Coronavirus disease 2019 (COVID-19) poses an occupational health risk to food system workers including farmers/producers, grocery store workers, emergency food system staff and volunteers (e.g., food pantry workers), and others. These food system workers have been pushed to the front-line of this pandemic, providing essential services that support food consumption for all Americans. Food system workers are some of the most economically vulnerable populations and are at risk of further financial disparities and contraction of COVID-19 during this pandemic. As we continue to grapple with the best strategies to support the food system and mitigate concerns around the spread of COVID-19, appropriate measures must be considered to better protect and support front-line food system workers that safeguard food access for all Americans.

Diet-related chronic disease remains a public health concern, and low intake of fruits and vegetables disproportionately affects low-income populations. Healthy food incentive (HFI) projects can help close the nutrition gap among low-income populations by increasing purchasing power and access to fruits and vegetables. This study aimed to qualitatively explore lessons learned and best practices from Food Insecurity Nutrition Incentive Grant Program (FINI) grantees across the United States. Thirty semistructured interviews were conducted with FINI grantees and stakeholders in 2018, eliciting best practices and promising findings, policy implications, and knowledge gaps and opportunities to pursue that inform program refinement and sustainability. Telephone and in-person interviews were conducted with FINI grant recipients from 2015 to 2016, specifically, recipients of FINI-funded multiyear community-based projects and large-scale projects. Our results highlighted (1) range of projects and scope, (2) program promotion and awareness, (3) community-based partnerships, (4) technical assistance and peer interactions, (5) measurement and evaluation, (6) program challenges, and (7) future directions and recommendations. Grantees reported a “trifecta of benefits” that affects low-income consumers, farmers, and food retailers. Our findings contribute to understanding how to implement HFI programs in a variety of settings and highlight the variations that can exist between programs, as well as the need for increased technical assistance and synergy between programs (communities of practice). Overall, these findings can help to inform implementation and practice of healthy food incentive programs and the Farm Bill and other policy discussions.

One in five food pantries had a formal nutrition policy, and informal nutrition policies existed for half of the food pantries that responded to the survey.

The growth of PSE changes across the food system helps illustrate the importance of translating multipronged approaches to address food insecurity in the U.S.