Housing insecurity, food insecurity and child health — branching viva

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]