. No single zipcode represented the majority of FI patients. Rather, a total of 14 zipcodes (3 counties) represented 51% (n = 101/198) of FI patients, each having >/= 4 patients. The remaining FI patients represented 65 different zipcodes (39 counties). Within the top 14 zipcodes, the average poverty rate was higher compared to the state average (23.9% vs 16.4%). Additionally, the large majority had “low” or “very low” COI, whereas the rest of our zipcodes had greater variability. Average HPSA score was also higher in the top 14 FI zipcodes compared to the remaining zipcodes (13.9% vs. 11.0%).

Conclusion: Approximately half of our FI patients reside in zipcodes/counties near our tertiary hospital location while the remaining represent significant geospatial spread across the greater area our hospital serves. The zipcodes representing the majority of FI patients had higher poverty rates, lower COI, and higher HPSA scores when compared to state averages as well as compared to zipcodes that had fewer FI patients admitted. Our data highlights the potential association between FI and other SDOH within the confines of geospatial location. Focused resources to these zipcodes is warranted, however data demonstrating spread of FI patients suggests promotion of statewide interventions as opposed to targeted local initiatives. We hope to conduct future studies evaluating the impact of resources such as food bank utilization in identified areas for FI patients.