Methods: This study used data from a cross-sectional online survey collected in spring and summer, 2020. The study recruited college students enrolled in a public urban university, employing convenience sampling. The dependent variable was mental health symptoms measured by the four-item Patient Health Questionnaire (PHQ-4). Higher scores represented more severe levels of anxiety and depression symptoms (range 4-16). Independent variables were food insecurity and economic hardship. Food insecurity was a binary indicator measured with the Six-Item Short Form of the USDA Food Security Survey Module. The pattern of economic hardship was measured using nine indicators of financial strain and stress: unable to pay for utilities, mortgage or rent, internet/phone, or medical care, overwhelming debt, family bankruptcy, eviction, temporary move-in, and couch-surfing. We conducted a Latent Class Analysis (LCA) with a distal outcome (N=375). Our analysis controlled for sociodemographic and health characteristics and pre-pandemic characteristics (mental health, food insecurity, and economic hardship before the pandemic onset).
Results: The sample consisted of undergraduate (64%) and graduate students (36%) from diverse backgrounds. One-third were first generation college students, and almost half of the sample were racial and ethnic minorities. The average score of mental health symptoms during the pandemic was 10 (SD = .05), which was higher by 2 points than before the pandemic. About 35% of the sample were food insecure. The LCA identified two groups of economic hardship: a low economic risk (79%) and multiple economic risks (21%). The group of the multiple risks had high probabilities of unmet basic needs (e.g., utilities, housing payment) and overwhelming debt, whereas the group of a low risk showed low probabilities in most hardship experiences. The final analysis presented that food-insecure students were more likely to have anxiety and depression symptoms (b = .752, p = .036) than food-secure students. Students classified to the multiple risks of economic hardship reported worse mental health than those in the low risk group, however, the significant difference disappeared after controlling for covariates (b = -.742, p = .077).
Discussion: Our findings provide timely, vital evidence to warrant public awareness and preventive support for young adults’ mental distress in relation to food insecurity and economic hardship in the unprecedented time of the pandemic. The findings support that food insecurity has more devastating effects relative to economic hardship. The current study emphasizes the emergent need for integrated services and university-community partnerships to support young adults’ mental health and continued success during their educational investment.