Changes in Food Security, Healthfulness, and Access During the Coronavirus Disease 2019 Pandemic: Results From a National United States Survey

Suzannah Gerber; Meghan O'Hearn; Sylara Marie Cruz; Julia Reedy; Dariush Mozaffarian

doi:10.1016/j.cdnut.2023.100060

Changes in Food Security, Healthfulness, and Access During the Coronavirus Disease 2019 Pandemic: Results From a National United States Survey

Curr Dev Nutr. 2023 Mar;7(3):100060. doi: 10.1016/j.cdnut.2023.100060. Epub 2023 Feb 26.

Authors

Suzannah Gerber^{1

2}, Meghan O'Hearn¹, Sylara Marie Cruz¹, Julia Reedy¹, Dariush Mozaffarian^{1

3}

Affiliations

¹ Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
² Betty and Guy Beatty Liver and Obesity Research Center, Inova Medical System, Fairfax, VA, United States.
³ Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.

Abstract

Background: Coronavirus disease 2019 (COVID-19) disrupted access to food and adequate nutrition and the types of foods consumed. However, little empiric data exists on the changes in American's food and nutrition habits 2 y into the pandemic.

Objectives: To assess current and altered food choices ∼2 y into the COVID-19 pandemic in the months after historic public pandemic relief.

Methods: A national sample of 1878 United States adults balanced by age, sex, race/ethnicity, and income completed a one-time, online, semi-quantitative, 44-item questionnaire in Fall 2021 asking about the demographics, COVID-19 food choice changes (including free-text), and consumer priorities. This analysis investigates COVID-19 impacts on food security, healthfulness, and access.

Results: More than 35% of respondents reported improved food security and >45% reported improved food healthfulness compared with prepandemic status. Improvement was reported in more than 30% of Black/African-American and Hispanic/Latinx adults, adults with lower annual income, and female sex, despite over 75% reporting reduced choice of where to eat or buy food. The pandemic offered occasion for many to improve diet, but a similar number expressed that the pandemic destabilized healthy habits.

Conclusions: Our novel findings suggest that by late 2021, most Americans had improved food security and food choice healthfulness, despite reduced access to food service and retail, although with worsening among a meaningful proportion of Americans as well as heterogeneity in these changes. Vigorous federal, state, city, and community responses to the pandemic may have played a role in improving the food security and food choice healthfulness during the COVID-19 pandemic. Health crises differently impact health behaviors, but when accompanied by vigorous civic and community response, food security, and food healthfulness can be fortified.

Keywords: ARP, American Rescue Plan Act; COVID-19, coronavirus disease 2019; ESAP, Elderly Simplified Application Project; FFCRA, Families First Coronavirus Response Act; NLP, Natural Language Processing; QOPS, Qualtrics Online Panel Services; SNAP, Supplemental Nutrition Assistance Program; access; coronavirus disease 2019; eating habits; food choice; food security; health behavior; health disparities; nutrition policy; nutrition security.