Food insecurity has long been a global challenge associated with negative health outcomes. The spectrum of food insecurity corresponds to a spectrum of negative health outcomes that range from kwashiorkor and marasmus to obesity and chronic disease. The burden of food insecurity is a stressor that additionally negatively effects mental health. In this study, the relationship between food insecurity and mental health was examined using data from the National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module, and participants were classified into one of four categories based on their responses: (1) full food security (FFS), for households with no concerns related to obtaining adequate food, (2) marginal food security (MFS), for households that occasionally had problems obtaining adequate food, (3) low food security (LFS), for households that had to reduce the quality, variety, or desirability of the food they ate, and (4) very low food security (VLFS), for households where at least one member had their food intake reduced due to a lack of money for food. Food insecurity survey scores were classified as FFS if zero affirmative responses were reported, MFS for 1 or 2 affirmative responses, LFS for 3 to 5 affirmative responses, and VLFS for 6 to 10 affirmative responses. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥ 10 indicating depression. Data were analyzed from 28,448 adults aged 20 and older who participated in NHANES from 2005 to 2016. Food insecurity was present in 19.2% of the sample population (n=5,452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Adults with FFS and VLFS experienced depression at rates of 5.1% and 25.8%, respectively. Participants with VLFS had a significantly greater odds of depression than FFS adults, OR=3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factor for depression among US adults. To address this issue in our citizenry, policy initiatives and public health interventions addressing both food access and mental health should be prioritized.

Thesis advisor: Summer Sherburne Hawkins / Background: The COVID-19 pandemic has exacerbated food insecurity among American households. There is limited knowledge on how university students, who were vulnerable to food insecurity prior to the pandemic, have been impacted by COVID-19. This study aimed to measure the prevalence of food insecurity at a private university during the pandemic and identify student coping strategies. Methods: An online survey was distributed via REDCap to university undergraduates. The U.S. Department of Agriculture’s Food Security Survey was utilized to determine the prevalence of food insecurity during the fall 2021 semester and 2020-2021 academic year. The survey collected information on student demographics and strategies students used to obtain food. Interviews were conducted with 6 survey participants to gather richer information about student experiences. Results: 292 student responses were analyzed. The prevalence of food insecurity during fall 2021 was 36.7%, and 34.6% during the 2020-2021 academic year. The strongest predictors of food insecurity (in fall 2021) were working 11+ hours/week (OR: 4.42, 95% CI: 1.73-11.7), previous participation in the National School Lunch Program (OR: 4.04, 95% CI: 1.43-12.2), and receiving financial aid (OR: 3.79, 95% CI: 1.70-8.86). Themes highlighted in interviews included barriers to accessing food, the impact food insecurity has on overall wellbeing, and programs that students would like implemented. Conclusions: Approximately a third of undergraduates at this university experience food insecurity, with financially disadvantaged students being at highest risk. Barriers to obtaining food for university students needs to be addressed with institutional, statewide, and federal policies. / Thesis (BS) — Boston College, 2022. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Departmental Honors. / Discipline: Biology.

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Food insecurity has emerged as a leading health care problem in the United States, impacting college students’ health, well-being, and academic performance. The aims of this study are: 1) to assess the prevalence of food insecurity at Mississippi State University, 2) to explore the coping mechanisms employed by students faced with food insecurity, and 3) to identify college students' perceptions about food access resources, 4) to identify ways in which a scenario that requires social distancing impacts food security in a college student population, and 5) to explore students' expressed needs from the university in improving food security status for all, whether they are learning on campus or in a distance environment. A mixed methods approach was used to assess the quantitative and qualitative aspects of the study aims. An online survey to gather demographic information and assess food security status using the 6-item version of the U.S. Household Food Security Scale Module (HFSSM) was administered. Next, qualitative focus groups with subsets of participants was conducted to gain further insight into the perceptions, coping mechanisms, and resource utilization issues related to food insecurity. Due to the impact of the COVID-19 pandemic on focus group data collection, an open-ended qualitative questionnaire was designed and sent to original survey participants to gather further data. This study found 34.1% of undergraduate college students to be food insecure. The strongest predictors of food insecurity were having received some type of food assistance in the past year and having received free- or reduced-lunches in elementary or secondary school. The data demonstrates that students with a meal plan are less likely to be food insecure. Qualitative data identified key influencers of food insecurity: 1) personal beliefs, 2) life skills, and 3) the university. The results of this study contribute to the literature focused on food insecurity prevalence in college students and help to fill in gaps in understanding food insecurity from the university student perspective. This will allow relevant interventions to be developed that are congruent with students’ needs, enhancing resource utilization to increase food security status among college students.

yes / Food insecurity is a determinant of maternal health; however, research on the health impact of food insecurity among mothers of varying ethnicities is under-developed. We assessed the association of food insecurity and health among white British and Pakistani mothers. Data from the Born in Bradford cohort were matched with data on food insecurity and self-reported health from the nested BiB1000 study (N= 1280). Food insecurity was associated with elevated odds of fair/poor health among white British mothers but not Pakistani mothers. Adjusting for financial security, the association between food insecurity and poor health was not significant among either white British or Pakistani mothers.

Certified Nursing Assistants (CNAs) are responsible for the care of America's aging population. CNAs are paid a miniscule amount of money and are often ineligible for medical benefits through their employers. CNAs bathe, change, feed, and help toilet the residents of long-term care facilities. The stressful work and personal lives of CNAs leads to many problems such as high turnover rates, absenteeism, health problems, and elder abuse. In the United States, food insecurity is a concern for many of the uninsured working poor. The purpose of this study was to assess the overall perceived concerns, barriers, and solutions of CNAs in both their work and family environments, identify where nutrition and food security fits into the priorities of CNAs, and identify educational strategies to improve their health and overall quality of life. Twenty-nine CNAs participated in six focus groups across the state of Virginia. Triangulation techniques were used to compare both qualitative (focus groups) and quantitative (participatory activities and questionnaires) research. Participatory activities showed that the top home concern of CNAs was money management. CNAs ranked keeping their family healthy fourth (9.6%), and they ranked preparing fast easy meals eighth (1.7%). The top work concern of CNAs was time management. Staying healthy at work ranked fourth (12.9%), while packing a nutritious lunch was sixth (3.4%). The preferred methods of education for the participants were watching videotapes, attending classes at a central location, and having a mentor to help them with their problems. / Master of Science

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