Determinants of food insecurity in homeless people: evidence from the territory-wide homeless census in Hong Kong

Objective: With the re-emerging homelessness issue in Hong Kong, given its least affordable housing, securing food to meet the basic physiological needs is of priority concern for the homeless. This study aims to examine the situation and determinants of food insecurity among the homeless in Hong Kong. Design: Cross-sectional survey on food insecurity level, sociodemographic characteristics, homeless experiences and health status and behaviours. Setting: 360communityhotspotsofhomelesspeopleidentifiedbyNGOandexperiencedsocialworkers in different districts of Hong Kong in 2021. Participants: 711 individuals experiencing homelessness. Results: The observed prevalence of low, medium and high food insecurity levels was 37.4%, 20.4% and 42.2%, respectively. Results from multivariable ordinal logistic regression showed that older, female, non-Chinese and non-married respondents were inversely associated with food insecurity, whereas having sufficient savings for more proper housing wastheprimarydeterminant amongsocio-economicindicators. In addition to reasons for homelessness, risk factors of food insecurity included living in guesthouses/hotels and difficulties due to government measures on homeless control. Except for disability, both selfrated physical and mental health statuses showed dose–response relationships with food insecurity level. Conclusions: The substantial individual variations in socio-demographic statuses, homeless experiences and health deficits shaped the differential risks of food insecurity within the homeless community in Hong Kong. Targeted homeless programmes should go beyond the conventionally vulnerable groups but consider the multifaceted nature of homeless experiences in relation to food access and integrate health assessments to holistically support the homeless.

©The Author(s), 2025