Food Insecurity Prevalence Among US Medical Students

Abstract

Importance: Food insecurity affects nearly 13.5% of US households and has worsened after the COVID-19 pandemic. However, the prevalence, associated factors, and impact on medical students is unclear, hindering targeted interventions.

Objective: To determine the prevalence of food insecurity among US allopathic medical students and identify associated sociodemographic factors to guide solutions.

Design, setting, and participants: This survey study was conducted across 8 US medical schools. A cross-sectional survey was administered to medical students between March 03, 2023, and September 19, 2023. Data were analyzed from March 2024 to May 2025.

Exposure: Sociodemographic characteristics of the participants: age, gender identity, race (African American; American Indian and Alaska Native or Native Hawaiian and Other Pacific Islander; Black; Central Asian; East Asian; Middle-Eastern or North African; South Asian; Southeast Asian; White, and other race), ethnicity, citizenship status, program of study, academic year, estimated total debt, sources of educational funding, undergraduate Pell grant recipient status, underrepresented in medicine (URiM) status, and basic needs insecurities.

Main outcomes and measures: The primary outcome was the prevalence of food insecurity, using the US Department of Agriculture Adult Food Security Survey Module. Univariable and multivariable regression were used to measure associations with demographic factors.

Results: A total of 1834 medical students (1073 cisgender women [58.5%]; median [IQR] age, 25 [24-27] years; 347 East Asian [18.9%]; 198 South Asian [10.8%]; and 907 White [49.5%]), food insecurity prevalence was 21.2% (389 individuals), with institutional prevalences ranging 16.0% to 31.9%. Compared with individuals identifying as White, food insecurity was more prevalent among medical students identifying as Black (odds ratio [OR], 2.91; 95% CI, 1.90-4.41), Southeast Asian (OR, 5.73; 95% CI, 2.43-13.81), Middle Eastern or North African (OR, 2.80; 95% CI, 1.47-5.17), and other race (OR, 2.65; 95% CI, 1.16-5.75), and food insecurity was higher among Hispanic or Latino individuals than non-Hispanic or Latino individuals (OR, 2.47, 95% CI, 1.75-3.45). Students of URiM backgrounds compared with non-URiM peers (OR, 2.45; 95% CI, 1.86-3.23) and Pell grant recipients compared with nonrecipients (OR, 3.00, 95% CI, 2.30-3.90) were more likely to be food insecure. Relative to students with parental financial support, those using private loans (OR, 15.43; 95% CI, 3.20-82.79), state scholarships (OR, 5.79; 95% CI, 1.16-23.66), school scholarships (OR, 4.06; 95% CI, 2.55-6.78), student contributions (OR, 3.40; 95% CI, 2.13-5.69), federal loans (OR, 3.29; 95% CI, 1.85-5.98), and other scholarships (OR, 3.25; 95% CI, 1.32-7.55) had higher odds of food insecurity as did those who had dependents (OR, 3.25; 95% CI, 2.25-4.68) or higher estimated debt (adjusted OR, 1.003; 95% CI, 1.002-1.005).

Conclusions and relevance: In this survey study of US medical students, the prevalence of food insecurity was nearly double the national household average, with significant disparities among students. These findings call for institutional and policy interventions to address medical students' basic needs, ensuring the success of future physicians.