Addressing Food Insecurity Among Medical Trainees in Arizona

Thu, 23 Apr 2026 20:42:19 GMT

Introduction By: Kriti Lalwani, Anna Leah Eisner, A. Chisom Okuagu, DO

The Reference Committee recommends amending this by striking "advocate for" and inserting "encourage" in the first resolve and adopting this as new ArMA Policy.

Does the resolution address a current need? Yes, many medical trainees (medical students, residents) face problems with food insecurity.

Is it directly applicable to the healthcare community? Yes, it affects trainees in the healthcare community.

Does it reflect emerging healthcare trends? Yes, multiple recent studies show the prevalence of food insecurity among medical trainees.

Is it within ArMA's or the AMA's scope to accomplish? Yes, it relates to healthcare and the healthcare training

Whereas, food security is a fundamental social determinant of health, and lack of consistent access to nutritious food adversely affects physical health, mental health, academic performance, and overall well-being^1,2; and

Whereas, medical trainees face unique financial, time-related, and structural barriers (such as educational debt, limited income, and demanding schedules) that increase their vulnerability to food insecurity³; and

Whereas, in a multi-institutional survey of 1,834 U.S. medical students, 21.2% reported food insecurity, with higher odds of insecurity among students of racial/ethnic minority backgrounds, those with dependents, and those relying on loans rather than parental support⁴; and

Whereas, in a single institution survey administered at Yale New Haven Health system, 27% of residents reported being food insecure: with 26% reporting having skipped or cut down on meal size, 22% frequently ate less, and 15% reported feeling hungry because they lacked sufficient food⁵; and

Whereas, intersectional risk factors such as low income, disability, and under-representation in medicine (URiM) further amplify the likelihood of food insecurity among medical students⁶; and

Whereas, food insecurity is also a documented problem among Arizona university students more broadly: a work-group report by the Arizona Board of Regents indicated that 25–50% of students at ASU, NAU, and UA experience food insecurity⁷; and

Whereas, validated social determinants of health screening tools (i.e. PRAPARE) already include standardized questions to assess food insecurity, and existing support pathways such as SNAP and other government benefit programs provide established mechanisms for connecting food-insecure individuals with resources^8,9; therefore, be it

Resolved, that ArMA ENCOURAGE ~~advocates~~ ~~for~~ institution-level screening and support systems to identify and assist food-insecure medical trainees in Arizona (e.g., medical student and resident food pantries, “meal ticket” programs, access to SNAP or emergency grants); and be it further

Resolved, that ArMA supports statewide efforts to collect and stratify data on food insecurity among Arizona medical trainees to inform targeted policies and interventions that promote equity, well-being, and retention in the physician workforce.

Reference:

Julie Berrett-Abebe, Sarah C Reed, Exploring the Relationship between Food Insecurity, Chronic Health Conditions, and Serious Mental Illness in the United States: Implications for Social Work, Health & Social Work, Volume 49, Issue 3, August 2024, Pages 147–156, https://doi.org/10.1093/hsw/hlae012
Betancourt-Núñez A, Díaz R, Nava-Amante PA, et al. Beyond the Classroom: The Influence of Food Insecurity, Mental Health, and Sleep Quality on University Students' Academic Performance. Foods. 2024;13(16):2508. Published 2024 Aug 11. doi:10.3390/foods13162508
AAMC: Physician Education Debt and the Cost to Attend Medical School
Shanab BM, Khosla P, Hammad NM, et al. Food Insecurity Prevalence Among US Medical Students. JAMA Netw Open. 2025;8(8):e2529926. doi:10.1001/jamanetworkopen.2025.29926
Vázquez M, et al. Food insecurity in medical residents at Yale New Haven Health System. Poster presented at: Pediatric Academic Societies (PAS) Meeting; May 4, 2024; Toronto, Ontario, Canada. Poster 424.1565.
Nguyen M, Shanab BM, Khosla P, et al. The Intersection of Disability, Race, Ethnicity, and Financial Background on Food Insecurity Among Medical Students. Acad Med. 2025;100(10S Suppl 1):S113-S118. doi:10.1097/ACM.0000000000006156
Arizona Board of Regents: Student Food and Housing Insecurity
Weir, R. C., Proser, M., Jester, M., Li, V., Hood-Ronick, C. M., & Gurewich, D. (2020). Collecting Social Determinants of Health Data in the Clinical Setting: Findings from National PRAPARE Implementation. Journal of health care for the poor and underserved, 31(2), 1018–1035.
Arizona Department of Economic Security: Nutrition Assistance

Food Insecuirty at UACOM-P

Sat, 25 Apr 2026 02:52:03 GMT

Hello,

My name is Frank Guerrero, and I am a rising MS3 at UACOM-P. I am writing to express my full support for this resolution and to offer some additional points that may strengthen the proposal.

I am currently leading a team at UACOM-P working to determine the prevalence of food insecurity among our medical students. In this effort, we have been collaborating closely with the team led by Bassel Shanab at Yale University, whose published work is referenced in the resolution. To my understanding, the team also has individual-level data from Mayo Clinic collected in 2024, which could provide further support by representing two of the six medical schools in Arizona.

At UACOM-P, we administered the same survey to students in the Classes of 2025-2029 and received a total of 314 responses. Our preliminary findings show that food insecurity affects approximately 1 in 4 medical students at our institution. Specifically, 26.6% of students in the Classes of 2025-2028 (59/222) and 25.0% of students in the Class of 2029 (23/92) were identified as food insecure.

Some additional notable findings include:
• Students reporting a disability had **3.61 times higher odds** of experiencing food insecurity (**p < 0.001**).
• First-generation college students had **2.39 times higher odds** of food insecurity (**p = 0.02**).
• Nearly half of students reported unmet needs related to **academic resources (49.6%)**, **personal vehicle costs (45.0%)**, and **rent/housing (44.6%)**.
• Among students reporting food/grocery insecurity, **74% cited cost** as the primary barrier.

We are currently in the process of preparing these findings for publication, but I would be happy to share preliminary data if it would help support this resolution.

Additionally, if there is any way I can assist with advocacy efforts or further support this initiative, I would be more than willing to help.

Best,
Frank Guerrero

Sun, 26 Apr 2026 01:43:35 GMT

Perhaps inability to afford groceries has smething to do with the outrageous cost of medical school.
Teaching students how to become welfare recipients hardly solves that problem.

Mon, 27 Apr 2026 16:54:07 GMT

Frank, thank you for your thoughtful comment citing actual trends in Arizona's medical schools. I'm glad you're working to publish your findings.

Overall, I support this resolution as this is an underrecognized issue for our students. It certainly strengthens other ArMA priorities to support trainees in our state - with the hopes that we will be able to also recruit them to stay in Arizona where we have significant physician shortage areas, particularly in primary care.

Thu, 30 Apr 2026 19:38:00 GMT

I appreciate and support this resolution that raises compassion for, and actual ways of meeting, basic needs of our trainees. We should also continue to work for more reasonable costs to become a doctor/less debt accumulation but this is a great tangible step for here and now problem.

Thu, 30 Apr 2026 22:59:43 GMT

Thank you, Frank, for your thoughtful work on this important issue and for sharing your preliminary data. I appreciate the effort to better understand the challenges faced by medical trainees.

That said, I do have some concerns regarding how the data is being interpreted and applied—particularly in the Arizona context.

First, much of the data cited (including the Arizona Board of Regents report and single-institution surveys) relies heavily on self-reported survey data, which can be highly sensitive to how “food insecurity” is defined. These definitions often capture a broad spectrum—from true lack of access to food, to more subjective concerns about food affordability or preference. Without clear stratification of severity, it is difficult to determine how many trainees are experiencing true nutritional deprivation versus financial prioritization challenges.

Second, it would be important to better differentiate subgroups within the trainee population. For example:

Single students vs. those with dependents
Traditional vs. non-traditional students
Geographic cost-of-living differences

These distinctions matter significantly, as financial strain—and therefore reported food insecurity—can vary widely across these groups.

Third, Arizona has a relatively robust network of food access resources, including community food banks, university-based programs, and eligibility pathways through programs like Supplemental Nutrition Assistance Program (SNAP). Before implementing new institutional screening programs, it would be helpful to better understand:

Awareness and utilization of existing resources
Whether barriers are truly access-related vs. informational or behavioral

Finally, while I support continued data collection, I would caution against assuming that findings from limited or early datasets are broadly generalizable across all Arizona medical trainees. More granular, stratified, and Arizona-specific data—particularly distinguishing degree and severity of food insecurity—would strengthen the case for targeted interventions.

In summary, this is a worthwhile area for continued study and thoughtful support. However, I would advocate for a more data-driven, stratified, and context-specific approach before broadly implementing screening programs or policy changes at the institutional or statewide level as these measures are not without cost and impact to other programs.

Sat, 2 May 2026 23:29:12 GMT

Support

Mon, 4 May 2026 00:33:23 GMT

I am in overall support of this resolution.
I agree with the edit in the first resolve, and would also suggest a strike through of the examples as providing concrete examples can be limiting.
I do also agree with M. Dunn that more detailed research is needed, and there are already networks within Arizona to assist with food insecurity. Promoting these to medical students who might be new to Arizona or unfamiliar with resources would be a first step.

Tue, 5 May 2026 21:48:20 GMT

I support and agree more research is needed.

Fri, 8 May 2026 00:06:56 GMT

I support this resolution and appreciate the measured approach it takes in encouraging institutions to better understand and address food insecurity among medical trainees while also supporting further data collection.

I agree that improving awareness of existing community resources is important. However, it is also important to recognize that many medical students face barriers to qualifying for SNAP benefits during training due to federal student eligibility requirements. Full time students are generally ineligible unless they meet specific exemptions such as qualifying work hour requirements, dependent care responsibilities, or participation in certain approved employment or training programs. Given the demanding structure of medical education and clinical training, many students experiencing financial strain may still not qualify for assistance despite significant educational debt and rising living costs.

This is particularly important to consider while students and residents are actively in training, when earning potential is limited and schedules often make outside employment difficult. Because of this, institution specific support systems and continued data collection remain important in supporting trainee wellness and retention within the future physician workforce.