Depression Mediates the Relationship between Food Insecurity and Pain Interference in College Students

Research trends and gaps concerning food insecurity in college students in the United States: a scoping review

OBJECTIVE

This scoping review explores the broad body of peer-reviewed research measuring food insecurity in post-secondary students in the U.S. to identify trends and gaps to inform future research.

METHODS

Three search engines (PubMed, Web of Science, and CINHAL Full Text) were systematically searched for articles reporting on food security status in U.S. college students.

RESULTS

One-hundred and sixty studies met inclusion criteria. Emerging high-risk student characteristics include gender non-conforming (GNC) and non-binary, financial independence in college, and pregnant and parenting students. Emerging correlates include lack of transportation, anxiety, and eating disorders.

CONCLUSIONS

Prevalence data can be used by colleges to advocate for services and programs. Additional multi-institutional cohort, longitudinal and qualitative studies are needed to identify timely interventions and effective solutions. A new "rights-based" approach to food security solutions that includes nutrition and food literacy for all students is needed.

Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review

In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.

Food insecurity and academic function among college students during the COVID-19 pandemic: A moderating role of the first-generation college student status

OBJECTIVE

To examine food insecurity (FI) prevalence among college students during the COVID-19 pandemic (April 2021) using cross-sectional design, and the moderating role of the first-generation student status in the relationship between FI and grade point average (GPA).

PARTICIPANTS

Three-hundred sixty students recruited mostly from upper-level kinesiology courses.

METHODS

General linear model was used to predict GPA based on food security status, psychological health, and bodily pain, with subgroup analysis performed by first-generation student status.

RESULTS

Approximately 19% were classified as having FI. Those with FI showed lower GPA and poor health compared to those without FI. The link between FI and GPA was moderated by first-generation student status, with the negative impact of FI on GPA more clearly observed among non-first-generation students.

CONCLUSION

First-generation student status could play a role in determining the impact of FI on academic performance.

Household Food Insufficiency and Chronic Pain among Children in the US: A National Study

This study aimed to determine the prevalence of pediatric chronic pain by household food sufficiency status and examine whether food insufficiency would be associated with greater risk for chronic pain. We analyzed data from the 2019-2020 National Survey of Children's Health of 48,410 children (6-17 years) in the United States. Across the sample, 26.1% (95% CI: 25.2-27.0) experienced mild food insufficiency and 5.1% (95% CI: 4.6-5.7) moderate/severe food insufficiency. The prevalence of chronic pain was higher among children with mild (13.7%) and moderate/severe food insufficiency (20.6%) relative to children in food-sufficient households (6.7%, p < 0.001). After adjusting for a priori covariates (individual: age, sex, race/ethnicity, anxiety, depression, other health conditions, adverse childhood events; household: poverty, parent education, physical and mental health; community: region of residence), multivariable logistic regression revealed that children with mild food insufficiency had 1.6 times greater odds of having chronic pain (95% CI: 1.4-1.9, p < 0.0001) and those with moderate/severe food insufficiency, 1.9 higher odds (95% CI: 1.4-2.7, p < 0.0001) relative to food-sufficient children. The dose-response relationship between food insufficiency and childhood chronic pain highlights the importance of further research to identify underlying mechanisms and evaluate the impact of food insufficiency on the onset and persistence of chronic pain across the lifespan.

Prevalence of Food Insecurity in the General College Population and Student-Athletes: a Review of the Literature

PURPOSE OF REVIEW

The purpose of this review is to examine the prevalence of food insecurity (FI) among the general college student population with a focus on student-athletes and the impact of the COVID-19 pandemic on FI in these groups.

RECENT FINDINGS

FI is estimated to be more prevalent in college students than in the general population, although ranges vary widely. Less is known about FI among college student-athletes. Data on changes in FI prevalence pre-pandemic and during is mixed. Colleges and universities should invest in interventions to address FI on their campuses, and further research on FI among student-athletes and the impact of the COVID-19 pandemic on FI is needed.

Pain-driven emergency department visits and food insecurity: a cross-sectional study linking Canadian survey and health administrative data

BACKGROUND

As the leading cause of emergency department visits in Canada, pain disproportionately affects socioeconomically disadvantaged populations. We examine the association between household food insecurity and individuals' pain-driven emergency department visits.

METHODS

We designed a cross-sectional study linking the Canadian Community Health Survey 2005-2017 to the National Ambulatory Care Reporting System 2003-2017. Food insecurity was measured using a validated questionnaire. We excluded individuals with missing food insecurity status, individuals younger than 12 years and jurisdiction-years with partial emergency department records. We assessed emergency department visits driven by pain at different sites (migraine, other headaches, chest-throat pain, abdomen-pelvis pain, dorsalgia, joint pain, limb pain, other pain) and their characteristics (frequency, cause, acuity and time of emergency department visit) in Ontario and Alberta. We adjusted for sociodemographic characteristics, lifestyle and prior non-pain-driven emergency department visits in the models.

RESULTS

The sample contained 212 300 individuals aged 12 years and older. Compared with food-secure individuals, marginally, moderately and severely food-insecure people had 1.42 (95% confidence interval [CI] 1.20-1.68), 1.64 (95% CI 1.37-1.96) and 1.99 (95% CI 1.61-2.46) times higher adjusted incidence rates of pain-driven emergency department visits, respectively. The association was similar across sexes and significant among adults but not adolescents. Food insecurity was further associated with site-specific pain, with severely food-insecure individuals having significantly higher pain incidence than food-secure individuals. Severe food insecurity predicted more frequent, multicause, high-acuity and after-hours emergency department visits.

INTERPRETATION

Household food insecurity status is significantly associated with pain-driven emergency department visits in the Canadian population. Policies targeting food insecurity may reduce pain and emergency department utilization.