Journal of the American College of Nutrition

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Hidden Hunger: Understanding the Complexity of

Food Insecurity Among College Students

Kelsey Fortin , Susan Harvey & Stacey Swearingen White

To cite this article: Kelsey Fortin , Susan Harvey & Stacey Swearingen White (2020): Hidden
Hunger: Understanding the Complexity of Food Insecurity Among College Students, Journal of the
American College of Nutrition, DOI: 10.1080/07315724.2020.1754304

To link to this article: https://doi.org/10.1080/07315724.2020.1754304

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Published online: 13 Oct 2020.

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JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION
https://doi.org/10.1080/07315724.2020.1754304

Hidden Hunger: Understanding the Complexity of Food Insecurity Among

College Students
Kelsey Fortina, Susan Harveyb, and Stacey Swearingen Whitec
a
Health Sport and Exercise Science, University of Kansas, Lawrence, Kansas, USA; bHealth Sport and Exercise Science, University of Kansas,
Lawrence, Kansas, USA; cSchool of Public Affairs and Administration, University of Kansas, Lawrence, Kansas, USA

ABSTRACT ARTICLE HISTORY

Objective: The aim of this research was to explore the complexity of college student food insecur- Received 17 February 2020
ity through eating patterns, food assistance, and health of food-insecure university students. Accepted 6 April 2020
Methods: A mixed-methods approach utilizing qualitative focus groups and individual interview
KEYWORDS
data and survey quantitative data was used. All data collection took place on campus at a large
Food insecurity; nutrition;
Midwestern university in the Spring semester of 2018. Participants were Midwestern university stu- community health;
dents (n ¼ 30), freshman to graduate level classified, with very low food security (USDA-Six Item qualitative research;
Short Form). health education
Results: Seven percent (n ¼ 2) were currently enrolled in food assistance programming (SNAP),
and 30% (n ¼ 9) reported family enrollment growing up (WIC and SNAP). Seven major themes
emerged highlighting nutritional habits, food adaptations, health and well-being impacts, and
additional campus programming addressing food assistance. Data triangulation informed a com-
plexity diagram with the major categories of student characteristics of food insecurity, campus
resource barriers, additional student needs, health and well-being impacts, and student adapta-
tions and coping influencing the complexity surrounding student food insecurity.
Conclusions: College student food insecurity is multifaceted and complex. Common themes
emerged among both individual-level factors and university structures, providing a deeper under-
standing of both the complexity and contributors to the college student experience. Further
research and intervention are needed to explore this phenomenon and address student needs.

Introduction them at higher risk for diet-related disease and malnutrition

The human body uses food to create energy that in turn
fuels activities of daily living. Without fuel in the form of
calories, daily life, or life at all, does not exist. Recent
research has measured food insecurity among different pop-
ulations in order to show the extent to which a lack of
access to healthy foods may affect their lives (1–5).
According to the United States Department of Agriculture,
“Food insecurity is the limited or uncertain availability of
nutritionally adequate and safe foods or limited or uncertain
ability to acquire acceptable foods in socially acceptable
ways” (6). It is estimated that 11% of U.S. households were
food-insecure at least some point during 2018 (7). The
USDA 2015–2020 Dietary Guidelines for Americans recom-
mend adults follow a healthy eating pattern consisting of a
variety of foods within an appropriate calorie range.
However, three-fourths of the U.S. population are consum-
ing diets low in fruits, vegetables, dairy, and oils and are
exceeding recommendations for added sugars, saturated fats,
and sodium (8).
American adults with low food security are at a larger
disadvantage to meet these guidelines, ultimately putting
(3). In 2017, the Academy of Nutrition and Dietetics issued
a position paper emphasizing the need to address food inse-
curity in the United States. Further, there is an emphasis on
nutrition and medical professionals intervening to improve
health outcomes of food-insecure individuals (9).
The Feeding America 2018 Poverty and Hunger Facts
Sheet reports that 12% of households are estimated to be
food-insecure. Households with children, single mothers,
single men, black non-Hispanics, and Hispanic households
have disproportionately higher rates of food insecurity (10).
In 2014 the National Hunger Survey included a student
population for the first time, with 31% of food-insecure
households reporting choosing between food and education
(11). While data indicate that these difficult decisions are
being made, there is a paucity of data on food insecurity
among college students, particularly in the qualita-
tive domain.
Of the qualitative research that does exist, college stu-
dents are expressing psychosocial impacts from food inse-
curity including food stress interfering with daily life,
feelings of hopelessness, and frustrations due to lack of uni-
versity supports (12). Further investigation of the impacts of

CONTACT Kelsey Fortin kelseyf123@ku.edu Health Sport and Exercise Science, University of Kansas, Lawrence, KS 66045, USA.
Supplemental data for this article can be accessed at https://doi.org/10.1080/07315724.2020.1754304
ß 2020 American College of Nutrition
2 K. FORTIN ET AL.
food insecurity on health showed that students who were
food-insecure had poorer health habits, consumed fewer
daily servings of fruits and vegetables, had fewer days of
enough sleep, and had increased body mass index (13).
Students with very low food security have also been shown
to experience higher levels of stress than classmates with
higher food security (14).
The dynamic across U.S. college campuses has changed,
leading to an increased number of low-socioeconomic-status
(SES) and first-generation college students (15). According
to the National Center for Education Statistics, wealthy high
school graduates continue to lead other groups in college
enrollment rates. However, low-income students have now
surpassed middle-income students by 3% in overall college
enrollment rates (16). Research is being conducted to under-
stand how the low-SES student experience compares to
high-SES counterparts. When compared, low-SES students
attending a 4-year institution work more hours per week,
spend less time studying, have less involvement in co-cur-
ricular activities, reported lower grade point averages
(GPAs), had lower incomes, and reported lower levels of
educational attainment and aspirations than their high-SES
classmates (17). With an increased number of college stu-
dents across the nation coming from low-income back-
grounds, there may be additional supports needed to
contribute to equity and student success.
The Government Accountability Office recognized these
needs by providing a report on college students and access
to federal food assistance benefits. In this report they high-
lighted nearly 2 million potentially SNAP-eligible at-risk stu-
dents not receiving benefits in 2016 (18). Food insecurity
rates among college students range from 14% to 59% among
college students across the United States (19–22), with
recently published meta-analysis data showing roughly 37%
of U.S. students experiencing food insecurity (23). Findings
indicate that hunger among college students occurs at much
higher rates than those reported by U.S. households (24).
Additionally, race, Pell grant eligibility, parental education,
place of residence, and GPA are correlates with food inse-
curity (25). A systematic review of the literature showed that
food insecurity was consistently associated with poor health
and academic outcomes and financial independence (26).
Although these are important strides, there is much to be
understood about the complexity of the college student
experience through the voices of students.
This research study aims to gain a valuable perspective
on the complexity of college student food insecurity by
exploring eating patterns, food assistance, and health
through the lens of food-insecure college students at a large
Midwestern university.
Materials and methods
Mixed methods were used to understand the current cir-
cumstances of college students at a Midwestern university
experiencing very low food security. This study was
approved by the Institutional Review Board Human
Subjects Committee.
Participants
Participants for this study included currently enrolled
undergraduate and graduate students. Those classified with
very low food security using the USDA-Six Item Short Form
of the Food Security Survey Module (FSSM) (27) and indi-
cating a willingness to participate in a focus group discus-
sion were recruited for participation.
Sampling method
During the spring 2018 semester, the USDA-FSSM was
used to assess food security status with a random sample
of 6000 students. Among survey questions, students indi-
cated willingness to participate in a follow-up focus group.
The survey response rate was at 13% (n ¼ 755), with 32%
(n ¼ 242) of those respondents categorized with very low
food security. Of the students who completed the survey,
90 students had very low food security and opted into
focus groups. Purposive sampling was used to reach out
students who met the inclusion criteria of a currently
enrolled student, English-speaking, classification of very low
food security, and willingness to participate in follow-up
conversations.
Participant recruitment
Participants were contacted directly via email to request par-
ticipation in focus group discussions. All 90 students identi-
fied by the campus-wide study reporting willingness to
participate in follow-up conversations and scoring with very
low food security were contacted. Seven focus groups were
conducted, with participation ranging from two to five per
session. Focus group representation was lacking from both
freshman and graduate-level students. Targeted emails were
sent to these two student groups, offering an option for indi-
vidual interviews. Following the completion of 11 individual
interviews, the study reached data saturation at 30 food-inse-
cure students, freshman to graduate level. Though all 90 eli-
gible students were contacted, data collected ceased after
saturation occurred at 30 participants. The study shift of
offering individual interviews proved to be successful in
recruiting more freshman and graduate students, which may
reflect existing social stigma. This may be a research design
consideration for future qualitative data collection with food-
insecure college students. Figure 1 demonstrates the sam-
pling framework.
Measures
Data collection measures included a moderator’s guide and
supplemental investigator-designed survey utilized for both
focus groups and individual interviews. Investigator-
designed questions were informed using what is available in
the literature (20, 28–31) and the current study’s research
question as a guide. This is a notable study limitation given
the paucity in exiting literature related to healthy eating pat-
terns and measures of mental, academic, and physical health
associated with food-insecure college students.

Figure 1. Study sample framework.
Supplemental survey
The supplemental survey was developed to probe additional
experiences pertaining to food insecurity and quantitative
data. Survey questions were organized into categories related
to nutritional needs, health impacts, and assistance pro-
grams. As this is a specially designed survey developed for
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION 3
the purpose of this study, no validity or reliability properties
of the survey exist. See Appendix 1.
Moderator’s guide
A moderator’s guide was used to maintain consistent ques-
tioning across focus group discussions. As with the
4 K. FORTIN ET AL.
supplemental survey, the development of the moderator’s
guide was in collaboration with a faculty advisory commit-
tee, as well as information collected through a comprehen-
sive literature review. The moderator’s guide was categorized
into subtopics including nutritional and eating habits, health
impacts, and assistance programs. See Appendix 2.
Procedures
Focus groups were audio-recorded and took place in a con-
fidential space on campus. Participants completed the sup-
plemental survey prior to focus group questioning. The
moderators guided directed questioning, and field notes
were taken by facilitators for cross reference during debrief-
ing and analysis. For each focus group, a moderator and
assistant moderator were present. Member checks took place
within interviews and focus groups through summarization
of information and confirmation of statements between the
research facilitators and study participants. Facilitators
debriefed following the sessions to discuss common
themes (32).
Individual interviews
In order to reach data saturation, targeted emails were sent
to students of freshman and graduate level class status to fill
gaps in these two representative groups. Interviews had the
presence of only one facilitator.
To ensure trustworthiness and credibility of data collec-
tion, and consequently data analyses, data triangulation
occurred through member checks, facilitator debriefing, and
facilitator field note comparison (33).
Data analysis
Data analysis included both quantitative and qualitative
data. SPSS software was used to provide descriptive statistics
on participant demographics (school class status, gender,
race, and use of food assistance programs within the last 6
months) and the supplemental survey.
All focus group and interview sessions were transcribed
verbatim. Once transcribed, common themes and subthemes
emerged using a manual open coding strategy. This process
included first a review of transcriptions to edit and clean.
Each transcript was then reviewed to categorize participant
quotes. Once categorized quotes were charted to align with
categories, categories were combined and reduced until
major themes, subthemes, and categorical focus areas
emerged. Key concepts were related to existing research as it
pertains to the study research question using the constant
comparative method (34). Making use of this analysis
method allowed application of themes identified through
focus group discussions to be compared across groups and
with other literature, integrated, and then translated into
categorical properties relating to developmental theory (35).
Results
Demographic results
Demographic information captured by participants (n ¼ 30)
includes class status, gender, race, and the use of food assist-
ance resources within the last 6 months. Roughly half of
participants identified as white (n ¼ 14), and 67% (n ¼ 20)
were considered undergraduate freshman through 5þ years.
Over half identified as female (n ¼ 19), with one student
identified as transgender, and 23% (n ¼ 7) reported use of
food assistance in the last 6 months. See Figure 1 for a full
demographic breakdown.
Supplemental survey results
Results for the supplemental survey are reported according
to the major categories of the survey.
Nutritional needs
Participants were asked to describe their current nutritional
habits from a list of four possible statements. Seventy-seven
percent (n ¼ 23) of students reported getting enough calories
to keep them satisfied but not getting the variety of food
they should to eat a well-balanced diet. Twenty-three per-
cent (n ¼ 7) reported not getting enough calories to keep
them satisfied and not getting the variety of food they
should to eat a well-balanced diet. Eighty percent (n ¼ 24) of
students reported that they did not have the resources to get
enough fruits and vegetables in their diet, and 43% (n ¼ 13)
reported lacking the means for enough protein.
Health impacts
Participants were asked to indicate to what extent they
thought nutritional needs had a negative impact on mental
and physical health, stress levels, and academic performance.
Sixty-three percent (n ¼ 19) of students agreed that current
nutritional needs had a negative impact on their physical
health, 50% (n ¼ 15) agreed that current nutritional needs
had a negative impact on stress levels, and 37% (n ¼ 11)
agreed nutritional needs negatively impacted academic per-
formance. Figure 2 provides a summary of responses for
these questions.
Assistance programs
Student participants reported on current and previous
enrollment in federally funded nutrition programs. Seven
percent (n ¼ 2) were currently enrolled in assistance
(SNAP), and 30% (n ¼ 9) reported family enrollment grow-
ing up (WIC and SNAP). Students were also asked to report
whether they had ever thought about applying for these pro-
grams. Seventy percent (n ¼ 21) reported never thinking
about applying for assistance, with “No, I think other people
have greater need” as the most frequent response.

Figure 2. Participant nutrition-related health impacts.
Focus groups and individual interviews results
All focus groups and individual interviews were transcribed,
cleaned, and edited for clarity. Table 1 displays seven major
emergent themes and corresponding quotes. These major
themes include the following: Eating and Shopping Habits,
Food Experience Growing Up, Health and Well-Being, Food
Assistance Use and Barriers, Adaptations and Coping
Strategies, Campus Environment, and Future Program
Interventions. Within each of these major themes, there are
several subthemes and categorical focal points that emerged.
A short description of each theme can be found in Table 1.
Eating and shopping habits
Context is given by students about eating and shopping pat-
terns to provide the connection with food security.
Subthemes within this major theme include disruptions to
eating patterns due to rigorous schedules, with students
reporting missed meals or off meal times, lacking in variety/
balance including increases in the consumption of grain
products and decreases in fruits and vegetables, increased
consumption of convenience food given rigorous schedules
and need for quick and easy options, and storage and cost
of healthy foods contributing to lack of intake in these
healthy foods, while providing barriers for students in pur-
chasing items like fresh produce due to spoilage and cost.
Food experience growing up
This is the major participant experience with food prior to
their life as a university student. Student responses were
split between having an experience growing up with more
consistency in eating patterns than current patterns and
growing up in food-insecure households and relying on
food assistance programs. Students who had more consist-
ency reported having healthy options consistently available
and a parent or guardian preparing meals. For example, one
student stated, “Yeah, it was always 3 meals a day. My mom
always had family dinner, and lunchtime, and always had
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION 5
breakfast made. So, the transition to college was definitely
… a transition, to say the least.” Another student growing
up with food insecurity indicated, “I grew up with my
parents on food stamps. … Oh, I was malnourished grow-
ing up, for sure.” Subthemes within this category include
meals provided at home or school, more stable meals and
increased options, and family experiencing food need.
Health and well-being
Students discussed stressors surrounding food needs impact-
ing academic performance as well as areas of emotional,
mental, and physical health. In some cases, students even
expressed having more serious health complications relating
to food. One pregnant student said, “I passed out and they
rushed me to the hospital because I fell. ‘We need to check
if the baby was fine’ [doctor voice], but they were like, you
are not eating enough food. You need to eat more food.”
Subthemes and categories include physical health (low
energy, health risks, and disease), mental health (lack of
concentration, increased stress relating to food), and aca-
demic performance (negative impacts on class performance,
compromise health for academics).
Food assistance use and barriers
This major theme demonstrates participant use, knowledge,
and barriers of food assistance programs, both federally
funded (e.g., SNAP) and supplemental programs (e.g., food
pantry, free food events). Within this major theme, there are
both subthemes and categorical focal areas. Subthemes and
categories include current program use (federal programs,
campus/community programs, free food events) and barriers
to program use (technical barriers, social barriers, lack of
knowledge, perception that need is not high enough).
Students used both formal and informal programs ranging
from the use of SNAP to accessing free events on campus
advertising free meals. Barriers to programming were strong
and included both technical barriers like meeting program
6 K. FORTIN ET AL.
Table 1. Themes summary.
Major theme Subthemes
Theme #1 Eating and Shopping Habits  Disruptions to eating patterns due to
rigorous schedules
 Lacking in variety/balance
 Increased consumption of
convenience food
 Cost and convenience guide purchases
 Storage and cost of healthy foods
Theme #2 Food Experience Growing Up  Meals provided at home or school
 Meals more stable and increased options
 Family experiencing food need
Theme #3 Health and Well-Being  Physical health
 Low energy
 Health risks and disease
 Mental health
 Lack of concentration
 Increased stress relating to food
 Academic performance
 Negative impacts on class performance
 Compromise health for academics
Theme #4 Food Assistance Use and Barriers  Current program use
 Use of federally funded programs
 Campus and community program use
 Free food events and resources
on campus
 Barriers to program use
 Technical barriers
 Social barriers
 Lack of knowledge/don’t qualify
 Perception that need isn’t high enough
Theme #5 Adaptations and Coping Strategies  Rationalized eating behaviors
 Distraction behaviors as
coping mechanisms
 Strategized use of food
 Creating opportunity for extra income
 Assistance from friends and family
Theme #6 Campus Environment  Cost of food on campus
 Access to food on campus
 Graduate student experience
Participant quotes
“On top of stress and work and everything like that, I can
go all day without eating. And then I remember like 8
or 9 o’clock that I need to eat, and then I just don’t
have anything around to eat, so I either eat junk, a
ramen, because it’s cheap, and it’s there, or I just have a
glass of chocolate milk and then I go to bed.” [II,1]
“Definitely more fruits and vegetables. Definitely more
vegetables. I really wish I didn’t eat as many grains too.
I eat so much bread and pasta because it’s so easy and
cheap.” [FG5, P.1]” “When I go grocery shopping, I look
for whatever is cheapest or fast.” [II, 3] “Buying produce
1) it’s very expensive, 2) it goes bad very quickly so if I
have a busy week at school or work it just goes bad
and I didn’t have time to cook it.” [II, 4]
“Get up for school eat breakfast, go to school, eat lunch.
My mom always had a meal prepared and it was a
healthy meal prepared.” [FG3, P.2] “I grew up in the
projects. So, I was, we had food stamps, we were in
subsidized housing, we were on Medicaid, all
throughout my childhood into high school.” [II, 1]
“The biggest one that I feel would be a complaint [relating
to food needs] for both my wife and I would be just
like, feeling physically fatigued, you know, like more
than we have in the past.” [FG7, P.1] “Well for me, I
don’t think I realized how much my health was being
impacted by my diet until last year. I started to get
really sick and developed pretty severe anemia. And
that’s when I realized oh steak is really expensive, red
meat are really expensive, and it was just really hard for
me to eat healthier foods because of my budget.” [FG5,
P.4] “It’s definitely stressful to worry [about food] on top
of like all the stressfulness of college and the classes
that it’s like you now have to worry about what you’re
going to eat or when you’re going to eat.” [FG1, P.2]
“When I study on campus and I get hungry it’s just like
ahh I can’t focus on studying or I need to get
something in my stomach to stay focused.” [FG5, P.3]
“I’m in school not to look good in order to be healthy.
I’m in school to get my degree so that I can be healthy
later on down. And I forget that – I forget that I won’t
make it. I won’t survive if I don’t treat myself well.”
[FG3, P.3]
“I am on food stamps, but they don’t necessarily give you
enough per month. Like you can eat an okay diet but
it’s not necessarily a healthy one.” [FG5, P.4] “Students
will seek out ‘pizza and politics,’ there are a lot of
events around that offer free food, students don’t really
care what the event is, they just want the food.” [II, 1]
“Some people feel like they will be looked down upon,
if they’re seen at it, like the food pantry or something.”
[II, 9] “Yeah. Like I didn’t even know you could apply for
food stamps until a couple of years ago and they would
always say I didn’t qualify for it.” [FG5, P.4] “Yeah, I
think for me there is always that thought that there is
someone else worse off than you.” [FG5, P.1]
“[There’s a] perception about college that it’s like your dog
years kind of, and so you’re struggling a little bit, like
that’s normal, like that’s supposed to happen.” [FG2, P1]
“I go to sleep usually if I am hungry, so I don’t have to
eat. That’s kind of not good, but I definitely do that.” [II,
4] “I’ve personally kind of scheduled if I’m going to be
hungry or not like for example if I have a test coming
up, especially if I have a test coming up, I try to make
sure that I have food for that day, that way I’m not
hungry during the test.” [FG2, P.2] “I had to reach out
to my family and they are all on the struggle bus too,
but they were like here’s 20 bucks to buy yourself
something that is a little healthier than what you’re
eating now.” [FG5, P.4]
“The price of the meal plan is definitely scary.” [FG5, P.5]
“None of the food places are open in the evenings, so I
don’t have any access to them, but for the vending
machines, and I don’t prefer vending machines, because
it’s kind of like a resolution that I’ve taken and I should
(continued)

Table 1. Continued.
Major theme Subthemes
Theme #7 Future Program Interventions  Changes to campus environment
 Meal swipe program
 Life skills training
 Additional resources
 Pantry logistics
qualifications and hours of operation and social barriers like
stigma associated with program use. Students often had a
perception that their need was not high enough to use those
resources and that someone else had a greater need.
Adaptations and coping strategies
Given the barriers presented in the previous theme, students
made additional adjustments to cope with food needs. This
includes alternative routes for income (“I would just log
more hours in my work to just get the money [to purchase
food]”) and making distractions for hunger (“[when hungry
on campus] I usually just get gum or something and just
wait until I get home.”) Subthemes include rationalized eat-
ing behaviors, meaning that it was a normal part of the col-
lege student experience to lack access to the amount and
quality of food needed, distraction behaviors like sleeping to
avoid hunger, strategized use of food, saving higher-quality
food to be consumed during finals, creating opportunity for
extra income by utilizing resources for quick money such as
selling items or donating plasma, and assistance from family
or friends.
Campus environment
Major issues were raised by students regarding the food
environment on campus. Subthemes included cost and
access of food on campus. Students reported that food prices
were too high and they could not afford items, particularly
healthy items, and that location hours may conflict with stu-
dent class schedules. Second, this major theme addresses
special circumstances within the campus environment as it
relates to the subtheme of the graduate student experience.
Within this subtheme, it points to additional struggles
brought up by graduate students about their experience,
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION 7
Participant quotes
not take anything from the vending machines because
nothing is healthy there.” [II, 11] “I am a GTA so I get a
subsidy, but then over the summer we lose that
subsidy, and, we go from paying $150 a semester, to
$300 dollars over summer [health insurance]. So right
there goes our summer funding. Summer is always the
hardest.” [II,1]
“I want real food, at an accessible price, near my
department, I can just walk up, eat my meal, and then
go back to work. And we don’t have this.” [II, 5] “Think
shopping lessons, cooking lessons, meal planning
resources, even giving out Tupperware, baggies, to
ensure people have snacks in them. Very practical things
that are tangible. Nutrition facts, like reading nutrition
labels, Swipe is awesome, I hope that builds. I think
location, again, games, utilizing, taking advantage of
being in the Union. Make sure if you’re going to table,
table, it’s right there. I like the idea of games. Turning it
into something more wholesome. A wholesome
nutrition program, something more than going in in
grabbing things. Understanding what you’re grabbing.
Money management showed me an app too, that you
get the leaflets of things that are on sale, and then you
select for your shopping list. So, making sure students
are utilizing that app. I think getting them to money
management.” [II, 1]
including things like graduate teaching assistant (GTA) sti-
pends, cost of health insurance, and additional stigmas in
utilizing resources given their position on campus with
undergraduate students.
Future program interventions
This theme focuses on changes to the current campus cli-
mate and additional resources relating to programs to help
improve student food circumstances. Subthemes within this
category include changes to the campus environment to
make food more accessible to students; a meal swipe pro-
gram showing positive feedback from students about the
implementation and use by food-insecure students in need
on campus; life skills training with general nutrition, cook-
ing, shopping, money, and time management education;
additional resources covering broad suggestions from stu-
dents like subsidies for books; and food pantry logistics with
suggestions of hours, locations, and ways to decrease stigma.
Figure 3 depicts a complexity diagram serving as a visual
representation of the triangulation of these key findings
partnered with existing literature to further understand the
complexity of the students experience with food insecurity.
Complexity is explained through the major categories of stu-
dent characteristics of food insecurity, campus resource bar-
riers, additional student needs, health and well-being
impacts, and student adaptations and coping influencing the
complexity surrounding student food insecurity.
Discussion
The complexity of the college student experience with food
insecurity is multifaceted. This research study aimed to fill a
gap in the current literature by utilizing mixed methods to
8 K. FORTIN ET AL.
Figure 3. College student food insecurity complexity diagram.
give a voice to students identified with very low food secur-
ity and understand the complex nature of their food-inse-
cure status, ability to navigate resources, and the impact
food need has on areas of health and well-being. Previous
research on this topic aligns with findings in the current
study, including sociodemographic characteristics, connec-
tions to health and well-being, assistance barriers, and a
need for a more holistic approach to campus programming.
Characteristics of food insecurity among
college students
The possible link between demographic identifiers and food
insecurity prevails. Previous research reports sociodemo-
graphic correlates and predictors connected between food
insecurity and race, Pell Grant eligibility, parental education,
place of residence, and GPA (25). The current study found
that 30% (n ¼ 9) reported family enrollment growing up and
7% (n ¼ 2) were currently enrolled in federal assistance pro-
gramming. One-third of the participants are demonstrating
that food insecurity follows them throughout childhood into
college life. This is consistent with previous research findings
demonstrating that students reporting the lowest level of food
insecurity were more likely to grow up in food-insecure homes
(36). Growing up in food-insecure homes may have exposed
students to resources like free and reduced lunch, which is no
longer available in college years. One student made recogni-
tion of this and advocated for a campus meal swipe program
by stating, “I think it’s a really good idea because in elemen-
tary school, middle school, and high school, we had that …
and then I get to college it’s all of a sudden gone.”
Transition to college comes with many developmental
challenges (37). This loss of fundamental programming pre-
viously keeping students fed may be leaving a gap in the
available campus resources that could contribute to student
success (38). Programs such as a meal swipe program pro-
vides familiarity connecting previous enrollment in free and
reduced lunch programming, contributing to lower social
stigma (39). Implementation of a meal swipe program could
supplement underutilization of federal food aid such as
SNAP by students (18).
Last, through participant conversations, there was
acknowledgement of the connection between low-SES
groups and food needs on campus (25). Students recom-
mended collaboration with low-income and first-generation
college student groups for targeted programming efforts.

Campus resource access barriers
Barriers to accessing food assistance resources are catego-
rized as either technical or social barriers, consistent with
findings in previous research (25). Social stigma, lack of
information needed to access the pantry (location, how, and
who can use), lack of self-identity conflicting with use of
assistance programs (not poor enough, others are worse off),
and hours of operation are common perceived barriers for
food-insecure students. Given these consistencies, technical
and social barriers need to be addressed for successful pro-
gram planning and implementation.
Social stigma is a steady barrier preventing use of food
and nutrition assistance programs (29). There is a strong
fear of embarrassment toward accessing the resources on
campus, partnered with the perception that need is not high
enough. This is reflected in a student saying, “I don’t know,
I just feel like in our society there’s just this idea that you
don’t go to food pantries unless you have no job and you
have no other way of getting food.” Campuses should use
this feedback to create messaging to destigmatize use of pro-
grams such as on campus food pantries.
Health and well-being impacts
Previous research connected food security status with areas
of health and well-being, finding that food-insecure students
are more likely to report psychosocial impacts, poor health,
lower energy levels, more frequent depressive symptoms,
impacts on their academic work, eating less and fewer bal-
anced meals during the past year, and higher rates of stress
(12–14, 40). These findings are consistent with results in the
current study. Students in this study showed consistency
with low energy and lack of concentration having the largest
impact on physical health and academic performance and
reported food negatively impacting levels of stress.
Diet is not only an important step in managing existing
illness, it is critical in disease prevention (41). Students were
reporting that current eating habits were so damaging they
contributed to diet-related disease. To illustrate, one student
indicated, “I started to get really sick and developed pretty
severe anemia.” Universities should consider how presence
of disease related to diet may impact academic performance
(42) and provide the knowledge and resources to promote
healthy, well-balanced diets.
Student adaption and coping strategies
Students in the current study talked about coping strategies
such as attending campus events serving food, selling
plasma, and going to sleep to avoid hunger. Though the lit-
erature is limited, food intake adjustments saving, support,
and selling were consistent with a large study that included
more than 13,000 students across 10 universities (43).
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION 9
Additional student support needs
Very little impact research has been conducted on food
assistance program interventions aimed at college students.
Recent reports have focused on the low enrollment rates in
SNAP and how colleges might facilitate increased participa-
tion and retention among college students (18, 44). Only
one study was found asking student pantry users about the
need for additional services (financial, employment) outside
of food resources (45). This finding is consistent with stu-
dent voices in the current study calling for a holistic pro-
gram approach addressing life skills training, meal swipe
programs, graduate student resources, changes to campus
environments, addressing pantry access barriers, and com-
prehensive resources (financial, employment, health, social
services). By having an office on campus dedicated to food
insecurity, resource cohesion can be built and maintained.
As one student expressed:
“Think shopping lessons, cooking lessons, meal planning
resources, even giving out Tupperware, baggies, to ensure
people have snacks on them. Very practical things that are
tangible. A wholesome nutrition program, something more than
going in and grabbing things. Understanding what
you’re grabbing.”
Limitations
This study is not without its limitations. Both measurement
tools including the supplemental survey and the moderator’s
guide were investigator-designed specifically for the study,
creating validity and reliability limitations. Additionally,
some questions gathered recollection and/or subjectivity
responses. The study findings are not generalizable to all
college students.
Public health implications
The college student experience with food insecurity and stu-
dents’ ability to access resources are complex. Participants
showed evidence of this complexity through the primary
domains of student characteristics of food insecurity,
campus resource access barriers, student adaptation and
coping, additional support needs, and health and well-being
impacts. Additional research within each domain is needed
to fully understand how they contribute to the college stu-
dent experience with food insecurity. Further, the impact
food needs may have on the health of college students is a
critical area within the public health scope. Through the voi-
ces of food-insecure college students, this study began to
uncover future program recommendations, which include
targeted programs and outreach, additional life skills train-
ing programs, addressing barriers pertaining to food assist-
ance programming, graduate student–specific research, and
cohesion of services through an office dedicated to food
insecurity on campus. Public health practitioners and uni-
versity administration alike would benefit from recognition
of the growing evidence supporting the college student
experience with food insecurity, the complexity of their
10 K. FORTIN ET AL.
situation with food need, and gaps in programming to
address the issue.
Acknowledgments
The work within this research wouldn’t be possible without a team of
faculty advisors and campus departments that supported the efforts.
Secondly, and most importantly, we thank the students that partici-
pated in this study and had the willingness to share compelling stories
about their experience with food needs.
Disclosure statement
The authors listed on this research project have no financial investment
associated with the current research project.
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