USPSTF: Insufficient evidence to recommend for or against food insecurity screening

Key takeaways:

• Screening did not have any significant effects on food insecurity in the USPSTF’s evidence review.
• Social policies may instead be needed to end food insecurity, researchers said.

The U.S. Preventive Services Task Force ruled that there is insufficient evidence to recommend for or against screening for food insecurity in primary care.

The I-grade final recommendation statement, which applies to youth and adults, is consistent with the task force’s draft recommendation from last year.

The ruling comes after recent research indicated that screenings for social risks, like food insecurity, have risen in practices since 2017.

It is the first time the task force reviewed this topic, which is the first in the USPSTF’s recent work on how to incorporate social risk factors into guidance, according to a press release.

Food insecurity, which has increased in the U.S. in recent years, “is linked to severe health issues across all age groups, including birth defects in neonates, anemia, cognitive problems [and] depression in children, and chronic conditions such as obesity, diabetes [and] hypertension in adults,” Richard Terry, DO, an osteopathic physician specializing in family medicine and associate dean of academic affairs at Lake Erie College of Osteopathic Medicine, told Healio.

Terry, who is not affiliated with the USPSTF or their recommendation, added that some professional medical organizations “have endorsed screening for food insecurity as part of routine health care.”

Certain populations — like Black, Hispanic, Native American and Alaskan Native people, as well as older adults, people with disabilities and veterans — may be more vulnerable to food insecurity, the task force noted.

Screening did not affect food insecurity

In the evidence report, researchers assessed 39 studies (n = 198,762) that had evaluated the effect of food insecurity screening or interventions.

One randomized controlled trial (n = 789) showed no difference in the percentage of people who reported food insecurity after 6 months between those who were screened and those who received usual care.

Almost all studies that assessed interventions for food insecurity were rated as poor quality, but a couple did suggest such interventions may be effective. For example, one analysis showed that home delivery of medically tailored meals reduced food insecurity, whereas another showed improved BMI among children whose families participated in mobile food banks.

According to the USPSTF, multiple factors “complicated” its assessment of food insecurity screening, such as limitations to food insecurity interventions that can be provided by primary care providers and social needs complicating the direct benefit of screening.

“For example, a clinician may identify a patient with food insecurity, but if the patient or clinician prioritizes other concerns, the effect of screening and subsequent interventions may be limited,” they wrote.

However, people should not assume that food insecurity does not exist and is not a significant social determinant of health just because of the lack of high-quality studies in the task force’s review, Terry explained.

“It is very significant,” he said. “I agree that the USPSTF recommendations encourage a re-evaluation of food insecurity screening within health care settings. Policymakers and health care leaders must consider whether broad, mandatory screening is beneficial or if tailored approaches based on patient and community feedback would be more effective.”

Policies needed to end food insecurity

In a related editorial, Arvin Garg, MD, MPH, from the Boston University School of Medicine, and colleagues explained that a “one-size-fits-all” approach for food insecurity screening “may not achieve the goal of delivering equitable care.”

“Screening all primary care patients for food insecurity may not be the right approach in all contexts, and clinicians should use patient and community feedback to tailor screening modalities and referral strategies,” they wrote. “Patients should have autonomy to decide whether they want to be offered food insecurity screening as part of their routine primary care vs. being required to complete a screener to meet quality measures.”

They added that the most effective solution to the insufficient evidence on screening “would be to effectively end food insecurity through social policies and an augmented social safety net.”

“To further this lofty but achievable goal, health care systems and medical professional organizations should collectively and courageously use their voices to advocate for such policies,” they wrote.

References:

• Garg A, et al. JAMA. 2025;doi:10.1001/jama.2025.1021.
• O’Connor EA, et al. JAMA. 2025;doi:10.1001/jama.2024.22805.
• USPSTF. JAMA. 2025;doi:10.1001/jama.2025.0879.
• U.S. Preventive Services Task Force issues draft recommendation statement on screening for food insecurity. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/food-insecurity-draft-bulletin.pdf. Accessed March 10, 2025. Published June 25, 2024.