Low social support is a risk factor for food insecurity: Evidence from France, the UK and the USA

Background. Food insecurity (FI) is associated with increased mortality and poor health. In high-income populations, documented risk factors for experiencing FI include low income, being female, having children, and ethnic minority status. Low social support may increase the risk of FI additively to these other risk factors, or may interact with them.

Methods. In two epidemiological datasets, the Changing Cost of Living Study (CCLS; UK and France) and the National Health Interview Survey 2024 (NHIS; USA), we used model selection to identify the best predictors of FI from a set including social support alongside socioeconomic and demographic variables, allowing for interactions between predictors.

Results. In both datasets, social support was selected as a predictor variable. High social support roughly halved the odds of experiencing FI (CCLS: 0.45 (95% CI 0.35 - 0.56); NHIS: OR 0.52 (95% CI 0.49 - 0.56)). Other selected predictor variables were income, income volatility, gender, and age (CCLS); and income, gender, age, having children, education and ethnicity (NHIS). Social support operated additively to other factors rather than interactively.

Conclusions. Low social support is an independent risk factor for FI in these high-income populations. FI may be reduced by fostering social connection and capital; and inferences about the causal effects of FI on health may be confounded by the influence of social support on both.