Document Type
Article
Abstract
Background
Food insecurity contributes to poor health and increased healthcare costs among patients with chronic diseases. Resource navigators can facilitate community-based resource connections, addressing food insecurity, but the impact on healthcare costs and quality of life remains unclear.
Objective
To examine whether food insecurity resource navigation improves clinical outcomes, healthcare charges, and quality of life for patients with diabetes and/or hypertension.
Design
Matched-control quasi-experimental study.
Patients
Patients underwent screening for food insecurity from July 12, 2021, to December 31, 2022, in South Carolina’s largest health system. Eligible patients (18 + years, having food insecurity, and diabetes and/or hypertension) enrolled for resource navigation in three primary care practices. Of 7592 screened patients, 371 (4.89%) were eligible and 236 (3.11%) consented to participation. A propensity-score matched cohort was obtained from practices without the navigator program. Each group included 219 patients, 20 (9.13%) with diabetes, 110 (50.2%) with hypertension, and 89 (40.6%) both.
Intervention
Resource navigator facilitated food-related community resource connections with 6-month follow-up.
Main Measures
Difference-in-difference specifications were used to examine 6-month differences in clinical outcomes (BMI, blood pressure, HbA1c) and healthcare charges (primary, inpatient, emergency department) between patients with and without navigation support. Quality of life changes were assessed for navigator group patients.
Key Results
Among patients with any primary care charges, those in the navigator group had 54.5% (SE = 0.099; p = 0.000) greater increase in 6-month charges than controls. Navigator group patients also had improved quality of life (0.345 quality-adjusted life years gained; p = 0.014) over 6 months. Emergency department, inpatient charges, and clinical outcomes did not differ between groups.
Conclusions
Food insecurity resource navigation was associated with increased primary care charges and improved quality of life in patients with chronic diseases, highlighting its value in improving patient care. Studies with larger cohorts and extended follow-ups may reveal substantial effects on other patient outcomes.
Digital Object Identifier (DOI)
Publication Info
Published in Journal of General Internal Medicine, 2025.
Rights
© The Author(s) 2025 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
APA Citation
Gupta, D., Thomas, D., Self, S., Frongillo, E. A., Litwin, A. H., Ewing, J. A., Ramos-Gonzalez, L., & Rudisill, A. C. (2025). Impact of Food Insecurity Resource Navigation for Primary Care Patients with Diabetes and Hypertension: A Matched Cohort Study. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-09713-1