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

Background: We aimed to assess the prevalence of food insecurity reported by children and young people in four areas of England in 2023 and examine its association with mental health and wellbeing. Methods: We used data from the OxWell student survey, a large, diverse, cross-sectional study of 38,430 students aged 8–19 years, conducted primarily in four counties in England (Berkshire, Buckinghamshire, Merseyside, Oxfordshire) during February and March 2023. Students responded to three food insecurity questions and completed a battery of mental health and wellbeing questionnaires. Analysis plans were pre-registered prior to data access. Bayesian mixed-effect ordinal regression models were used to estimate associations with outcomes, controlling for gender, school year, ethnicity, birth location, parental birth location, deprivation and school. Results: Depending on the question, 4%–6% of children and young people reported sometimes experiencing food insecurity, and 1%–2% reported often experiencing it. After controlling for covariates, high levels of food insecurity were associated with increased depression (SMD = 0.51) and anxiety scores (SMD = 0.36), reduced adolescent wellbeing (SMD = −0.44) and positive thoughts (SMD = −0.30). Food insecurity's association with loneliness (SMD = 0.20, 99% CI [−0.03, 0.42]) and child wellbeing (SMD = 0.40, 99% CI [−0.00, 0.79]) were less certain in direction. Conclusions: Food insecurity remains a persistent problem facing children and young people in England and is associated with deteriorated wellbeing. Our findings underscore the urgent need to identify and support families struggling with the rising cost of living.