We conducted a Northern New England survey in March-June of 2021 to understand the initial and continued impacts of the COVID-19 pandemic on food security, health behaviors, and health outcomes. A total of 988 adults (562 in Maine and 426 in Vermont) responded regarding food access and availability, health behaviors such as diet composition and exercise, and use of habit-forming substances (e.g. alcohol, tobacco, etc.) before and in the year following the onset of the COVID-19 pandemic. Key findings include: 1. 39.1% of Maine and 43.2% of Vermont respondents indicated weight gain since the start of the COVID-19 pandemic. 2. Individuals with food insecurity were significantly less likely to consume fruits and vegetables and engage in physical activity than those who report being food secure. 3. Nearly half of respondents indicated anxiety or depression during the COVID-19 pandemic. 4. Those with persistent food insecurity (i.e. food insecure before and during the COVID-19 pandemic) were 8.8 times more likely to experience higher levels of stress, 2.6 times more likely to experience anxiety and be diagnosed with diabetes type 2 and hypertension during the COVID-19 pandemic. 5. Individuals who identify as LGBTQ+ were more likely to be food insecure, 4 times more likely to report anxiety or depression, and also experienced higher levels of stress than individuals who did not identify as LGBTQ+ during the COVID-19 pandemic. 6. Individuals with food insecurity were up to 7 times more likely to skip or stop their medication for anxiety, depression, and/or hypertension, as compared to food secure respondents. 7. Individuals reporting the use of substances prior to the onset of the pandemic (e.g., tobacco, alcohol, and drugs) were more likely to have increased their use of additional habit-forming substances during the COVID-19 pandemic. Substance use was also associated with a higher prevalence of stress