The Centers for Disease Control and Prevention defines disability as “any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions)” 1 and reports about 61 million American adults, or 1 in 4 have a disability.2 Financial stressors are one of the many hardships people with disabilities often experience. Higher healthcare costs and out-of-pocket health expenditures, such as specialized aids, prescriptions, equipment, and transportation contribute to the increased financial burden that comes with the presence of disability in a household.3 A particularly vulnerable time for financial stability for persons with disabilities is during the transition to adulthood, as equipment, housing, basic needs, and education expenses increase, while parental financial support and guidance might wane.4 During young adulthood, new challenges may arise, including changes in healthcare, education, and income support, affecting both persons with and without disabilities. Persons with disabilities, particularly during young adulthood, face increased unemployment rates and healthcare costs which may contribute to higher rates of food insecurity.3

Young adults attending college may also have additional stressors related to the financial burden of higher education costs. Despite the high costs of tuition and other educational expenses, U.S. college students are increasingly diverse, with a greater proportion identifying as students of color, first-generation students, and students with physical and intellectual disabilities.5,6 While a post-secondary education offers numerous benefits, these underrepresented groups may experience increased rates of economic hardships, including food insecurity, during the collegiate experience. 5,7

In the United States, approximately 1 in 10 households are classified as food insecure,8 which is defined by the United States Department of Agriculture (USDA) as the lack of sufficient access to food to live an active and healthy life.8 Reported rates of food insecurity among college students range from 14-59%,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 exceeding the national average of 10.2%.8 A 2017 cross-sectional survey administered to 43,000 U.S college students found that 48% of university participants reported marginal, low, or very low food security.15 Further, when asked about their food security status in the past 30 days, 36% of the college students reported experiencing the lowest or very low levels of food security.15 Almost 25% said they had skipped or cut the size of their meals due to lack of money.15

There are several negative academic implications of food insecurity for college students, including lower grade point average,10,11,14,15,20,21 class attendance,10,15,21 and difficulty concentrating.15,21 Food insecurity has also been associated with poor mental health, including measures of sadness, anxiety, and depression in the college population.20,21 Further, food insecurity is linked to worsened sleep,22 overall health, and diet quality.20 These compound the severity of the implications of food insecurity, including long term health effects such as increased risk of chronic disease.20,23,24 A recent study examining the effects of food insecurity during college on graduation and degree retainment found that food insecurity was associated with lower odds of graduating college and a reduced likelihood of completing a bachelor’s degree.19

Pooled data from the National Health and Nutrition Examination Survey (NHANES) (1999-2014) associated disability with an increased food insecurity prevalence, regardless of the type of disability.25 The national dataset also shows that work-limiting disabilities and functional limitations are associated with food insecurity.26According to the National Health Interview Survey (NHIS), young adults 18-25 years old with disabilities were more likely to have spent their past 30 days in food insecure households (32-50%) compared to those without disabilities (13-15%).25 Furthermore, food insecure households with young adults with disabilities were more likely to enroll in the Supplemental Nutrition Assistance Program (SNAP).25,27 Another study that focused on the food insecurity of households with children with autism spectrum disorder and intellectual disabilities found this population were 1.3-1.5 times more likely to be food insecure than households without these disabilities.28 Although many studies have explored food insecurity in both persons with disability and college students, little research has examined the food insecurity within the cross-section of these two populations. While the reasons behind this gap are likely multifaceted, recruitment and retention of individuals with disability to participate in health research is a noted challenge that further contributes to the health disparities observed.29

One out of every five U.S. college students report having a disability30, most commonly reporting learning disabilities, attention deficit disorder, and attention deficit hyperactivity disorder.4 Improving higher education access for underrepresented groups is important, however, many students with a disability report a challenging experience once they arrive on campuses. This could include feeling a lower sense of belonging than their peers, as well as higher encounters with discrimination.31 While campus have increased resources to support the diverse needs of students with disabilities, these students are more likely than students without disabilities to underutilize many campus-based services such as career services.32 As students with disabilities are also less likely to participate in work-related experiences in college,32 these undergraduates are likely at a financial disadvantage compared to their peers, which in turn, may contribute to added risk in covering basic needs.

Current information about college students and food insecurity, combined with information about adults with disabilities, suggest that college students with disabilities may be especially at risk for food insecurity. Therefore, the purpose of this study is to characterize the prevalence of food insecurity among college students with disabilities. It is hypothesized these individuals will have increased basic needs insecurities, specifically food insecurity when compared to students without disabilities.