Family Food Insecurity, Food Acquisition, and Eating Behavior Over 6 Months Into the COVID-19 Pandemic

OBJECTIVES

Describe coronavirus disease 2019 (COVID-19)-related employment and food acquisition changes for food-secure and food-insecure households. Examine associations between food insecurity, parent food acquisition, and child eating.

METHODS

A nationally representative cross-sectional survey with parents (N = 1,000) in Fall 2020. Measures included sociodemographics, food retail regulations, food insecurity, frequency of meals, changes in parent employment, food preparation, and food acquisition because of COVID-19.

RESULTS

Parents that reported recent food insecurity were more likely to report COVID-19-related employment changes (eg, job loss, reduced hours) and food acquisition changes. Food insecurity was modestly associated with more frequent in-person restaurant dining (B = 0.12, t(999) = 4.02, P < 0.001), more frequent restaurant delivery (B = 0.13, t(999) = 4.30, P < 0.001), less frequent homecooked meals (B = -0.14, t(999) = 4.56, P < 0.001) but was not associated with take-out (B = 0.02, t(999) = 0.62, P = 0.54).

CONCLUSIONS AND IMPLICATIONS

Food insecurity was associated with employment changes, parent food acquisition, and children's consumption of homecooked and restaurant meals during COVID-19. Future work could explore resources that help parents acquire affordable, nutritious food.

Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation

Background

Indigenous food systems have been displaced with the emergence of colonization, industrialization, and cultural, economic, political, and environmental changes. This disruption can be seen in marked health and food environment disparities that contribute to high obesity and diabetes mellitus prevalence among Native American peoples.

Methods

A Community-Based Participatory Research (CBPR) approach was used to document food environment experiences among residents of the Flathead Reservation in rural Montana. Participants were identified using purposive sampling techniques to participate in a survey and a semi-structured interview. Descriptive statistics helped to describe participant demographics, food access variables, and household food security status. Food environment perceptions were analyzed using the constant comparison method among trained researchers.

Results

Participants completed surveys (n = 79) and interviews (n = 76). A large number participated in federal nutrition assistance programs. Many self-reported experiencing diet-related chronic diseases. Major themes included the community food environment, dietary norms, and food-health connections. Subthemes were represented by perceptions of food environment transitions and the important role of food in familial life. Further, opportunities and challenges were identified for improving community food environments.

Conclusions

Perceptions of the food environment were linked to strategies that could be targeted to improve dietary quality along a social-ecological model continuum. There is need for skill-based education that directly addresses the time and monetary constraints that were commonly experienced by residents. Coinciding food environment interventions to promote dietary quality that engage community members, store management, and government policy stakeholders are also needed to reestablish healthy Native American food systems and environments within this community.

Addressing food insecurity in the United States: the role of policy, systems changes, and environmental supports

This commentary provides a brief overview of the historical, contemporary, and potential future approaches for using policy, systems changes, and environmental supports (PSE) to address food insecurity in the United States. We reflect on and integrate where possible the findings put forth in the other 16 papers included in the Translational Behavioral Medicine Special Issue entitled: Food Access Among Low-Income Populations: Understanding the Potential Intersect of Diet, Obesity, Food Insecurity, and Hunger.