Prevalence and factors associated with adolescent-reported food insecurity in an urban Spanish setting: a cross-sectional study

Food insecurity (FI) is a multidimensional phenomenon with significant consequences for adolescent health and wellbeing. Much of the existing evidence relies on household-level indicators that may underestimate adolescents’ own experiences. In Spain, systematic data on adolescent FI remain scarce, particularly in settings shaped by distinct socioeconomic and community conditions. This study aimed to estimate the prevalence of adolescent-reported FI in Palma de Mallorca and to examine its association with individual, household, and community factors. A cross-sectional study was conducted between 2022 and 2024 among adolescents aged 10 to 19 attending secondary schools in Palma de Mallorca, Spain. Schools were selected through stratified sampling based on their socioeconomic profile. FI was assessed at adolescent level using the Child Food Insecurity Experiences Scale and at household level using the Food Insecurity Experiences Scale (parent-reported). Perceptions of neighbourhood assets were assessed using the Neighborhood Assets Assessment Scale. Weighted prevalence estimates accounting for the sampling design were calculated. Bivariate analyses, generalized estimating equations, and Cohen’s Kappa coefficient were used. Among 600 adolescents (mean age 14.1 years; 57.5% female), the weighted prevalence of FI was 40.4% (95% CI: 31.1–50.5), with 31.7% experiencing mild FI and 8.7% moderate or severe FI. Agreement between adolescent and parental reports was low (K = 0.232), and 66.7% of adolescents reporting FI lived in households classified as food secure by their parents or guardians. In the adjusted model, being born outside Spain (OR = 3.04; 95% CI: 1.43–6.45) and living in a household with a monthly income below €1,500 (OR = 3.88; 95% CI: 2.08–7.22) were independently associated with higher odds of FI. Higher perceived neighbourhood social support was also independently associated with lower odds of FI (OR = 0.96; 95% CI: 0.92–0.99). FI affects a substantial proportion of adolescents in this urban Spanish setting, with prevalence higher than in previous studies. Economic disadvantage and migrant background were the factors most strongly associated with FI, while perceived neighbourhood social support was associated with lower odds of FI. The marked discrepancy between adolescent and parental reports supports incorporating adolescent self-report alongside household measures in FI research and monitoring. Addressing adolescent FI requires structural responses and sustained institutional commitment.