College and Childhood Food Insecurity

Overview

• Study examines college food insecurity (CoFI), childhood food insecurity (ChFI), and their links to student health and well-being.
• Convenience sample: 372 students at a public Southeastern U.S. land‑grant university; data collected Oct–Nov 2021.
• Framework: Social Determinants of Health (SDOH) and cumulative disadvantage across the life course.
• Key findings: 23.7% reported CoFI; ChFI increases odds of CoFI; CoFI strongly associated with worse health, stress, concentration, and academic progress. CoFI mediates much of ChFI's impact.

Methods

• Sample and recruitment:
  • Students enrolled fall 2021 at one public university; survey publicized by classroom visits, faculty emails, flyers.
  • Incentive: raffle for gift cards.
• Measures:
  • College Food Insecurity: 6-item USDA short form, 30-day timeframe; 2+ affirmative responses = food insecure.
  • Childhood Food Insecurity: 2-item Hunger Vital Sign retrospective measure; any "sometimes/often true" = ChFI.
  • Outcomes: food stress, difficulty concentrating due to lack of food, general stress, self-rated health, COVID-19 impact on food access, perceived academic progress.
  • Demographics: gender, sexual orientation (LGBTQIA++), race/ethnicity, living situation, first-generation status, residency (in-state), field of study.
• Analysis:
  • Descriptives and chi-square tests comparing FS vs FI students.
  • Binary logistic regression: CoFI on demographics and ChFI (Model 1 demographics; Model 2 adds ChFI).
  • Ordered/binary logistic regressions for well-being outcomes with KHB mediation test to decompose ChFI effects via CoFI.
  • Multiple testing adjustment: Romano–Wolf stepdown procedure.
  • Software: STATA 18. Significance threshold p < 0.05 (two‑tailed).

Sample Characteristics (summary)

• N = 372; 73% female; 11.6% LGBTQIA++; 76.6% non‑Hispanic White.
• CoFI prevalence: 23.7% (88 students).
• ChFI prevalence: 12.1% overall; 27.3% among CoFI students.

Key Results

• Predictors of College Food Insecurity (binary logistic regression):
  • Living off campus: AOR ≈ 1.98 (p < 0.05).
  • In‑state student: AOR ≈ 1.82 (p < 0.05) in demographics-only model; attenuated after adding ChFI.
  • First‑generation student: AOR ≈ 2.29 (p < 0.05) in demographics-only model; attenuated after adding ChFI.
  • Humanities/behavioral/social/health majors: AOR ≈ 2.09 (p < 0.05).
  • Non‑Hispanic Black students: elevated odds (AOR ~3.44) but marginal significance (p < 0.1); attenuated with ChFI included.
  • Childhood food insecurity: AOR ≈ 3.17 (p < 0.01) — students with ChFI are >3× likely to report CoFI.
• Associations with Health and Well-Being (models controlling demographics and ChFI):
  • College food insecurity strongly associated with worse outcomes (Model 2):
    • Food stress: AOR ≈ 10.87 (p < 0.01).
    • Difficulty concentrating: AOR ≈ 11.55 (p < 0.01).
    • More food challenges after COVID: AOR ≈ 2.54 (p < 0.01).
    • Higher general stress: AOR ≈ 2.80 (p < 0.01).
    • Lower self-rated health: AOR ≈ 0.42 (p < 0.01).
    • Lower perceived academic progress: AOR ≈ 0.47 (p < 0.01).
  • Childhood food insecurity (Model 1) predicts higher food stress, difficulty concentrating, higher general stress, worse self-rated health; some effects attenuate when CoFI is added.
• Mediation:
  • KHB analysis: CoFI mediates a significant portion (23%–56%) of ChFI’s total effect on various well-being outcomes.
  • After mediation, ChFI still had direct associations with difficulty concentrating and self-rated health for some models.
• Multiple testing adjustment:
  • After Romano–Wolf correction, CoFI remained significantly associated with all six outcomes.
  • Some ChFI and sociodemographic associations remained significant or marginal after adjustment (notably ChFI → difficulty concentrating; LGBTQIA++ associations with stress and lower self-rated health).

Key Terms and Definitions

• Social Determinants of Health (SDOH): Conditions where people are born, grow, live, work, and age; five domains include economic stability, education access/quality, health care access/quality, neighborhood/built environment, social/community context.
• College Food Insecurity (CoFI): Measured via 6‑item USDA short form over past 30 days; 2+ affirmative responses = food insecure.
• Childhood Food Insecurity (ChFI): Retrospective 2‑item Hunger Vital Sign assessing whether food “didn't last” or worry about running out during childhood.
• Cumulative Disadvantage/Advantage: Life-course process where advantages or disadvantages accumulate over time, affecting later outcomes.

Discussion Points

• CoFI is common (≈24%) and strongly linked to negative mental, physical, and academic outcomes.
• ChFI increases risk of CoFI, demonstrating temporal/cumulative disadvantage.
• Structural factors matter: living situation, first‑generation status, field of study, race/ethnicity show disparities.
• Individual-level solutions (e.g., financial literacy, pantry use) insufficient without structural approaches and SDOH framing.
• Trauma‑informed, non‑stigmatizing screening and programs recommended; integrate SDOH screening into student intake/health services.
• Policy implications: broaden SNAP eligibility for students, increase financial supports (e.g., Pell grants), institutional strategies beyond food pantries.

Limitations

• Convenience sample at one institution limits generalizability.
• Cross-sectional design prevents causal inference.
• Retrospective ChFI measure subject to recall bias; small cell sizes for some demographic groups.
• USDA household-based measures may not fully capture college students’ living arrangements and experiences.
• Quantitative design could benefit from longitudinal and qualitative follow-up.

Implications and Recommendations (Action Items / Next Steps)

• Universities should adopt SDOH framework and structural competency in program design and screening.
• Implement non‑stigmatizing SDOH screening (e.g., Hunger Vital Sign, LIFESCREEN‑C) at student intake, orientation, or health centers.
• Develop institution-specific, trauma-informed supports: coordinated offices addressing food/housing, stigma reduction strategies for pantry use.
• Advocate for policy changes expanding SNAP access for college students and increased financial aid (Pell increases).
• Future research: longitudinal and qualitative studies; include measures of SNAP/Pell receipt; evaluate whether USDA measures capture student food experiences accurately.
• Educate students and staff about SDOH to reduce stigma and increase awareness of structural drivers of food insecurity.

Conclusions

• Food insecurity among college students reflects structural and life-course factors, not just temporary or individual deficits.
• Childhood food insecurity contributes to college disadvantages; college food insecurity mediates many negative outcomes.
• Addressing CoFI requires SDOH-informed, structural, and trauma-informed institutional and policy responses to reduce cumulative disadvantages and support student well-being and academic success.