'Food Insecurity Common Among Medical Students, Survey Shows'

 

• In a survey of 1,834 U.S. medical students, 21.2% reported food insecurity, a rate well above the national household average of 13.5%.
• Students from backgrounds underrepresented in medicine or those using loans or scholarships to pay for school were more likely to report food insecurity.
• The authors said their findings reflect the high cost of attending medical school and a gap between financial aid packages and the students' expenses.

More than one in five medical students reported food insecurity, a rate well above the national household average, according to a cross-sectional survey study.

Of 1,834 U.S. medical students surveyed, 21.2% said they lacked reliable access to adequate food, reported Bassel M. Shanab, BA, and Pavan Khosla, BA, both medical students at Yale School of Medicine in New Haven, Connecticut, and colleagues.

By comparison, 13.5% of U.S. households reported being food insecure during the same time period, the researchers noted in JAMA Network Openopens in a new tab or window.

"This likely reflects both the high cost of attending medical school and the mismatch between estimated financial aid packages and students' real expenses," Khosla told MedPage Today. "Many students likely prioritize tuition, rent, and dependent costs, leaving less money for food."

The disparities could worsen existing inequities in the medical workforce pipeline, the authors noted.

"Despite widespread efforts to conduct clinical screening for food insecurity, there is a lack of comprehensive assessment on the prevalence of food insecurity among medical students, hindering the establishment of equitable interventions and inadvertently perpetuating hardship that is disproportionately concentrated among already vulnerable students," they wrote.

Compared with white students, food insecurity was more prevalent among students who were Black (OR 2.91, 95% CI 1.90-4.41), Southeast Asian (OR 5.73, 95% CI 2.43-13.81), or Middle Eastern or North African (OR 2.80, 95% CI 1.47-5.17). Additionally, Hispanic or Latino students (OR 2.47, 95% CI 1.75-3.45) and those from "underrepresented in medicine" backgrounds (OR 2.45, 95% CI 1.86-3.23) were more than twice as likely to experience food insecurity versus their counterparts.

"These are students who are most likely to practice medicine in an underserved community facing an unduly difficult and entirely preventable challenge in their journey to becoming physicians," Shanab told MedPage Today.

The authors also observed a link between how a student pays for medical school and the likelihood of reporting food insecurity. Compared with students whose parents were supporting them financially, recipients of Pell grants (OR 3.00, 95% CI 2.30-3.90) -- a proxy for low-income status -- were more likely to say they were food insecure. So were those receiving private loans (OR 15.43, 95% CI 3.20-82.79), federal loans (OR 3.29, 95% CI 1.85-5.98), state scholarships (OR 5.79, 95% CI 1.16-23.66), or school scholarships (OR 4.06, 95% CI 2.55-6.78).

"These students, in general, are not able to access more money -- the cost-of-living estimate by a medical school is a ceiling for borrowing and scholarship estimates, and doled out by semester," Shanab said. "For students with parental support, there may not be a ceiling; come exam time, a student with financial means ordering food delivery can do so, perhaps with less concern for their semester budget."

The authors proposed several solutions, suggesting schools offer students meals during their hospital rotations or meal-credit stipends at campus and hospital cafeterias, and overhauling the financial aid process to more closely align cost-of-living estimates with actual expenses.

"Medical schools would benefit from treating food insecurity as a critical barrier to student success and well-being," Khosla said.

In what the authors described as the first multi-institutional study of its kind, participants from eight medical schools across the Northeast and Midwest were surveyed between March 3 and Sept. 19, 2023, with institutional prevalences ranging from 16% to 31.9%.

In this cross-sectional study, 5,099 medical students were invited to participate and 1,834 completed the survey, resulting in an overall response rate of 36%. Median age was 25, 58.5% identified as cisgender women, 49.5% as white, 18.9% as East Asian, 10.8% as South Asian, 9.5% as Hispanic or Latino, and 7% as Black.

Food insecurity was measured using the Department of Agriculture's 10-item U.S. Adult Food Security Survey Module.

The authors acknowledged several study limitations, including its cross-sectional design that prevents them from making causal interpretations, and the possibilities of social desirability and nonresponse biases. Additionally, because the study was conducted predominantly at private allopathic schools, the results may not be generalizable to institutions that are public or have lower rankings, which may have a higher proportion of students from lower socioeconomic backgrounds.

Disclosures

Data collection for the study was funded by Harvard University and Case Western Reserve University.

The authors reported no disclosures.

Primary Source

JAMA Network Open

Source Reference: Shanab BM, et al "Food insecurity prevalence among US medical students" JAMA Netw Open 2025; DOI: 10.1001/jamanetworkopen.2025.29926.

https://www.medpagetoday.com/publichealthpolicy/medicaleducation/117222