COVID and Hunger

When the Revere HealthCare Center opened its therapeutic food pantry almost a year ago in January 2020, the plan was to start off with a three-month, 10-patient pilot program. The pantry would provide plant-based, healthy food to the patients, all with nutrition-dependent chronic diseases, like diabetes and obesity, and were food insecure, meaning they lacked access to food to live a healthy and active life. “Of course, then COVID hit,” says Jacob Mirsky, MD, a primary care physician at MGH Revere and the food pantry’s medical director. As the numbers of people affected by COVID grew, so did the pantry - once operating from a closet it now fills a 1,000 square foot storage space that feeds up to 80 patients and their families weekly.

Before COVID-19, food insecurity was at its lowest since the Great Recession, but still impacted 37 million people. It’s estimated that the pandemic will create a reality that leaves 1 in 6 Americans and 1 in 4 children will experiencing food insecurity. That’s an almost 50 percent increase. Disproportionately affecting Black and Hispanic households with children under 6 years of age, female-headed households, adults living alone, and adults with disabilities, Black and Hispanic households, the COVID-19 pandemic has exposed another systemic fault line based on racial and socioeconomic differences.

There are two basic systems that bring food to the table in the US. One supports household food preparation and consumption and the other is designed for consumption in institutions and outside the home like schools and restaurants. The extraordinary and lengthy shutdown of restaurants, schools, worksites, and other institutions due to COVID-19 increased demand for food at home and created food supply disruptions in grocery stores and the charitable feeding system that’s delivered through food banks and pantries. This rapid shift in demand also forced farmers to waste staggering amounts of food.

But food insecurity and hunger isn’t just about feeling pain in the stomach. It’s a powerful stressor that intersects with job and financial stress, disconnection from social support systems, and worry about one’s own health and the health of loved ones during the COVID-19 pandemic. This stress has increased domestic violence, the incidences of child abuse, and mental health issues including depression, anxiety, and post-traumatic stress disorder.

People experiencing food insecurity do things that place them at increased risk for poor health outcomes in the long and short term. For example, some food-insecure individuals engage in high-risk sex in exchange for money and food, which increases the risk of HIV transmission. Some food-insecure individuals make the decision to stop taking medications when they do not have enough food to eat due to increased side effects such as nausea or fear of adverse effects related to taking medication on an empty stomach, and because the simply need to make the trade-off between using limited resources to purchase food or purchase medications or medical care. These choices result in cost-related medication nonadherence and interruptions in healthcare. Chronically ill patients trying to navigate systems overwhelmed by the COVID-19 pandemic are less likely to receive adequate care, and they risk the development of chronic disease or chronic disease complications in the long-term.

A North Carolina Central University (NCCU) study conducted in November found that 20 percent of respondents had someone diagnosed with COVID-19, and over 30 percent reported lost income. Of the homes reporting food insecurity, 60 percent had one or more children in the home. Over 75 percent reported sharing a meal for Thanksgiving or during the holiday season, according to Christopher Paul, principal investigator and assistant professor of Public Administration at NCCU.

There is a long road ahead. People are hungry. Hunger is creating stress and mental pain, provoking physical abuse, and causing people to ignore distancing and gathering policies and laws. We cannot ignore the lasting effects of hunger and food insecurity on chronic illness - and their risk on severe and long term COVID-19 illness.

Last year alone, pre-pandemic, Loaves & Fishes in Charlotte fed enough people to fill theBank of America stadium. That is roughly 80,000 people in Charlotte and the surrounding area that relied on food pantries. If you've ever been to a third-world country, you have witnessed extreme poverty and devastation. It may seem difficult to wrap your mind around that happening in your community. It may be shocking, and it should be, but together we can put at least a dent in reversing this tragedy.