Marginal Food Security and Depressive Symptoms: NHANES 2009–2020

ABSTRACT Objective This study explores the association between marginal food security (MFS) and depressive symptoms. MFS, or “hidden food stress,” refers to stress or concern regarding meeting nutritional needs without a substantial reduction in food intake. Although large‐scale surveys classify these households as food secure, prior research indicates that MFS may be linked to adverse mental health outcomes similar to those observed in food‐insecure populations. Methods Data from the National Health and Nutrition Examination Survey (NHANES) from 2009 and 2020 were analyzed using weighted probit regression models to examine associations between MFS and depressive symptoms. Results Individuals with MFS exhibited demographic and health characteristics more similar to those with low or very low food security than to those with full food security (FFS). After adjusting for covariates, MFS was associated with a higher probability of depressive symptoms. Conclusion MFS is significantly associated with increased depressive symptoms, independent of poverty and other factors. Current food security classification practices that include MFS within FFS obscure important mental health disparities. These findings suggest that MFS should be recognized as a distinct category of food hardship with important mental health implications.