Regional Hotspots of Food Insufficiency During COVID-19: Evidence From the Household Pulse Survey

OBJECTIVES: To examine regional differences in food insufficiency among households with children between Deep South states and the rest of the United States during the second year of the COVID-19 pandemic. METHODS: The U.S. Census Bureau's Household Pulse Survey is a massive, online, and rapid interagency effort to provide data on the social consequences of COVID-19. Here, data on food insufficiency among households with children, reported by household respondents (N = 232,016), were taken from phases 3.1 (4/15–7/5/2021) and 3.2 (7/21–10/11/2021). The main predictor was living in a Deep South state (Alabama, Georgia, Louisiana, Mississippi, South Carolina). Logistic regression models were run separately for each phase, adjusting for age, gender, race/ethnicity, marital status, household head educational attainment, number of children in the household, and household income-to-poverty ratio. Differences in these variables between the regions were also assessed. Survey weights included with Pulse were used in all analyses. RESULTS: The overall prevalence of food insufficiency among households with children was 12.2% in phase 3.1, with a higher prevalence in Deep South states (16.4%) compared to non-Deep South states (11.8%; p < .0001). Food insufficiency prevalence decreased in phase 3.2 to 10.3% for all households, but regional differences remained (Deep South = 13.9%, non-Deep South = 9.9%). Crude analysis showed that households with children in Deep South states had 46% and 63% higher odds of food insufficiency than non-Deep South states in phases 3.1 and 3.2, respectively. Factors associated with food insufficiency, including lower income and lower educational status, were more common in the Deep South, but after adjusting for these and other covariates, the odds of food insufficiency in Deep South states were still significantly greater (phase 3.1: OR = 1.19, 95%CI = 1.04–1.37; phase 3.2: OR = 1.30, 95%CI = 1.13–1.51). CONCLUSIONS: Regional inequities in food insufficiency among households with children were present in the second year of the COVID-19 pandemic, with Deep South states suffering from higher rates. Factors associated with this problem were worse in the Deep South, but they did not fully explain differences between regions. Future studies should investigate the reasons for these inequities. FUNDING SOURCES: Health Research Services Administration, DHHS.