Abstract
Introduction:
Food insecurity has been associated with adverse health and academic outcomes among college students. However, little is known about the long-term effects of experiencing food insecurity during college. This study examines the effects of college food insecurity (measured from 1999 to 2003) on future food insecurity (measured from 2015 to 2017), and whether this association differs by economic independence during college.
Methods:
Data came from 1,508 participants in the Panel Study of Income Dynamics, the longest running and nationally representative panel survey. Household food security was assessed using the 18-item U.S. Household Food Security Survey Module during college enrollment in 1999–2003 and again during adulthood in 2015–2017. Generalized linear models were used to examine the effect of college food insecurity on food insecurity in adulthood, adjusting for individual- and family-level sociodemographic characteristics. Data analysis was conducted in 2020–2021.
Results:
After multivariable adjustment, college food insecurity was associated with an increased prevalence of food insecurity in adulthood (prevalence ratio=1.45, 95% CI=1.16, 1.81). This association was more pronounced among students who were economically independent from their parents during college (prevalence ratio=2.23, 95% CI=1.27, 3.90).
Conclusions:
Food insecurity during college is associated with a higher prevalence of food insecurity in early to middle adulthood, particularly among economically independent students. Given the seemingly cyclical nature of food insecurity over the life course, policies are needed to alleviate food insecurity during the critical college years.
Keywords: food insecurity, College, panel study
INTRODUCTION
Food insecurity, a condition of limited access to nutritious food, is a critical issue for college students’ health and well-being.1,2 Recent studies have demonstrated unprecedented levels of food insecurity on college campuses, with under-represented minorities, low-income, and first-generation students at higher risk.3,4 This disparity in food insecurity has been attributed to the changing demographics of college students over the past decades, as more young adults have had the opportunity to pursue a college education.2
Recent studies find that college students experiencing food insecurity have poorer health and psychosocial outcomes, and have lower academic achievement when compared with their food-secure peers.5–10 Most research to date has been cross-sectional; few studies have examined the longitudinal implications of college food insecurity. In a study of university freshmen, concurrent food insecurity more strongly predicted dietary behaviors and mental health outcomes than past food insecurity.11 Another longitudinal study found poorer psychosocial health mediated the association between food insecurity and academic performance.12 To date, no study has prospectively examined the effects of college food insecurity on food insecurity in early/middle adulthood.
Using longitudinal data from a nationally representative household panel study, this study examines the long-term effects of experiencing food insecurity during college on food insecurity in early/middle adulthood. Differences in this association by economic independence during college are also investigated.
METHODS
Study Population
The Panel Study of Income Dynamics (PSID) is the longest running household panel survey designed to be representative of the U.S. population. Begun in 1968, data on sociodemographic and health characteristics were collected annually through 1997 and biennially thereafter.13
For this study, a balanced panel was created of 1,508 individuals aged 16–29 years, enrolled in ≥1 year of college between 1999 and 2003, remained in the sample through follow-up (2015–2017), and had information on food security status at both timepoints. Individuals who were not economically independent by 2015–2017 (n=66)—defined as holding the position of Reference Person/Spouse/Partner of their own PSID household—were excluded from the analytic sample as their food security status in 2015–2017 would not reflect their own reports. Sensitivity analyses were also conducted including those individuals not economically independent by 2015–2017.
Measures
The primary exposure of interest was food security status measured between 1999 and 2003 concurrent with the participant’s college enrollment (i.e., college food insecurity). Food security status was reported using the 18-item U.S. Household Food Security Survey Module (HFSSM).14 College food insecurity was classified as having a score ≥1 on the HFFSM during 1999–2003. PSID participants who were economically independent during college completed their own food security assessments (n=301). For PSID participants who were not economically independent during college, food security status was reported by the householder of their family unit (i.e., parent/caregiver; n=1,207).
The primary outcome was food security status measured in 2015–2017 (i.e., food insecurity during adulthood) using the HFSSM. Individuals were categorized as food-insecure if they had a score ≥1 on the HFFSM in 2015 or 2017.
Covariates included age (continuous), sex (male/female), race/ethnicity (non-Hispanic White/other), economic independence (yes/no), and income-to-needs ratio (continuous) during college. Models also adjusted for parental educational attainment (college attainment/no college attainment) and childhood receipt of Supplemental Nutrition Assistance Program (SNAP) benefits (ever/never).
Statistical Analysis
The PSID longitudinal survey weights were applied to all analyses to account for sample attrition and clustering, and to generate nationally representative estimates. Descriptive statistics were used to compare distributions of sociodemographic characteristics by college food insecurity status. Multivariable generalized linear models were used to estimate prevalence ratios (PRs) for adult food insecurity in relation to college food insecurity. Stratified analyses investigated differences in the primary association by economic independence. All statistical tests were 2-sided; significance was considered at p<0.05. Statistical analyses were performed using Stata/SE, version 12.1 in 2020–2021.
RESULTS
The overall prevalence of college food insecurity was 14.9%. Compared with students who were food-secure in college, students who were food-insecure had lower household incomes, and were more likely to be non-White, have lower parental educational attainment, and have received SNAP during childhood (p<0.01) (Table 1).
Table 1.
Descriptive Characteristics During College Among 1,508 PSID Individuals Stratified by College Food Insecurity (1999‒2003)
| Characteristics | All PSID participants (n=1,508) | Food-secure (n=1,107) | Food insecure (n=401) | p-value |
|---|---|---|---|---|
| n (%) | n (%) | n (%) | ||
| Age, mean (SD) | 21.6 (3.2) | 21.6 (3.1) | 21.7 (3.9) | 0.79 |
| Income to needs ratio, mean (SD) | 5.2 (4.6) | 5.7 (4.6) | 2.1 (1.7) | <0.0001 |
| Sex | 0.58 | |||
| Male | 612 (44.7) | 496 (45.1) | 116 (42.6) | |
| Female | 896 (55.3) | 710 (54.9) | 186 (57.4) | |
| Race/ethnicity | <0.0001 | |||
| White | 866 (74.2) | 774 (78.5) | 92 (49.5) | |
| Non-White | 642 (25.8) | 432 (21.5) | 210 (50.5) | |
| Parental education attainment | <0.0001 | |||
| At least 1 parent attained a college degree | 600 (46.5) | 545 (50.8) | 55 (21.8) | |
| Neither parent attained a college degree | 908 (53.5) | 661 (49.2) | 247 (78.2) | |
| Economically independent during college | 0.004 | |||
| Yes | 301 (22.3) | 230 (20.7) | 71 (31.4) | |
| No | 1,207 (77.7) | 976 (79.3) | 231 (68.6) | |
| Childhood SNAP participation | <0.0001 | |||
| No | 941 (69.1) | 840 (74.8) | 101 (36.8) | |
| Yes | 567 (30.9) | 366 (25.2) | 201 (63.2) |
Note: Boldface indicates statistical significance (p<0.05).
PSID, Panel Study of Income Dynamics; SNAP, Supplemental Nutrition Assistance Program.
Among college students, food insecurity was associated with a 45% higher prevalence of food insecurity in adulthood (PR=1.45, 95% CI=1.16, 1.81), after adjusting for sociodemographic characteristics (Table 2). The association between college food insecurity and adult food insecurity was more pronounced among students who were economically independent from their parents during college (PR=2.23, 95% CI=1.27, 3.90). This association was attenuated among students who were economically dependent during college (PR=1.19, 95% CI=0.86, 1.64). Sensitivity analyses including individuals not economically independent by 2015–2017 were substantively unchanged.
Table 2.
Associations Between College Food Insecurity and Adult Food Insecurity by Economic Independence
| College food insecurity | All PSID participants (n=1,508) | Economically independent during college (n=301) | Economically dependent on parents during college (n=1,207) |
|---|---|---|---|
| PRa (95% CI) | PRa (95% CI) | PRa (95% CI) | |
| Food secure | ref | ref | ref |
| Food insecure | 1.45 (1.16, 1.81) | 2.23 (1.27, 3.90) | 1.19 (0.86, 1.64) |
Note: Boldface indicates statistical significance (p<0.05).
Models adjusted for age, income to needs ratio, sex, race/ethnicity, parental education attainment, economic independence (except in stratified models), and childhood participation in the Supplemental Nutrition Assistance Program.
PR, prevalence ratio; PSID, Panel Study of Income Dynamics.
DISCUSSION
This study utilizes nationally representative data from a longitudinal panel study to examine the cyclical nature of food insecurity during college and adulthood. Among students who were economically independent during college, experiencing food insecurity during college was associated with a >2-fold greater likelihood of experiencing food insecurity in adulthood. This association may be mediated by the experience of social exclusion15,16 or greater academic disruption,5,12,17 both which could affect future employment patterns and earnings. These results are concerning given rising trends in economic independence and food insecurity among college students today,1,2 and the health consequences of food insecurity in adulthood.18
In past decades, federal programs have allowed more individuals to pursue a college education. Unfortunately, these programs fall short of covering the comprehensive costs of college, leading to disproportionate levels of food insecurity among students. Thus, experiences of food insecurity may hinder the impact of a college education to promote upward socioeconomic mobility.19 Given the current hardships due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, temporary changes have been made to expand SNAP access and increase SNAP benefits to alleviate food insecurity among college students.20 These changes need to be sustained and paired with comprehensive financial aid programs in order to help break this cycle of chronic food insecurity, particularly for economically independent students.
Limitations
The strengths of this study include the prospective collection and national representativeness of the sample. There are also some limitations. First, for individuals who were not economically independent from their parents, their college food security measurement was completed by their parent and may not reflect their own food security status. Second, no measures of food security were collected between 2005 and 2013, precluding the examination of food insecurity immediately after college. The demographics of college students in this sample may not be representative of the current college population, as evidenced by the lower prevalence of college food insecurity observed in this study compared to recent studies.1,4 Future research should also examine transitions between food security categories over time to better understand changes in the severity of food insecurity in subsequent periods. Finally, it is debatable whether the HFSSM is appropriate to assess food insecurity among college students.21 Future efforts should focus on examining the psychometric properties of the HFSSM for this heterogeneous population. Other limitations specific to PSID include the cumulative attrition over the study period, biennial data collection of dynamic variables (e.g., income), and self-reported data from a single repsondent.22
CONCLUSIONS
Food insecurity during college is associated with food insecurity in early/middle adulthood, particularly among economically independent students. These findings underscore the need for policy interventions to alleviate food insecurity during college and potentially break the cycle of chronic food insecurity over the life course.
ACKNOWLEDGMENTS
This work was supported by the University of Kentucky Center for Poverty Research through funding by the Economic Research Service and Food and Nutrition Service in the U.S. Department of Agriculture. In addition, CW Leung and JA Wolfson were supported by NIH (R00 HD084758 to CWL and K01 DK119166 to JAW), and AJ Cohen was supported by the Department of Veterans Affairs Health Services Research & Development grant CDA 20-037.
Footnotes
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No financial disclosures were reported by the authors of this paper.
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