UCSF

OBJECTIVES: Studies suggest that people experiencing housing insecurity and homelessness (HIH) have varying experiences with food insecurity. We estimated the prevalence of food insecurity and identified the factors associated with it among people experiencing HIH in the United States. METHODS: We conducted a meta-analysis of the prevalence of food insecurity among people experiencing HIH and a systematic review of associated factors through a comprehensive search of 8 academic databases. We identified 3398 unique articles and included 40 studies in the review that met the following criteria: included observational or experimental data on the prevalence of food insecurity among people experiencing HIH, conducted in the United States, and written in English. RESULTS: The overall prevalence of food insecurity was 57% (95% CI, 48%-65%). Most people experiencing HIH had food insecurity, and our estimated prevalence among people experiencing HIH was >4 times higher than the prevalence in the US population. Experiencing symptoms of a mental health condition (eg, depression, posttraumatic stress disorder, anxiety) in addition to HIH was most frequently (7 datasets) associated with increased odds of food insecurity. Social and institutional support was most frequently (5 datasets) associated with decreased odds of food insecurity. CONCLUSION: Our findings suggest that multisector coordination is needed to address individual- and system-level factors associated with food insecurity and HIH.