Graduation Year
2022
Document Type
Dissertation
Degree
Ph.D.
Degree Name
Doctor of Philosophy (Ph.D.)
Degree Granting Department
Public Health
Major Professor
Heewon L. Gray, Ph.D., RDN
Committee Member
David Himmelgreen, Ph.D., MA
Committee Member
Dina Martinez Tyson, Ph.D., MPH, MA
Committee Member
Lauri Wright, Ph.D., RDN, LD/N
Keywords
COVID-19, food pantries, food security, Transactional Model of Stress and Coping
Abstract
Background: In the United States, 13.8 million households were food insecure in 2020, or 10.5% of the country’s population. Although the annual food insecurity rates remained stable between 2019 and 2020, largely due to increased COVID-19 pandemic relief efforts, many households experienced food insecurity and hardship at unprecedented rates. Food assistance provided by the largest government nutrition and food program, Supplemental Nutrition Assistance Program (SNAP), and emergency food providers (EFPs) such as food banks and pantries intended to provide short-term solutions have ended up as chronic, long-term methods of survival for many of these families, especially during COVID-19 and the recovery period. Although these resources have proved to improve conditions, SNAP advocates have long been urging for higher benefits to meet the food and nutrition needs of families and allow people to choose their own foods. In 2020, 37.2% of people that received SNAP benefits in the prior 30 days also reported obtaining groceries from a food pantry. Even with emergency food, dietary needs may not be sufficient for the whole family. These resources are not enough to alleviate the problem - to end hunger, let alone promoting food security.
Food insecurity has been a concerning issue for decades, as it is associated with many negative health outcomes across the life span and increases risk for chronic diseases, poor mental health, and lower quality of life. Though there has been progress in assessing the magnitude of the problem with prevalence rates and identifying groups that are at higher risk, current solutions and understanding of food insecurity still lack the ability to provide long-term support for these families to become self-sufficient in a dignified manner.
Purpose: The purpose of the study was to examine the multidimensional aspects of food security (food availability, access, utilization, and stability) through the experiences of food insecure emergency food assistance users in West Central Florida during the COVID-19 pandemic.
Methods: This convergent, embedded mixed methods study was designed to assess change in food insecurity status among people who sought food assistance over a three- to nine-month follow-up period. Participants were recruited to complete an initial (N=129) and follow-up survey (N=59, three months later) at select Feeding Tampa Bay distribution sites in West Central Florida from November 2020 to July 2021. Individuals were eligible if they were between 18 and 64 years of age, a Florida resident, and proficient in English. The survey included a demographic questionnaire, the US Department of Agriculture’s (USDA) 10 or 18-item Household Food Security Survey Module (HFSSM), and other questions about food assistance use. Food insecure respondents were recruited to participate in in-depth interviews and separated into two groups: visitors that sought food assistance prior to COVID-19 or due to the pandemic (first time visitor during COVID-19). Due-to-COVID-19 participants were interviewed once (N=18), and Prior-to-COVID-19 visitors were interviewed at baseline (N=18) and follow-up (N=16, after three months). Guided by the Multidimensional Food Security Continuum and the Transactional Model of Stress and Coping, interviews explored food pantry clients’ multidimensional experience of food insecurity, coping strategies, and impact of the emergency food assistance system (EFAS), i.e., how EFAS impacted the client’s food availability, access, utilization, and stability over time. Applied thematic analysis was conducted to identify emergency themes, and quantitative analyses included Wilcoxon signed rank test and univariate analyses.
Results: Food security status using HFSSM score improved at follow-up compared to the initial survey (p < .001). There were no significant associations between participant characteristics and improved food security score at follow-up, except for duration of pantry use and frequency of pantry visits. Across all the interview participants (N=36), food availability was impacted the most because food pantries provided families with large quantities of foods from different food groups. Food access may have increased during COVID-19 due to increased federal and local funding to support enhanced operation and additional food distributions Although participants were mostly satisfied with the foods received from the pantry especially the fresh produce, many reported the foods being “hit or miss” and not always sufficient for a full meal due to excessive amounts of one item (e.g., 20-pound bag of potatoes), not providing essential items like dairy or meat, or having other issues such as expired cans or not being able to use something. Coping strategies ranged from stockpiling when things were on sale to increase food stores (food availability); “food bank shopping” for pantries that fit their schedule and provided what they needed that week such as meat, bread, or specific items (food access); and finding creative ways and new recipes to use items like squash and eggplant (food utilization). Overall, Due-to-COVID participants seemed more stable than Prior-to-COVID because these new visitors were only temporarily impacted by job or income loss due to the pandemic (stability over time). New visitors seemed to have a plan to manage their finances to become stable while Prior-to-COVID participants had multiple stressors and financial burdens ranging from health expenses to unexpected or late bills and lapse or difficulty securing social services. Both groups mentioned a variety of feelings ranging from gratitude and comfort to embarrassment and other forms of judgment.
Conclusion: Study findings can inform emergency food assistance providers and other practitioners to create targeted strategies to address each food security dimension and promote long-term food security. The triangulation of quantitative and qualitative data to understand the dimensions and food insecurity change can also inform theory within the context of emergency food assistance and coping strategies.
Scholar Commons Citation
Fung Uy, Whitney M., "Understanding Food Insecurity as a Multidimensional Construct: A Mixed Methods Approach to Assess Changes in Food Insecurity Status among People Seeking Emergency Food Assistance" (2022). USF Tampa Graduate Theses and Dissertations.
https://digitalcommons.usf.edu/etd/10291
