Prevalence and Sociodemographic Determinants of Household Food Insecurity in Urban and Rural Puducherry, India: A Community-Based Cross-Sectional Study

Background: Food insecurity remains a major public health problem in India. While rural household food insecurity in Puducherry was previously quantified at 31.7%, no study has assessed its prevalence among urban households or compared the burden across settings. Objective: To estimate the prevalence of household food insecurity and identify its sociodemographic determinants in urban and rural areas of Puducherry, India. Methods: A community-based cross-sectional study was conducted from January 2024 to December 2024 among 227 households (130 rural, 97 urban) selected via multistage cluster sampling. Food security was measured using the Household Food Insecurity Access Scale (HFIAS). Data were collected via structured interviews. Multivariable logistic regression identified sociodemographic determinants, with results expressed as adjusted odds ratios (aORs) with 95% confidence intervals. Results: The overall prevalence of household food insecurity was 40.1%, significantly higher in rural households (51.5%) than in urban households (24.7%). High-school education of the household head was associated with lower odds of food insecurity (aOR=0.23; 95% CI: 0.07-0.79). Conversely, unskilled occupation (aOR=6.22; 95% CI: 1.08-35.70) and rural residence (aOR=3.87; 95% CI: 1.24-12.10) were significantly associated with higher odds of the outcome. Conclusion: Household food insecurity is highly prevalent in Puducherry, showing notable rural-urban disparities. Targeted interventions, including strengthened food assistance, social protection for rural and unskilled-labor households, and educational empowerment, are essential to reduce this public health burden.