Food Insecurity on College and University Campuses: A Context and Rationale for Solutions

Abstract

Food insecurity, even for short time periods, is associated with detrimental physiological and psychological impacts on college students. Compared with students who are food secure, students who are food insecure have been associated with having poor dietary quality, poor physical activity habits, and greater odds for obesity.1El Zein A. Colby S.E. Zhou W. et al.Food insecurity is associated with increased risk of obesity in US college students.Curr Dev Nutr. 2020; 4: nzaa120Crossref PubMed Scopus (11) Google Scholar, 2Leung C.W. Wolfson J.A. Lahne J. Barry M.R. Kasper N. Cohen A.J. Associations between food security status and diet-related outcomes among students at a large, public midwestern university.J Acad Nutr Diet. 2019; 119: 1623-1631Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar, 3Bruening M. van Woerden I. Todd M. Laska M.N. 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: 9Crossref PubMed Scopus (61) Google Scholar, 4Bruening 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: 1450-1457Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar Food insecurity in college students has also been associated with poor mental health, depression, anxiety, and stress.5Martinez S.M. Frongillo E.A. Leung C. Ritchie L. No food for thought: Food insecurity is related to poor mental health and lower academic performance among students in California’s public university system.J Health Psychol. 2020; 25: 1930-1939Crossref PubMed Scopus (51) Google Scholar, 6Becerra M.B. Becerra B.J. Psychological distress among college students: Role of food insecurity and other social determinants of mental health.Int J Environ Res Public Health. 2020; 17: 4118Crossref Scopus (10) Google Scholar, 7Raskind I.G. Haardorfer R. Berg C.J. Food insecurity, psychosocial health, and academic performance among college and university students in Georgia, USA.Public Health Nutr. 2019; 22: 476Crossref PubMed Scopus (49) Google Scholar, 8Coffino J.A. Spoor S.P. Drach R.D. Hormes J.M. Food insecurity among graduate students: Prevalence and association with depression, anxiety and stress.Public Health Nutr. 2021; 24: 1889-1894Crossref PubMed Scopus (10) Google Scholar Students who are food insecure may have difficulty concentrating in class and, as a result, have a lower grade point average and overall poorer academic performance.5Martinez S.M. Frongillo E.A. Leung C. Ritchie L. No food for thought: Food insecurity is related to poor mental health and lower academic performance among students in California’s public university system.J Health Psychol. 2020; 25: 1930-1939Crossref PubMed Scopus (51) Google Scholar,7Raskind I.G. Haardorfer R. Berg C.J. Food insecurity, psychosocial health, and academic performance among college and university students in Georgia, USA.Public Health Nutr. 2019; 22: 476Crossref PubMed Scopus (49) Google Scholar,9Maroto M.E. Snelling A. Linck H. Food insecurity among community college students: Prevalence and association with grade point average.Community Coll J Res Pract. 2015; 39: 515-526Crossref Scopus (105) Google Scholar,10Camelo K. Marta E. Food insecurity and academic achievement among college students at a public university in the United States.J Coll Stud Dev. 2019; 60: 307-318Crossref Scopus (13) Google Scholar The college experience is enhanced for all in a healthy food environment when students can focus on academics without embarrassment, social stigma, or drawing on resources of friends when they run out of money for food. Efforts to eliminate food insecurity on college campuses are worth pursuing through collective action by college administrators, credentialed nutrition and dietetics practitioners, and policy makers. Institutions of higher education will more successfully foster excellence and achievement when all students have access to the food they need. However, efforts have been stymied by challenges describing the prevalence of food insecurity, differing college student experiences and backgrounds, and several solutions attempting to ameliorate the problem with limited sustained effectiveness. The purpose of this commentary was to explore and contextualize the problem and solutions to food insecurity on college campuses, including gaps in understanding the magnitude, severity, and persistence, and how current efforts have been insufficient to meaningfully address food insecurity among college students. Thoughts on how federal assistance programs can be better leveraged and recommendations for a targeted focus of future efforts and research to improve campus food insecurity are also offered. Food insecurity in college students can be evaluated in several ways, including magnitude or prevalence, severity, and persistence.11Ellison B. Bruening M. Hruschka D.J. et al.Viewpoint: Food insecurity among college students: A case for consistent and comparable measurement.Food Policy. 2021; : 102031Crossref Scopus (7) Google Scholar Comparisons with other groups may also help to contextualize the problem. The prevalence of food insecurity among college students has been reported previously in several reviews of the literature, with estimates ranging from 10% to 75% and average prevalence rates of 33% to 51%.12Nazmi A. Martinez S. Byrd A. et al.A systematic review of food insecurity among US students in higher education.J Hunger Environ Nutr. 2019; 14: 725-740Crossref Scopus (44) Google Scholar, 13Bruening M. Argo K. Payne-Sturges D. Laska M.N. The struggle is real: A systematic review of food insecurity on postsecondary education campuses.J Acad Nutr Diet. 2017; 117: 1767-1791Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar, 14Nikolaus C.J. An R. Ellison B. Nickols-Richardson S.M. Food insecurity among college students in the United States: A scoping review.Adv Nutr. 2019; 11: 327-348Crossref Scopus (32) Google Scholar The extraordinarily high rates of food insecurity among college students that have been reported in some of these studies are disconnected to estimates within a larger scope of food insecurity among at-risk subpopulations within the United States with a known high risk of food insecurity and for whom other measures of poverty and manifestations of disparities coalesce, such as American Indians and people with disabilities.15Gundersen C. Ziliak J.P. Food insecurity research in the United States: Where we have been and where we need to go.Appl Econ Perspect Policy. 2018; 40: 119-135Crossref Scopus (101) Google Scholar, 16Gundersen C. Are college students more likely to be food insecure than nonstudents of similar ages? Appl Econ Perspect Policy.https://doi.org/10.1002/aepp.13110Google Scholar, 17Castor M.L. Smyser M.S. Taualii M.M. Park A.N. 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Food insecurity across the adult life span for persons with disabilities.J Disabil Policy Stud. 2017; 28: 109-118Crossref Scopus (21) Google Scholar These variations in food insecurity prevalence are likely due to the small, nonrepresentative nature of many college student samples.12Nazmi A. Martinez S. Byrd A. et al.A systematic review of food insecurity among US students in higher education.J Hunger Environ Nutr. 2019; 14: 725-740Crossref Scopus (44) Google Scholar, 13Bruening M. Argo K. Payne-Sturges D. Laska M.N. The struggle is real: A systematic review of food insecurity on postsecondary education campuses.J Acad Nutr Diet. 2017; 117: 1767-1791Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar, 14Nikolaus C.J. An R. Ellison B. Nickols-Richardson S.M. Food insecurity among college students in the United States: A scoping review.Adv Nutr. 2019; 11: 327-348Crossref Scopus (32) Google Scholar Few studies12Nazmi A. Martinez S. Byrd A. et al.A systematic review of food insecurity among US students in higher education.J Hunger Environ Nutr. 2019; 14: 725-740Crossref Scopus (44) Google Scholar have used random or representative sampling strategies due to the burden of data collection with large college student populations. Nonresponse is another pervasive problem, at <15% in most studies12Nazmi A. Martinez S. Byrd A. et al.A systematic review of food insecurity among US students in higher education.J Hunger Environ Nutr. 2019; 14: 725-740Crossref Scopus (44) Google Scholar, 13Bruening M. Argo K. Payne-Sturges D. Laska M.N. The struggle is real: A systematic review of food insecurity on postsecondary education campuses.J Acad Nutr Diet. 2017; 117: 1767-1791Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar, 14Nikolaus C.J. An R. Ellison B. Nickols-Richardson S.M. Food insecurity among college students in the United States: A scoping review.Adv Nutr. 2019; 11: 327-348Crossref Scopus (32) Google Scholar; it is unclear whether students who are food insecure respond to surveys more or less frequently than their peers who are food secure.21Nikolaus C.J. Ellison B. Nickols-Richardson S.M. Are estimates of food insecurity among college students accurate? Comparison of assessment protocols.PLoS One. 2019; 14e0215161Crossref PubMed Scopus (39) Google Scholar In addition, the questionnaires used to determine prevalence of food insecurity vary widely from study to study, putting their respective prevalence estimates on unequal scales.4Bruening 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: 1450-1457Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar,22Twill S.E. Bergdahl J. Fensler R. Partnering to build a pantry: A university campus responds to student food insecurity.J Poverty. 2016; 20: 340-358Crossref Scopus (24) Google Scholar,23Silva M.R. Kleinert W.L. Sheppard A.V. et al.The relationship between food security, housing stability, and school performance among college students in an urban university.J Coll Stud Ret. 2017; 19: 284-299Crossref Scopus (55) Google Scholar One of the most frequently used measures is the US Department of Agriculture Adult Food Security Survey Module, which is also included as part of the US Census survey used to provide national-level estimates. Research suggests that this survey may not perform well in college populations due to documented issues with the ability of the survey to accurately capture financial food resources and experiences that are unique to college students.11Ellison B. Bruening M. Hruschka D.J. et al.Viewpoint: Food insecurity among college students: A case for consistent and comparable measurement.Food Policy. 2021; : 102031Crossref Scopus (7) Google Scholar,21Nikolaus C.J. Ellison B. Nickols-Richardson S.M. Are estimates of food insecurity among college students accurate? Comparison of assessment protocols.PLoS One. 2019; 14e0215161Crossref PubMed Scopus (39) Google Scholar,24Nikolaus C.J. Ellison B. Nickols-Richardson S.M. College students’ interpretations of food security questions: Results from cognitive interviews.BMC Public Health. 2019; 19: 1-16Crossref PubMed Scopus (15) Google Scholar Most college students are single and newly independent of their guardians’ or caregivers’ households. Yet, financial independence may vary widely among students,25Gaines A. Robb C.A. Knol L.L. Sickler S. Examining the role of financial factors, resources and skills in predicting food security status among college students.Int J Consum. 2014; 38: 374-384Crossref Scopus (108) Google Scholar challenging the line of query to classify food security using the Food Security Survey Module. Respondents are asked about having enough food in the context of resources, but may find it difficult to answer questions about the resources they have or that they may or may not have access to through their families. Furthermore, their access or lack of access to the resources of their families may be unique to the college experience and not linked with future need or food insecurity. Despite this, using the Food Security Survey Module may still be the most appropriate measure of food security status, as it entails the benefit of comparability with national rates of food insecurity among the general and similarly aged population. For example, Gundersen16Gundersen C. Are college students more likely to be food insecure than nonstudents of similar ages? Appl Econ Perspect Policy.https://doi.org/10.1002/aepp.13110Google Scholar found food insecurity rates among 18- to 30-year-old noncollege students were almost double those of similarly aged college students. These findings highlight that although food insecurity is a problem among college students, more widespread food insecurity may exist among the noncollege population for this age group. As such, these other groups should not be neglected when considering policies for people in this age group. Data on severity is often less available compared with prevalence. The prevalence of college students with very low food security, the level of most restriction where the amount of food is not adequate, ranges from 5% to 59%, but not all studies provide this breakdown to food security level or range.13Bruening M. Argo K. Payne-Sturges D. Laska M.N. The struggle is real: A systematic review of food insecurity on postsecondary education campuses.J Acad Nutr Diet. 2017; 117: 1767-1791Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar,14Nikolaus C.J. An R. Ellison B. Nickols-Richardson S.M. Food insecurity among college students in the United States: A scoping review.Adv Nutr. 2019; 11: 327-348Crossref Scopus (32) Google Scholar These high rates are unlikely to represent a general group of college students. In addition, information on the persistence of food insecurity among college students and the link of food insecurity to future food insecurity and outcomes is even less available. As mentioned previously, college students are faced with independence with varying degrees of resource support from their families. Students from families with less access to resources may have a higher likelihood of lifelong consequences when faced with food insecurity during college compared with those with more family resources.25Gaines A. Robb C.A. Knol L.L. Sickler S. Examining the role of financial factors, resources and skills in predicting food security status among college students.Int J Consum. 2014; 38: 374-384Crossref Scopus (108) Google Scholar The opportunity for advancement through education continues to be challenging for those from low-resource backgrounds. The uncertain prevalence, severity, and persistence, and lack of longitudinal trends of food insecurity among college students have made addressing this problem difficult.11Ellison B. Bruening M. Hruschka D.J. et al.Viewpoint: Food insecurity among college students: A case for consistent and comparable measurement.Food Policy. 2021; : 102031Crossref Scopus (7) Google Scholar The National Center for Education Statistics plans to gather surveillance data on college food insecurity in the coming years, and this may help provide a national statistic to clarify the true magnitude and severity of the problem, although it neglects examining the more vulnerable group of noncollege students of similar ages.26Evans C. U.S. gov’t to ask students about food insecurity. The Temple News.https://temple-news.com/u-s-govt-to-ask-students-about-food-insecurity/Google Scholar National tracking of college food security will inform plans for interventions through programs or policies, but studies on the link between persistence of food insecurity and longitudinal impacts are needed. Until a comprehensive assessment of college food insecurity and its links to future outcomes is conducted, inferences on the prevalence of college food insecurity should be drawn carefully, given the limitations. Access to higher education in the younger adult years sets the stage for greater earning potential over a lifetime and a decreased risk of poverty.27Semega J. Kollar M. Shrider E.A. Creamer J.F. US Census BureauIncome and Poverty in the United States: 2019. US Government Printing Office, 2020Google Scholar Despite rising college tuition28Table 330.10. Average undergraduate tuition and fees and room and board rates charged for full-time students in degree-granting postsecondary institutions, by level and control of institution: Selected years, 1963-64 through 2018-19. Digest of Education Statistics. National Center for Education Statistics.https://nces.ed.gov/programs/digest/d19/tables/dt19_330.10.aspGoogle Scholar and need-based financial aid with dwindling purchasing power (eg, Pell grants),29Protopsaltis S. Parrott S. Pell grants—A key tool for expanding college access and economic opportunity—Need strengthening, not cuts. Center on Budget and Policy Priorities.https://www.cbpp.org/research/federal-budget/pell-grants-a-key-tool-for-expanding-college-access-and-economicGoogle Scholar there are more than 16 million undergraduate college students in the United States.30Table 303.70. Total undergraduate fall enrollment in degree-granting postsecondary institutions, by attendance status, sex of student, and control and level of institution: Selected years, 1970 through 2029. Digest of Education Statistics. National Center for Education Statistics.https://nces.ed.gov/programs/digest/d19/tables/dt19_303.70.aspGoogle Scholar In recent years, the college student population has become increasingly diverse, with growing numbers of nontraditional, low-income, and first-generation students.31Chen J.C. Nontraditional adult learners: The neglected diversity in postsecondary education.SAGE Open. 2017; 7 (2158244017697161)Crossref PubMed Scopus (24) Google Scholar,32First-generation college students: Demographic characteristics and postsecondary enrollment. RTI International.https://firstgen.naspa.org/files/dmfile/FactSheet-01.pdfGoogle Scholar There have also been significant racial and ethnic demographic shifts in the census of students. Students who identify with a race or ethnicity other than White are currently estimated to make up nearly 45% of all enrolled students, an increase of more than 15% in the past 20 years.33Table 306.10. 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Students may not prioritize health over expense when making dietary selections, as many may have a general lack of awareness of nutrition, the importance of nutrition for current and future health, and available food resources on campus.40Zollinger B. Mills S. Brandt E. Rohleder-Sook W. College student food insecurity and awareness and use of supports: Recent findings from a survey of students at a mid-sized state comprehensive university in Kansas.eJournal of Public Affairs. 2018; 7 (Accessed November 2, 2021): 57-59http://www.ejournalofpublicaffairs.org/college-student-food-insecurity/Google Scholar,41Harris D.A. Just the “typical college diet”: How college students use life stages to account for unhealthy eating.Symb Interact. 2017; 40: 523-540Crossref Scopus (7) Google Scholar Some students may come from disadvantaged backgrounds and may be more familiar with bouts of food insecurity.37Martinez S.M. Webb K. Frongillo E.A. Ritchie L.D. Food insecurity in California’s public university system: What are the risk factors?.J Hunger Environ Nutr. 2018; 13: 1-18Crossref Scopus (46) Google Scholar Based on their lived experiences, some students may have knowledge of how to locate, access, and navigate food assistance programs. However, students who are newly food insecure may be unfamiliar and unaware of the aid available and how to enroll in these programs. Some college and universities have hired dedicated staff or assigned existing staff to lead campus initiatives; aid students in finding assistance; or streamline, centralize, or coordinate delivery of on-campus services.42Hagedorn R.L. Pampalone A.L. Hood L.B. Yura C.A. Morrow D.F. Olfert M.D. Higher education food insecurity toolkit development and feedback.J Nutr Educ Behav. 2020; 52: 64-72Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Yet, even when students are aware of available resources, additional barriers, such as restrictive policies or requirements, unstaffed programs, or inability to access programs due to inconvenient hours of operation, may prevent use.43El Zein A. Mathews A.E. House L. Shelnutt K.P. Why are hungry college students not seeking help? Predictors of and barriers to using an on-campus food pantry.Nutrients. 2018; 10: 1163Crossref Scopus (54) Google Scholar,44Diaz J. Gaylor R.L. How university infrastructure contributes to student food insecurity: The student experience.About Campus. 2020; 25: 19-24Crossref Google Scholar Other students may struggle to accept food assistance or use various campus- or community-based programs because they want to avoid being stigmatized.43El Zein A. Mathews A.E. House L. Shelnutt K.P. 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Predictors of and barriers to using an on-campus food pantry.Nutrients. 2018; 10: 1163Crossref Scopus (54) Google Scholar Although, pantries vary in scope and size from campus to campus, universities with limited resources can partner with local food banks that are able to provide greater purchasing power and processes for food distribution.46Berry T. Sloper M. Doll K. Addressing Food Insecurity Among College Students: The Landscape of the Feeding America Network.https://www.feedingamerica.org/sites/default/files/2019-10/Feeding%20America%20College%20Hunger%20Landscape%20-%20Full%20Report_October%202019.pdfGoogle Scholar Despite their widespread use, there is limited research on their reach and efficacy in reducing food insecurity.47McArthur L.H. Fasczewski K.S. Farris A.R. Petrone M. 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Other solutions include meal sharing or voucher programs, cash assistance for emergency expenses, food scholarships, or campus garden programs.42Hagedorn R.L. Pampalone A.L. Hood L.B. Yura C.A. Morrow D.F. Olfert M.D. Higher education food insecurity toolkit development and feedback.J Nutr Educ Behav. 2020; 52: 64-72Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar,56Freudenberg N. Goldrick-Rab S. Poppendieck J. College students and SNAP: The new face of food insecurity in the United States.Am J Public Health. 2019; 109: 1652-1658Crossref PubMed Scopus (23) Google Scholar,57Ullevig S.L. Vasquez L.L. Ratcliffe L.G. Oswalt S.B. Lee N. Lobitz C.A. Establishing a campus garden and food pantry to address food insecurity: Lessons learned.J Am Coll Health. 2021; 69: 684-688Crossref PubMed Scopus (2) Google Scholar All of these campus responses to the hunger crisis can be good interim solutions to increase access to food for students. 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