Food Insecurity and Suicidal Behaviors among Bangladeshi University Students: a Multi-Institutional Cross-Sectional Study

Abstract Objective: Suicidal behaviors among students pose a significant public health concern, with mental health problems being well-established risk factors. However, the association between food insecurity (FIS) and suicidal behaviors remains understudied, particularly in Bangladesh. This study aimed to investigate the relationship between FIS and suicidal behaviors among Bangladeshi university students. Design: A cross-sectional survey using convenience sampling was conducted between August 2022 and September 2022. Information related to socio-demographic, mental health problems, FIS and related events, and suicidal behaviors were collected. Chi-squared tests and multivariable logistic regression models, both unadjusted and adjusted, were employed to examine the relationship between FIS and suicidal behavior. Setting: Six public universities in Bangladesh. Participants: 1,480 students from diverse academic disciplines. Results: A substantial proportion of respondents experienced FIS, with 75.5% reporting low or very low food security. Students experiencing FIS had significantly higher prevalence of suicidal ideation, plans, and attempts compared to food-secure students (18.6% vs. 2.8%, 8.7% vs. 0.8%, and 5.4% vs. 0.3%, respectively; all p<0.001). In addition, students who have personal debt and participate in food assistance programs had higher risk of suicidal behaviors. Conclusions: This study sheds light on the association between FIS and suicidal behaviors among university students. Targeted mental health screening, evaluation, and interventions within universities may be crucial for addressing the needs of high-risk students facing FIS.