More than 5 million children in the United States experience food insecurity (FI), yet little guidance exists regarding screening for FI. A prediction model of FI could be useful for healthcare systems and practices working to identify and address children with FI. Our objective was to predict FI using demographic, geographic, medical, and historic unmet health-related social needs data available within most electronic health records.

This was a retrospective longitudinal cohort study of children evaluated in an academic pediatric primary care clinic and screened at least once for FI between January 2017 and August 2021. American Community Survey Data provided additional insight into neighborhood-level information such as home ownership and poverty level. Household FI was screened using two validated questions. Various combinations of predictor variables and modeling approaches, including logistic regression, random forest, and gradient-boosted machine, were used to build and validate prediction models.

A total of 25,214 encounters from 8521 unique patients were included, with FI present in 3820 (15%) encounters. Logistic regression with a 12-month look-back using census block group neighborhood variables showed the best performance in the test set (C-statistic 0.70, positive predictive value 0.92), had superior C-statistics to both random forest (0.65, p < 0.01) and gradient boosted machine (0.68, p = 0.01), and showed the best calibration. Results were nearly unchanged when coding missing data as a category.

Although our models could predict FI, further work is needed to develop a more robust prediction model for pediatric FI.

Households with children accessing food aid in high-income countries are often food insecure. We aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health.

A systematic search was conducted using Web of Science, MEDLINE, CINAHL and PsycINFO. Articles published from January 2008 to July 2022 including cross-sectional, cohort and interventional studies in high-income countries were eligible.

Food aid is defined as the use of interventions providing free food items by community and/or charitable organisations.

Two-parent, lone parent or households with a primary caregiver with at least one child ≤ 18 years.

From a total of 10 394 articles, nine were included. Food banks, mobile pantry combined with a free meal for children, backpack provision during school term and food parcel home delivery interventions were evaluated. Food bank models offering additional support such as community programmes, health and social services, cooking classes and free meals for children, client-choice-based models and programmes providing convenient access were associated with improved food security and diet quality (increased intake of wholegrains, fruit and vegetables). One study reported an improvement in mental health and food bank access at the end of 18 months but not at earlier timepoints and one study reported no change in parents’ mental health.

Accessing food aid was linked to improved diet quality and reduced food insecurity in some studies. Allowing clients to choose food items and providing support services were most effective.

To characterise the association between risk of poor glycaemic control and self-reported and area-level food insecurity among adult patients with type 2 diabetes.

We performed a retrospective, observational analysis of cross-sectional data routinely collected within a health system. Logistic regressions estimated the association between glycaemic control and the dual effect of self-reported and area-level measures of food insecurity.

The health system included a network of ambulatory primary and speciality care sites and hospitals in Bronx County, NY.

Patients diagnosed with type 2 diabetes who completed a health-related social need (HRSN) assessment between April 2018 and December 2019.

5500 patients with type 2 diabetes were assessed for HRSN with 7·1 % reporting an unmet food need. Patients with self-reported food needs demonstrated higher odds of having poor glycaemic control compared with those without food needs (adjusted OR (aOR): 1·59, 95 % CI: 1·26, 2·00). However, there was no conclusive evidence that area-level food insecurity alone was a significant predictor of glycaemic control (aOR: 1·15, 95 % CI: 0·96, 1·39). Patients with self-reported food needs residing in food-secure (aOR: 1·83, 95 % CI: 1·22, 2·74) and food-insecure (aOR: 1·72, 95 % CI: 1·25, 2·37) areas showed higher odds of poor glycaemic control than those without self-reported food needs residing in food-secure areas.

These findings highlight the importance of utilising patient- and area-level social needs data to identify individuals for targeted interventions with increased risk of adverse health outcomes.

The COVID-19 pandemic and subsequent policy response to mitigate disease spread had far-reaching impacts on health and social well-being. In response, the Supplemental Nutrition Assistance Program (SNAP) underwent several pandemic-era modifications, including a 15 % monthly benefit increase on January 1, 2021. Research documenting the health effects of these SNAP modifications among low-income households and minoritized groups who were most impacted by the economic fallout during the first years of the pandemic is lacking. We aimed to estimate the health effects of the 15 % SNAP benefit increase in January 2021, among SNAP-eligible US households.

We estimated the effects of the SNAP increase on food insufficiency, mental health, and financial well-being using a rigorous quasi-experimental difference-in-differences (DID) analysis.

August 19, 2020, to March 29, 2021.

Participants were drawn from the national US Census Bureau Household Pulse Survey waves 13–27 (n 44 477).

Compared with SNAP-eligible non-recipients, SNAP-eligible recipients experienced decreased food insufficiency (–1·9 percentage points (pp); 95 % CI –3·7, –0·1) and anxiety symptoms (–0·09; 95 % CI –0·17, –0·01), and less difficulty paying for other household expenses (–3·2 pp; 95 % CI –4·9, –1·5) after the SNAP benefit increase. Results were robust to alternative specifications.

Expansions of federal nutrition programmes have the potential to improve health and financial well-being. This study provides timely evidence to inform comprehensive safety net nutrition policies during future economic crises and public health preparedness response plans.

To identify (1) who experiences food insecurity of differing severity and (2) who uses food banks in England, Wales and Northern Ireland; (3) whether the same groups experience food insecurity and use food banks; and (4) to explore country- and region-level differences in food insecurity and food bank use.

This pooled cross-sectional study analysed the characteristics of adults experiencing food insecurity of differing severity using generalised ordinal logistic regression models and the characteristics of adults using food banks using logistic regression models, using data from three waves of the Food and You 2 surveys, 2021–2023.

England, Wales and Northern Ireland.

18 557 adults.

20·8 % of respondents experienced food insecurity in the past 12 months, and 3·6 % had used a food bank. Food insecurity was associated with income, working status, respondent age, family type, ethnicity, country, long-term health conditions, food hypersensitivity, urban-rural status and area-level deprivation. Severe food insecurity was concentrated among respondents with long-term health conditions and food hypersensitivities. Food bank use was more prevalent among food insecure respondents and unemployed and low-income respondents. Neither outcome showed clear geographical variation. Certain groups experienced an elevated likelihood of food insecurity but did not report correspondingly greater food bank use.

Food insecurity is unevenly distributed, and its nutrition and health-related consequences demonstrate that food insecurity will intensify health inequalities. The divergence between the scale of food insecurity and food bank use strengthens calls for adequate policy responses.

Social determinants of health (SDoH), such as food and financial insecurity and food assistance, are potentially modifiable factors that may influence breastfeeding initiation and duration. Knowledge gaps exist regarding the relationship between these SDoH and infant feeding practices. We explored the relationships of food and financial insecurity and food assistance with the continuation of breastfeeding at four months postpartum among mothers and whether race and ethnicity modified these associations.

Mothers retrospectively reported food and financial insecurity and receipt of food assistance (e.g. Women, Infants and Children and Supplemental Nutrition Assistance Program) during pregnancy with their first child and infant feeding practices (exclusive/mostly breastfeeding v. exclusive/mostly formula feeding) following the birth of their first child. Sociodemographic-adjusted modified Poisson regressions estimated prevalence ratios and 95 % CI.

Minneapolis-St. Paul, Minnesota.

Mothers who participated in the Life-course Experiences And Pregnancy study (LEAP) (n 486).

Ten percent of mothers reported food insecurity, 43 % financial insecurity and 22 % food assistance during their pregnancies. At four months postpartum, 63 % exclusively/mostly breastfed and 37 % exclusively/mostly formula-fed. We found a lower adjusted prevalence of breastfeeding at four months postpartum for mothers who reported experiencing food insecurity (0·65; 0·43–0·98) and receiving food assistance (0·66; 0·94–0·88) relative to those who did not. For financial insecurity (aPR 0·92; 0·78, 1·08), adjusted estimates showed little evidence of an association.

We found a lower level of breastfeeding among mothers experiencing food insecurity and using food assistance. Resources to support longer breastfeeding duration for mothers are needed. Moreover, facilitators, barriers and mechanisms of breastfeeding initiation and duration must be identified.

Suicidal behaviours among students pose a significant public health concern, with mental health problems being well-established risk factors. However, the association between food insecurity (FIS) and suicidal behaviours remains understudied, particularly in Bangladesh. This study aimed to investigate the relationship between FIS and suicidal behaviours among Bangladeshi university students.

A cross-sectional survey using convenience sampling was conducted between August 2022 and September 2022. Information related to socio-demographics, mental health problems, FIS and related events and suicidal behaviours were collected. Chi-squared tests and multivariable logistic regression models, both unadjusted and adjusted, were employed to examine the relationship between FIS and suicidal behaviour.

Six public universities in Bangladesh.

This study included 1480 students from diverse academic disciplines.

A substantial proportion of respondents experienced FIS, with 75·5 % reporting low or very low food security. Students experiencing FIS had a significantly higher prevalence of suicidal ideation, plans and attempts compared with food-secure students (18·6 % v. 2·8 %, 8·7 % v. 0·8 % and 5·4 % v. 0·3 %, respectively; all P < 0·001). In addition, students who have personal debt and participate in food assistance programmes had a higher risk of suicidal behaviours.

This study highlights the association between FIS and suicidal behaviours among university students. Targeted mental health screening, evaluation and interventions within universities may be crucial for addressing the needs of high-risk students facing FIS.

To assess the effect of food insecurity on perinatal depression in rural Ethiopia.

We used a prospective cohort in which food insecurity was considered as primary exposure and perinatal depression as an outcome. Food insecurity at baseline (in the period of 8–24 weeks of pregnancy) was measured using the Household Food Insecurity Access Scale (HFIAS), and perinatal depression at follow-up (in 32–36 weeks of pregnancy) was measured using a Patient Health Questionnaire (PHQ-9). We used multivariable regression to assess the effect of food insecurity on the prevalence of perinatal depression. We explored food insecurity’s direct and indirect impacts on perinatal depression using structural equation modelling (SEM).

This paper used data from the Butajira Nutrition, Mental Health and Pregnancy (BUNMAP) cohort established under the Butajira Health and Demographic Surveillance Site (BHDSS).

Seven hundred and fifty-five pregnant women.

Among the study participants, 50 % were food-insecure, and about one-third were depressed at 32–36 follow-up. In SEM, higher values of baseline food insecurity, depressive symptoms and state–trait anxiety (STA) were positively and significantly associated with perinatal depression. The direct impact of food insecurity on perinatal depression accounts for 42 % of the total effect, and the rest accounted for the indirect effect through baseline depression (42 %) and STA (16 %).

The significant effect of food insecurity at baseline on perinatal depression and the indirect effect of baseline food insecurity through baseline anxiety and depression in the current study implies the importance of tailored interventions for pregnant women that consider food insecurity and psychosocial problems.

To investigate food insecurity and related coping strategies, and their associations with the risk of anxiety and depression, among South African households with children.

Nationally representative cross-sectional study. Tools for assessing food insecurity, coping strategies, risk of anxiety and depression were assessed from the Community Childhood Hunger Identification Project, Coping Strategies Index, Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. We used ordered logistic regression to test associations of food insecurity and coping strategies with the risk of anxiety and depression. Moderating effects of each coping strategy were tested in the associations of food insecurity with anxiety and depression.

South Africa, post COVID-19 restrictions, May–June 2022.

1,774 adults, weighted to 20,955,234 households.

Food insecurity prevalence was 23·7 % among households with children. All coping strategies were used to some extent, but relying on less preferred and less expensive foods was the most used strategy (85·5 % of food-insecure households). Moving to a higher level of food insecurity was associated with >1·6 greater odds of being in a higher risk of anxiety and depression. Sending a household member to beg for food was the strongest associated factor (OR = 1·7, P < 0·001). All coping strategies partly moderated (lessened) the associations of food insecurity with a higher risk of anxiety and depression.

Food insecurity among households with children was high following the COVID-19 pandemic. Collaborative efforts between government, private sector and civil society to eradicate food insecurity should prioritise poorer households with children, as these populations are the most vulnerable.

Food insecurity (FI) is the lack of daily access for everyone to quality food in sufficient quantity. In many populations, it presents as a chronic and persistent condition. This study analysed the association between the length of time living with FI and socio-demographic conditions in households in a semi-arid municipality in the Brazilian Northeast between 2011 and 2019.

This is a population-based cohort study among families in the municipality in Northeast Brazil (2011, 2014 and 2019). FI was estimated through the Escala Brasileira de Insegurança Alimentar (EBIA, Brazilian Household Food Insecurity Measurement Scale), and the longitudinal category of time of living with FI was adopted to classify them according to the time they remained in FI during the cohort. The association with the socio-demographic profiles of the population was verified through multinomial logistic regression.

Households in semi-arid, Northeast of Brazil.

Household respondents interviewed in 2011, 2014 and 2019 (n 274).

Sixty-seven percentage (67 %) of families lived in FI in this period. Rural residence, low monthly per capita income and low schooling of the household reference person increased the chances of these families living longer in FI. These overlapping conditions increased the odds of FI in the household.

Coping with FI requires intersectoral intervention that improves the socio-demographic conditions of the population.