The prevalence of food insecurity and its relationship with wellbeing in a large, cross-sectional study of children and young people in England

There is a well-established link between poverty and mental health problems in childhood and adolescence, but poverty is complex and comprises multiple potentially harmful factors. One aspect of poverty is food insecurity, and here, we aimed to measure the prevalence of food insecurity reported by children and young people in England in 2023 and assess its association with six mental health and wellbeing assessments. Data were analysed from the 2023 OxWell student survey, a large, diverse, cross-sectional study of 38,430 students aged 8 – 19 years across England, assessed in February and March 2023. We recruited 185 primary schools, secondary schools and further education colleges, and children and young people completed the survey during the school day using a parental opt-out model. Students answered three questions regarding their experiences of food insecurity and completed a battery of mental health and wellbeing questionnaires. Post-stratification weighting was used to estimate the population prevalence and total cases of food insecurity. Bayesian mixed-effect ordinal regression models were used to measure associations with outcomes, controlling for gender, school year, ethnicity, birth location, parental birth location, deprivation and education setting.FindingsDepending on the question, four to six percent of children and young people reported sometimes experiencing food insecurity, and one to two percent reported often experiencing it. Extrapolating from our sample to the population of students in school year groups 5 – 11 (approx. 9 – 16 years) across England (~ 4.8 million pupils), we estimate that 352,000 students are aware of family food bank usage, 332,000 are unable to afford to eat in school, and 260,000 go to bed hungry due to a lack of food. These totals comprise students who reported either sometimes or often to each question. Compared to children and young people reporting low food insecurity, those reporting high levels had elevated depression (Standardised Mean Difference = 0·51) and anxiety scores (SMD = 0·36), reduced adolescent wellbeing (SMD = −0·44) and positive thoughts (SMD = −0·30). The effects of food insecurity on loneliness (SMD = 0·20, 95% CI [−0·03, 0·42]) and child wellbeing (SMD = 0·40, 95% CI [0·00, 0·79]) were less certain in direction.Food insecurity remains a persistent problem facing children and young people in England and is associated with elevated depression and anxiety. Our findings highlight the urgent need to identify and support families struggling with the cost of living.