Food Insecurity, Financial Hardship, and Mental Health Among Multiple Asian American Ethnic Groups: Findings from the 2020 COVID-19 Household Impact Survey

Abstract

Background: The COVID-19 pandemic has adversely impacted the financial and mental well-being of U.S. adults, however, Asian American (AA)-specific data are lacking, particularly disaggregated by AA ethnicity. Our objective was to evaluate food insecurity (FI), financial hardship, and mental health among disaggregated AA ethnic groups during the COVID-19 pandemic. Methods: We used data from the COVID-19 Household Impact Survey, a sample of 10,760 U.S. adults weighted to reflect the U.S. population ( weighted n: 418,209,893) . AA ethnic categories were based on self-report ( n =312, 5.1%; weighted n: 21,143,079 ) and provided as follows: Chinese American, South Asian, Filipino+Vietnamese, and Japanese+Korean. We estimated the prevalence of FI and financial hardship across AA ethnic categories. We estimated the demographic determinants of FI, including financial hardship, among AA adults using multivariable Poisson regression. We calculated the prevalence of mental health symptoms among food-insecure AA adults, as well as among AA adults experiencing both FI and financial hardship. Results: Overall, the prevalence of FI and financial hardship among AA adults was highest among Filipino+Vietnamese adults (52.9–24.5%) and lowest among Japanese+Korean adults (13.9–8.6%). Determinants of FI among AA adults included Filipino+Vietnamese ethnicity (adjusted prevalence ratios [aPR]: 2.81, 95% confidence interval [CI]: 1.49–5.29), being widowed/divorced/separated (aPR: 3.14, 95% CI: 1.37–7.23), high school graduate only (aPR: 3.46, 95% CI: 1.96–6.11), having low income <$30,000 (aPR: 2.54, 95% CI: 1.27–5.06), and living in rural areas (aPR: 7.65, 95% CI: 1.17–50.14). Eighty-one percent and 63% of AA adults with anxiety and hopelessness at least 3–7 days/week, respectively, were food insecure and experiencing financial hardship. Conclusion: Disparities exist in FI and financial hardship among AA adults, particularly Filipino+Vietnamese adults, and are associated with increased self-reporting of feelings of anxiety and hopelessness.

Socioeconomic differences in dietary habits in Italy before and during COVID-19 pandemic: secondary analysis of a nationwide cross-sectional study

“…Moreover, depression and anxiety moods that were caused by COVID-19 spreading among all countries, especially during the first wave, may have influenced food habits since these emotional reactions may have increased craving for comfort eating characterized by assumption of high-fat, high sugar or high-calorie food [ 17 , 22 , 35 ]. Further consideration must be done regarding financial hardship, since the COVID-19 pandemic has led to an economic crisis that influenced food behavior, habits, and food insecurity as indicated by several studies [ 36 – 38 ]. This resulted in a heightened likelihood of unhealthy behaviors and choices.…”

A systematic review/meta‐analysis of prevalence and incidence rates illustrates systemic underrepresentation of individuals racialized as Asian and/or Asian‐American in ADRD research

“…The history of individuals racialized as Asian and/or Asian‐Americans in the United States is riddled with residential segregation, workplace discrimination, and food insecurity 14–16 . When integrated with individuals racialized as White, individuals racialized as Asian and/or Asian‐American experience a myriad of interpersonal discrimination, including microaggressions, some leading to more rapid cognitive decline 17 .…”

“…The history of individuals racialized as Asian and/or Asian‐Americans in the United States is riddled with residential segregation, workplace discrimination, and food insecurity. 14 , 15 , 16 When integrated with individuals racialized as White, individuals racialized as Asian and/or Asian‐American experience a myriad of interpersonal discrimination, including microaggressions, some leading to more rapid cognitive decline. 17 Most notably, the perceived socioeconomic and integration successes of a few have fueled the construction of the “model minority myth” that erroneously posits that individuals racialized as Asian and/or Asian‐American have achieved socioeconomic and social success, yielding benefits to health and well‐being in the United States.…”

Racial/Ethnic Disparities in Financial Hardship During the First Year of the Pandemic

“… 2 , 8 For instance, one study among adults ages >50 years old found that Black/African American and Latino adults reported more difficulty paying for basic needs and expenses such as food, bills, health care, medical care, and housing during the first year of the pandemic than White adults. 9 Other studies have found that almost half (49.3%) of Asian adults would be unable to pay for an unexpected expense using cash or savings 10 and that 60% of Native Hawaiian/Pacific Islander households experienced a loss of income during the first year of the pandemic. 11 However, additional studies investigating financial hardship during the pandemic among racial/ethnic minority groups, and how financial hardship is experienced (e.g., food insecurity, unmet health care needs) across race–ethnicity is still needed.…”