Finding Solutions: Meeting Essential Needs to Overcome Health and Educational Inequities Among College Students

Abstract

Many economic, academic, and social factors influence college completion, and scholars have documented that a significant cause of students leaving school before graduation is that many do not have their basic needs for food, housing, and health care met. These barriers undermine their academic success by forcing students to reduce the time spent on their studies, work more hours, or stop out of school to support themselves or their families. Unmet essential needs jeopardize academic and life success for students in higher education across the United States and widen racial/ethnic and class inequities in college completion and health. Our review is based on a synthesis and summary of the recent multidisciplinary literature on this topic and our own 15 years of experience planning, implementing, and evaluating essential needs initiatives at two large university systems. This report summarizes evidence on the prevalence and the health- and academic-related consequences of these unmet needs and reviews their proximate and fundamental causes. We assess common approaches that universities, governments, and other institutions use to reduce unmet needs, and suggest policies and programs that can contribute to more equitable educational and health outcomes for college students by meeting their basic needs.

1. Introduction

In the last two decades, a growing number of college students in the United States have faced food insecurity, housing instability, and inadequate access to physical and mental health care. These unmet essential needs jeopardize academic and life success for students and widen racial/ethnic and class inequities in college completion and health. In this conceptual analysis, we summarize evidence on the prevalence and health and academic consequences of these unmet needs and consider their proximate and fundamental causes. We then assess common approaches that universities, governments, and other institutions are using to reduce unmet needs. Finally, we suggest several policies and programs that we believe can contribute to more equitable educational and health outcomes for college students by meeting their food, housing, and health care needs.

Our report is a narrative review based on a synthesis and summary of the recent multidisciplinary literature on this topic and our own experiences planning, implementing, and evaluating essential needs initiatives at two large university systems. Narrative reviews provide a flexible approach to summarizing the diverse research on emerging topics of interest. For the last 15 years, one of us (RC) has supported efforts to tackle food insecurity, homelessness, and other needs at the California State University (CSU), the largest public university system in the United States, with 23 campuses and about 460,000 students. The other co-author (NF) has played a similar role at City University of New York (CUNY), the largest urban public university in the nation, with 240,000 students enrolled on 26 campuses including seven community colleges.

2. The Prevalence and Consequences of Unmet Essential Needs

Each year, about 1 million U.S. students leave college without graduating and in 2024, about 39 million Americans had attended college but not earned a degree (Cohen et al. 2025). Leaving college without a degree deprives students of the lifelong economic, social, and health benefits that a college degree confers, and potentially leaves them with student debt without advancing their professional opportunities. It also reduces the well-being and prosperity of their families and communities. Since rates of non-completion are much higher for low-income, Black, Latiné, or immigrant students in the United States, the failure of higher education institutions to achieve higher graduation rates narrows an important path to social mobility and widens existing racial/ethnic and class inequities in health and education.

Many economic, academic, and social factors influence college completion (Reason and Braxton 2023). In recent years, scholars from higher education, public health, social work, public policy, and other fields have documented that a significant cause of students leaving school before graduation is that many do not have their basic needs for food, housing, and health care met (Leung et al. 2021; Meza et al. 2019; Martinez et al. 2021). These barriers undermine their academic success by forcing students to reduce the time spent on their studies, work more hours, or stop out of school to support themselves or their families.

3. Prevalence and Consequences of Unmet Needs for Food, Housing, Health Care and Mental Health Services

In 2008, the World Health Organization defined the social determinants of health as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources (WHO Commission on Social Determinants of Health 2008). In recent decades, public health researchers have recognized that social determinants of health have a powerful influence on health and other inequities (Donkin et al. 2018). In our perspective, adequate food, housing, health care, and mental health services constitute social determinants of the health of college students, essential prerequisites for current and future well-being and academic success.

Food Insecurity: In 2006, the National Research Council defined food insecurity as a household-level economic and social condition of limited or uncertain access to adequate food and hunger as an individual-level physiological condition that may result from food insecurity (National Research Council 2006). The 1996 World Food Summit defined “food security”, as having “consistent, physical, and economic access to enough safe and nutritious food to live active and healthy lives.”(Rao Bhaskara 1997). By including dietary quality as well as quantity in the definition, food security is considered a social determinant of health, making its achievement a strategy for improving the health of populations.

Recent reviews summarize the findings of surveys of food insecurity among U.S. college students. A scoping review published in 2020 of 51 studies of college students determined that the overall weighted estimate across all studies of 41%. In comparison, the prevalence of food insecurity (FI) in the general population in 2019 was 10.5% (Nikolaus et al. 2020). A 2024 GAO report, based on 2020 data from the U.S. Department of Education’s National Postsecondary Student Aid Study (NPSAS), estimated that 23% of undergraduate students (3.8 million) experienced food insecurity. A majority of these students (2.2 million) had very low food security (United States Government Accountability Office 2024). A study of college food insecurity in high-income countries published in 2025 found that food insecurity was highest in the USA (53.5%, SD 24.9, 139 studies), followed by Canada (48.4%, SD 28.1, 4 studies) and Australia (44.3%, SD 14.3, 8 studies) (McKay et al. 2025). These studies found that, in general, food insecurity was higher among low-income, Black and Latiné, parenting, or Lesbian, Gay, Bisexual, Transsexual, Queer or Questioning, and Intersex (LGBTQI) students.

These and other studies document a range of health and academic problems associated with food insecurity among college students. Compared to food-secure students, FI students experienced higher rates of anxiety, depression, stress, and sleep problems. They also reported higher rates of inadequate nutrition, characterized by lower consumption of fruits and vegetables and higher consumption of food products high in fat, sugar and salt, as well as higher rates of obesity and diet-related diseases such as diabetes Type 2 (Oh et al. 2022; Radtke et al. 2024). Other studies show that compared to peers who are food-secure, FI students have lower GPAs, the most common outcome assessed (McKay et al. 2025), higher rates of self-reported academic problems, and higher rates of stopping out or dropping out of school. One study found that students experiencing food insecurity are about 3.5 times more likely than their food secure peers to consider dropping out of school, and about 3 times more likely to neglect academia in favor of earning a wage to support themselves when compared with students with similar demographic and financial characteristics (Phillips et al. 2018).

Housing: Since the Great Recession of 2008, many low- and middle-income communities across the United States face growing shortages of affordable housing. Nationally, about 22% of full-time students enrolled in U.S. colleges and universities live in college dormitories, with the lowest rates observed in community colleges—where they are close to 0—and large public universities serving lower-income students and the highest rates at private non-profit colleges and universities. As a result, many students, especially low-income, immigrant, Black, and Latiné students struggle to find affordable housing and may face housing instability or homelessness. Housing instability describes a lack of secure, safe, and affordable housing, and includes a continuum of problems from difficulty paying rent, frequent moves, overcrowding, facing eviction, living in poor or dangerous conditions, and, at the extreme end, being without housing, living in a shelter or on the street (Office of Disease Prevention and Health Promotion 2020). Further, given the associated trauma for students who experience prolonged homelessness, these challenges can persist even after students are housed (Hallett et al. 2019).

Several studies document high levels of housing instability and homelessness among various populations of college students. A 2019 systematic review of 17 studies from the United States found that 45% of college students experience some form of housing insecurity, including problems related to housing unaffordability and instability, with 12% reporting homelessness (Broton 2020). In this study, community college students reported higher rates of housing insecurity and homelessness than four-year college students. A 2023 survey of students in California found that 52% of CSU students and 65% of CCC students who receive financial aid experienced housing insecurity (California Student Aid Commission 2023). A 2023 survey of a weighted sample of students at City University of New York found that 50% reported one or more of seven housing problems used to define housing instability; 5.7% reported being homeless at some point in the last 12 months (Sanborn et al. 2024).

Housing instability and homelessness among college students also contribute to health and academic problems. Several studies show associations between housing instability and health problems such as anxiety, depression, stress, and social isolation (Kornbluh et al. 2024; Martinez et al. 2021); interpersonal violence victimization (Johnson et al. 2025); food insecurity and its multiple adverse effects (Broton and Goldrick-Rab 2018; Olfert et al. 2023); and, like other inadequately housed populations, interruptions in access to medical care (Taylor and Munson 2023). Older students, those with children, and LGBTQI students experiencing housing instability were more likely to experience these health problems than their peers with other social characteristics (Kornbluh et al. 2024). Students facing housing instability and especially homelessness often have lower GPAs and are more likely to stop out or take a leave of absence than their stably housed peers (Sanborn et al. 2024).

Health Care Access: The Affordable Care Act of 2010 significantly expanded access to health care for low-income and previously uninsured adults, including young adults (Sommers et al. 2013). However, young adults, including college students, continue to have higher rates of uninsurance than children and older adults (United States Census Bureau 2020). Of the approximately 4000 US. colleges and universities that enrolled about 18 million students in 2023, about 1500 sponsored campus-based college health centers, serving about 10 million college students (Nunez 2024), suggesting that 45% of US. college students lacked such facilities. Schools serving low-income populations and those without dormitories are less likely to operate health centers than the more adequately resourced institutions serving wealthier students.

Young people without health insurance are more likely to go without necessary care, such as not seeing a doctor, failing to fill a prescription, or skipping a recommended test, treatment, or follow-up visit, because of the cost (Nicholson et al. 2009). Another part of health care access is having a regular health care provider—a doctor, other health professional, or clinic that can provide most of the care a person needs. A study of uninsured young adults found that only one-third of uninsured young adults had a regular doctor, compared with 81% of those with insurance for the entire year. Having a regular doctor improves continuity of care, use of preventive services, and receiving early care for emerging conditions (White and Cooley 2018).

For college students with chronic conditions, such as asthma, diabetes, or long COVID, mental health problems, or acute illnesses, lack of medical care can lead to absences, hospitalizations, or debts that lead students to drop out of school (Michaels 2024).

Mental Health Services: The adverse impact of college students’ unmet needs regarding mental health services on overall well-being and academic success has been well documented. Students experiencing depression, anxiety, and traumatic stress also report higher rates of academic problems. An analysis of trends in prevalence from the Healthy Minds Study, a survey of 359,777 students from 373 United States campuses from 2013 to 2021, found that among all students, symptoms of depression increased by 134.6%, anxiety increased by 109.5%, suicidal ideation increased by 64.0%, and reports of any mental health problems increased by 49.7% (from 8.2% to 13.5%) (Lipson et al. 2022). While the COVID-19 pandemic beginning in 2020 exacerbated these increases, the rise in prevalence preceded the pandemic.

Students with mental health conditions such as depression, anxiety, or traumatic stress report higher rates of co-morbidities than their unaffected peers. In the Healthy Minds study, 60% of the 2021 respondents reported positive screenings in tests for more than one mental health condition (Lipson et al. 2022). Researchers have reported reciprocal relationships among mental health conditions and inflammatory, immunological, and substance use disorders (Prince et al. 2007). Like other populations, students with mental health conditions also report higher rates of food insecurity and housing instability than their non-affected peers (Broton et al. 2022; Oh et al. 2022).

Not surprisingly, mental health conditions also affect academic achievement. Students with one or more mental health diagnoses report higher stop-out rates, longer times to complete their degrees, and poorer academic habits and self-efficacy than their non-affected peers (Jeffries and Salzer 2022; Marmolejo et al. 2024). A study on state-level mental health parity laws regarding the academic success of college students found that the passage of a state-level full parity mental illness law increased academic performance among college students (Solomon and Dasgupta 2022). Parity laws ensure that states provide individuals with mental health conditions with equal coverage and treatment to those with physical health conditions.

Other Unmet Needs: The focus of this report is on four specific needs—food security, housing stability, and access to health care and mental health services—that affect both overall well-being and academic achievement and remain unmet for significant proportions of U.S. college students. These four core essential needs of course intersect with the need for financial security, childcare, access to transportation, and protection from discrimination and stigma, to name just a few. These other needs have been examined elsewhere (Goldrick-Rab 2016; Gansemer-Topf and Schuh 2024; Manze et al. 2023; Elengold 2022; Stevens et al. 2018), and future research should further elucidate the connections among these various needs.

A few researchers have studied the intersecting impact of multiple unmet needs, generally concluding that two or more unmet needs have a cumulative and synergistic impact (Leung et al. 2021; Becerra et al. 2023). A study at CUNY found that each increase in the number of unmet needs increased the odds of having an academic problem (i.e., low GPA, dropout, or leave of absence) by 29% (p < 0.01). Students with two unmet needs had 43% greater odds (p < 0.01), students with three unmet needs had 57% greater odds (p < 0.01), and students with four unmet needs had 82% greater odds (p < 0.01) of having any academic problem, compared to those without unmet needs (Sanborn et al. 2024). These findings highlight the importance of comprehensive multisectoral, rather than siloed, approaches to reducing unmet needs.

4. Causes of High Rates of Unmet Essential Needs Among College Students

The evidence summarized above shows that many college students have unmet needs for food, housing, and health care and mental health services. It also shows that these unmet needs are associated with a variety of health and academic problems that affect the current and future well-being and academic and life success of college students. What are the underlying causes of this high and often increasing level of unmet needs? A deeper understanding of these causes can help colleges and universities—and elected officials—advocate for policies and design institutional practices that better meet the needs of their students, thus contributing to improved health and academic achievement, and reductions in health and educational inequities. We describe seven inter-related underlying causes.

4.1. More Low-Income and Other Previously Excluded Groups of Students Are Now Attending College

Between 1970 and 2010, college enrollment in the United States increased from 8.6 million to a peak of 21 million in 2010, then declined slightly (Hanson 2025). Between 1970 and 2022, the bachelor’s degree attainment rate of families in the lowest two quartiles of household income more than doubled (from 17% to 40%) while the proportion in the highest-income quartile increased by less than 1.5 times (Cahalan et al. 2022). As a result of this change, the proportion of low-income students on college campuses increased after 1970, and especially from 2000 to 2020, especially at public institutions and community colleges. Similarly, between 1976 and 2022, the proportion of enrolled students of color increased from 15.4% to 45.2%, an absolute increase of almost 30%. Latiné student enrollment increased by 483% while Black enrollment increased by 125% (Hanson 2025).

These changes have made what conventional wisdom called “non-traditional students”—those who are older, parents, the first generation in college, or Black or Latiné—the majority of U.S. college students (Dunn 2025), while traditional students—white, middle- or upper-class students, and 18- to 24-year-olds whose parents also went to college—constitute a smaller proportion of college enrollment. Few campuses have the resources, mission, or infrastructure to meet the needs of the new majority.

It is important to recognize that this constitutes a success of public policy—ensuring greater access to higher education for low-income students. However, unless those admitted to college receive the support they need to complete their degrees, the full potential social impact of this earlier success will not be achieved.

4.2. College Is More Expensive Now, Leaving Students with Fewer Resources for Essential Needs

Between 1970 and 2023, the average inflation-adjusted (to USD 2023) cost of colleges increased from:

• USD 12,391 to USD 35,248 for private four-year institutions (an 84% increase).
• USD 2843 to USD 9750 for public four-year institutions (a 243% increase) (Tucker et al. 2025).
• From USD 1771 to USD 4050 at public two-year institutions, a 129% increase (Mitchell et al. 2019).

Living expenses—such as rent, food, transportation, books, and supplies—also rose rapidly, putting further pressure on students’ family or household budgets (Goldrick-Rab 2016).

As students at all types of colleges paid more for tuition and fees, and as the proportion of students enrolled in college coming from lower-income households increased, it is hardly surprising that more students had trouble finding the resources for food, housing, health care, and their college education. Public and private scholarships and tuition assistance have helped some students but failed to meet many students’ needs. Moreover, especially in the last few years, the cost of food, housing, and health care increased, forcing students and their families to either divert resources from educational expenses to meeting essential needs or choose to leave some of these needs unmet, depriving students and their household of the resources they need to thrive.

4.3. Colleges Have Embraced Market Perspectives, Looking to Increase Revenues and Lower Costs While Public Spending on Higher Education and Tuition Assistance Has Fallen

Even as tuition costs were increasing at public and private institutions, overall state funding for public two- and four-year colleges was falling. By 2018, state funding for public universities was more than USD 6.6 billion below what it was in 2008, just before the Great Recession fully took hold, after adjusting for inflation (Mitchell et al. 2019). Between 1988 and 2018, the percentage of tuition paid for by students more than doubled, from 22% to 46%.

As the proportion of students from low-income households increased, the purchasing power of the Pell Grant, the main federal subsidy for low-income undergraduate students, declined. When the program started in 1974, Pell Grants covered more than 118% of the cost of attending the average 4-year public university. By 2013, Pell Grants covered less than one third of the costs. The original Pell Grant covered 90% of all costs of the typical community college; by 2013, it covered only 35% (Goldrick-Rab 2016). Overall, the growth of federal Pell funding has not kept pace with the rise in the number of recipients, and out-of-pocket college costs have risen dramatically. The barriers to student financial aid incorporated in policies approved by Congress and President Trump in 2025 further deepen existing threats, particularly for those who seek advanced degrees, and may exacerbate student debt by driving students to private loans.

Changes in the patterns and wages of employment have also made it harder to pay for college by working. The value of the minimum wage has declined substantially, and college students compete in labor markets where people are often underemployed and wages are low. Coupled with rising college prices, students must work nearly full-time to afford full-time community college (Goldrick-Rab 2016).

Between 1975 and 2005, American higher educational institutions’ total spending in constant dollars tripled, to more than USD 325 billion per year. During this period, the faculty-to-student ratio remained constant, about fifteen or sixteen students per instructor. The administrator-per-student ratio, however, increased dramatically in those 30 years. Colleges increased staffing from 1 administrator per 84 students to 1 per 68 students and professional staffers increased from 1 per 50 students to 1 per 21 students (Hanson 2024). This shift in funding from educational to administrative costs reflected, in part, the increased emphasis universities placed on responding to market forces such as competition, the recruitment of faculty and students, and the corporatization of higher education (Bryant 2025; Ginsberg 2011).

Between 1975 and 2005, the number of administrators and managers increased by 66% at public institutions and by 135% at private colleges. From 1993 to 2009, administrative positions at colleges and universities grew by 60%, a rate 10 times higher than that of tenured faculty positions. Between 1963 and 2022, the inflation-adjusted cost of room and board nearly doubled, increasing by 81% (Lieberwitz 2022).

These cost trends affect all college students but hit the new majority of new non-traditional, working class, Black, and Latiné students hardest, forcing them to make daily choices between pursuing and focusing on their education and ensuring that they and their families have the resources needed for food, housing, and health care.

4.4. Many Students Are Ineligible for or Have Difficulty Enrolling in Public Benefit Programs Such as SNAP and Medicaid

The Supplemental Food Assistance Program (SNAP, also known as Food Stamps) is a federal program that provides food benefits to low-income families to supplement their grocery budget so they can afford the nutritious food essential to health and well-being. SNAP provides recipients with electronic or paper benefits they can redeem for produce and other food products in participating grocery stores. A 2024 report by the Government Accountability Office estimated that 3.3 million college students met the eligibility requirements for SNAP at that time, but that 67% of those students did not receive food assistance in 2020, the most recent data available (United States Government Accountability Office 2024). Complex and changing eligibility and enrollment requirements, understaffing in government and campus enrollment services, and limited and ineffective educational campaigns contribute to the low enrollment rates (Freudenberg et al. 2019).

Medicaid, the government health insurance program that pays for health care for low-income individuals and households, also plays a key role in supporting low-income college students. An estimated 3.5 million college students were covered by Medicaid in 2023 (Granville 2025). The Affordable Care Act led to more college students enrolling in Medicaid: the program covers 18.9% of college students in states that expanded Medicaid, compared to just 10.7% in those that did not. Medicaid thus plays a significant role in providing health coverage for students.

An estimated 1.6 million college students lack health insurance and although accurate data are lacking, it is presumed that many of these students are eligible for Medicaid. As with SNAP, complex and changing eligibility and enrollment rules, inadequate staffing of government agencies that enroll people, and the very limited number of college campuses that have the capacity to enroll students in Medicaid leave potentially eligible students unenrolled.

The significant cuts in federal funding approved by Congress and President Trump in 2025 pose additional threats to student enrollment in SNAP and Medicaid, the two public benefits programs that provide the most support to college students with unmet essential needs. One analyst estimates that 3 in 10 young adults could lose health care coverage and up to 3 million young adults could have reduced access to healthy food during their transition into adulthood as a result of the changes in Medicaid and SNAP funding and regulations imposed by the 2025 budget agreement (Coffey and Hahn 2025a, 2025b).

4.5. The United States Faces an Affordable Housing Crisis That Makes It Difficult for College Students to Find Safe, Adequate, Affordable Housing

Like so many other low- and middle-income Americans, college students experience the nation’s crisis in affordable housing (Marcuse and Madden 2024). A 2024 survey by the Hope Center of 74,350 college students from 91 campuses found that 48% reported housing insecurity and 14% homelessness within the past year (The Hope Center for Student Basic Needs at Temple University 2025). Only about 18% of undergraduates lived in on-campus housing as of 2020, a trend that has largely held steady for decades (Kelchen 2018). As more students and more students from lower-income families attend college, they are forced to confront the shrinking supply of affordable housing in their communities.

4.6. The American Credo of Individual Responsibility Leads Many Policy Makers and Universities to Believe That Students and Their Families Should Be Responsible for Meeting Their Essential Needs

Ideological forces, as well as economic drivers, have contributed to the rise in college students with unmet essential needs. The American credo of individual responsibility (Geronimus and Thompson 2004) and the “deserving” and “undeserving” poor (Katz 2013) have led some politicians to argue that college students do not deserve public benefits or help in receiving the food, housing, or health care they need to complete their education. As early as 1980, in response to complaints that college students from middle-income and wealthy families were qualifying for food stamps when establishing households independent from their parents, the New York Times stated that “that food stamps were fueling the iconoclastic culture and radical politics of the nation’s youth,” and Congress declared that full-time students, which it defined as students attending classes at least half of the time, were ineligible for food stamps unless they were working 20 h a week or more or qualified for one of several possible other exemptions. Four fifths of the 250,000 students then in the program lost their benefits (Roberts 1981).

4.7. COVID Pandemic Exacerbated Drivers of Inequitable Outcomes

Finally, the COVID pandemic beginning in 2020 intensified many of these other drivers of inequitable health and educational outcomes. It forced many colleges to switch to remote learning, increased students’ food insecurity and housing instability, reduced family incomes due to loss of employment, and increased social isolation.

A variety of studies show that the pandemic led to increases in the prevalence of mental health conditions such as anxiety, depression, loneliness, stress, and suicidal ideation (Elharake et al. 2023); made it more difficult for students to find needed mental health services (Kring et al. 2025); and exacerbated social stressors such as family conflict, unsafe home environments, financial insecurity, discrimination, and limited access to culturally competent care (Pandya and Lodha 2022). These changes had a disproportionate impact on Blacks and Latinés, LGBTQI students, recent immigrants, and students with children (Sakaretsanou et al. 2025).

The pandemic also led to declining enrollment (and therefore tuition revenue), faculty dissatisfaction with remote learning, and disruption of campus environments (Ammigan et al. 2022), each of which had the potential to undermine the academic success of students.

In sum, given the cascade of social and political challenges to the well-being of young adults and college students that has unfolded over the last 50 years, it is hardly surprising that a significant proportion lack the resources to meet their needs for food, housing, and health care.

5. The Societal Value of Meeting Essential Needs

Why should the growing prevalence of unmet essential needs among college students trouble the higher education community, advocates and social movements seeking a more equitable society, and the broader American public? We describe three key rationales for making reversing this increase a public policy priority.

First, the high level of unmet needs risks halting the trend of the last 50 years of more students from the half of the U.S. population with lower income and less wealth enrolling and graduating, an increase that continues to be one of the triumphs of United States social policy in the late 20th century. This would shut down one of the most practical and realistic short-term strategies for promoting social mobility and disrupting the increasing concentration of income and wealth (Reneau and Villarreal 2021; Complete College America 2022; Cohen and Syme 2013).

Second, U.S. higher education institutions at present face numerous threats to their future: the attacks on academic freedom, reductions in research funding, rising costs of a college education, reductions in existing poverty mitigation for low-income students like Pell and SNAP, and isolation and seeming irrelevance of many working-class Americans (Rippberger et al. 2025; American Association of University Professors 2024). If colleges lose their ability to assist students from the lower half of the income spectrum in attending and graduating from college, higher education risks losing additional public and policy maker support, making it more vulnerable to political attacks.

Third, at the population level, higher college graduation rates can contribute to improved public health: those with college degrees live longer, have fewer hospitalizations and illnesses, participate more actively in society, are happier, earn more, and pay more taxes (Cohen and Syme 2013). However, universities can only play this role if they enroll and ensure the graduation of the populations who experience the highest levels of health and social problems. By excluding, reducing or forcing out the portion of students from the lower end of the economic spectrum, universities lose their capacity to contribute to improving public health and reducing health inequities.

In summary, reversing the increasing difficulty that middle- and working-class college students face in finding the food, housing, and health care they need to stay in school, earn their degrees, and participate more fully in society can play a key role in overcoming the most serious threats facing our country. Ensuring that higher education continues to provide a path to social mobility can help to counteract rising income inequality, attacks on democracy, the dismantling of safety net programs, and the reinforcement of racist and sexist policies and practices. Meeting essential needs is only one of many strategies needed to overcome these problems but, in some ways, it is a simple solution that has potential to gather popular support.

What can those working in higher education do to move our institutions from abandoning efforts to promote educational and health equity to embracing this goal? We propose five steps.

6. Policy, Practice, and Research Recommendations

First, those seeking to strengthen higher education’s role in reducing inequity should encourage faculty unions, student organizations, college leaders, and higher education associations to make meeting essential needs a priority and take actions to make this shift a reality. This can include supporting changes in university and public policy and budgets to more fully support essential needs programs and policies, leading and joining campaigns to counteract misinformation and disinformation about the status of college students, and adding actions to meet students’ essential needs to faculty and staff collective bargaining negotiations. Moving towards a place where higher education speaks in a more unified voice about the needs of our students offers an alternative to the rightwing messages of austerity, victim-blaming, and individual responsibility.

Next, advocates of more robust essential needs responses can educate public officials about the connections between meeting basic needs, academic success, social mobility, and shared prosperity. More college degrees are not the sole solution to the economic problems facing the nation. However, every year, one million students leave college before graduating and many more qualified students choose not to enroll in college because they cannot both attend college and support their own and their families’ needs for food, housing, and health care. Leading effective communications campaigns that bring these messages to local, state, and national policy makers can set the stage for meaningful reforms. Such changes will enable more students to escape from poverty, find meaningful employment, and contribute more to their families and communities.

Operationally, institutions of higher education must create policies and programs that move towards the elimination of hunger and food insecurity amongst college students. Colleges across the country have developed food pantries, short-term/emergency grant options, Supplemental Nutrition Assistance Program (SNAP) enrollment campaigns, case management and wrap-around services, and healthy food initiatives to address insecurity regarding basic needs. In California, for example, College Focused Rapid Rehousing is providing case management and subsidized housing for students who experience homelessness. A robust and growing body of literature shows that some of these programs have improved campus food and housing and health care options and contributed to the stability, retention, and well-being of college students (Hallett et al. 2019; Sommers et al. 2013; Goldrick-Rab et al. 2021; Nazmi et al. 2023; Riggs and Hodara 2024; Kramer et al. 2025).

Further, no single constituency currently has the power to force the comprehensive changes in policy, budgeting, and institutional practices that would transform current approaches to meeting the essential needs of students. By strengthening existing alliances and creating new coalitions among higher education, health care, and social service organizations and youth, immigrants’ rights, women’s rights, civil rights, and labor movements, proponents of transformative changes can begin to forge a shared agenda and plan for action. Such an agenda would specify the changes needed at the local, state, and national levels to better enable students and their families to meet their essential needs. Supporting policy and budgeting changes will enable college students and other communities that struggle to meet their essential needs to create determined and powerful coalitions.

Finally, essential needs alliances can identify, document, evaluate, and promote best practices for meeting essential needs and so provide the evidence needed to expand from local and regional solutions to national programs as political circumstances permit. Faculty and researchers are uniquely qualified to provide the research, communications campaigns, and theoretical frameworks that can guide this effort. Well-designed and disseminated evaluation studies can document obstacles and identify promising strategies for success.

Higher education in the United States has always been a battleground between those seeking to use universities to promote privilege and the welfare of elites and those wanting to make higher education institutions incubators of equity, democracy, and social justice. In this decade, one of the frontlines in these recurrent battles is the fight for colleges to meet their students’ food, housing, and health care needs. The current challenges to public benefits, the rights of immigrants, the role of universities in our society, and the nation’s commitment to universal access to health care and food create the opportunity and reveal the necessity of developing new approaches to meet these needs.