In recent years, many students have faced economic hardship and experienced food insecurity, even as universities strive to create more equitable pathways to college. There is a need for a more holistic perspective that addresses the complexity of food insecurity amongst college students. To this end, we examined the relationship between the social determinants of health, including college food insecurity (CoFI) and childhood food insecurity (ChFI), and their relationship with well-being measures. The study sample was a convenience sample that included 372 students at a public university who responded to an online survey in fall 2021. Students were asked to report their food security status in the previous 30 days. We used the following analytical strategies: chi-square tests to determine differences between food secure (FS) and food insecure (FI) students; binary logistic regression of CoFI on student demographics and ChFI; and ordinal or binary logistic regression for well-being measures. Black students, off-campus students, first-generation students, in-state students, and humanities/behavioral/social/health sciences majors were more likely to report CoFI. FI students were more likely to have experienced ChFI and to have lower scores on all well-being measures. ChFI was associated with four well-being measures and its effects were mediated by CoFI. College student health initiatives would benefit from accounting for SDOH, including ChFI experiences and its subsequent cumulative disadvantages experienced during college.

The purpose of this study was to understand the demographic, student, financial, and academic differences between marginally food secure college students and students with high, low, or very low food security (FS). Unlike highly food secure students, marginally food secure students worry about the quantity and quality of their food, yet they are classified in the same category as highly food secure individuals as per the United States Department of Agriculture (USDA) reporting standards. To investigate marginal FS among college students, a cross-sectional online survey was administered at a large, public, research university in the Northeastern United States. A largely representative sample of 6823 undergraduate students completed the survey with a 19.7% response rate. Self-reported level of FS was measured using the validated USDA 10-item FS survey module. Independent variables, such as demographic and student characteristics and cumulative grade point average (GPA), were gathered from institutional databases, and self-reported mechanisms of financing education were measured using a novel scale. Results from the multinomial logistic regression revealed statistically significant differences in GPA between students with marginal and high FS (p < 0.001), but not between students with marginal and low FS (p = 0.31). This work has implications beyond college students and suggests that marginally food secure populations should not be labeled as food secure.