A Multi-Site Analysis of the Prevalence of Food Insecurity in the United States, before and during the COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs. Objective: The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods: A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences. Results: Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys. Conclusions: This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method

Food Insecurity Prevalence Across Diverse Sites During COVID-19: A Year of Comprehensive Data

Key Findings NFACT includes 18 study sites in 15 states as well as a national poll, collectively representing a sample size of more than 26,000 people. Some sites have implemented multiple survey rounds, here we report results from 22 separate surveys conducted during the year since the COVID-19 pandemic began in March 2020. 18 out of 19 surveys in 14 sites with data for before and since the pandemic began found an increase in food insecurity since the start of the COVID-19 pandemic as compared to before the pandemic. In nearly all surveys (18/19) that measured food insecurity both before and during the pandemic, more Black, Indigenous, and People of Color (BIPOC) were classified as food insecure during the pandemic as compared to before it began. Prevalence of food insecurity for BIPOC respondents was higher than the overall population in the majority of surveys (19/20) sampling a general population. In almost all surveys (21/22), the prevalence of food insecurity for households with children was higher than the overall prevalence of food insecurity. Food insecurity prevalence was higher for households experiencing a negative job impact during the pandemic (i.e. job loss, furlough, reduction in hours) in nearly all surveys and study sites (21/22). Food insecurity prevalence in most sites was significantly higher before COVID-19 than estimates from that time period. Reporting a percent change between pre and during COVID-19 prevalence may provide additional information about the rate of change in food insecurity since the start of the pandemic, which absolute prevalence of food insecurity may not capture. Results highlight consistent trends in food insecurity outcomes since the start of the COVID-19 pandemic, across diverse study sites, methodological approaches, and time

Impact of Employment, Essential Work, and Risk Factors on Food Access during the COVID-19 Pandemic in New York State

The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New York residents were recruited to complete a web-based survey through Qualtrics. The survey took place in May and June 2020 and asked participants about COVID-19 health impacts, risk factors, and food access. Chi-square analysis examined issues with food access experienced by demographic characteristics, work disruptions, health impacts, and household risk for contracting the virus and experiencing severe illness, and significant results were analyzed in a series of logistic regression models. After accounting for covariates, Hispanic respondents, those with likely Major Depressive Disorder, and essential workers were more likely to experience worse food access during COVID-19. Improved policies and services to address impacts on vulnerable populations such as BIPOC, those suffering from mental health disorders, and workers in lower-paying essential jobs can reduce the risk of food access issues at this time. Future research can identify how food access issues during the pandemic influenced diet quality, chronic disease risk and infection, and persistence of food access issues

Characteristics of School Districts Offering Free School Meals to All Students Through the Community Eligibility Provision of the National School Lunch Program

The Community Eligibility Provision (CEP) of the National School Lunch Program allows high-poverty schools to provide USDA school meals at no charge to all of their students. USDA reimbursement for meals is simplified by making use of routinely collected administrative data, such as participation in the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) or Temporary Assistance for Needy Families (TANF), rather than collecting school meal applications. Schools and districts with at least 40 percent of enrolled students identified as participating in these assistance programs through the administrative data—also known as the Identified Student Percentage, or ISP—are eligible to participate in the CEP. This report examines the characteristics of school districts that participated in the CEP in school year 2015-16—with participation defined as CEP being implemented in at least one eligible school in the district—using administrative data from USDA’s Food and Nutrition Service, the National Center for Education Statistics, and State education agencies, where available. The highest school-level ISP in the district was found to be significantly associated with CEP participation, holding other factors constant, although the association varied for different sized districts. Participation also varied significantly by region and length of time since CEP became available

Association between Food Worry and Self-Rated Mental Health during the COVID-19 Pandemic

This study aimed to assess the association between food worry and self-rated anxiety and depression during the early phase of COVID-19. We recruited a cross-sectional proportional quota sample of 415 respondents from 15 May through July 2020 in New York State. A validated food access survey instrument was administered to the respondents, capturing demographic information and data on food access issues and self-rated mental health. Multiple logistic regression models were fitted to examine the relationship between food worry, anxiety, and depressive symptoms. Of the respondents included in the study, 43.4% were male, and 55.4% were female. Forty-three percent reported high food worry, and 39.5% and 41.2% reported symptoms suggestive of anxiety and depression, respectively. Respondents with high food worry were more likely than respondents with low or no food worry to experience anxiety symptoms (adjusted odds ratio (aOR) = 4.80; 95% CI: 3.02, 7.62). Likewise, respondents with high food worry had higher odds of reporting depressive symptoms than respondents with low or no food worry (aOR = 3.89; 95% CI: 2.45, 6.18). Identifying the personal and contextual drivers of food worry and mental health outcomes would guide public mental health intervention efforts