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

BackgroundThe 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. ObjectiveOur 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. MethodsA 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. ResultsIn 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. ConclusionsThis 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.

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

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.