Home food procurement associated with improved food security during the COVID-19 pandemic (preprint)

Home food procurement (HFP), including gardening, is associated with food security and improved health behaviors and outcomes. In the beginning of the COVID-19 pandemic, HFP increased in many high-income countries; yet little evidence has demonstrated what impact HFP had on food security. Furthermore, existing HFP studies are largely qualitative from unrepresentative samples, limiting population-level understanding of HFP engagement and impact. Using data from a representative sample of residents (n=988) in northern New England in the United States conducted in Spring/Summer 2021, we explore the relationship between HFP engagement in the first year of the pandemic and changes in food security status. We employ matching techniques to compare food security outcomes in households with observably similar demographic and social characteristics, and examine food security outcomes in three periods among households who do and do not participate in HFP. Our results show that nearly 60% of respondents engaged in at least one kind of HFP in the first year of the COVID-19 pandemic, with food insecure households being more likely to do HFP. Food insecure households (both newly and chronically food insecure) were also more likely to do HFP activities for the first time or more intensely than they had previously. Newly food insecure households were the most likely to engage in HFP overall, especially gardening. Furthermore, HFP engagement early in the COVID-19 pandemic is associated with improved food security for food insecure households in the 9-12 months after the start of the pandemic, though these improvements were primarily associated with newly, not chronically, food insecure households. Future research about HFP should continue to explore multiple HFP strategies and their potentially myriad relationships to food security, diet, and health outcomes.

Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: A mixed methods study in Vermont (preprint)

Background Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated public health outcomes.Methods Using data from a representative statewide survey administered in Vermont (n = 600) during the early months of the COVID-19 pandemic, we examine participant experiences with the 3 major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explore quantitative and qualitative responses regarding perceptions of program utility, and use nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.Results One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we find higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < .001), an association that persists even when we compare similar households using matching techniques (p ≤ .001). From matched analyses, we find that, compared to low-income non-participants, low-income program participants are less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants are less likely to meet vegetable intake recommendations (p = 0.035). We also find lower rates of perceived stress among low-income school meal participant households compared to low-income nonparticipants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.Conclusions We find that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

Food Security Impacts of the COVID-19 Pandemic: Following a Cohort of Vermonters During the First Year (preprint)

ObjectiveThis study assessed changes in household food insecurity throughout the first year of the COVID-19 pandemic in a cohort of Vermonters and examined the socio-demographic characteristics associated with increased odds of experiencing food insecurity during the pandemic. DesignWe conducted three online surveys with a cohort of Vermonters between March 2020 and March 2021 to collect longitudinal data on food security, food access, and job disruptions during the COVID-19 pandemic. Food security was measured using the USDA six-item module. We used t-tests and chi-square tests to determine statistically significant differences between groups and multivariate logistic regression models to determine the factors correlated with food insecurity. Participants441 adults (18 years and older) SettingVermont, United States ResultsFood insecurity rates increased significantly during the pandemic and remained above pre-pandemic levels a year after the start of the pandemic. Nearly a third (31.6%) of respondents experienced food insecurity at some point during the first year of the pandemic. Certain demographic groups were at significantly higher odds of experiencing food insecurity during the first year of the COVID-19 pandemic including households with children (OR 5.1, p < 0.01), women (OR 7.3, p < 0.05), BIPOC/Hispanic respondents (OR 10.4, p < 0.05), and households experiencing a job disruption (OR 4.6, p <0.01). ConclusionThe prevalence of food insecurity increased during the first year of the COVID-19 pandemic and remained higher than pre-pandemic levels a year after the pandemic began. Odds of experiencing food insecurity during the pandemic vary based on socio-demographic factors.

A Multi-Site Analysis of the Prevalence of Food Security in the United States, before and during the COVID-19 Pandemic (preprint)

Background. The 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. Our team- the National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. Here we present 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 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 six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results. In total, more than 27,000 people responded to the surveys. We find higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, we find higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. We also demonstrate lingering food insecurity, with high or increased prevalence over time in sites with repeat surveys. We find no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions. This comprehensive multi-study site effort demonstrates higher prevalence of food insecurity since the beginning of the COVID-19 pandemic, which in multiple survey sites continues throughout the first year of the pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations.

The Charitable Feeding System helps Food Insecure Participants maintain Fruit and Vegetable intake during COVID-19. (preprint)

Charitable food services, including food banks and pantries, support individual and households food access, potentially maintaining food security and diet quality during emergencies. During the COVID-19 pandemic, the use of food banks and pantries has increased in the US. Here we examine perceptions of the charitable food system and its relationship to food security and dietary quality, specifically fruit and vegetable (FV) intake during the first six months of the COVID-19 pandemic, using a statewide representative survey (n=600) of residents of Vermont. We find that demand for charitable food services increased by 68%. The utilization of food pantries was more common among food insecure households and households with children. Among food insecure respondents, those who used the charitable food system were less likely to reduce their FV intake during the pandemic than those who did not use the charitable food system. Further, we find significant interactions between food pantry use and food insecure households, suggesting that, for food, insecure households, utilizing a food pantry since the onset of the COVID-19 pandemic was associated with higher fruit consumption. These results indicate that these services may support food access and diet quality for at-risk populations during emergencies.

Home Food Procurement Impacts Food Security and Diet Quality during COVID-19 (preprint)

BackgroundHome food procurement (HFP) (i.e. gardening, fishing, foraging, hunting, backyard livestock and canning) have historically been important ways that people obtain food. Recently, some HFP activities have grown (e.g. gardening), while other activities (e.g. hunting) have become less common in the United States. Anecdotally, COVID-19 has sparked an increase in HFP evidenced by increased hunting licenses and shortages in seeds and canning supplies. HFP may have positive benefits for food security and diet quality, though research beyond gardening is especially limited in high-income countries. MethodsWe examine HFP activities before and since the COVID-19 pandemic, and their relationship to food security and dietary quality using multivariable logit models and matching analysis with a statewide representative survey (n=600) of residents of Vermont, United States. ResultsWe find 29% of respondent households classified as food insecure since COVID-19, and more prevalence among those experiencing a negative job change since COVID-19, households earning less than $50,000 annually, Hispanic and multi-race respondents. Forty-two percent of respondents engaged in HFP activities; the majority of those gardened, and more than half pursued HFP activities more intensely than before the pandemic. HFP was more common among food insecure households, who were more likely to fish, forage, hunt and have backyard livestock. Respondents who were food insecure, Black, Indigenous, People of Color and/or Hispanic, those with a negative job disruption, and larger households all had greater odds of increased intensity of HFP since COVID-19. HFP were significantly associated with eating greater amounts of fruits and vegetables, especially if gardening and canning, while respondents hunting or having backyard livestock were significantly more likely to have higher red meat intake. ConclusionOverall, these results suggest that HFP activities have increased since the start of the COVID-19 pandemic, and may be an important safety net for food insecure households, and provide diet quality impacts. Long-term, HFP activities may have important food security and diet quality impacts, as well as conservation implications, which should be more thoroughly explored. Regardless, the increased interest and intensity of HFP demonstrates multiple opportunities for educational and outreach efforts.

Food insecurity during COVID-19: A multi-state research collaborative (preprint)

The COVID-19 pandemic has had profound impacts on the global food system, supply chain, and employment, which, in turn, has created numerous challenges to food access and food security. Early exploratory studies suggest significant increases in food insecurity in the United States. Comprehensive longitudinal research across multiple locations is needed to understand the range of impacts and responses at the household level and to improve preparedness for future events. This protocol paper outlines the formation of the National Food Access and COVID research Team (NFACT), a collaborative, interdisciplinary, multi-state research effort that will utilize common measurement tools, codebooks, code, data aggregation tools, and outreach materials to collectively examine and communicate the effect of COVID-19 on household food access and security. NFACT is led by an executive committee of researchers from four institutions, with additional NFACT collaborating institutions across more than a dozen states. A survey was developed by the NFACT executive team in March 2020, with additional refinements in May 2020, using both existing validated questions and new original questions, which were piloted and validated in Vermont. The project provides suggestive guidance for recruitment, and is designed to allow each study site to adopt recruitment strategies that meet their budget and needs. Primary outcomes of interest include food security status, employment status, food access challenges and concerns, dietary intake, and use of food assistance programs. Additional outcomes assess emotional eating, stigma, COVID-19 perceptions and experiences, and pro-environmental purchasing behaviors. This protocol and the establishment of NFACT provide important advancements in COVID-19 and food security research by generating harmonized data and assessing comparable outcomes across geographies and time. The collaborative, open-source approach makes research tools available to teams who might not have the resources to design their own tools, and can enable streamlined data collection, large-scale comparative analyses, and cost savings through reduced administrative tasks. The project has contributed to building new networks between and within states. Enabling facilitation and implementation of instruments in study sites has provided flexibility and meaningful opportunity for local stakeholder engagement and relevant outreach for informed public health decision-making.

The Early Food Insecurity Impacts of COVID-19 (preprint)

Background COVID-19 has disrupted food access and impacted food insecurity, which is associated with numerous adverse individual and public health outcomes. Methods We conducted a statewide population-level survey in Vermont from March 29-April 12, 2020, during the beginning of a statewide stay-at-home order. We utilized the USDA six-item validated food security module to measure food insecurity before COVID-19 and since COVID-19. We assessed food insecurity prevalence and reported food access challenges, coping strategies, and perceived helpful interventions among food secure, consistently food insecure (pre-and post COVID-19), and newly food insecure (post COVID-19) respondents. Results Among 3,219 respondents, there was a 33% increase in household food insecurity since COVID-19 (p<0.001), with 35.6% of food insecure households classified as newly food insecure. Respondents experiencing a job loss were more likely to experience food insecurity (OR 3.43; 95% CI, 2.45-4.80). Multiple physical and economic barriers, as well as concerns related to food access during COVID-19, are reported, with respondents experiencing household food insecurity more likely to face access challenges (p<0.001). Significant differences in coping strategies were documented between respondents in newly food insecure vs. consistently insecure households. Conclusions Since the declaration of the COVID-19 pandemic, there has been a significant increase in food insecurity in Vermont, accompanied by major food access barriers. These findings have important potential impacts on individual health, including mental health and malnutrition, as well as on future healthcare costs. We suggest proactive strategies to address food insecurity during this crisis.