Food Insecurity During COVID-19: An Acute Crisis With Long-Term Health Implications

As of this writing, more than 177 000 Americans have died of COVID-19, and nearly 6 million cases have been confirmed in the United States. The pandemic has exposed and exacerbated serious disparities along racial/ethnic and socioeconomic lines with low-income Americans and Black and Hispanic Americans being the most likely to get sick and die from COVID-19. But the case counts, infection rates, and deaths are just the tip of the iceberg. The economic downturn caused by the COVID-19 pandemic has already led to devastating consequences for millions of Americans who were struggling to make ends meet and will continue to exert lasting damages disproportionately felt by low-income Americans and communities of color.

As society shut down to curb the spread of the virus, tens of millions of Americans lost their jobs or saw their incomes dramatically reduced, likely increasing poverty rates.¹ As a consequence, Americans struggled to afford food, shelter, and other basic needs, widening existing disparities that will result in long-term health consequences. One immediate consequence of the economic downturn has been apparent since the start of the pandemic. Since mid-March 2020, numerous surveys have documented unprecedented levels of food insecurity that eclipse anything seen in recent decades in the United States, including during the Great Recession. Over the past five years, US Department of Agriculture (USDA) estimates of food insecurity in the United States have hovered around 11% to 12%.²

As of March and April 2020, national estimates of food insecurity more than tripled to 38%.³ In a national survey we fielded in March 2020 among adults with incomes less than 250% of the 2020 federal poverty level (based on thresholds from the US Census), 44% of all households were food insecure including 48% of Black households, 52% of Hispanic households, and 54% of households with children.⁴

Food insecurity is defined as limited or uncertain access to sufficient, nutritious food for an active, healthy life. People experiencing severe food insecurity skip meals or go hungry because they lack sufficient financial resources to purchase food or otherwise lack access to food. The experience of food insecurity is stressful and has been associated with numerous harmful physical and mental health outcomes over the short and long term.⁵ Among children, food insecurity is also associated with adverse behavioral and academic outcomes. The disruptions to daily life generated by COVID-19 have created unique hardships, particularly for low-income Americans and communities of color, who are historically at higher risk for food insecurity, and who are also at disproportionately higher risk for negative health and economic outcomes associated with COVID-19.

In response to this crisis, the emergency food system (i.e., food banks and other charitable organizations that distribute food) have mobilized to respond to a 50% increase in demand.⁶ Local school districts have innovated and mobilized to provide meals to children even while schools have been closed for in-person instruction. The USDA has provided some flexibility and support to do so, though much more is needed.

Since March 2020, Congress and the USDA have taken some temporary steps to strengthen the Supplemental Nutrition Assistance Program (SNAP), which has expanded its caseload to 6.2 million more participants in the past few months. Key provisions of the Families First Coronavirus Act included a suspension of the three-month time limit on low-income adults without children to receive SNAP benefits and the creation of the Pandemic Electronic Benefits Transfer (Pandemic-EBT) program, which enabled households with children who relied on free or reduced-price school meals to access extra monetary benefits while schools were in distance learning (a value of approximately $114 per child per month). The USDA also allowed states to increase SNAP benefits up to the maximum benefit level, an action that increased benefits for approximately 60% of participating households. However, no increases were made to the maximum benefit level itself thereby excluding households with the fewest resources (who have no net income) from this added benefit. Many of these provisions have expired or will expire this summer, and USDA has indicated that it may not continue providing these flexibilities in the fall, which would result in many low-income children and households losing critical SNAP benefits as the COVID-19 pandemic continues to surge.

In addition to short-term boosts to SNAP, the Coronavirus Aid, Relief, and Economic Security Act provided a one-time stimulus payment for up to $1200 per adult and $500 per child, and an extra $600 per week to supplement state unemployment benefits (which expired on July 30). These efforts have mitigated some financial distress brought on by the pandemic, but the economic pain has continued, and extraordinary levels of food insecurity have persisted. In a national Web-based survey we fielded June 23 to July 1, 2020, we found that 43% of low-income adults with incomes less than 250% of the federal poverty level continued to experience food insecurity. Among households in which one member lost a job or income, 59% were food insecure. Among households in which more than one person lost a job or income, 72% were food insecure (Table 1).

TABLE 1—

Food Insecurity in the United States Among Low-Income Households.

	Food Insecure, %
	March 2020 (n = 1478)	June 2020 (n = 1741)
Total	44.4	43.3
Race/ethnicity
Non-Hispanic White	42.5	39.8
Non-Hispanic Black	48.5	47.7
Hispanic	51.6	51.2
Children < 18 y in home
Yes	53.9	57.9
No	40.3	36.9
Employment statusa
Job or income loss (self)	. . .	63.5
Job or income loss (anyone in household)	. . .	59.2
Job or income loss (both self and others in household)	. . .	71.9
Neither self nor others in household lost job or income	. . .	39.3

Note. Both the March and June surveys were fielded by using TurkPrime, a Web-based survey platform for academic research. For both surveys, we used a census-matched panel of US adults (matched on age, sex, and race/ethnicity to the overall population) and limited the sample to adults with household income < 250% of the 2020 federal poverty level (according to the US Census; based on household size and annual household income). The March survey was fielded March 19–24, 2020, and the June survey was fielded June 23–July 1, 2020. Additional details about the survey methodology are available elsewhere.⁴

^aRespondents were asked, “Have you lost your job or lost income due to the COVID-19 outbreak?” Response options included, “Yes, I lost my job and am still not working”; “Yes, I lost my job, but am now working again”; “Yes, I had reduced hours or income at my job”; “Yes, I have been furloughed without pay”; and “No, I have not lost my job or income due to COVID-19.” Respondents with more than one person in their household were also asked whether others in the household experienced job or income loss with the same response categories (in this case they were able to check all that applied).

Clearly, the steps taken to date have not been enough to ensure low-income and out-of-work Americans do not go hungry. As of this writing, as key components of this patchwork of programs are expiring, policymakers are unable to agree on a path forward. For example, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act was passed by the House of Representatives in May, and would provide needed funding and support for food banks and the extended emergency food system as well as additional money to support school lunch programs so that children can get school meals as the pandemic continues. The HEROES Act also increases SNAP benefits for all program participants by 15%. A 15% increase in SNAP benefits during the Great Recession is attributed with helping to improve food security among participants.⁷ SNAP benefits also generate economic activity ($1.70 in spending for every $1.00 in benefits), so they can be a boon for local businesses in a struggling economy. In contrast, the Health, Economic Assistance, Liability Protection, and Schools Act, which was recently introduced by the Senate as the counterpart to the HEROES Act, provides no support for the emergency food system, no increases in SNAP benefits, and no extension of the Pandemic-EBT program.

Robust, sustained, and coordinated federal policies are required. It is essential that the federal government continues to support programs to provide nutrition assistance to low-income children and families including long-term flexibilities to SNAP and other food assistance programs to reduce food insecurity. In addition, strong social safety-net programs that include robust federal unemployment benefits or universal basic income are essential to allow people to weather economic shocks without falling deeper into debt and going hungry. Failure to do so will have a cascading effect further exacerbating food insecurity for low-income households who are only barely able to make ends meet now.

COVID-19 continues to spread across the United States and there is no indication that the end of the economic pain is in sight. The pandemic has caused a never-before-seen food insecurity crisis in this country that shows no sign of abating. Failure to pass, implement, and adequately fund a suite of comprehensive economic and antihunger policies will result in an acute hunger crisis that will exacerbate existing health disparities and lead to long-term health consequences we will be grappling with for years to come. We cannot afford to wait.