Is hunger sending people to the hospital?

More than half of frequently-hospitalized Americans have regular problems accessing adequate food, according to a new study.

Researchers from the Center for Urban Health Policy and Research in Philadelphia surveyed 40 patients, all of whom had been hospitalized three or more times in the previous year. A majority suffered from six or more chronic conditions and more than half lived in areas with high rates of poverty.

Thirty percent of the participants reported being “food insecure,” meaning they had skipped meals in the last 30 days or had other problems obtaining food, and another 25 percent were on the brink. In contrast, 14 percent of Americans had problems accessing food at some point in 2014, according to the U.S. Department of Agriculture.

“It’s troubling that such medically fragile patients, suffering from multiple chronic diseases, may not have enough food on the table,” says Dr. Asad Zaman, an internal medicine physician on staff at Advocate South Suburban Hospital in Hazel Crest, Ill. “A healthy diet is critical for managing diseases like diabetes, and if not controlled, patients are at increased risk of developing complications or other conditions, like cardiovascular disease.”

Seventy-five percent of participants said they were unable to shop for food without assistance, creating additional barriers to good health. A majority had received food from food pantries or other community groups at some point, but many relied on family members or friends to help them shop or prepare food.

“Data like this underscores how important it is for physicians to take a holistic approach to treating their patients. Successfully managing disease is about more than simply prescribing the right medications,” says Dr. Zaman. “It’s vital that we check in with patients on things like living situation, relationships, and mental health if we want to keep them healthy and out of the hospital, where they belong.”

Dr. Zaman says that social isolation is a concern as well. Study participants were largely senior citizens, many of whom lived alone, and more than half said they need help preparing meals.

“As front line caregivers, physicians and other clinicians should be able to refer patients to resources in the community,” says Dr. Zaman. “Sometimes the safety net is out there, but they don’t know how to find it.”