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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

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

Authors: Aseel El Zein, Karla P. Shelnutt, Sarah Colby, Melissa J. Vilaro, Wenjun Zhou, Geoffrey Greene, Melissa D. Olfert, Kristin Riggsbee, Jesse Stabile Morrell, Anne E. Mathews

Published in: BMC Public Health | Issue 1/2019

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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.
Literature
1.
2.
3.
4.
5.
Pancer SM, Hunsberger B, Pratt MW, Alistat S. Cognitive complexity of expectations and adjustment to university in the first year. J Adolesc Res. 2000;15(1):38–57.CrossRef
6.
Henry L. Understanding food insecurity among college students: experience, motivation, and local solutions. Ann Anthropol Pract. 2017;41(1):6–19.CrossRef
7.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.CrossRef
8.
9.
Worthy SL, Jonkman, J. & Blinn-Pike, L. Sensation-seeking, risk-taking, and problematic financial behaviors of college students. J Fam Econ Issues. 2010;31:161–170.
10.
Bozick R. Making it through the first year of college: the role of students' economic resources, employment, and living arrangements. Sociol Educ. 2007;80(3):261–84.CrossRef
11.
Larson IN, Perryl CL, Story M, Neumark-Sztainer D. Food preparation by young adults is associated with better diet quality. J Am Diet Assoc. 2006;106(12):2001–7.CrossRef
12.
Clifford D, Anderson J, Auld G, Champ J. Good Grubbin': impact of a TV cooking show for college students living off campus. J Nutr Educ Behav. 2009;41(3):194–200.CrossRef
13.
McArthur LH, Ball L, Danek AC, Holbert D. A high prevalence of Food insecurity Among University students in Appalachia reflects a need for educational interventions and policy advocacy. J Nutr Educ Behav. 2018;50(6):564–72.CrossRef
14.
Anderson DA, Shapiro JR, Lundgren JD. The freshman year of college as a critical period for weight gain: an initial evaluation. Eat Behav. 2003;4(4):363–7.CrossRef
15.
Lloyd-Richardson EE, Bailey S, Fava JL, Wing R. A prospective study of weight gain during the college freshman and sophomore years. Prev Med. 2009;48(3):256–61.CrossRef
16.
Pan L, Sherry B, Njai R, Blanck HM. Food insecurity is associated with obesity among US adults in 12 states. J Acad Nutr Diet. 2012;112(9):1403–9.CrossRef
17.
Bruening M, Argo K, Payne-Sturges D, Laska MN. The struggle is real: a systematic review of food insecurity on postsecondary education campuses. J Acad Nutr Diet. 2017;117(11):1767–91.CrossRef
18.
Gaines A, Robb CA, Knol LL, Sickler S. Examining the role of financial factors, resources and skills in predicting food security status among college students. Int J Consum Stud. 2014;38(4):374–84.CrossRef
19.
Patton-Lopez MM, Lopez-Cevallos DF, Cancel-Tirado DI, Vazquez L. Prevalence and correlates of food insecurity among students attending a midsize rural university in Oregon. J Nutr Educ Behav. 2014;46(3):209–214.CrossRef
20.
21.
El Zein A, Mathews AE, House L, Shelnutt KP. Why are hungry college students not seeking help? Predictors of and barriers to using an on-campus Food pantry. Nutrients. 2018;10(9):1163.CrossRef
22.
Watson T, Malan H, Glik D, Martinez S. College students identify university support for basic needs and life skills as key ingredient in addressing food insecurity on campus. Calif Agric. 2017;71(3):130–8.CrossRef
23.
Farahbakhsh J, Hanbazaza M, Ball GDC, Farmer AP, Maximova K, Willows ND. Food insecure student clients of a university-based food bank have compromised health, dietary intake and academic quality. Nutr Diet. 2017;74(1):67–73.CrossRef
24.
Bruening M, Brennhofer S, van Woerden I, Todd M, Laska M. Factors related to the high rates of food insecurity among diverse, urban college freshmen. J Acad Nutr Diet. 2016;116(9):1450–7.CrossRef
25.
Bruening M, van Woerden I, Todd M, Laska MN. Hungry to learn: the prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen. Int J Behav Nutr Phys Act. 2018;15:9.CrossRef
26.
Ford E. Food security and cardiovascular disease risk among adults in the United States: findings from the National Health and nutrition examination Survey, 2003–2008. Prev Chronic Dis. 2013;10(9):130244.CrossRef
27.
Seligman HK, Laraia BA, Kushel MB. Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr. 2010;140(2):304–10.CrossRef
28.
Darling KE, Fahrenkamp AJ, Wilson SM, D'Auria AL, Sato AF. Physical and mental health outcomes associated with prior food insecurity among young adults. J Health Psychol. 2015:1–10.
29.
Maroto M. Food insecurity among community college students: prevalence and relationship to GPA. Community Coll J Res Pract. 2015;39(6):515–626.CrossRef
30.
Hagedorn RL, Olfert MD. Food insecurity and behavioral characteristics for academic success in young adults attending an Appalachian university. Nutrients. 2018;10:361.CrossRef
31.
Thompson FE, Subar AF, Smith AF, Midthune D, Radimer KL, Kahle LL, et al. Fruit and vegetable assessment: performance of 2 new short instruments and a food frequency questionnaire. J Am Diet Assoc. 2002;102(12):1764–72.CrossRef
32.
Boyce W, Torsheim T, Currie C, Zambon A. The family affluence scale as a measure of national health: validation of an adolescent self-report measure. Soc Indic Res. 2006;78(3):473–87.CrossRef
33.
34.
Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to measuring household food security. Revised. Alexandria; 2000. p. 2000.
35.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRef
36.
Manzar MD, Moiz JA, Zannat W, Spence DW, Pandi-Perumal SR, Hussain ME. Validity of the Pittsburgh sleep quality index in Indian university students. Oman Med J. 2015;30(3):193–202.CrossRef
37.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef
38.
Amr M, Hady El Gilany A, El-Hawary A. Does gender predict medical students’ stress in Mansoura, Egypt? Med Educ Online. 2008;13:12.CrossRef
39.
Shah M, Hasan S, Malik S, Sreeramareddy CT. Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school. BMC Med Educ. 2010;10:2.CrossRef
40.
Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12(4):871–8.CrossRef
41.
Constain GA, Rodriguez-Gazquez ML, Ramirez Jimenez GA, Gomez Vasquez GM, Mejia Cardona L, Cardna Velez J. Diagnostic validity and usefulness of the eating attitudes Test-26 for the assessment of eating disorders risk in a Colombian male population. Aten Primaria. 2017;49(4):206–13.CrossRef
42.
Pope Z, Gao Y, Bolter N, Pritchard M. Validity and reliability of eating disorder assessments used with athletes: a review. J Sport and Health Sci. 2015;4(3):211–21.CrossRef
43.
Alaimo K, Olson CM, Frongillo EA. Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. J Nutr. 2002;132(4):719–25.CrossRef
44.
Jung NM, de Bairros FS, Pattussi MP, Pauli S, Neutzling MB. Gender differences in the prevalence of household food insecurity: a systematic review and meta-analysis. Public Health Nutr. 2017;20(5):902–16.CrossRef
45.
Morris LM, Smith S, Davis J, Null DB. The prevalence of food security and insecurity among Illinois university students. J Nutr Educ Behav. 2016;48(6):376–82.CrossRef
46.
Heflin CM, Siefert K, Williams DR. Food insufficiency and women's mental health: findings from a 3-year panel of welfare recipients. Soc Sci Med. 2005;61(9):1971–82.CrossRef
47.
Ding M, Keiley MK, Garza KB, Duffy PA, Zizza CA. Food insecurity is associated with poor sleep outcomes among US adults. J Nutr. 2015;145(3):615–21.CrossRef
48.
Dinour LM, Bergen D, Yeh MC. The food insecurity-obesity paradox: a review of the literature and the role food stamps may play. J Am Diet Assoc. 2007;107(11):1952–61.CrossRef
49.
Townsend MS, Peerson J, Love B, Achterberg C, Murphy SP. Food insecurity is positively related to overweight in women. J Nutr. 2001;131(6):1738–45.CrossRef
50.
Tester J, Lang T, Laraia BA. Disordered eating behaviors and food insecurity: a qualitative study about children with obesity in low-income households. Obes Res Clin Pract. 2016;10(5):544–52.CrossRef
51.
Laugero KD, Falcon LM, Tucker KL. Relationship between perceived stress and dietary and activity patterns in older adults participating in the Boston Puerto Rican health study. Appetite. 2011;56(1):194–204.CrossRef
52.
McCuen-Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge-eating disorder, night-eating syndrome, and weight-related comorbidities. Ann N Y Acad Sc. 2018;1411(1):96–105.CrossRef
53.
Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011;14(4):402–12.CrossRef
54.
Dietz WH. Does hunger cause obesity? Pediatrics. 1995;95(5):766–7.PubMed
55.
Zekeri AA. Livelihood strategies of food-insecure poor, female-headed families in rural Alabama. Psychol Rep. 2007;101(3 Pt 2):1031–6.CrossRef
56.
Hamelin AM, Habicht JP, Beaudry M. Food insecurity: consequences for the household and broader social implications. J Nutr. 1999;129(2S Suppl):525s–8s.CrossRef
57.
Maroto ME. Food insecurity among community college students: prevalence and relationship to GPA, energy, and concentration: Morgan State University; 2013.
58.
59.
60.
Smith-Carrier T, Ross K, Kirkham J, Decker Pierce B. ‘Food is a right … nobody should be starving on our streets’: perceptions of food bank usage in a mid-sized city in Ontario, Canada. J Hum Rights Pract. 2017;9(1):29–49.CrossRef
61.
Anderson MD. Beyond food security to realizing food rights in the US. J Rural Stud. 2013;29:113–22.CrossRef
62.
Campbell E, Hudson H, Webb K, Crawford PB. Food preferences of users of the emergency food system. J Hunger Environ Nutr. 2011;6(2):179–87.CrossRef
63.
Chilton M, Rose D. A rights-based approach to food insecurity in the United States. Am J Public Health. 2009;99(7):1203–11.CrossRef
64.
Purdam K, Garratt EA, Esmail A. Hungry? Food insecurity, social stigma and embarrassment in the UK. 2015;50(6):1072–88.
Metadata
Title
Prevalence and correlates of food insecurity among U.S. college students: a multi-institutional study
Authors
Aseel El Zein
Karla P. Shelnutt
Sarah Colby
Melissa J. Vilaro
Wenjun Zhou
Geoffrey Greene
Melissa D. Olfert
Kristin Riggsbee
Jesse Stabile Morrell
Anne E. Mathews
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6943-6

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