Housing insecurity, food insecurity and child health — formative SAQs

SAQ 1 (10 marks)

A 20-month-old attends for a well-child visit. Caregivers answer “sometimes true” to both Hunger Vital Sign items. BMI is on the 85th centile. Growth velocity is steady. ^[5]

1. Interpret the screen and state why body size does not exclude the problem. (3) ^{[1] [5]}
2. List four medical or developmental sequelae you will still review today. (3) ^{[1] [8]}
3. Outline a closed-loop management plan for the next two weeks. (4) ^[1]

Model answer

Positive Hunger Vital Sign: either item affirmative is enough. Food insecurity can coexist with overweight because cheap energy-dense foods may fill hunger without dietary quality. Do not wait for thinness. ^{[1] [5]}

Review iron/diet risk, dental health, development/behaviour, immunisation status, caregiver mental health and housing trade-offs (rent vs food). Marginal/low food security still associates with adverse outcomes. ^{[1] [8]}

Validate without shame; offer concrete food access this week (food bank/school/community programme as locally available); name a referral owner and timeframe; document needs; book early follow-up to confirm connection and recheck growth/symptoms; ask about housing stress driving food shortfalls. ^[1]