Food Insecurity Conditions Worsen in the US During COVID-19 Pandemic

Jason M. Nagata, MD, MSc

Increases in food insecurity and mental illness prevalence both might be a byproduct of the coronavirus disease 2019 (COVID-19) pandemic.

A team, led by Jason M. Nagata, MD, MSc, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, estimated the prevalence of food insufficiency, correlates of food insufficiency, and associations between food insufficiency and symptoms of poor mental health in the US during the ongoing pandemic.

In the cross-sectional study, the investigators collected and analyzed the data of 63,674 participants from the US Census Household Pulse Survey. The researchers used multiple Poisson regression models to estimate the associations with food insufficiency.

Food Insufficiency Data

Overall, food insufficiency increased from 8.1% to 10% between March and June. Some of the factors associated with food insufficiency included lower age, African American or Latin race/ethnicity, being unmarried, larger household size, recent employment loss, income below the federal poverty line, and lower education (all P <0.001).

Food insufficiency was independently linked to all symptoms of poor mental health, adjusting for socioeconomic and demographic factors (adjusted RRs ranged from 1.16-1.42, all P <0.001). The link between food insufficiency and poor mental health was also attenuated among individuals who received free groceries or meals.

“Food insufficiency has increased during the COVID-19 pandemic and affects vulnerable populations, placing individuals at higher risk for symptoms of poor mental health,” the authors wrote. “Particularly in the current crisis, clinicians should regularly screen patients for food insufficiency and mental health outcomes as well as provide support in accessing appropriate resources.”

Root Causes of the Problem

The inability to access food is a major global problem, even before the COVID-19 pandemic. Some of the reasons COVID-19 has increased this trend include the social and economic consequences of the pandemic, including stay-at-home orders, changes in consumer demand, school closures, and rising unemployment.

Prior to the pandemic, there was approximately 35 million children in the US receiving free meals at school daily.

Worsening food insecurity could exacerbate worse health outcomes in terms of COVID-19 illnesses and can contribute to weakened host defenses and immunologic decline due to micronutrient deficiencies. Food insecurity is also linked to diets high in low-cost, energy-dense packaged foods, but low in fruits and vegetables.

This type of diet can lead to chronic medical conditions, including diabetes and hypertension, both of which are associated with a higher risk of severe COVID-19 illness.

There are also concerns over the progression of COVID-19 leading to poor mental health conditions, including anxiety and depression. Food insecurity also has the potential to further exacerbate the mental health issues, as it has been linked as an important contributor to poor mental health.

The researchers suggest a better understanding of the factors associated with food insecurity and insufficiency during the pandemic could inform policy and resource allocation for federal pandemic relief legislations being discussed.

The study, “Food Insufficiency and Mental Health in the U.S. During the COVID-19 Pandemic,” was published online in the American Journal of Preventive Medicine.