Food Insecurity Associated with Higher COVID-19 Infection in Households with Older Adults

Choi, Shinae L.; Men, Fei

Objectives As a well-documented social determinant of health, food insecurity may be associated with COVID infection in households with older adults. We examined whether older adults were vulnerable to COVID infection during the early pandemic if they were food insecure versus food secure. Study design Cross-sectional study using a nationally representative population-based survey of US older adults. Methods We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3,212). We compared the odds of reporting COVID infection in a household, COVID infection and mortality among acquaintances, and respondent’s perceived fair or poor health across household food insecurity status resulted from financial or nonfinancial barriers. Baseline health and socioeconomic circumstances were adjusted in the models. Results Results showed higher COVID infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to nonfinancial obstacles was associated with greater likelihood of COVID infection both within respondents’ households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03–2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05–1.65). Food insecurity caused by both nonfinancial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27–3.61). Conclusions Food insecurity driven by nonfinancial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources.