Food Insecurity Among Post-Secondary Students in High Income Countries: Systematic Review and Meta-Analysis

Food insecurity has recently emerged as a growing problem among students attending post-secondary institutions in high income countries, where it is associated with poorer health outcomes and poorer academic performance. The aim of this systematic literature review and meta-analysis is to synthesize evidence from published studies describing the prevalence of food insecurity among students in post-secondary educational institutions. A broad search was employed to identify any studies related to food security among post-secondary students in high income countries (PROSPERO identifier: CRD42023468944). Four electronic databases were systematically searched: Medline, CINAHL, Global Health, and Embase, in November 2023. Key thematic areas searched were food insecurity and education; no temporal limitations were placed on the search. Only English language peer-reviewed articles were considered. Four authors independently reviewed all articles to identify relevant studies.

156 studies are included in this review. Sample sizes ranged from 10 to 122,269 participants (total participants 743,075; 409,047 women) with a median of 4764. Most studies were based in the USA (n = 139, 88%), and most were cross-sectional (n = 131, 84%). All articles were published after 2009, with more than three-quarters (n = 121, 77.5%) published after 2020. One hundred (64%) studies reported the mean age of participants; across these studies the average age was 22.4 years (range 18 to 78 years). Almost all studies employed one form of the USDA household food security survey module. Food insecurity across the whole sample ranged from 11.8 to 98%, the pooled estimate for food insecurity was 42.2%, (95% CI = 38.8-45.8%). Our findings show that a high proportion of students attending post-secondary institutions experience food insecurity, potentially leading to both poorer academic and health outcomes.