Clinical Care and Referral Pathways for Food Security Screening in Health Care: A Scoping Review

Journal of the American Heart Association, Volume 15, Issue 11 , June 2, 2026. BackgroundFood and nutrition insecurity are linked to poor health outcomes and disparities, yet how health care systems implement screening and referrals remains poorly understood.MethodsWe searched for studies evaluating screening and referral processes for food and nutrition insecurity for patients of all ages in US health care settings.

Searches were performed through May 2025 in MEDLINE (via PubMed), Cochrane (via Ovid), Cumulative Index of Nursing and Allied Health (EBSCO), and Social Interventions Research and Evaluation Network Evidence and Resource Library. Studies were included if they reported both a screening process and referral mechanism.

Findings were synthesized narratively.ResultsOf 11 406 records identified, 136 studies met the inclusion criteria; all screened for food insecurity, and none screened for nutrition insecurity. Most studies screened general populations across age, sex, race, and ethnicity, with few restricting by socioeconomic status or clinical conditions.

Screening primarily used tools embedded within broader social determinants of health screenings (46%) and integrated into electronic health records (48%), typically in outpatient settings (49%).