DOI

10.1111/josh.70172

Author ORCID Identifier

orcid.org/0000-0001-8514-8976

Abstract

Background

Youth mental health problems are rising nationally. Virginia ranks among the lowest states in youth mental health access and has concentrated pockets of food insecurity (FI), underscoring the urgency of policy responses. FI is a known risk factor, yet surveillance often relies on single-item measures. We introduce a multidimensional Food Insecurity Index (FII) to examine associations with adolescent mental health.

Methods

We analyzed 2023 Youth Risk Behavior Surveillance System data from Virginia (n = 1866) and the United States (n = 10,724). The FII combined five indicators capturing acute scarcity and chronic dietary compromise. Survey-weighted logistic regression estimated adjusted odds ratios (AORs) for persistent sadness or hopelessness.

Results

Each 1-point increase in FII was associated with higher odds of persistent sadness or hopelessness in Virginia (AOR = 1.066, 95% CI: 1.005–1.130) and nationally (AOR = 1.087, 95% CI: 1.062–1.112). Female students had higher odds than males, and bullying was a strong correlate. A dose–response pattern was observed.

Implications for School Health Policy, Practice, and Equity

Integrating FI screening with nutrition and behavioral health supports may help identify and address overlapping risks.

Conclusions

Multidimensional FI is consistently associated with poorer mental health among high school students.

Document Type

Article

Publisher Statement

© 2026 The Author(s). Journal of School Health published by Wiley Periodicals LLC on behalf of American School Health Association.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publication Date

5-26-2026

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