D.A. Micevski et al.. D.A. Micevski et al.. Food insecu

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Nutrition&Dietetics2014;71:258–264DOI: 10.1111/1747-0080.12097258© 2013 Dietitians Association ofAustraliaORIGINAL RESEARCHFood insecurity among university students inVictoria: A pilotstudyDee A. MICEVSKI,1Lukar E. THORNTON2and Sonia BROCKINGTON11School of Exercise and Nutrition Sciences, Faculty of Health, and2Centre for Physical Activity and NutritionResearch, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, AustraliaAbstractAims:Susceptibility to food insecurity can vary over a life course; however, a potential period of particularvulnerability is while studying at a tertiary institution. This pilot study aimed to assess the prevalence, severityand potential determinants of food insecurity among tertiary students attending a Victorian-based institution.Methods:The present study employed a cross-sectional design, involving use of a self-reportedquestionnaire. Thesurvey,conducted in 2012, was administered to a sample of 124 Deakin University studentsand containsmeasures offoodinsecuritystatus,demographicsandotherpotentialexplanatoryfactors.Descriptiveandregressionanalysis was undertaken to investigate the prevalence of food insecurity andassociations with factors that may support or hinder a student’s ability to procure food, such as livingarrangements, income and knowledge of support services.Results:Food insecurity without hunger wasreported by 18% of Deakin University students, while an additional 30% reported experiencing the moresevere form of food insecurity (with hunger). A lower odds of being food insecure was reported amongstudents living with their family (without hunger OR 0.35; 95% CI 0.12–0.99; with hungerOR0.29;95%CI0.12–0.70),whileahigheroddswasfoundamongthosereceivinggovernmentsupport(with hunger OR 2.52;95% CI1.05–6.04).Conclusions:The reported prevalence of food insecurity among the tertiary student sample was greater thanthe general Australian population, suggesting they are a vulnerable group. This may be attributable tofinancial pressures faced when students are not living with their parents.Key words:food insecurity, risk factors, universities.IntroductionFood insecurity is defined as the inability toaccess and procure, through conventionalavenues, nutritionally adequate foods capableof supporting an active and healthy lifestyle.1Food security status exists on a continuumranging from:food security, when individualsshow no evidence of food insecurity anddietary preferences are consistently sat-isfied;food insecurity without hunger, when regularconsump-tion of food occurs, however anxietyor uncertainty over access to food of asufficient quality or quantity may even-tuate;and to a greaterseverity,food insecurity withhunger,when meals are neglected orinadequate, with hunger and possiblymalnutrition being directoutcomes.2–4D.A.Micevski,BAppSc(FoodSc&Nutr)(Hons),HonoursCandidateL.E. Thornton, PhD, Alfred Deakin PostdoctoralResearch FellowS. Brockington, MPH, BHSc(Nutr.Diet)(Hons),GradCertHigherEd APD, LecturerCorrespondence:S. Brockington, School ofExercise and NutritionSciences, Faculty of Health, DeakinUniversity, 221 Burwood Highway,Burwood, Victoria, 3125, Australia. Email:sonia.brockington@deakin.edu.auAccepted August 2013
Food insecurity of tertiarystudents259© 2013 Dietitians Association ofAustraliaFood insecurity represents a significant publichealth dilemma and remains a contributor to manynutritional, healthanddevelopmentalproblems.5,6Inparticular,moder- ate forms of food insecurity(without hunger) are knownto be associated withchronic diseases including overweight andobesity,which can be the consequence of a reliance oncheap calorically dense foods.7,8Further, foodinsecurity (with hunger) is associated with undernutrition.1,9Experi- encing food insecurity may alsoaffect psychological, social and economicwellbeing.6,10InAustralia,conservativeestimatesindicated5.2%ofthe general population experienced foodinsecurity,with 40%of those at a severe level.10,11The extent of food insecurity is likely to vary acrossthe lifespan; however, the years attending a tertiaryinstitution may be one period of life when foodinsecurity becomes pronounced.12–14This may be dueto university students having more independence ifthey are living out of home for the first time or fromman- aging the demands of both employment andstudy.12,15,16Todate, a few studies have assessed theprevalence of food insecurity among universitystudents as well as the poten- tial determinants.12Agreater level of understanding iswar-ranted giventhese students represent a group thatwill
contribute to the future progression andprosperity of Australia.17,18Research atGriffith UniversityinQueensland, Australia,recently reported that the prevalence of foodinsecurity among tertiary students was 72%(47% without hunger; 25% with hunger) usinga multi-item assessment measure.12Inter-nationally,research conducted at theUniversity of Hawaii(UHM) in the UnitedStates discovered 21% of the student bodyexperienced food insecurity (15% withouthunger; 6% with hunger) using the UnitedStates Department of Agricul- ture (USDA)multi-item assessmentmeasure.19Food insecurity is the outcome of immediateissues aroundfood availability,accessibilityandutilisation.9Although diversefactors expose certaingroups in society to varying degrees of foodinsecurity,11financial constraints arerecognised as a key predictor.20–24Relevantindicators of financial status include totalincome and income source (employment,welfare dependency and parental support).20–24Further, for students who are livingindependently away from home for the firsttime (renting, share house, universityresidence, with extended family), the cost ofliving and utility expenses may amplifyeconomic stress and lead to the displacementof money away from purchasing nutritiousfood.19,25,26The present pilot study aimed to quantifythe prevalence and severity of foodinsecurity among tertiary students enrolledinaVictorian-basedinstitution(DeakinUniversity) andtoinvestigatekeyfactorspotentiallyassociatedwiththis.Toourknowledge, the prevalence of and factorscontribut- ing to food insecurity inAustralian students have onlybeen reportedin one priorstudy.12The present study is thefirst toundertakethiswithinaVictorianinstituteandthefirstto use multivariateregression models to examine explanatoryfactors. Results may help advocate forfurtherresearch funding to assess this issueon a wider scale and eventually informpoliciestoprotectthewellbeingofstudentsaswellas their academic performance byminimising food insecurity prevalence.9,11MethodsDeakin University has campuses located inthreetownships (Burwood,Geelong(twoseparatecampuses:WaterfrontandWaurnPonds)andWarrnambool)withinthestateofVicto- ria, Australia, and has over 40 000enrolled students. Stu- dents from each ofthese campuses were eligible to participate,with the only exclusion criteria beingstudents below 18 years of age (for ethicspurposes). Students were invited to completea self-reported questionnaire on their eatingbehaviours and personal characteristics (nodirect mention of food insecurity occurredduring recruitment to avoid bias). All surveyscompleted by students were anony- mous.Ethics approval for this cross-sectional studywas granted by the Deakin University Facultyof HealthHuman EthicsAdvisoryGroup.Therecruitmentprocessspannedfourweeksinduration. A range of techniqueswere used to recruit participants, including:on-campus recruitment; information flyers,bul- letins and posters situated at prominentsites throughoutall
campusesandallfaculties;noticesviaDeakinStudiesOnline unit sites; andannouncements made at 10 lectures fromrandomly selected courses across allfaculties. Surveys were distributed withinlectures where announcements weredelivered,andalsomailedtothosewhoexpressedinterestin participating.Information was posted on a further 68 unitsitesbyunitchairsuponrequest.Attheendofrecruitment, 124 surveys werecompleted for this pilotstudy.In place of acompensation for each participant, a smalldonation was made for each surveycompleted ($0.25 per survey) to thecharitable food organisation SecondBite.27Toestimatetheprevalenceandseverityoffoodinsecurity within the studentbody,the survey included several ques- tionsderivedfromthemulti-itemUnitedStatesDepartment ofAgriculture-AdultFoodSecuritySurveyModule(USDA- AFSSM).3This survey is the mostcontemporary,validated and commonly employed measureof food insecurity inter- nationally.10,28Ourquestionnairetoassessfoodinsecurityandassociated factors amongtertiary students contained 45 items, in aformat that included both open- and closed-ended ques- tions.Withpermission,thesurveywasbasedonthatusedby Hughesand colleagues in Queensland,12with slightmodifi- cationstoaccommodatetheDeakinUniversitycohort.The relative severity of food insecurityreflected the ranking outlined in the USDA-AFSSM.4This scale’s algo- rithmcategorises individuals as either foodsecure, food insecure without hunger, orfood insecure with hunger.3,25Individuals were classified as food insecurewithout hunger if their responses were ‘oftentrue’ or ‘sometimes true’ to any of thefollowing statements related to their currentuniversity year:3,28IworriedthatmyfoodwouldrunoutbeforeIhadmoney to buymore.I couldn’t afford to eat balanced meals.The food that you bought just didn’t lastand you didn’t have money to get more.Individualswereclassifiedasfoodinsecure(withhunger) if,inadditiontoansweringaffirmativelytoanyoftheabovequestions,theyalsoanswered‘yes’toanyofthefollowing:3,28Didyoueverdecreasethesizeofyourmealsorskipmeals becausetherewasn’tenoughmoneyforfood?Wereyou ever hungry but didn’t eatbecause you couldn’t afford enough food?Did you lose weight because you didn’thave enough money for food?Didyouevernoteatforawholedaybecausetherewasn’t enough money forfood?Thosestudentswhoresponded‘no’totheabovequestions were classified as foodsecure. Factors associated withfoodinsecurity were measured using a range ofquestions, with those examined in thepresent study relating to factors that mightsupport or hinder a student’s ability toprocurefood, including: living arrangements(not living with family or living with family),employment status (yes or no),personalannualincome($0–$16000or$16000),mainfoodcon-
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