key: cord-1001191-ayteq3oa
authors: Laska, Melissa N.; Fleischhacker, Sheila; Petsoulis, Christina; Bruening, Meg; Stebleton, Michael J.
title: Addressing College Food Insecurity: An Assessment of Federal Legislation Before and During Coronavirus Disease-2019
date: 2020-08-27
journal: J Nutr Educ Behav
DOI: 10.1016/j.jneb.2020.07.001
sha: 739ea4dd05ded1c3fcba6e8e244f6d4dd0471d8a
doc_id: 1001191
cord_uid: ayteq3oa

Research conducted before coronavirus disease-2019 illustrated high rates of food insecurity among college students. The pandemic has likely increased student food insecurity because of factors like unemployment and closure of campus resources, and many students cannot access federal food assistance because of long-standing student restrictions. This perspective reviews federal legislation on college food insecurity introduced in the 116th legislative session (2019–2020) immediately before coronavirus disease-2019 in the US, as well as pandemic-related stimulus bills and their implications for future policies and practice. Food insecurity promises to become more pressing as colleges try to reopen and the country grapples with economic recovery.

A key social determinant of health in the US is the successful completion of higher education, 1 and it has been recognized as such by authorities such as the National Institutes of Health (NIH) 2,3 and Healthy People 2020. 4 When Americans envision a typical college student, some may call up stereotypical images of students from generations ago-young people supported by upper-middleclass families, living in exclusive dormitories, and eating in bountifully sourced dining halls. 5−7 However, times have changed. With Obamaera policies creating new opportunities for students at both 2-and 4-year postsecondary institutions, we see that now 44% of students seeking Bachelor's degrees are students of color 8 and 56% of all undergraduates are first-generation students, 9 or, in other words, do not have a parent with a 4-year degree.

These new-to-college students face challenges to academic success, many of which stem from economic hardship. For example, many of the 20 million US college students today 10 experience food insecurity, defined by the US Department of Agriculture (USDA) as a lack of consistent access to enough food for an active, healthy lifestyle. 11 Although there are no nationally representative estimates of food insecurity among students, recent literature reviews showed that about 1 in 3 college students experienced food insecurity before the coronavirus disease-2019 (COVID- 19) crisis. 12, 13 The COVID-19 pandemic has made things much worse for students. Jobs have been cut in unprecedented numbers, and 18−24-yearolds have experienced some of the highest rates of unemployment. 14 In 2020, students living on campus were forced to relocate; some had limited options of where to go. 15 Students paid 2020 spring semester costs for goods and services they could not use, such as meal plans and Internet access, and although some universities have provided refunds, others have not. 16 Many students worry about what to expect in the shortand long-term future. 17, 18 Troublingly, many students may have limited access to community resources, such as food pantries, and also cannot access federal nutrition assistance, such as the USDA Supplemental Nutrition Assistance Program (SNAP) benefits. 19 There have been longstanding SNAP restrictions for fulltime college students, known as the college SNAP rule, that were created under the assumption that most students enter college directly after high 1 school and are supported by their parents. 19, 20 There are limited exceptions to these restrictions, and those students who are SNAP-eligible face significant challenges in getting this much-needed assistance, a challenge that has been thoroughly detailed in a recent Government Accountability Office report. 21 Unfortunately, a federal waiver to provide college students with expanded access to SNAP (ie, eliminate the requirement to work at least 20 hours per week) was recently denied. 22 

With its substantial impact on health and other metrics, successful completion of higher education is important. 1 College graduates earn more money 23 and have half the unemployment 24 of nongraduates, translating into more long-term resources, better health, and, ultimately, longer life expectancy. 25 A growing patchwork of recent research studies further shows college students experiencing food insecurity are in poorer health and have higher rates of depression, lower grades, and more academic challenges 12,13 than their counterparts. Although much of the research on this topic has been conducted with undergraduates, 12, 13 some evidence from 2019 suggests that rates of food insecurity may be similar between graduate and undergraduate students. 26 Students of color and first-generation students are at the highest risk for food insecurity, 12 which could ultimately delay or derail graduation. In recent years, research on college food insecurity has spurred national attention to this crisis. 6,27−31 In response, colleges leaders are now struggling to understand the scope of student food insecurity and identify evidence-based prevention strategies. 32−35 Many colleges have begun to operate campus food pantries and other hunger relief initiatives as a result. However, many people, 36−38 including the authors, assert that many of these strategies are short-term remedies, and federal policy changes are needed to initiate and enhance systemic support for students.

In response to the food insecurity crisis, federal policymakers have introduced a range of bills to address college food insecurity during the current 116th legislative session (2019−2020). The authors here sought to comprehensively summarize the current federal legislative efforts addressing college food insecurity, to identify opportunities and gaps in this area better.

In total, 17 such bills (12 unique bills) were introduced in the current legislative session, before COVID-19 in the US. These bills (see Table) were identified through a key-word guided search of the current 116th legislative session (2019−20), in consultation with university librarians and 2 legal experts (S.F. and C.P.) independently screening results, extracting data, and coding. We excluded legislative efforts focused generally on college affordability.

Findings indicated that 1 bill (S. 1221) had been sponsored by a Republican, whereas the remaining were Democrat-sponsored. Key mechanisms of the 12 unique bills included the following: (1) small-scale grant programs or related grant eligibility changes (n = 7), (2) SNAP eligibility information dissemination and outreach (n = 2), (3) SNAP eligibility expansion (n = 2), (4) required food insecurity reporting (n = 2), and (5) cross-agency data sharing to identify students eligible for food assistance (n = 1).

All bills were in the early stages, having been only introduced and referred to the: House Committee on Education and Labor (n = 10), House Committee on Agriculture (n = 3), Senate Committee on Agriculture, Nutrition and Forestry (n = 1), and Senate Committee on Health, Education, Labor and Pensions (n = 4). 

The rapidly growing legislative enthusiasm across agriculture and education committees and a range of legislative leaders is encouraging but also challenging, given the limited evidence on which proposed legislation can be based. From the authors' perspective, 1 limiting factor and pressing research need is for nationally representative estimates of college food insecurity. In addition, to conduct research on college student food insecurity, a valid, widely accepted measure of food insecurity is needed. This issue needs consideration given recent research suggesting standard USDA food insecurity measures may not perform well in college populations. 39 Despite this potential limitation, the National Center for Education Statistics has recently announced their intention to collect surveillance data on college food insecurity in the coming years. 40 The authors here also assert that to inform policy efforts effectively, other pressing research needs include (1) rigorous longitudinal cohort studies quantifying short-and long-term consequences of food insecurity, including those related to health, academic, and economic outcomes, and, perhaps more importantly, (2) rigorous evaluation of natural experiments and controlled intervention trials to identify approaches that are both viable and effective in lessening the burden of food insecurity on students. Ultimately, once strategies to effectively reduce the duration and magnitude of college food insecurity have been identified, the extent to which these strategies also attenuate long-term disease risks known to accompany food insecurity in the general population can subsequently be evaluated. Legislative action can help create opportunities for such natural experiments.

One reason research on college food insecurity has been challenging is that this issue (food insecurity) and population (college students) do not clearly fall in the purview of a specific institute at NIH, the major sponsor of health research in the US. College food insecurity often falls outside the scope of child health, and also has not yet been generally adopted within the chronic disease research portfolios.

Importantly, college youth, particularly those with food insecurity, are a vulnerable population needing special consideration and prioritization by NIH and other funding agencies, along with nongovernment funders. The first-of-itskind Strategic Plan for NIH Nutrition Research 41 may help accelerate progress on such research needs, but only time will tell.

However, although pressing research needs exist, public health nutrition professionals and policy advocates have long had to cope with the slow pace of scientific research. Many assert that policy action cannot necessarily wait for scientific certainty. 42 Through this legislative review, several bills were identified from this legislative session that proposed more promising approaches, despite limited evidence, including piloting federal meals programs in community colleges and expanding SNAP eligibility for students.

Other bills have proposed grant programs for postsecondary institutions to support students' basic needs, which may be successful, but the authors believe colleges need support from nutrition and other professionals to identify best practices in which to invest. In addition, although successful pilot initiatives can establish feasibility and estimate To amend the Higher Education Act of 1965 to require annual disclosure of nutrition assistance program eligibility criteria on the Department of Education Web site and elsewhere SNAP, Supplemental Nutrition Assistance Program.

reach, high-quality evaluation is needed. The authors' view is that partnerships with skilled, independent nutrition/food insecurity evaluators are imperative for adequately assessing the effectiveness and sustained impact on longer-term food insecurity, health, and well-being. The authors believe federal support for rigorous, independent, and coordinated evaluation across institutions is warranted. For example, similar to the $31 million USDAfunded center charged with evaluating local programs providing financial incentives for healthy SNAP purchasing, the US Department of Education and USDA could fund grants to rigorously evaluate programs across the US addressing food insecurity in college students. 43 Beyond federal efforts, there are also emerging state legislative initiatives to address food insecurity. Although outside the scope of this federal assessment, a preliminary 50state assessment of legislative initiatives by the authors revealed 14 states have introduced and/or passed legislation to address college food insecurity. California leads this area, having enacted 4 laws to date; for example, 1 law mandated all community colleges in the state offer a "hunger-free campus" designation for campuses with a food pantry, a meal donation program, and dedicated staff to disseminate food assistance information. 44 Other states have also taken policy action; for instance, Minnesota recently enacted a law also establishing minimum criteria for Minnesota State community and technical colleges to receive a hunger-free campus designation. 45 Beyond these efforts at both state and federal levels, the downstream impact of COVID-19 may result in opportunities to make other upstream changes to move the needle on college food insecurity. Additional policy opportunities have been suggested regarding SNAP, including SNAP agency mandates to collaborate with colleges to screen eligible students; enhance enrollment processes for efficiency and transparency; and address concerns about financial aid, loans, and work-study funds limiting students' SNAP eligibility by being included in income assessments. 46 Other suggested policy actions have included: requirements for colleges to convene student food insecurity task forces, possibly as part of hunger-free campus designations; incentives for SNAP purchases at on-campus retailers; and funding or technical assistance for creation of campus food pantries, food recovery, or dining center meal donations. 47 Although the authors contend these additional suggested policies alone are likely weak, they may provide important first steps toward more comprehensive policy action.

Well-informed advocacy can accelerate policy change. 48 The Society for Nutrition Education and Behavior includes advocacy as a core component of the leadership for which it strives. 49 Nutrition professionals with expertise in school meals and SNAP enrollment can play an especially valuable role in advocacy efforts for college food insecurity now, as well as in implementation later, should such bills be passed and codified into law.

In the authors' view, nutrition professionals must work with others across disciplines to advocate for promising policy changes to support students who identify as food insecurity, especially as academic institutions aim to reopen this fall amidst an on-going pandemic, as well as at a time when widespread economic recovery efforts are being considered and launched. For example, higher education professionals, including student affairs practitioners and others, could be important partners in addressing food insecurity needs. Multidisciplinary task forces could facilitate the visioning, planning, and implementation of campus-based action and advocacy. These types of coordinated efforts can provide collective and intentional plans to support students' basic needs. 50 Other keys to accelerating successful action on college food insecurity include coordinated national surveillance and more whole-ofgovernment approaches, between agencies like the Department of Education, USDA, and Centers for Disease Control and Prevention, as well as federal, state, tribal, and local governments and postsecondary institutions. Given the pace of rapidly developing action to address college food insecurity in the US, there is also a critical need for strong communication networks across diverse disciplinary perspectives, enhanced, for example, by cross-sectoral convenings for sharing cutting-edge findings and best practices in research, policy, and practice innovation. Groups like the Hope Center for College, Community, and Justice 51 and the Food Research & Action Center 52 have established convenings across several sectors in recent years; hopefully these efforts will continue to spur comprehensive national communication and rapid dissemination that can fuel future policy action.

Finally, as a result of COVID-19, additional university-and collegelevel challenges relevant to food insecurity are now surfacing with the anticipated reopening of college campuses-including food service venues and campus food pantriesthis fall. Society for Nutrition Education and Behavior members can play a pivotal role in reviewing these reopening policies to ensure they are most sensitive to the needs of students experiencing food insecurity. Importantly, more work is needed to assess the implications of the Centers for Disease Control and Prevention guidance for reopening college campuses 53 and the growing patchwork of university and college reopening policies, particularly with a food insecurity lens.

Overall, through collective action, strong communication, and wellinformed decision-making, nutrition professionals can play important roles in building systems that better support students in their pursuit of higher education and better health. Without collective and timely action for policy change, college food insecurity will likely only worsen.

This work was funded by the University of Minnesota Grand Challenges Research Initiative.

Mortality and morbidity in the 21 st century

Implementing the National Heart, Lung, and Blood Institute's strategic vision in the division of cardiovascular sciences

NICHD Strategic Plan 2020: Health Pregnancies. Healthy Children. Healthy and Optimal Lives

Social determinants of health

Today's college students aren't who you think they are. NPR

It's hard to be hungry on spring break. The New York Times

How financial aid betrays the modern family. The Atlantic

Postsecondary National Policy Institute. Factsheets. First-generation students

The struggle is real: a systematic review of food insecurity on postsecondary education campuses

Food insecurity among college students in the United States: a scoping review

Labor force statistics from the current population survey

When colleges shut down, some students have nowhere to go

Demand for refunds intensifies among college students. CNBC

How college students manage coronavirus stress

Coronavirus fears may lead to big gap year for college students. PBS

New SNAP rule impacts college students by limiting benefits and adding confusion. NPR

US Government Accountability Office. Food insecurity: better information could help eligible college students access federal food assistance benefits

20GAO's%20analysis%2C%20having

SNAP -denial of certain requests to adjust SNAP regulations

Despite Rising Cost, College Is Still a Good Investment

Unemployment rate 2.1 percent for college grads, 3.9 percent for high school grads in

Association between educational attainment and causes of death among white and black US adults

#RealCollege 2020: Five Years of Evidence on Campus Basic Needs Insecurity. Philadelphia: The Hope Center

Tuition or dinner? Nearly half of college students surveyed in a new report are going hungry. The New York Times

The number of hungry and homeless students rises along with college costs. NPR

It's hard to study if you're hungry. The New York Times

In college and homeless. The New York Times

Have you ever experienced food insecurity? The New York Times

Colleges grapple with student food insecurity

Covering college student homelessness and food insecurity: 7 tips from Sara Goldrick-Rab

Hunger on campus: the fight against student food insecurity. NBC News

In dealing with campus hunger, one solution is to tell students where they can get help. The Chronicle of Higher Education

Moon E. Half of college students are food insecure. Are universities doing enough to help them? Pacific Standard

For many college students, hunger 'makes it hard to focus

Nickols-Richardson SM. Are estimates of food insecurity among college students accurate? Comparison of assessment protocols

US gov't to ask students about food insecurity. The Temple News. February 25

Food insecurity and obesity: research gaps, opportunities, and challenges

Public health action amid scientific uncertainty: the case of restaurant calorie labeling regulations

Donahoe Higher Education Act. California Code, Education Code (EDC) x 66027

Hunger Free Campus Designation. Minnesota Statute x 136F

Addressing student hunger through policy change: leveraging federal food benefits to support college completion

National Conference of State Legislatures. College student hunger

Effective advocacy strategies for influencing government nutrition policy: a conceptual model

Society for Nutrition Education and Behavior

Food insecurity on college campuses: collateral damage of a societal crisis

Centers for Disease Control and Prevention. Coronavirus disease 2019: colleges, universities and higher learning