Academic medicine : journal of the Association of American Medical Colleges · 2025
The Intersection of Disability, Race, Ethnicity, and Financial Background on Food Insecurity Among Medical Students.
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Nguyen Mytien, Shanab Bassel M, Khosla Pavan, Boatright Dowin, Chaudhry Sarwat I, Brandt Eric J, Hammad Nour M, Grob Karri L, Brinker Morgan, Cannon Caden, Cermack Katherine, Fathali Maha, Kincaid John W R, Ma Yuxing Emily, Ohno Yuu, Pradeep Aishwarya, Quintero Anitza, Raja Neelufar, Rooney Brendan L, Stogniy Sasha, Smith Kiara K, Sun George, Sunkara Jahnavi, Tang Belinda, Rubick Gabriella VanAken, Wang JiCi, Bhagwagar Sanaea Z, Luzum Nathan, Liu Frank, Francis John S, Meeks Lisa M, Leung Cindy W
Аннотация
PURPOSE: Food insecurity is negatively associated with college students' well-being and academic performance. Little is known about the prevalence of food insecurity among medical students. This study examined variations in food insecurity among medical students at 15 schools, analyzing differences by disability status, race, ethnicity, and financial background.
METHOD: Between March-October 2024, 1,659 students across 15 MD-granting medical schools completed an online survey. Over the past 12 months, food insecurity was assessed using the 10-item U.S. Household Food Security Survey Module. Additional survey measures included age, gender identity, race, ethnicity, Pell Grant recipient status, disability status, and graduation year. Poisson regression models were utilized to estimate the relative risk of food insecurity based on self-reported disability, race, ethnicity, and financial background and their intersections.
RESULTS: In the analytic sample, a higher proportion of students with disability (33.7% vs 21.8%, P <.001), from low-income backgrounds (34.9% vs 20.3%, P <.001), and those underrepresented in medicine (URiM) reported food insecurity (37.6% vs 19.7%, P <.001). Across intersectional groups, URiM low-income students with disability have the highest rate of food insecurity (62.5% vs 16.8% for nondisabled non-URiM non-low-income peers, P <.001). In the fully adjusted model, compared to nondisabled non-URiM non-low-income students, non-URiM and URiM low-income students with disability (non-URiM aRR: 2.44, 95% CI: 1.72-3.48; URiM aRR: 3.52, 95% CI: 2.79-4.45) had a higher relative risk of food insecurity.
CONCLUSIONS: In this study, nearly 1 in 4 medical students were food insecure. URiM, low-income, and students with disabilities reported food insecurity at a significantly higher rate than their peers, with over half of URiM low-income students with disabilities reporting food insecurity. These findings suggest a promising yet underutilized avenue for approaches to enhancing well-being. Proactive efforts should prioritize supporting marginalized students by linking them to nutrition resources and advocating for policies that address their essential needs.
METHOD: Between March-October 2024, 1,659 students across 15 MD-granting medical schools completed an online survey. Over the past 12 months, food insecurity was assessed using the 10-item U.S. Household Food Security Survey Module. Additional survey measures included age, gender identity, race, ethnicity, Pell Grant recipient status, disability status, and graduation year. Poisson regression models were utilized to estimate the relative risk of food insecurity based on self-reported disability, race, ethnicity, and financial background and their intersections.
RESULTS: In the analytic sample, a higher proportion of students with disability (33.7% vs 21.8%, P <.001), from low-income backgrounds (34.9% vs 20.3%, P <.001), and those underrepresented in medicine (URiM) reported food insecurity (37.6% vs 19.7%, P <.001). Across intersectional groups, URiM low-income students with disability have the highest rate of food insecurity (62.5% vs 16.8% for nondisabled non-URiM non-low-income peers, P <.001). In the fully adjusted model, compared to nondisabled non-URiM non-low-income students, non-URiM and URiM low-income students with disability (non-URiM aRR: 2.44, 95% CI: 1.72-3.48; URiM aRR: 3.52, 95% CI: 2.79-4.45) had a higher relative risk of food insecurity.
CONCLUSIONS: In this study, nearly 1 in 4 medical students were food insecure. URiM, low-income, and students with disabilities reported food insecurity at a significantly higher rate than their peers, with over half of URiM low-income students with disabilities reporting food insecurity. These findings suggest a promising yet underutilized avenue for approaches to enhancing well-being. Proactive efforts should prioritize supporting marginalized students by linking them to nutrition resources and advocating for policies that address their essential needs.