Characterizing adolescent-reported experiences of food insecurity in the ten Canadian provinces in 2019, 2020, and 2021: A cross-sectional analysis

Objectives: Estimate the prevalence and sociodemographic correlates of adolescent-reported food insecurity experiences from 2019-2021. Methods: Repeat cross-sectional data were collected in November-December 2019, 2020, and 2021 from adolescents aged 10-17 years living in the ten Canadian provinces (n = 11,057). The prevalence of ten items and five food insecurity subconstructs based on the 10-item Child Food Insecurity Experiences Scale was estimated. Weighted multinomial logistic regression assessed associations between sociodemographic characteristics and food insecurity experiences as a four-level (no, few, several, or many experiences) variable. Results: Across 2019-2021 among adolescents, the prevalence of worrying about food scarcity ranged between 18.4%-22.5%, worrying about parental/guardian ability to get food ranged between 22.8%-26.9%, and not being able to get the food they wanted ranged between 23.5%-26.1%. Close to or above one in four adolescents affirmed the uncertainty (range: 26.9%-29.9%) and compromised diet quality or preferences (range: 23.5%-26.1%) subconstructs. In 2021, adolescents identifying as Black had a higher relative risk ratio of few food insecurity experiences (adjusted relative risk ratio (ARRR): 2.04 [95% CI: 1.20, 3.47], p-value: <0.01) and adolescents identifying as Indigenous had a higher relative risk ratio of several food insecurity experiences (2.38 [1.10, 5.15], p-value 0.03) compared to adolescents identifying as White. The relative risk ratio of having few, several, or many food insecurity experiences also differed by age, sex-at-birth, perceived income adequacy, and region. Conclusion: The type and number of experiences reported underscores the value of directly measuring food insecurity. Interventions to mitigate food insecurity's adverse consequences are warranted.