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Food Insecurity Associated with Educational Disruptions during the COVID-19 Pandemic for College Students and the Role of Anxiety and Depression

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Title: Food Insecurity Associated with Educational Disruptions during the COVID-19 Pandemic for College Students and the Role of Anxiety and Depression
Language: English
Authors: Emily Berger, Jenna Larsen, Nicholas Freudenberg, Heidi E. Jones (ORCID 0000-0002-4285-3752)
Source: Journal of American College Health. 2024 72(6):1684-1687.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 4
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Tests/Questionnaires
Education Level: Higher Education
Postsecondary Education
Descriptors: Hunger, COVID-19, Pandemics, Anxiety, Depression (Psychology), College Students, Student Characteristics, Incidence, Barriers, Food, Student Experience
Geographic Terms: New York (New York)
DOI: 10.1080/07448481.2022.2093115
ISSN: 0744-8481
1940-3208
Abstract: Objective: To test the association between food insecurity and educational disruptions from the COVID-19 pandemic and the role of anxiety or depression in mediating this association. Participants: Representative sample of 2,282 City University of New York students. Methods: Using an April 2020 online survey, we estimated adjusted prevalence ratios (aPR) for educational outcomes based on food insecurity status, adjusting for age, sex, race/ethnicity, and degree level with weighted Poisson regressions with robust standard errors. Results: Prevalence of decreased ability to do schoolwork was greater in those with moderate (aPR = 1.12, 95% CIs 1.02, 1.23) and high (aPR = 1.18, 95% CIs 1.08, 1.2) levels of food insecurity compared to food-secure students. Results were similar for dropping/withdrawing from classes and expecting delays or uncertainty around graduation. Anxiety and depression mediated the relationship between food insecurity and educational outcomes. Conclusion: Findings emphasize the urgency of expanded food assistance and mental health services for college students.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1433070
Database: ERIC
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  Value: <anid>AN0178681391;acl01aug.24;2024Jul31.05:49;v2.2.500</anid> <title id="AN0178681391-1">Food insecurity associated with educational disruptions during the COVID-19 pandemic for college students and the role of anxiety and depression </title> <p>Objective: To test the association between food insecurity and educational disruptions from the COVID-19 pandemic and the role of anxiety or depression in mediating this association. Participants: Representative sample of 2,282 City University of New York students. Methods: Using an April 2020 online survey, we estimated adjusted prevalence ratios (aPR) for educational outcomes based on food insecurity status, adjusting for age, sex, race/ethnicity, and degree level with weighted Poisson regressions with robust standard errors. Results: Prevalence of decreased ability to do schoolwork was greater in those with moderate (aPR = 1.12, 95% CIs 1.02, 1.23) and high (aPR = 1.18, 95% CIs 1.08, 1.2) levels of food insecurity compared to food-secure students. Results were similar for dropping/withdrawing from classes and expecting delays or uncertainty around graduation. Anxiety and depression mediated the relationship between food insecurity and educational outcomes. Conclusion: Findings emphasize the urgency of expanded food assistance and mental health services for college students.</p> <p>Keywords: College; education; food security; mental health</p> <hd id="AN0178681391-2">Introduction</hd> <p>Food insecurity has increased dramatically in the United States (US) since the COVID-19 pandemic began, with rates increasing from 11–12%[<reflink idref="bib1" id="ref1">1</reflink>] in the general population pre-pandemic to 38% by March/April of 2020.[<reflink idref="bib2" id="ref2">2</reflink>] Food insecurity is a concern among US college students[<reflink idref="bib3" id="ref3">3</reflink>] and has also increased in this population as a result of the pandemic.[[<reflink idref="bib4" id="ref4">4</reflink>], [<reflink idref="bib6" id="ref5">6</reflink>]] For students at the City University of New York (CUNY), a large public university system in New York City, 50% reported worrying that they would run out of food before they could buy more in April 2020[<reflink idref="bib7" id="ref6">7</reflink>] compared with 16% prior to the pandemic in 2018.[<reflink idref="bib6" id="ref7">6</reflink>]</p> <p>Several cross-sectional studies in the US have found an association between food insecurity and lower grade point average among college and university students.[[<reflink idref="bib8" id="ref8">8</reflink>], [<reflink idref="bib10" id="ref9">10</reflink>]] A recent study using a national sample of college students found that food-insecure students were less likely to graduate than their food-secure peers and that these associations were stronger for first-generation students.[<reflink idref="bib3" id="ref10">3</reflink>] A longitudinal study conducted in Georgia from 2014–2016 identified psychosocial health as a mechanism through which food insecurity affects college students.[<reflink idref="bib12" id="ref11">12</reflink>] Depression and anxiety also have been shown to be associated with poor student academic performance.[<reflink idref="bib13" id="ref12">13</reflink>],[<reflink idref="bib14" id="ref13">14</reflink>] In a secondary analysis of a population-representative CUNY-wide student survey on the impact of COVID-19,[<reflink idref="bib7" id="ref14">7</reflink>] we explored the association between food insecurity and the impact of COVID-19 on educational outcomes and tested whether anxiety and depression mediated this relationship.</p> <hd id="AN0178681391-3">Materials and methods</hd> <p>This study was a cross-sectional population representative online survey of matriculated students from April 2020 as previously described.[<reflink idref="bib7" id="ref15">7</reflink>] In brief, of the approximate 274,000 CUNY students matriculated in spring 2020, a simple random sample of 10,000 were invited to participate, of whom 2,282 completed 70% or more of the survey (response rate of 23%). Data were weighted to account for non-response bias based on sex, race/ethnicity, campus type (undergraduate or graduate), and part- or full-time student status. The first 1,000 respondents received a $20 gift card and five were selected randomly to receive a $100 gift card. The study was approved by the CUNY Institutional Review Board (IRB) (protocol #695980).</p> <p>Four questions adapted from the US Department of Agriculture's US Household Food Security Survey Module: Six-Item Short Form[<reflink idref="bib15" id="ref16">15</reflink>] were used to measure food insecurity: "In the last 2 weeks, how often have you: (<reflink idref="bib1" id="ref17">1</reflink>) Worried that you would run out of food before you could afford to buy more?; (<reflink idref="bib2" id="ref18">2</reflink>) Cut or skipped a meal because you didn't have enough money to buy more?; (<reflink idref="bib3" id="ref19">3</reflink>) Been unable to eat balanced or nutritious meals because of lack of money?; and (<reflink idref="bib4" id="ref20">4</reflink>) Gone hungry due to lack of access to food?" We defined food security as responding never or rarely to all four questions, moderate food insecurity responding sometimes to one or two of the questions, and high food insecurity defined as responding sometimes to three or four questions or often to any of the four questions.</p> <p>We hypothesized that food insecurity would be associated with negative educational outcomes, and that this association would be mediated by increased anxiety and depression. We therefore tested whether food insecurity was associated with the impact of COVID-19 on three educational outcomes–whether the student reported dropping or withdrawing from courses, whether they expected to graduate earlier or at the same time versus later than or not sure and whether their ability to do schoolwork increased or stayed the same versus decreased, as a result of the COVID-19 pandemic. We measured anxiety and depression using the Patient Health Questionnaire-4 (PHQ-4) scale.[<reflink idref="bib16" id="ref21">16</reflink>],[<reflink idref="bib17" id="ref22">17</reflink>] We present chi-squared results in bivariate analyses of the association between food security and educational outcomes. We used weighted multivariable Poisson regression models with robust standard errors to estimate prevalence ratios for the association between food insecurity and educational outcomes and used the PROC CAUSALMED SAS procedure[<reflink idref="bib18" id="ref23">18</reflink>] to estimate the natural direct effect, natural indirect effect, and percent mediated by anxiety or depression for all three outcomes (we found no evidence for interaction between food insecurity and anxiety/depression and thus did not include interaction terms in mediation analysis). Hypothesized confounders included in adjusted models were age, race/ethnicity, household size, gender, and degree level (associate, bachelor or graduate).[<reflink idref="bib12" id="ref24">12</reflink>]</p> <hd id="AN0178681391-4">Results</hd> <p>In April 2020, CUNY students were 58% female and 42% male, with 55% pursuing a bachelor's degree, 33% an associate degree and 12% graduate degrees. Most were young adults (median age of 22 years), and diverse by race/ethnicity (30% Hispanic, 25% Black non-Hispanic, 23% White non-Hispanic, 22% Asian/Pacific Islander, <1% American Indian/Native Alaskan).</p> <p>Over half of CUNY students faced some degree of food insecurity—30% high level, 28% moderate level—with 42% food secure in April 2020. When asked to what extent the coronavirus reduced their household's ability to get the food they needed, 24% responded a lot, 36% somewhat, and 25% a little. More than a third (36%) of students reported that hunger or lack of food had interfered with school to some extent in the two weeks preceding the survey. At the time of the survey, about 6% of the students reported visiting a food pantry since the start of the pandemic.</p> <p>Food insecurity was more prevalent among students enrolled in associate degree programs than bachelor or graduate degrees—38% of associate degree students experienced high food insecurity compared to 28% of bachelor and 22% of graduate degree students (p < 0.001). Food insecurity was also more prevalent among students of color than among white students and among females compared to males (data not shown).</p> <p>CUNY students indicated that the pandemic affected their educational experiences: at the time of the survey, 57% reported decreased ability to do schoolwork, 52% reported expecting to graduate later than anticipated or were unclear of the impact on graduation date and 6% reported dropping or withdrawing from classes as a result of the COVID-19 epidemic. The prevalence of decreased ability to do schoolwork was higher in students experiencing moderate and high levels of food insecurity (58% and 62% respectively) compared to those who were food secure (52%, <emph>p</emph> =.001). Similarly, food insecurity was associated with anticipating delays in graduation—44% of food secure students compared with 59% of those with moderate food insecurity, and 69% of those with high food insecurity anticipated delays (<emph>p</emph> <.0001). Of 125 students who dropped or withdrew from courses due to COVID-19 and reported reasons, 42% reported the need to focus on basic needs such as housing and food as a reason.</p> <p>In adjusted models, the prevalence of decreased ability to do schoolwork, delayed or uncertain graduation dates, and dropping or withdrawing from courses as a result of the epidemic were significantly higher among students reporting moderate and high food insecurity compared to those reporting being food secure (Table 1). For example, the prevalence of dropping or withdrawing from courses was 1.64 (95% confidence intervals, CIs, 1.02, 2.65) times greater in those with moderate food insecurity and 1.94 (95% CIs 1.22, 3.08) times greater in those with high food insecurity compared to those who were food secure.</p> <p>Table 1. Crude and adjusted prevalence ratios for effect of COVID-19 on educational outcomes by food insecurity status, with natural direct and indirect estimates when mediated by anxiety or depression, City University of New York (CUNY) student COVID-19 survey, April 2020.</p> <p> <ephtml> <table><thead><tr><td /><td>Decreased ability to do schoolwork due to COVID-19 epidemic? (<italic>n</italic> = 2163)</td><td>Dropped or withdrawn from a class due to COVID-19 epidemic? (<italic>n</italic> = 2159)</td><td>Graduating later than expected/unsure due to COVID-19 epidemic (<italic>n</italic> = 2162)</td></tr></thead><tbody valign="top"><tr><td><bold>Total effects for food insecurity on educational outcomes</bold></td></tr><tr><td><bold>Food insecurity status</bold></td><td><bold>weighted %</bold></td><td><bold>Crude PR</bold><bold>(95% CI)</bold></td><td><bold>Adjusted PR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>weighted %</bold></td><td><bold>Crude PR</bold><bold>(95% CI)</bold></td><td><bold>Adjusted PR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>weighted %</bold></td><td><bold>Crude PR</bold><bold>(95% CI)</bold></td><td><bold>Adjusted PR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td></tr><tr><td>Food secure</td><td char=".">52.4</td><td char=".">1.00</td><td char=".">1.00</td><td char=".">3.7</td><td char=".">1.00</td><td char=".">1.00</td><td char=".">44.2</td><td char=".">1.00</td><td char=".">1.00</td></tr><tr><td>Moderately food insecure</td><td char=".">58.4</td><td char=".">1.11 (1.01, 1.22)</td><td char=".">1.12 (1.02, 1.23)</td><td> 6.3</td><td char=".">1.70 (1.07, 2.71)</td><td char=".">1.64 (1.02, 2.65)</td><td> 58.6</td><td char=".">1.32 (1.20, 1.46)</td><td char=".">1.27 (1.15, 1.41)</td></tr><tr><td>Highly food insecure</td><td char=".">61.5</td><td char=".">1.17 (1.07, 1.28)</td><td char=".">1.18 (1.08, 1.29)</td><td> 7.7</td><td char=".">2.09 (1.34, 3.26)</td><td char=".">1.94 (1.22, 3.08)</td><td> 69.3</td><td char=".">1.57 (1.43, 1.71)</td><td char=".">1.50 (1.37, 1.65)</td></tr><tr><td><bold>Direct and indirect effects for food insecurity</bold><xref ref-type="table-fn" rid="tfn3">**</xref><bold>on educational outcomes mediated by mental health</bold></td></tr><tr><td><bold>Mental health mediator</bold></td><td><bold>% Mediated</bold></td><td><bold>Natural direct aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>Natural indirect aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>% Mediated</bold></td><td><bold>Natural direct aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>Natural indirect aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>% Mediated</bold></td><td><bold>Natural direct aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td><td><bold>Natural indirect aPR</bold><xref ref-type="table-fn" rid="tfn2">*</xref><bold>(95% CI)</bold></td></tr><tr><td>Anxiety</td><td char=".">27.9</td><td char=".">1.08 (0.93, 1.23)</td><td char=".">1.03 (1.00, 1.05)</td><td> 8.6</td><td char=".">1.69 (0.87, 2.50)</td><td char=".">1.04 (0.99, 1.08)</td><td> 6.7</td><td char=".">1.26 (1.07, 1.44)</td><td char=".">1.01 (1.00, 1.03)</td></tr><tr><td>Depression</td><td char=".">67.2</td><td char=".">1.05 (0.90, 1.20)</td><td char=".">1.10 (1.06, 1.15)</td><td> 8.6</td><td char=".">1.90 (0.98, 2.82)</td><td char=".">1.04 (0.92, 1.17)</td><td> 15.1</td><td char=".">1.42 (1.21, 1.62)</td><td char=".">1.05 (1.01, 1.09)</td></tr></tbody></table> </ephtml> </p> <p>1 PR = adjusted prevalence ratio; PR = prevalence ratio; CI = confidence interval.</p> <ulist> <item>2 adjusted for race/ethnicity, age group, gender, degree program, and household size.</item> <item>3 food security dichotomized as food secure (reference) vs. moderately/highly food insecure.</item> </ulist> <p>Over half (54%) of students reported anxiety or depression–43% anxiety and 42% depression. In adjusted models, the data supported the hypothesis that both anxiety and depression partially mediated the relationship between food insecurity and decreased ability to do schoolwork, while only depression was found to be a potential mediator of the relationship between food insecurity and delayed or uncertain graduation as a result of the pandemic (Table 1).</p> <hd id="AN0178681391-5">Discussion</hd> <p>CUNY students experienced increased rates of food insecurity as a result of the COVID-19 pandemic during the spring 2020 semester, especially students in the associate degree programs. Students who were food insecure were more likely to experience disruptions to their educational experience, reporting higher rates of being unable to do their schoolwork, dropping or withdrawing from classes and anticipating delays in their graduation. There was some evidence that food insecurity may lead to anxiety and/or depression, with both affecting students' ability to do schoolwork, and depression also affecting potential delays in graduation. These analyses are limited in that they are cross-sectional and thus we cannot establish the direction of the associations. Nevertheless, our findings are similar to those of Raskind and colleagues, who identified anxiety and/or depression as a mechanism through which food insecurity affects academic performance.[<reflink idref="bib12" id="ref25">12</reflink>] Other limitations of the analyses include use of self-reported measures with potential for misclassification due to social desirability and not asking students whether they had been food insecure prior to the COVID-19 pandemic.</p> <p>As colleges consider how best to assist students to meet the essential needs that contribute to academic success during the COVID-19 pandemic and beyond, this study suggests a few strategies that college student services can consider. First, a recent systematic review found that the associations between depression, anxiety and food insecurity are reciprocal, with depression and anxiety leading to food insecurity and food insecurity leading to psychological distress.[<reflink idref="bib19" id="ref26">19</reflink>] This suggests the potential for developing student campus services that link food assistance with psychological services such as mental health counseling or referrals to community-based or telehealth mental health services to maximize opportunities for leveraging this reciprocal relationship. Similarly, college student health services may more effectively achieve their goals of improving student health and reducing health inequities among their student population if they reduce the compartmentalization of health care and mental health services from other services designed to meet students' essential needs such as food, housing and financial stability. The link between mental health and food security shown in this study suggests that health, mental health and social problems that many college students face are closely intertwined. Finally, many university leaders may be reluctant to take on services such as food assistance that may fall outside the defined core educational mission. However, the evidence in this and other studies[<reflink idref="bib3" id="ref27">3</reflink>] that food insecure students experience higher levels of disruption of their academic work and are less likely to graduate suggests that providing food assistance can contribute to higher retention and graduation rates, key indicators of success for any university. Expanding food assistance during times of rising food insecurity may help especially those community colleges and public universities serving low-income populations to avoid the drops in enrollment that the COVID-19 pandemic has triggered.</p> <hd id="AN0178681391-6">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of the City University of New York (CUNY).</p> <ref id="AN0178681391-7"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Coleman-Jensen A. U.S food insecurity and population trends with a focus on adults with disabilities. 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Jones</p> <p>Reported by Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref9"></nolink> <nolink nlid="nl2" bibid="bib12" firstref="ref11"></nolink> <nolink nlid="nl3" bibid="bib13" firstref="ref12"></nolink> <nolink nlid="nl4" bibid="bib14" firstref="ref13"></nolink> <nolink nlid="nl5" bibid="bib15" firstref="ref16"></nolink> <nolink nlid="nl6" bibid="bib16" firstref="ref21"></nolink> <nolink nlid="nl7" bibid="bib17" firstref="ref22"></nolink> <nolink nlid="nl8" bibid="bib18" firstref="ref23"></nolink> <nolink nlid="nl9" bibid="bib19" firstref="ref26"></nolink>
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  Data: Food Insecurity Associated with Educational Disruptions during the COVID-19 Pandemic for College Students and the Role of Anxiety and Depression
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  Data: <searchLink fieldCode="AR" term="%22Emily+Berger%22">Emily Berger</searchLink><br /><searchLink fieldCode="AR" term="%22Jenna+Larsen%22">Jenna Larsen</searchLink><br /><searchLink fieldCode="AR" term="%22Nicholas+Freudenberg%22">Nicholas Freudenberg</searchLink><br /><searchLink fieldCode="AR" term="%22Heidi+E%2E+Jones%22">Heidi E. Jones</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4285-3752">0000-0002-4285-3752</externalLink>)
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  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(6):1684-1687.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 4
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research<br />Tests/Questionnaires
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Hunger%22">Hunger</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Pandemics%22">Pandemics</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+%28Psychology%29%22">Depression (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Barriers%22">Barriers</searchLink><br /><searchLink fieldCode="DE" term="%22Food%22">Food</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Experience%22">Student Experience</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22New+York+%28New+York%29%22">New York (New York)</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2093115
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To test the association between food insecurity and educational disruptions from the COVID-19 pandemic and the role of anxiety or depression in mediating this association. Participants: Representative sample of 2,282 City University of New York students. Methods: Using an April 2020 online survey, we estimated adjusted prevalence ratios (aPR) for educational outcomes based on food insecurity status, adjusting for age, sex, race/ethnicity, and degree level with weighted Poisson regressions with robust standard errors. Results: Prevalence of decreased ability to do schoolwork was greater in those with moderate (aPR = 1.12, 95% CIs 1.02, 1.23) and high (aPR = 1.18, 95% CIs 1.08, 1.2) levels of food insecurity compared to food-secure students. Results were similar for dropping/withdrawing from classes and expecting delays or uncertainty around graduation. Anxiety and depression mediated the relationship between food insecurity and educational outcomes. Conclusion: Findings emphasize the urgency of expanded food assistance and mental health services for college students.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1433070
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1433070
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2022.2093115
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 4
        StartPage: 1684
    Subjects:
      – SubjectFull: Hunger
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Pandemics
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Depression (Psychology)
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Student Characteristics
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: Barriers
        Type: general
      – SubjectFull: Food
        Type: general
      – SubjectFull: Student Experience
        Type: general
      – SubjectFull: New York (New York)
        Type: general
    Titles:
      – TitleFull: Food Insecurity Associated with Educational Disruptions during the COVID-19 Pandemic for College Students and the Role of Anxiety and Depression
        Type: main
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            NameFull: Emily Berger
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            NameFull: Jenna Larsen
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            NameFull: Nicholas Freudenberg
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            NameFull: Heidi E. Jones
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              Y: 2024
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              Value: 1940-3208
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              Value: 72
            – Type: issue
              Value: 6
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            – TitleFull: Journal of American College Health
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