Food Insecurity Disparities and Mental Health Impacts Among Cancer Survivors During the COVID-19 Pandemic

Abstract

Introduction: Food insecurity can negatively impact adherence and receipt of high-quality cancer care. The purpose of the study was to (1) compare the prevalence of COVID-19-associated food insecurity by cancer history and (2) examine determinants associated with COVID-19-related food insecurity among cancer survivors. Methods: We used nationally representative data from the 2020 COVID-19 Household Impact Survey ( n =10,760). Our primary exposure was participants' self-report of a cancer diagnosis ( n =854, 7.1%). Primary outcomes of food insecurity were categorized by the following questions: “We worried our food would run out before we got money to buy more” or “The food that we bought just didn't last, and we didn't have money to get more”; respondents were categorized as food insecure if they chose often true or sometimes true. Multivariable Poisson regression was used to identify demographic determinants of food insecurity among cancer survivors. Results: Thirty-two percent of cancer survivors were food insecure. Cancer survivors 30–44 years of age and those ≥60 years of age were more likely to report being food insecure compared to respondents without a history of cancer, respectively (30–44 years, 59.9% vs. 41.2% p =0.01, ≥60 years 27.2% vs. 20.2%, p =0.01). Cancer survivors without a high school diploma were more likely to report food insecurity compared to adults with no history of cancer (87.0% vs. 64.1%, p =0.001). In multivariable models, uninsured cancer survivors (adjusted prevalence ratio [aPR] aPR: 2.39, 95% CI: 1.46–3.92) and those on Medicaid (aPR: 2.10, 95% CI: 1.40–3.17) were also more likely to report being food insecure. Conclusion: Food insecurity during the COVID-19 pandemic is vast, but disparities persist. Among cancer survivors, differences in food insecurity were observed by age and socio economic status. Cancer survivors experiencing food insecurity more frequently reported mental health symptoms of depression, loneliness, and hopelessness compared to those who were food secure.

COVID-19-Associated Food Insecurity and Mental Health Symptoms Among Latinx Adults in the United States

“…For example, it was found that the determinants of food insecurity among individuals with cardiometabolic conditions, during the pandemic, included Hispanic race/ethnicity, an educational degree lower than a baccalaureate, a household of less than $100,000, and having Medicaid or no insurance (Camacho-Rivera et al, 2022a). Similar factors associated with an increased risk of food insecurity were seen among cancer survivors, including lower levels of education, household income of less than $30,000 per year, and having Medicaid or no insurance coverage (Camacho-Rivera et al, 2022b).…”

“…Studies have shown that racial/ethnic minority adult populations experiencing pulmonary chronic conditions (e.g., asthma) reported elevated mental health complications during the pandemic (Wei et al, 2021). However, less attention has been supplied to the interplay between asthma, mental health symptoms, and broader social inequities in food insecurity experienced by U.S. Latinx adults (Camacho-Rivera et al, 2022a, 2022b).…”