Food security and well-being among older, rural Americans before and during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has impacted many aspects of our lives. Older adults, those with less income or fewer resources, and those living in rural parts of the United States are potentially more vulnerable. To understand the negative impact of COVID-19 on perceived food security, physical and mental health, and loneliness in a sample of older, rural, low-income adults in the United States, we use results from a mailed survey in which residents of four Indiana counties contrasted their status during the early period of the pandemic to their typical pre-pandemic status. We test for significant changes in status and what predicts negative impacts to food security, health, and loneliness. We asked respondents to report on both pre-pandemic and since-pandemic experiences in the instrument, which was administered after the pandemic had begun, in May 2020. We measure food security using the U.S. Household Food Security Survey Module (six-item short form; HFSSM), physical and mental health using the Centers for Disease Control’s Healthy Days Measures (HRQOL-4), and loneliness using the UCLA Revised Loneliness Scale. A binomial test identified significant declines in status for all three measures. Logistic regressions identified factors associated with each of the measures worsening. Fear of going to the store or food pantry was associated with all three measures. Decreased store hours and closed food pantries were associated with lower food security. More education, fewer years of age, being female, decreased income, and stockpiling were associated with more reported days of poor physical or mental health. Fewer years of age, lack of transportation, and eating less often with others were associated with perceived increased loneliness. The pandemic had a negative impact on respondents’ food security, unhealthy days, and loneliness, but different factors were associated with each measure for this population. Our findings provide insight for targeted recovery efforts.

Impact of community-driven interventions on dietary and physical activity outcomes among a cohort of adults in a rural Appalachian county in Eastern Kentucky, 2019–2022

“…Research has highlighted how COVID-19 was related to food insufficiency and especially among rural underserved communities. Thus, our results may suggest how COVID-19 and subsequent economic impacts influenced higher rates of food sufficiency and thus the discrepancy in dietary intake patterns (61)(62)(63). Pressing issues like poor housing, inadequate food access, dilapidated water infrastructure, and limited disaster response are compounded even more by the geographic remoteness and mountainous terrain of the region.…”

The Interactions of Food Security, Health, and Loneliness among Rural Older Adults before and after the Onset of COVID-19

“…In addition, we expected stronger interrelations among the outcome variables based on the literature that shows food insecurity is related to chronic disease risk and COVID-19 risk and complications. Furthermore, COVID-19 can further impair physical health leading to more severe food insecurity and isolation [ 4 , 9 ].…”

“…According to Feeding America, “rural communities have been particularly vulnerable during the pandemic because they frequently contain older populations, higher rates of chronic disease, and limited healthcare infrastructure” [ 3 ]. Shutdowns and stay-at-home orders, while important for mitigating the spread of the virus, played a role in increasing food insecurity, isolation, and feelings of loneliness [ 1 , 4 , 5 ]. Congregate meal sites, including many senior centers, were shut down due to the pandemic [ 6 ].…”

“…This took away one of the few, if not the only, opportunities for older adults in rural spaces to socialize and share a reduced-cost meal with others [ 6 , 7 ]. Likewise, the closing of food pantries, food shortages, limited store and pantry hours, and fear of contracting the virus further impacted food security [ 4 , 8 ].…”

The Association between Food Insecurity and Making Hunger-Coping Trade-Offs during the COVID-19 Pandemic: The Role of Sources of Food and Easiness in Food Access

“…As such, food insecurity is both a cause and a symptom of other household challenges, including financial duress, housing insecurity, and increased health care costs. These challenges have especially intensified during the COVID-19 pandemic, as for many families, income streams were diminished, food sources were altered, health care challenges increased, and housing arrangements shifted to accommodate precautions necessitated by the pandemic [ 2 , 3 , 4 ]. To cope with these myriad challenges, individuals often engage in a variety of coping strategies.…”