Food pantry clients experienced economic hardship and psychological distress during COVID-19

A novel study by UT Southwestern researchers who conducted interviews as the nation shut down due to COVID-19 tells the stories of those who routinely faced hunger before the pandemic upended their lives. The research, which could be used to improve the response in future emergencies, finds food pantry clients experienced increased economic hardship, food insecurity, and psychological distress.

The researchers queried members of 40 Dallas County households – 20 in English and 20 in Spanish – served by Crossroads Community Services, a networked organization of more than 140 food pantries that are part of the North Texas Food Bank (NTFB) system. All of the clients had been receiving federal Supplemental Nutrition Assistance Program (SNAP) benefits as well as monthly food assistance from Crossroads' main food pantry for at least six months to supplement their SNAP benefits. Their median income was $1,235 per month with an average household size of four individuals.

"Texas is one of the most severely affected states during the pandemic, with more than 1 in 4 households (26.8%) estimated to be food insecure at some point since March 2020," said senior author Sandi L. Pruitt, Ph.D., Associate Professor of Population and Data Sciences at UT Southwestern and co-leader of the study published in the journal Public Health Nutrition (Cambridge University Press).

This study is unique in qualitatively examining the experiences of individuals who were food insecure prior to the pandemic."

Robin T. Higashi, PhD, Study Lead Author and Assistant Professor of Population and Data Sciences, UT Southwestern Medical Center

Trained as a medical anthropologist and fluent in Spanish, Dr. Higashi specializes in using qualitative methods to evaluate and optimize health service delivery and study health outcomes for underserved populations. She is currently also Principal Investigator on a study for the Harold C. Simmons Comprehensive Cancer Center to evaluate the rapid implementation of telehealth during the pandemic.

Other studies have assessed the impact of the pandemic on similar populations using quantitative approaches, which measure changes in food security using surveys and statistics. "In contrast, in this study, we gathered narratives from individuals describing in their own words the ways in which the pandemic affected their daily lives and how they felt about it," she said.

The study reported three main findings:

• Participants experienced increased economic distress related to job loss and/or increased utility bills or other household expenses due to household members being at home more than usual.
• Participants saw a rise in food needs, prices, and shortages.
• Increased economic stress and food insecurity contributed to substantial psychological stress, adding to fears of infection, isolation, and stress related to children confined to home.

The 40 households represent a small slice of Crossroads' clients who predominantly come from Dallas, Navarro, and Ellis counties. Study participants were drawn from a larger, ongoing randomized-controlled trial that is looking at whether the timing of food pantry visits could better reduce food insecurity. Results of that study are pending.

All interviews were conducted in May and June 2020, approximately two to three months after the pandemic began and lasted an average of 26 minutes. The interviews were then transcribed, de-identified, and thematically analyzed.

"What we found early on is that the amount of economic disruption due to the pandemic caused new problems that exacerbated food insecurity. With schools closed, children who had previously received free breakfast and lunch at school were home all day, so the household needed more food and had higher utility costs," Dr. Pruitt said.

She acknowledged that many people may be surprised to learn that SNAP and a monthly food pantry visit are inadequate to feed a family for a month. "Neither program is designed to provide all the food for everyone in the household," she explained.

Co-authors include Anubha Sood, Ana Belen Conrado, Kathryn Shahan, and Tammy Leonard.

The study was funded by the W. W. Caruth, Jr. Fund at Communities Foundation of Texas.

The researchers thank the clients and staff of Crossroads Community Services for their participation and assistance with this research. The published manuscript will be part of the Cambridge Coronavirus Collection.