Characteristics of food insecurity prevalence in North Philadelphia Federally Qualified Health Center target populations, a cross-sectional study

Abstract Background The prevalence of food insecurity declined in the United States but paradoxically increased in the large metropolitan area of Philadelphia in the past decade, and compared to the general U.S. population, a greater percentage of households in Philadelphia are affected by food insecurity and dependent on programs such as SNAP. The objective of this study was to determine food insecurity prevalence and demographics of the populations near Philadelphia Federally Qualified Health Center (FQHC) clinics. In line with risk factors on the national level, we hypothesized that food insecure people in a low-income area of Philadelphia would be more likely to be older, female, Hispanic, and overweight or obese. Methods This cross-sectional study took place in North Philadelphia, a populous section of Philadelphia with a high concentration of poverty and many zip codes reporting 30–45% or more of the population below the federal poverty line. Students and clinicians affiliated with a local FQHC conducted surveys on residents (n = 379) within 1-mile radiuses of three FQHC sites using the validated food security tool, the Hunger Vital Sign™. Survey data were collected through door-to-door visits in the summer of 2019. We used multivariate logistic regression models to predict food insecurity with independent variables including age, sex, language preference, and BMI category. Results The percentage of food insecurity in the area surveyed was much higher (36.9%) than previously reported in both Philadelphia and nationwide. Contrary to our hypothesis, food insecure individuals were younger on average and more likely to be English-speaking; these individuals had statistically significant lower mean BMI and lower odds of being overweight or obese vs. normal weight, with no significant difference by sex. Conclusion These North Philadelphia areas had a high prevalence of food insecurity associated with normal and low BMI and demographics of younger, English-speaking individuals. Some of these findings may be related to local confounding factors such as employment or substance abuse status, demonstrating a need for public health and organizations to work together for more locally targeted research and interventions on food insecurity in impoverished urban settings.