Sociodemographic and health disparities among students screening positive for food insecurity: Findings from a large college health surveillance system.

Food insecurity among college students has begun to be recognized as a pressing social issue. However, much of the research in this area to date is limited by factors like small sample sizes and convenience sampling. The objective of this study was to assess sociodemographic and health disparities among two- and four-year post-secondary students screening positive for food insecurity, using one of the largest relevant health surveillance databases available. This study included analyses of pooled annual data (2015-2018; n = 13,720) from students participating in state-based surveillance of 27 two- and four-year Minnesota post-secondary institutions. Food security was determined using a validated two-item screener. Disparities were examined across numerous factors including: sociodemographic, economic, academic, institutional, nutrition and weight-related health risk and resiliency. In total, 24% of students experienced food insecurity. Findings highlighted stark disparities, with notably high positive screening rates of food insecurity among non-Hispanic Black (43%), transgender/non-binary (42%) and first-generation (33%) students. Food insecurity was significantly associated with nearly every adverse health factor examined, despite controlling for demographics (p < 0.0001). Overall, these findings represent one of the largest peer-reviewed studies of college food insecurity to date and underscore robust differences between who experiences food insecurity and who does not. They also highlight troubling health risks that accompany food insecurity. Importantly, the COVID-19 pandemic has worsened these realities. To inform prevention efforts, additional research is urgently needed, including cohort studies, controlled trials, and quasi-experimental research based on rigorous evaluation of policy initiatives now being considered at institutional, state and federal levels.