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Food Insecurity, Mental Health, and Post-Secondary Students

 

Curtis D'Hollander

The Food and Agriculture Organization (FAO) of the United Nations defines food insecurity as “lacking regular access to enough safe and nutritious food for normal growth and development and an active and healthy life. This may be due to unavailability of food and/or lack of resources to obtain food”.1 Food insecurity ranges from mild, meaning there is uncertainty about the ability to obtain food, to severe, when food is missed for a day or more.1 There are important health implications of food insecurity. A dose dependent response has been demonstrated between food insecurity severity and mental health status – that is, as food insecurity worsens, so does mental health status.2 This trend has been observed consistently over all regions around the world, including North America.2 The relationship is likely bi-directional, with food insecurity being extremely stressful, and those already struggling with mental illness at risk for food insecurity. 

In Canada, household food insecurity is measured via the Household Food Security Survey Model (HFSSM) on the Canadian Community Health Survey (CCHS) by Statistics Canada. This data was last collected in 2017/2018, which found 1 in 8 Canadian households were food insecure - an increase from 2007/2008 and 2011/2012.3 The relationship between food insecurity and mental health has also been observed in Canada. Jessiman-Perreault & McIntyre used CCHS data from ~300,000 Canadian adults to examine the relationship between food insecurity and 6 adverse mental health outcomes. After adjusting for socioeconomic and demographic factors, the results clearly supported a possible dose-dependent relationship between food insecurity and mental health outcomes (Figure 1).4 For instance, if a moderately food insecure household were to become food secure, a 14% reduction in the reporting of depressive thoughts in the past month would be expected.4 On the other hand, if a severely food insecure household were to become food secure, a 25% reduction in the reporting of depressive thoughts in the past month would be expected.4 Similarly, Davison & Marchall-Fabien used data on three provinces from the CCHS to examine the relationship between food insecurity and suicide ideation among 5,270 Canadian adults. Those with moderate and severe food insecurity were found to be more likely to have suicidal ideation.5 

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Figure 1 | Percent and 95% confidence intervals of six adverse mental health outcomes reported for each level of household food insecurity (Jessiman-Perreault et al., 2017)

Food insecurity is not experienced equally across Canada. As a vulnerable group, the food insecurity experiences of post-secondary students deserves greater attention. Post-secondary students are faced with high and increasing costs of tuition, housing, and living expenses while receiving little or no income and often carrying debt. For instance, tuition fee increases historically outpace inflation. In 2014/2015, Canadian undergraduate tuition fees rose 3.3% while inflation measured by the Consumer Price Index rose 1.3% in the same period.11 This same trend is shown from 1990 through 2005 in Figure 2.12 Additionally, in the year 2000, the average debt for a Canadian Masters student at graduation was $20,300, while it increased to $28,000 in 2015.13 A search of public databases revealed only 5 recent studies examining food insecurity at Canadian universities. Results are summarized in Table 1. There are two important messages from these results; 1) Food insecurity among Canadian post-secondary students is about triple the national average and, 2) There is no data on food insecurity among University of Toronto students. 

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Figure 2 | Rates of increase in Canadian undergraduate tuition fees versus inflation (Statistics Canada, 2004)

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Table 1 | Summary of studies examining food insecurity among Canadian post-secondary students

The purpose of this article is to raise attention to the invisible food insecurity problem which is (very) likely occurring at the University of Toronto and subsequently effecting students’ well-being and mental health. For any problem to be solved, it first needs to be well defined, which is why we should collect food insecurity data on University of Toronto students. 

Edited by Emily Mastragostino & Jeffrey Lynham

References

1. Food and Agriculture Organization of the United Nations. Hunger and food insecurity [Internet]. [cited 2021 May 27]. Available from: http://www.fao.org/hunger/en/

2. Jones AD. Food insecurity and mental health status: A global analysis of 149 countries. Am J Prev Med. 2017 Aug; 53(2):264-273. Available from: https://doi.org/10.1016/j.amepre.2017.04.008

3. Tarasuk V, Mitchell A. Household food insecurity in Canada, 2017-18 [Internet]. Toronto: Research to identify policy options to reduce food insecurity (PROOF); 2020. Available from: https://proof.utoronto.ca/wp-content/uploads/2020/03/Household-Food-Insecurity-in-Canada-2017-2018-Full-Reportpdf.pdf

4. Jessiman-Perreault G, McIntyre L. The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults. Population Health. 2017 Dec; 3: 464-472. Available from: https://doi.org/10.1016/j.ssmph.2017.05.013

5. Davison KM, Marshall-Fabien GL. Association of moderate and severe food insecurity with suicidal ideation in adults: national survey data from three Canadian provinces. Soc Psychiatry Psychiatr Epidemiol. 2015; 50: 963-972. 

6. Wagner J, Hayward C, Salatas C. Student food insecurity at Wilfred Laurier University [Internet]; 2020 [cited 2021 May 27]. Available from: https://static1.squarespace.com/static/5e8ca65bb9823031b5e55b03/t/601c08838861017a99a8604a/1612449938245/Food4Hawks-Report.pdf

7. Entz M, Slater J, Desmaraise AA. Student food insecurity at the University of Manitoba. Canadian Food Studies. 2017 May; 4(1): 139-159. 

8. Olauson C, Engler-Stringer R, Vatanparast H, Hanoski R. Student food insecurity: Examining barriers to higher education at the University of Saskatchewan. Journal of Hunger & Environmental Nutrition. 2018; 13(1):19-27. 

9. Frank L. “Hungry for an Education”: Prevalence and outcomes of food insecurity among students at a primarily undergraduate university in rural Nova Scotia. Canadian Journal of Higher Education. 2018; 48(2): 109-129. 

10. Silverthorn D. Hungry for knowledge: Assessing the prevalence of student food insecurity on five campuses. Toronto: Meal Exchange [Internet]; 2016 [cited 2021 May 27]. Available from: http://mealexchange.com

11. Statistics Canada. University tuition fees, 2015/2016. The Daily [Internet]; 2015. [cited 2021 May 28]. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/150909/dq150909b-eng.htm

12. Statistics Canada. Paying for higher education [Internet]; 2004 [cited 2021 May 28]. Available from: https://www150.statcan.gc.ca/n1/pub/81-004-x/200409/7018-eng.htm#ref

13. Statistic Canada. Table 37-10-0036-01 Student debt from all sources, by province of study and level of study [Internet]; 2015 [cited 2021 May 28]. Available from: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3710003601