Prevalence and correlates of food insecurity among U.S. college students: a multi-institutional study

Abstract

Background College students may be vulnerable to food insecurity due to limited financial resources, decreased buying power of federal aid, and rising costs of tuition, housing, and food. This study assessed the prevalence of food insecurity and its sociodemographic, health, academic, and food pantry correlates among first-year college students in the United States. Methods A cross-sectional study was conducted among first-year students ( n = 855) across eight U.S. universities. Food security status was assessed using the U.S. Department of Agriculture Adult Food Security Survey Module. Cohen’s Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26 were used to assess perceived stress, sleep quality, and disordered eating behaviors, respectively. Participants self-reported their grade point average (GPA) and completed questions related to meal plan enrollment and utilization of on-campus food pantries. Results Of participating students, 19% were food-insecure, and an additional 25.3% were at risk of food insecurity. Students who identified as a racial minority, lived off-campus, received a Pell grant, reported a parental education of high school or less, and did not participate in a meal plan were more likely to be food-insecure. Multivariate logistic regression models adjusted for sociodemographic characteristics and meal plan enrollment indicated that food-insecure students had significantly higher odds of poor sleep quality (OR = 2.32, 95% CI: 1.43–3.76), high stress (OR = 4.65, 95% CI: 2.66–8.11), disordered eating behaviors (OR = 2.49, 95% CI: 1.20–4.90), and a GPA < 3.0 (OR = 1.91, 95% CI: 1.19–3.07) compared to food-secure students. Finally, while half of the students (56.4%) with an on-campus pantry were aware of its existence, only 22.2% of food-insecure students endorsed utilizing the pantry for food acquisition. Conclusions Food insecurity among first-year college students is highly prevalent and has implications for academic performance and health outcomes. Higher education institutions should screen for food insecurity and implement policy and programmatic initiatives to promote a healthier college experience. Campus food pantries may be useful as short-term relief; however, its limited use by students suggest the need for additional solutions with a rights-based approach to food insecurity. Trial Registration Retrospectively registered on ClinicalTrials.gov , NCT02941497.

Food Insecurity and Eating Disorders: a Review of Emerging Evidence

“…In recent years, food insecurity has been found to be associated with higher levels of overall ED pathology in cross-sectional studies of college students [ 42 , 43 ], postpartum women of higher weight status [ 44 ], and adult clients of food pantries [ 45 ••, 46 •], with effect sizes ranging from small to medium across studies [ 47 ]. Specifically, when comparing participants with food insecurity versus food security, effect sizes were small, with a Cohen’s d of 0.31 [ 43 ], to medium, with Cohen’s d ’s ranging from 0.55 [ 44 ] to 0.64 [ 42 ]. When comparing food pantry clients with severe food insecurity versus marginal food security, effect sizes were also medium, with Cohen’s d ’s ranging from 0.58 [ 46 •] to 0.76 [ 45 ••].…”

“…The studies reviewed above represent the extent of the existing empirical literature on food insecurity and ED pathology that we identified since database inception via searches of MEDLINE and PsycINFO in July 2020. Overall, we identified a total of fourteen studies quantitatively examining the link between food insecurity and either overall ED pathology, disordered eating behaviors, or ED diagnoses [ 34 , 42 – 44 , 45 ••, 46 •, 48 – 51 , 52 ••, 53 , 55 ••, 56 ••], eleven of which were published since 2017 [ 42 , 43 , 45 ••, 46 •, 48 , 50 , 51 , 52 ••, 53 , 55 ••, 56 ••]. Although this body of research is still small, it has grown tremendously in recent years relative to the limited attention this topic previously garnered.…”

“…One such consideration is the samples in which existing studies were conducted. The majority of these studies were conducted in relatively large samples of greater than 500 participants [ 43 , 44 , 45 ••, 46 •, 48 , 49 , 52 ••, 53 , 55 ••, 56 ••], thereby reducing the likelihood that observed associations represent false positive results due to low statistical power [ 58 ]. However, with a few exceptions in which samples were drawn from the population-based Project EAT (Eating and Activity over Time) studies [ 48 , 49 , 52 ••, 53 ], the majority of these studies also utilized nonprobability samples (typically a mix of convenience and purposive sampling), resulting in lower generalizability of their findings.…”

“…To assess food insecurity, most studies used some form of the U.S. Household Food Security Scale (HFSS), which has demonstrated reliability and convergent validity [ 59 , 60 ] but relies upon retrospective recall, the impact of which on validity has not been evaluated. Some studies used the 18-item full version of the HFSS [ 44 ], the 10-item adult version [ 43 , 50 ], or the six-item short form [ 49 , 51 , 52 ••, 55 ••, 56 ••]. Other studies used the HFSS-derived two-item Hunger Vital Sign [ 42 ], a different pair of HFSS items [ 48 ], a single HFSS item [ 53 ], or the Radimer/Cornell Food Insecurity Measure [ 34 , 45 ••, 46 •].…”

“…Regarding potential confounders of the relationship between food insecurity and ED pathology, most estimates reported above (e.g., effect sizes, prevalences) were unadjusted, but associations remained statistically significant in a number of these studies after adjusting for socioeconomic factors such as education level and income [ 43 , 48 – 51 , 52 ••, 55 ••, 56 ••]. In other words, in several of these studies, food insecurity was found to be associated with ED pathology above and beyond the contribution of socioeconomic status broadly, suggesting that food insecurity is not simply a proxy for socioeconomic status but rather may play a unique role in relation to ED risk.…”