Food insecurity trends and disparities according to immigration status in the US households, 2011-2021

Background: Food insecurity related to immigration status remains largely underexplored. This study examined trends and disparities in household food insecurity by immigration status in the United States (US). Methods: We analyzed data from 427,942 households from the US Current Population Survey Food Security Supplement from 2011 to 2021. Immigration status categories included recent immigrants (< 5 years), long-term immigrants (>= 5 years), naturalized citizens, and US-born citizens. Food insecurity was assessed using validated questions on consistent access to enough food for an active and healthy life. Results: From 2011 to 2021, food insecurity prevalence declined from 14.9% (95% CI, 14.5 %-15.3 %) to 10.2% (95 % CI, 9.8 %-10.6 %). Among recent immigrants, prevalence decreased from 25.2 % (95 % CI, 23.1-27.4) in 2011 to 15.0% (95% CI, 12.8 %-17.2 %) in 2019, then increased to 17.7% (95% CI, 14.7 %-20.2 %) in 2020 and 17.4% (95% CI, 14.7 %-20.2 %) in 2021. Long-term immigrants' prevalence dropped from 20.4% (95% CI, 16.9 %-24.0 %) in 2011 to 10.2 % (95% CI, 7.2 %-13.1 %) in 2018, then increased to 17.7% (95% CI, 13.7 %-21.7 %) in 2021. Naturalized citizens' prevalence decreased from 14.4% (95% CI, 12.9 %-15.9 %) to 9.5% (95% CI, 8.2 %-10.9 %). US-born citizens' prevalence decreased from 14.2 % (95% CI, 13.8 %-14.6 %) to 9.7% (95 % CI, 9.3 %-10.2 %). Compared to the US-born citizens, the adjusted prevalence ratio was 1.63 (95 % CI,1.57-1.69) for recent immigrants, 1.22 (95 % CI, 1.13-1.31) for long-term immigrants, and 0.94 (95 % CI, 0.90-0.98) for naturalized citizens. Significant disparities exist in subgroups. Conclusions: The findings provide insights for stakeholders to address food insecurity among vulnerable immigrant groups in the US.