March 2025 Board of Health Meeting - Food Insecurity Screener: A Brief Contact Intervention Pilot Information Report

PREPARED BY: Comprehensive Health Promotion

DATE: March 20, 2025

SUBJECT: Food Insecurity Screener: A Brief Contact Intervention Pilot

BACKGROUND/PURPOSE

Income inequality has been recognized as one of the most significant social determinants contributing to poor population health outcomes and is the main driver of food insecurity. Upstream income-based solutions are needed to address the root cause of food insecurity. However, with the rise in food insecurity rates locally, there is a growing need for immediate action. Windsor and Essex County (WEC) had a 20.7% household food insecurity rate between 2021-2023, with a 24.1% rate in 2023 alone¹ which is comparable to the Ontario average in 2023 (24.5%)². Many health care providers report not being confident in their knowledge regarding the impact of food insecurity on patients’ health. Further, screening for food insecurity is not common practice for health and social service providers. Leading Canadian food security authorities recommend that screening for food insecurity (or poverty) occur in conjunction with income support counselling³.

Through a partnership between the Comprehensive Health Promotion (CHP) team and the Healthy Families (HF) team, a food insecurity screening tool will be pilot tested as a brief contact intervention in the Healthy Babies, Healthy Children program (HBHC), the Building Blocks for Better Babies (BBBB) program (via vitamin distribution), and the Nurse Practitioner Program. Although it is not anticipated that screening for food insecurity will directly reduce food insecurity rates in our community, screening will allow WECHU staff, health care providers and community partners the ability to identify and meaningful support clients who are experiencing food insecurity.

DISCUSSION

The pilot project will begin in April 2025. Prior to the launch, the CHP nutritionists will train the HF department on the screening tool and associated referral pathways (emergency food, income optimization and/or other community supports). Using the Hunger Vital Sign^TM screening tool, clients will be asked two questions to assess their risk of food insecurity (see figure 1 for questions). This tool has been validated for use with youth and adults⁴ and has been successfully used in multiple medical and community-based settings in North America. The training process will outline how to properly screen patients/clients; determine the needs of individuals that screen positive; identify what resources are available; select the best options based on the individuals needs; and track the individual’s progress. To ensure consistent implementation of the screening tool, it will be added into the existing workflow established by the pilot HF department. 

Figure 1: HUNGER VITAL SIGNS^TM SCREENING TOOL

The overall goals of this pilot include:

• Building a common understanding about the root causes of food insecurity, and its impact on health and well-being.
• Providing a guide to help with uncomfortable conversations to ensure consistent screening practices.
• Strengthening referral pathways that connect individuals/families to programs and community resources. For example, WECHU staff seeing a client who screens positive for food insecurity, can provide information around emergency food provision if that is an immediate need.  
• Guide effective actions in addressing household food insecurity and related health inequities, as well as actions to support community food security.

The results of the pilot will allow the CHP nutritionists to further refine the training and implementation process, with the goal of training other client facing departments within WECHU, as well as relevant community partners on this screening process. In addition, this pilot will help us to further understand which community supports are available and accessible, as well as identify gaps in services in our community.

Further, this pilot project works to fulfill one of the initiatives outlined in the Food Insecurity Compromises Infant Health Resolution, passed in March of 2024. The initiative, the creation of a comprehensive strategic plan to improve infant food security in Windsor-Essex County, including targeted food insecurity screening initiatives and the creation of an associated referral pathway, is of interest to public health professionals across the province. The results of this pilot will be shared with provincial colleagues, in hopes of replication in other communities.