College student sleep quality and mental and physical health are associated with food insecurity in a multi-campus study

Objective: To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students. Design: An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health. Setting: Twenty-two higher education institutions. Participants: College students (n 17 686) enrolled at one of twenty-two participating universities. Results: Compared with food-secure students, those classified as food insecure (43 center dot 4 %) had higher PSQI scores indicating poorer sleep quality (P < 0 center dot 0001) and reported more days with poor mental (P < 0 center dot 0001) and physical (P < 0 center dot 0001) health as well as days when mental and physical health prevented them from completing daily activities (P < 0 center dot 0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1 center dot 13; 95 % CI 1 center dot 12, 1 center dot 14), days with poor physical health (AOR: 1 center dot 01; 95 % CI 1 center dot 01, 1 center dot 02), days with poor mental health (AOR: 1 center dot 03; 95 % CI 1 center dot 02, 1 center dot 03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1 center dot 03; 95 % CI 1 center dot 02, 1 center dot 04). Conclusions: College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes.