food security

Food Insecurity Worsens Amid Increasing Economic Burden Post-COVID

As food and other daily living expenses remain high, a team of researchers led by Jacey Greece and Jacqueline Hicks is shedding light on the factors that affect hunger among people who utilize food pantries. 

The holiday season is synonymous with indulgent treats and festive celebrations centered around food. But for families that are food-insecure, gathering for meals during this season—and year-round—is a daily struggle marked by stress, uncertainty, and often very limited portions of food.

Food insecurity, defined as having limited or unreliable access to adequate food due to a lack of money or other resources, is a persistent public health issue that has worsened in recent years for a multitude of reasons, from skyrocketing costs for other necessities—including housing, transportation, and childcare—to the health and economic repercussions from the COVID-19 pandemic that continue to reverberate disproportionally across society. 

But well before these massive economic disruptions, a team of researchers at the School of Public Health recognized the need to better understand the factors that contribute to moderate and severe hunger among individuals and families. The team examined data among a group that was undoubtedly affected: people who rely on local food pantries, specifically pantries affiliated with the Greater Boston Food Bank (GBFB). Thanks to an SPH idea hub pilot award funded by food service provider Aramark, what began as a student class project on food insecurity with GBFB as a community partner in Jacey Greece’s 2018 strategic interventions and communications class (SB806), has blossomed into a years-long SPH research collaboration with the food bank.

The $20,000 pilot award, granted in 2020 to Greece, clinical professor of community health sciences, and Jacqueline Milton Hicks, clinical associate professor of biostatistics, enabled the professors and a team of GBFB researchers, SPH staff, and students—some of whom are now alums embarking on careers in food access—to dive deeper into the GBFB data that the SB806 group originally collected. They sought greater insight into the characteristics and needs of people who visit food pantries, but are still in need of additional food assistance. Even though the data was collected prior to COVID, these analyses can inform policies and programs that support an expansion of food assistance efforts and other resources to alleviate food insecurity among populations most likely to experience the heaviest economic burdens from the pandemic.

“This collaboration is an incredible opportunity that has allowed us to conduct research directly to inform practice,” says Greece, adding that the dataset the team has compiled on food pantry clients is the largest of its kind in the country. “What our analyses have shown is that levels of severe hunger among people who consistently access food pantries decreases, even if their income is also decreasing, which was the case during the pandemic. So what this tells us is that these services are definitely needed.”

In the last two years, the team has published a series of papers that explore hunger among food pantry clients, including a study in the Journal of Nutritional Science that examines the overall determinants of hunger among this population; a Frontiers in Public Health study on the relationship between adverse economic hardships and hunger levels, and a study in the Journal of Public Health that analyzes hunger in households with children. An additional manuscript that assesses how changes in income affect hunger among this group is currently in the works. 

Quantifying hunger levels among any population, particularly one that is often transient, is an important contribution to the literature on food insecurity. Defined as the individual-level physiological condition that results from the severest form of food insecurity, hunger is a more complex—and therefore, less studied—indicator than food insecurity, a broader term related to food access resulting from various social, economic, and structural causes. 

In Massachusetts, one in three individuals do not have enough food to eat, with Black, Hispanic, and LGBTQ+ residents experiencing the greatest difficulties accessing enough food on a daily basis.

Findings from the team’s studies provide additional insight, based on surveys administered to more than 600 food pantry users at 10 sites in Eastern Massachusetts during the summer of 2018. Measuring hunger levels using the widely validated Household Hunger Scale, the researchers found that:

• Food pantry users who were single, divorced or separated; had less than a high school education; worked part-time, or were unemployed or retired; or who earned incomes less than $1,000 per month, were most likely to experience severe or moderate hunger. 

• More than a third of food pantry users reported that they were moderately or severely hungry, despite using food pantries and federal food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) or Women, Infants, and Children (WIC).

• People who experienced any economic hardship were much more likely to experience severe hunger than moderate hunger.

• Experience with debt, pay reduction, eviction, and death of a family member were significantly associated with moderate and/or severe hunger.

• Food pantry users with three or more children in the household were more likely to experience moderate hunger than households with just one child.

Notably, US food insecurity did not increase during the height of the pandemic in 2020 and 2021 due to swift federal expansion of food assistance programs through Emergency Allotments, which increased SNAP benefits for the more than 41 million Americans that participate in the program and spurred additional local and state-level efforts to meet the sudden and increased need. In some jurisdictions, school meals were provided at no cost to all students, regardless of need. 

But this support began to dissipate in 2022 once states began lifting their emergency declarations, followed by the federal decision to end the national public health emergency that enabled this temporary economic relief. 

“Food insecurity remained at 10.5 percent nationwide during the height of the COVID-19 pandemic between 2019 and 2021 because of comprehensive services offered by both the government and community-based organizations,” says Eva Nelson (SPH’22), a graduate of SPH’s MPH program who is now an impact and capacity analyst at the Community FoodBank of New Jersey. “However, when expanded SNAP benefits were removed in 2022, there was an increase in food insecurity in the US from 12.8 percent in 2022 to 13.5 percent in 2023.”

Similarly in Massachusetts, once these benefits ended and daily expenses continued to increase in 2022, household food insecurity rates reached their highest level of the pandemic. 

“Government benefits have proven to be an effective strategy to address food insecurity, so publishing research that supports this finding is important for public health professionals and policymakers to make decisions that affect the health of the country,” says Nelson, who is an author of each of the team’s published manuscripts. Nelson continues to conduct this research as a maternal and child health research fellow at SPH and currently leads the analysis on hunger and income. 

Ultimately, the data clearly show that when food assistance programs are offered to communities, people utilize them and they are effective in reducing hunger, even though additional support is needed, says Greece. 

“We shouldn’t only offer this support during emergencies or crises,” she says. “We need to sustain and expand programs that provide nutritional and adequate food to individuals and families who demonstrate this need, or we will continue to see food insecurity rates rise across the nation.”

Academic-government-industry partnerships, in particular, can drive research innovation and resulting data that underscore the urgency of addressing hunger, as well as other public health issues. In addition to the faculty pilot grant, Aramark also provided SPH with funding for student practica, as well as an Activist Bucks project, to also examine food insecurity. And Nelson says the four years she has conducted research on food insecurity is what drew her to her current role at New Jersey’s largest food bank earlier this year. 

“We’re in a field where change doesn’t happen without collaboration,” Greece says. “Cross-institutional and cross-disciplinary collaboration—along with passion—will lead to more effective policies, and I’m so appreciative to SPH and to Aramark for this pilot funding. The information we can generate for the field is exceptional and much-needed.”