Indications of food insecurity in the content of telephone calls to a community referral system

BACKGROUND: Food insecurity is a social determinant of health that impacts more than 10% of U.S. households every year. Many unexpected events make food-insecure people and those with unmet food needs seek information and help from both formal (e.g., community organizations) and informal (e.g., family/friends) resources. Food-related information seeking through telephone calls to a community referral system—211 network—has been used as a proxy for food insecurity but the context of these calls has not been characterized and the validity of this proxy measure is unknown. OBJECTIVE: To investigate the content of food-related telephone calls to 211 and explore the indications of food insecurity during these calls. METHODS: We conducted a secondary qualitative analysis on the transcripts of food-related calls to Utah’s 211. From February to March 2022, 25 calls were sampled based on the location of callers to ensure the representation of rural residents. 13 calls from metropolitan and 12 calls from nonmetropolitan ZIP Codes were included. Using a purposive sampling approach, we also made sure that the sample varied with regard to race and ethnicity. Calls were transcribed and de-identified by our community partner—Utah’s 211 and were analyzed using a thematic analysis approach by our research team. RESULTS: Three themes emerged from the qualitative analysis including referral to 211, reasons for food-related calls, and reasons for unmet food needs. Results highlight the complex social environment around 211 food-related callers, lack of knowledge about available food resources, and indications of food insecurity in calls. CONCLUSION: Information seeking for food-related resources through 211 is a problem-solving source for people living in a complex social environment. Indications of food insecurity through these calls validate the use of these calls as a proxy measure for food insecurity. Interventions should be designed to increase awareness about the available resources and address the co-existing social needs with food insecurity.