Analysis of Food Insecurity in U.S. Colleges Using Current Assessment Tools-A Systematic Review

Objectives: Food insecurity (FI) among college students is an emerging global public health concern. While the burden is international in scope, this systematic review evaluates the prevalence of FI in college populations in the United States (U.S.) and examines the suitability of commonly used FI assessment tools for this population. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted (up to April 2026) in accordance with the PRISMA 2020 Abstracts checklist. Eligible studies were peer-reviewed research articles published between 2005 and 2026, conducted in the U.S., written in English, and including college or university students with sample sizes ≥ 30. Studies were required to use validated FI assessment tools developed by the United States Department of Agriculture (USDA) or Health Watch. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools and only studies rated as moderate or high quality were included. Results were synthesized by grouping studies according to the FI assessment tools used. Results: Thirty studies met the inclusion criteria (total n = 213,624 students surveyed). FI prevalence among U.S. college students ranged from 14% to 72.9%. Variability in estimates was influenced by the assessment tool used, demographic characteristics, institutional settings, and regional socioeconomic differences. Shorter screening instruments, including the USDA six-Item Household Food Security Survey Module (HFSSM) Short Form and Hunger Vital Sign, demonstrated greater variability in reported FI prevalence (47% and 41%, respectively) compared with longer assessment measures. Higher FI prevalence was also more frequently reported among students of color, those from lower socioeconomic backgrounds, and female students. Conclusions: Findings demonstrate FI is prevalent among college students. Limitations of the current study include restriction to three databases, exclusion of pre-2005 studies, and inclusion of only U.S.-based studies. Variability in assessment methods, as well as consideration of confounding variables (e.g., socioeconomics, demographics and institutional settings), underscores the need for context-specific tools tailored to this population to inform effective interventions and policies globally.