Food insecurity and sociodemographic determinants: a cross-sectional analysis from Türkiye nutrition and health survey (TNHS) – 2017

Food insecurity is a major public health concern with multidimensional determinants and varying severity levels. Understanding its sociodemographic and regional drivers is essential for developing targeted interventions. This study aimed to examine the prevalence of mild, moderate, and severe food insecurity in Türkiye and to identify associated sociodemographic determinants using nationally representative data. This cross-sectional study analyzed secondary data from the Türkiye Nutrition and Health Survey (TNHS-2017), which included 12,986 individuals aged 15 years or older. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES) and categorized as mild, moderate, or severe. Associations between the severity of food insecurity and sociodemographic factors were examined using multinomial logistic regression, with food-secure individuals as the reference group. Perceived household financial situation emerged as the strongest determinant across all severity levels, followed by low educational attainment (p < 0.001). Compared with men, women had a higher risk of mild and moderate food insecurity (p < 0.001) but a lower risk of severe food insecurity (p < 0.001). Older age showed a protective effect, with significantly reduced risks among individuals aged 50–64 years and those aged 65 years and older (p < 0.001). Relative to higher education levels, all lower education levels were associated with an increased risk of food insecurity, reaching a 5.7-fold increase for severe food insecurity (p < 0.001). While marital status showed no significant association for mild and moderate food insecurity, never-married and widowed/divorced/separated individuals had a higher risk of severe food insecurity (p < 0.05). Significant regional disparities were observed, with the highest risks concentrated in Northeastern Anatolia, while some regions exhibited protective effects. Food insecurity in Türkiye is shaped by intersecting socioeconomic and regional factors that vary in severity. Income inadequacy and low education represent the most critical risk factors, while advanced age appears to be protective. These findings underscore the need for region-specific and equity-oriented policies that address the structural determinants of food insecurity.