Struggling with the basics: food and housing insecurity among college students across twenty-two colleges and universities.

OBJECTIVES: To quantify the number and type of students failing to secure basic needs. PARTICIPANTS: Students attending 22 postsecondary schools in the United States in Fall 2019. METHODS: The Adult Food Security Module and part of the #RealCollege Survey were used to measure food and housing insecurity, respectively. Logistic and linear regression models were used to assess the relationship between selected factors and basic needs insecurities. RESULTS: Participants (n = 22,153) were classified as 44.1% and 52.3% food insecure and housing insecure, respectively. Homeless students or those who experienced childhood food insecurity were at the greatest odds of college food insecurity. Year in school was the largest contributor to being housing insecure, with PhD or EdD students being 1,157% more likely to experience housing insecurity compared to freshmen. CONCLUSIONS: High prevalence of basic needs insecurities remain. Current campus initiatives may be insufficient, calling for a more holistic approach at the campus, state, and national levels.

Supporting wellness at pantries (SWAP) nutrition stoplight system aids rural food pantry clients living with chronic disease in selecting nutritious options.

OBJECTIVES: Chronic disease accounts for 70% of U.S. deaths, with suboptimal nutrition an important, preventable risk factor. Food insecurity is a contributor to poor nutrition. Food pantries are a regular source of groceries for the food insecure and an ideal place for nutrition literacy programs. Supporting Wellness at Pantries (SWAP) is a stoplight nutrition ranking system based on 2015-2020 Dietary Guidelines, but has only been implemented in urban areas. Rural communities experience higher rates of poor health and food insecurity. METHODS: This study implements SWAP at a food pantry in a rural community with high rates of food insecurity and chronic disease. Food was sorted into "green," "yellow," and "red" items on color-coded shelves, with green foods the most accessible, and signage explaining the sorting was displayed. Surveys measured whether clients found SWAP helpful in choosing nutritious foods, particularly for households with chronic diseases. RESULTS: Clients reported that it was significantly (p <.0001) easier to choose items low in salt, sugar, and fat. The benefits of SWAP extended outside the pantry by increasing confidence in choosing nutritious foods while grocery shopping. DISCUSSION: SWAP can be an effective tool for improving nutrition literacy among food insecure rural residents with chronic illnesses.

College student sleep quality and mental and physical health are associated with food insecurity in a multi-campus study.

OBJECTIVE: To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students. DESIGN: An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health. SETTING: Twenty-two higher education institutions. PARTICIPANTS: College students (n 17 686) enrolled at one of twenty-two participating universities. RESULTS: Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P < 0·0001) and reported more days with poor mental (P < 0·0001) and physical (P < 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P < 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04). CONCLUSIONS: College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes.

A geo-ethnographic analysis of low-income rural and urban women's food shopping behaviors.

Many scholars have found evidence that low-income neighborhoods contain fewer supermarkets, but there is a lack of consensus regarding whether and how this matters to residents. A few qualitative studies have asked food desert residents about their experiences of their food environments, while a small number of other studies have utilized spatial analyses to examine actual shopping behaviors. To better understand barriers to food access, this study combines the two in a geo-ethnographic analysis. This study draws on data from a USDA-funded project about families and food to combine quantitative geographic data with qualitative interview data of 100 rural and urban low-income mothers of young children. For each participant, the nearest supermarket, as well most-frequented supermarket, was mapped, and distances to stores were calculated. On average, participants traveled more than twice as far as their nearest supermarket to reach a preferred store. Interviews with participants were conducted to assess the motivations and strategies of shoppers, in particular why they chose to bypass their nearest supermarkets. They shared a variety of reasons for doing so; foremost to find lower prices of food in order to stretch income and SNAP benefits. Access to transportation also played a major role in determining where people shopped for food. This research challenges scholars, policymakers, and health practitioners to look beyond proximate food environments to consider the lived experiences of food desert residents. Efforts to address poor food access should aim to increase household income, in addition to providing targeted food and nutrition assistance.

How Social, Cultural, and Economic Environments Shape Infant Feeding for Low-Income Women: A Qualitative Study in North Carolina.

BACKGROUND: This study focuses on the cultural, social, and economic factors that shape infant feeding practices among low-income mothers. OBJECTIVE: The objective was to understand factors that inhibit or facilitate breastfeeding practices of low-income mothers, including how they are linked to broader social, cultural, and economic processes. DESIGN: In-depth qualitative interviews were conducted with women about their feeding practices and food environments, including their experiences with breastfeeding and formula feeding. PARTICIPANTS: The sample was comprised of 98 low-income mothers with at least one child between 2 and 9 years old at the time of interview. RESULTS: Sixteen mothers (16.7%) breastfed for 6 months, and six (6.3%) were still breastfeeding at 12 months. Only 11 mothers (11.5%) exclusively breastfed for 6 months. Women reported several factors influencing infant feeding: interactions with medical providers, work environments, shared living spaces and family supports, and concerns about supply and production. CONCLUSIONS: This research highlights the complex interplay of economic and social barriers that shape how and what low-income women feed their infants. The study contributes to a better understanding of the social, cultural, and economic constraints faced by women in poverty. To improve breastfeeding rates among low-income women, it is important to examine the impacts of poverty and food insecurity on infant feeding practices.