Ecological risk and protective factors for food insufficiency in Los Angeles County during the COVID-19 pandemic

Objective:The COVID-19 pandemic increased food insufficiency: a severe form of food insecurity. Drawing on an ecological framework, we aimed to understand factors that contributed to changes in food insufficiency from April to December 2020, in a large urban population hard hit by the pandemic. Design:We conducted internet surveys every 2 weeks in April-December 2020, including a subset of items from the Food Insecurity Experience Scale. Longitudinal analysis identified predictors of food insufficiency, using fixed effects models. Setting:Los Angeles County, which has a diverse population of 10 million residents. Participants:A representative sample of 1535 adults in Los Angeles County who are participants in the Understanding Coronavirus in America tracking survey. Results:Rates of food insufficiency spiked in the first year of the pandemic, especially among participants living in poverty, in middle adulthood and with larger households. Government food assistance from the Supplemental Nutrition Assistance Program was significantly associated with reduced food insufficiency over time, while other forms of assistance such as help from family and friends or stimulus funds were not. Conclusions:The findings highlight that during a crisis, there is value in rapidly monitoring food insufficiency and investing in government food benefits.